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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture</title><author><name sortKey="Mele Canu Imre, M" sort="Mele Canu Imre, M" uniqKey="Mele Canu Imre M" first="M" last="Mele Canu Imre">M. Mele Canu Imre</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey="Preoteasa, E" sort="Preoteasa, E" uniqKey="Preoteasa E" first="E" last="Preoteasa">E. Preoteasa</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey=" Ncu, Am" sort=" Ncu, Am" uniqKey=" Ncu A" first="Am" last=" Ncu">Am Ncu</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey="Preoteasa, Ct" sort="Preoteasa, Ct" uniqKey="Preoteasa C" first="Ct" last="Preoteasa">Ct Preoteasa</name><affiliation><nlm:aff id="A2">Department of Oral Diagnosis, Ergonomics, Scientific Research Methodology, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23599828</idno><idno type="pmc">3624656</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624656</idno><idno type="RBID">PMC:3624656</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001E68</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001E68</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture</title><author><name sortKey="Mele Canu Imre, M" sort="Mele Canu Imre, M" uniqKey="Mele Canu Imre M" first="M" last="Mele Canu Imre">M. Mele Canu Imre</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey="Preoteasa, E" sort="Preoteasa, E" uniqKey="Preoteasa E" first="E" last="Preoteasa">E. Preoteasa</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey=" Ncu, Am" sort=" Ncu, Am" uniqKey=" Ncu A" first="Am" last=" Ncu">Am Ncu</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author><author><name sortKey="Preoteasa, Ct" sort="Preoteasa, Ct" uniqKey="Preoteasa C" first="Ct" last="Preoteasa">Ct Preoteasa</name><affiliation><nlm:aff id="A2">Department of Oral Diagnosis, Ergonomics, Scientific Research Methodology, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Medicine and Life</title><idno type="ISSN">1844-122X</idno><idno type="eISSN">1844-3117</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Rationale.</bold> The imaging methods are more and more used in the clinical process of modern dentistry. Once the implant based treatment alternatives are nowadays seen as being the standard of care in edentulous patients, these techniques must be integrated in the complete denture treatment. </p><p><bold> Aim.</bold> The study presents some evaluation techniques for the edentulous patient treated by conventional dentures or mini dental implants (mini SKY Bredent) overdentures, using the profile teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide that allows the prosthetically driven implants placement. </p><p><bold> Material and method.</bold> Clinical case reports were made, highlighting the importance of cephalometric evaluation on lateral teleradiographs in complete edentulous patients. A clinical case that gradually reports the surgical guide preparation (Bredent silicon radio opaque), in order to place the mini dental implants in the best prosthetic and anatomic conditions, was presented.</p><p><bold> Conclusions.</bold> The profile teleradiograph is a useful tool for the practitioner. It allows establishing the optimal site for implant placement, in a good relation with the overdenture. The conventional denture can be easily and relatively costless transformed in a surgical guide used during implant placement.
</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mele Canu, M" uniqKey="Mele Canu M">M Meleşcanu </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whaites, E" uniqKey="Whaites E">E Whaites</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dorob T, V" uniqKey="Dorob T V">V Dorobăt </name></author><author><name sortKey="Stanciu, D" uniqKey="Stanciu D">D Stanciu </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Preoteasa, E" uniqKey="Preoteasa E">E Preoteasa </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Juodzbalys, G" uniqKey="Juodzbalys G">G Juodzbalys </name></author><author><name sortKey="Wang, Hl" uniqKey="Wang H">HL Wang </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Preoteasa, E" uniqKey="Preoteasa E">E Preoteasa </name></author><author><name sortKey="Mele Canu Imre, M" uniqKey="Mele Canu Imre M">M Meleşcanu-Imre</name></author><author><name sortKey="Preoteasa, Ct" uniqKey="Preoteasa C">CT Preoteasa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Preoteasa, E" uniqKey="Preoteasa E">E Preoteasa</name></author><author><name sortKey="Marin, M" uniqKey="Marin M">M Marin </name></author><author><name sortKey="Imre, M" uniqKey="Imre M">M Imre </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bassi, F" uniqKey="Bassi F">F Bassi </name></author><author><name sortKey="Deregibus, A" uniqKey="Deregibus A">A Deregibus </name></author><author><name sortKey="Previgliano, V" uniqKey="Previgliano V">V Previgliano </name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bassi, F" uniqKey="Bassi F">F Bassi </name></author><author><name sortKey="Rizzatti, A" uniqKey="Rizzatti A">A Rizzatti </name></author><author><name sortKey="Schierano, G" uniqKey="Schierano G">G Schierano </name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Med Life</journal-id><journal-id journal-id-type="iso-abbrev">J Med Life</journal-id><journal-id journal-id-type="publisher-id">JMedLife</journal-id><journal-title-group><journal-title>Journal of Medicine and Life</journal-title></journal-title-group><issn pub-type="ppub">1844-122X</issn><issn pub-type="epub">1844-3117</issn><publisher><publisher-name>Carol Davila University Press</publisher-name><publisher-loc>Romania</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23599828</article-id><article-id pub-id-type="pmc">3624656</article-id><article-id pub-id-type="publisher-id">JMedLife-06-86</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Presentation</subject></subj-group></article-categories><title-group><article-title>Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Meleşcanu Imre</surname><given-names>M</given-names></name><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Preoteasa</surname><given-names>E</given-names></name><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Țâncu</surname><given-names>AM</given-names></name><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Preoteasa</surname><given-names>CT</given-names></name><xref ref-type="aff" rid="A2">**</xref></contrib></contrib-group><aff id="A1"><label>*</label>Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</aff><aff id="A2"><label>**</label>Department of Oral Diagnosis, Ergonomics, Scientific Research Methodology, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy</aff><author-notes><corresp><bold>Correspondence to:</bold>: Marina Meleşcanu-Imre, MD, PhD
Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila" University of Medicine and Pharmacy
12 Ionel Perlea Street, District 1, Bucharest, Romania
Mobile phone: 0040722555960; E-mail: melim.marina@gmail.com
</corresp></author-notes><pub-date pub-type="ppub"><day>15</day><month>3</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>25</day><month>3</month><year>2013</year></pub-date><volume>6</volume><issue>1</issue><fpage>86</fpage><lpage>92</lpage><history><date date-type="received"><day>01</day><month>9</month><year>2012</year></date><date date-type="accepted"><day>25</day><month>1</month><year>2013</year></date></history><permissions><copyright-statement>©Carol Davila University Press
</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is
an open-access article distributed under the terms of 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><p><bold>Rationale.</bold> The imaging methods are more and more used in the clinical process of modern dentistry. Once the implant based treatment alternatives are nowadays seen as being the standard of care in edentulous patients, these techniques must be integrated in the complete denture treatment. </p><p><bold> Aim.</bold> The study presents some evaluation techniques for the edentulous patient treated by conventional dentures or mini dental implants (mini SKY Bredent) overdentures, using the profile teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide that allows the prosthetically driven implants placement. </p><p><bold> Material and method.</bold> Clinical case reports were made, highlighting the importance of cephalometric evaluation on lateral teleradiographs in complete edentulous patients. A clinical case that gradually reports the surgical guide preparation (Bredent silicon radio opaque), in order to place the mini dental implants in the best prosthetic and anatomic conditions, was presented.</p><p><bold> Conclusions.</bold> The profile teleradiograph is a useful tool for the practitioner. It allows establishing the optimal site for implant placement, in a good relation with the overdenture. The conventional denture can be easily and relatively costless transformed in a surgical guide used during implant placement.
</p></abstract><kwd-group><kwd>edentulous</kwd><kwd>overdenture</kwd><kwd>teleradiography</kwd><kwd>mini dental implants</kwd></kwd-group></article-meta></front><body><sec><title>Introduction</title><p>Nowadays, the imaging techniques are frequently used in dental removable prosthodontics, especially for implant-based treatment alternatives. They represent mandatory paraclinical exams in implantology, giving the information needed in order to establish the optimal treatment plan (i.e., number and place for the dental implants, their length and diameter). </p><p> The radiographic techniques usually used in prosthodontics on implants are the following: orthopantomography, teleradiography, computerized tomography, CBCT. Orthopantomography gives the doctor general information regarding the available bone volume and the neighborhood relationships with the anatomical structures –i.e. the maxillary sinus, the mandibular nerve path and nasal fosses. Another imaging investigation that provides more data and is used frequently in implantology in order to obtain an accurate evaluation is the computer tomography technique. This method provides also qualitative data regarding the bone, respectively the bone density. </p><p> Besides these imaging techniques frequently used in implantology, sometimes frontal and lateral teleradiography are used for cephalometric analysis. The latter are mainly used in orthodontics, but have applicability also in full edentulism patient evaluation [<bold><xref ref-type="bibr" rid="R1">1</xref></bold>]. Lateral teleradiography allows the complex visualization of the bone outlines in relation to the soft tissues, like the lips, important elements in positioning the teeth from the esthetic point of view, with consequences on complete denture`s balance.
</p><sec><title>Objective</title><p>The study aims to present some evaluation techniques for the edentulous patient, treated by conventional dentures or mini dental implants overdentures, using the lateral teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide which allows the prosthetically driven implants placement in accordance with the criteria mentioned before.</p></sec></sec><sec><title>Matherial and method</title><p>Cranial teleradiography is standardized and reproducible radiography of the cranium used especially in orthodontics to analyze the relationship between teeth and maxilla and between maxilla and the bones of the facial massive. With it can be done a better prognosis, more exact and dynamic, offering details about the most adequate treatment, and it’s efficacy in time.</p><p> In 1960, Skotnycky lays out the teleradiographie’s value from the prosthodontic point of view, showing that an anatomical evaluation of the visceral cranium (skull) can be done, knowing the normal profile, which may represent an important guide for the dento-facial reconstructions that will be done. The skull teleradiography can be done in 3 positions: latero-lateral, postero-anterior and axial [<bold><xref ref-type="bibr" rid="R2">2</xref></bold>].</p><p> Sagital and frontal teleradiographies can be done before or during the treatment, with occlusal rims, mock-ups, dentures. Before, in relation to the investigated areas, the base or denture’s teeth, have to be radio opaque. The periodical over positioning of the negatives allows the evaluation of the prosthetic treatment its failure and the causes of them can be discovered.
</p><fig id="F1" position="float"><label>Fig. 1</label><caption><p>Profile teleradiography of a complete edentulous patient </p></caption><graphic xlink:href="JMedLife-06-86-g001"></graphic></fig><p> The profile teleradiography allows the comparative study of the soft parts and osseous infrastructure (Fig.1) [<bold><xref ref-type="bibr" rid="R3">3</xref></bold>]. </p><p> In order to obtain on the film the equal dimensions with the real one is necessary that the distance between the radiogenic tube and the object (the medio-sagital plane of the head in the profile teleradiography) is 3-5 cm, and the distance between the object and the radiologic film is 14 mm (Castano şi Chateau, 1960 citied by Firu). </p><p> In the wake of gnato- and cephalometric analysis, we can conclude about the intern and extern morphology, the teleradiography being helpful in establishing a more complete diagnosis [<bold><xref ref-type="bibr" rid="R1">1</xref></bold>]. </p><fig id="F2" position="float"><label>Fig. 2</label><caption><p>Plans and cefalometric points</p></caption><graphic xlink:href="JMedLife-06-86-g002"></graphic></fig><p> Current methods of teleragiography interpretation in prosthodontic treatment</p><p> The cranio-facial structures and the relationships between them are evaluated trough the measurement of the distances, angles and proportions between different cephalometric layouts (<bold><xref ref-type="fig" rid="F2">Fig. 2</xref></bold>). The anthropometric points can be osseous, dental, dermic, obtained through the attentive observation of the anatomical structures, or built through the intersection of lines and layouts. There are many interpretation methods of the profile teleradiography: Sassouni, Ricketts, Steiner, depending of the area of interest.</p><p> As we mentioned before, the major problem in the use of profile teleradiography in full edentulism is the radiopacisation of the denture’s elements, the acrylic base and artificial teeth. In order to visualize them, different methods can be used, that will be illustrated. The first method consists in laying on the artificial teeth of a thin film of aluminium that allows the visualization of the artificial arcades. This type of teleradiography gives to the doctor information regarding the occlusion relationships in the front area reported to the osseous markers and the relationships with the lips and soft parts, aspect that will described in a suite of clinical cases.</p><p> Case 1 – The imaging evaluation using the profile teleradiography of the correctness of the conventional denture at the full edentulous patient. </p><p> With the use of the teleradiograpgy, corroborated with the facial clinical exam, the former dentures were evaluated, from the normal and profile view. The profile teleradiography was done following the next protocol: the patient has his head in the cefalostat, with the dentures in the oral cavity, within teeth in contact (occlusion), with the relaxed muscles, not to modify the facial soft parts. The radiologic highlight of the artificial dental arcades and the occlusal relationships between the dentures was possible applying a thin lead layer of 2 mm on the outline of the teeth.</p><p> Profile teleradiography with the old and new dentures</p><p> Patient M.M,, 85 years old, full edentulous with conventional total dentures, with incorrect old dentures with unsatisfactory esthetic aspect [<bold><xref ref-type="bibr" rid="R4">4</xref></bold>]. Thus, one can observe the plugged aspect of the lips, the prominent chin (menton) and the lack of proportion between the face’s parts (<bold><xref ref-type="fig" rid="F3">Fig. 3</xref></bold>).</p><fig id="F3" position="float"><label>Fig. 3</label><caption><p>Facial oral exam – front and profile- old dentures</p></caption><graphic xlink:href="JMedLife-06-86-g003"></graphic></fig><p> The observations of the clinical image of the face with the old dentures and the incorrect occlusal relationships in the front are confirmed by the cephalometric exam and analysis, aspect that has to be redressed (<bold><xref ref-type="fig" rid="F4">Fig. 4</xref></bold>).</p><fig id="F4" position="float"><label>Fig. 4</label><caption><p>Profile teleradiography with the old dentures</p></caption><graphic xlink:href="JMedLife-06-86-g004"></graphic></fig><p>More than this, the modern imaging techniques allow the over position of the photographic image over the profile teleradiography in order to verify the integrity of the dental arches with the soft face’s parts (<bold><xref ref-type="fig" rid="F5">Fig. 5</xref></bold>). Orofacial exam with the new dentures from the front and profile (<bold><xref ref-type="fig" rid="F6">Fig. 6</xref></bold>).</p><fig id="F5" position="float"><label>Fig. 5</label><caption><p>The overpositioning of the forography over the profile teleradiograph</p></caption><graphic xlink:href="JMedLife-06-86-g005"></graphic></fig><fig id="F6" position="float"><label>Fig. 6</label><caption><p>Oral exam with the new dentures</p></caption><graphic xlink:href="JMedLife-06-86-g006"></graphic></fig><p> After the new dentures’ achievement, we can observe clinical the harmonious renewal of the face, according to the age of the patient, the normal lips step, the correct proportions between the face’s parts and an agreeable visibility of the teeth in the smile dynamic. Profile teleradiography with the new dentures in the mouth (<bold><xref ref-type="fig" rid="F7">Fig. 7</xref></bold>).</p><fig id="F7" position="float"><label>Fig. 7</label><caption><p>Profile teleradiography with the new dentures</p></caption><graphic xlink:href="JMedLife-06-86-g007"></graphic></fig><p> Case 2. The imaging evaluation of the full edentulous for overdentures on implants and mini implants</p><p> Imaging evaluation of the complete edentulous for the overdentures on implants and mini implants treatment</p><p> Another case, intended for demonstrating another applicability of the imaging techniques, respective the contribution of the profile teleradiography in implantology and full overdentures. According to the implanto-prosthodontic standards, the implant’s placement is prosthodonticly guided. More than that, in the overdentures cases is necessary to evaluate the space needed for the implants, to respond at the balance criteria of the conventional full prosthodontic treatment (function and esthetics), but also the space needed for the special anchorage elements of the overdenture.</p><p> Patient A.L., 42 years old, came to our Prosthodontic Dental Clinic, Department of Full Edentulous Clinic of UMF Carol Davila to be treated suffering of a subtotal maxillary edentulism and a mandibular full edentulism, treated with a unsatisfactory denture. The patient was dissatisfied because of the unsatisfactory chewing and physionomics deficiencies with the conventional dentures. She was treated with a maxillary overdenture on ball attachments on the restant teeth and overdenture on mini implants at the mandibula (Mini Sky1 Bredent) in order to offer the dynamic balance of the oral rehabilitation. In order to apply the mini implants in the optimal position as anatomical rapports but also from the prosthodontic point of view related to the occlusal relationships, the antagonist dental arch and to obtain the mandibular balance conditions, we used the full conventional denture to obtain an implanto-prosthodontic guide. </p><p> The surgical guide, implant - prosthodontic was done in the denture’s base. After we obtained the mandibular full denture, this was used to make a teleradiography with an opaque substance. X-resin Flow (Bredent) radio opaque substance was used. The used substance is low consistency silicon with radio opaque properties; with it, important elements are highlighted in the X-rays. The product is packed in two auto-mixing tubes for a precise dosage. The mixing is obtained by pushing the content of the 2 tubes trough a mixing canola using a piston. To carry off the silicon from the denture is very simple using alcohol [<bold><xref ref-type="bibr" rid="R4">4</xref></bold>].</p><p> a) To verify the denture, on the artificial dental arches we pensulated X-resin flow in a thin film and then we waited for 5 minutes to indurate (<bold><xref ref-type="fig" rid="F8">Fig. 8</xref></bold>). The profile teleradiography was done with the mandibular denture covered with X-resin flow, the denture being on the prosthodontic field, in order to verify the teeth montage, in harmony with the cranio-facial markers and soft facial parts (<bold><xref ref-type="fig" rid="F9">Fig. 9</xref></bold>).</p><fig id="F8" position="float"><label>Fig. 8</label><caption><p>Apllying the X-resin on the denture’s teeth</p></caption><graphic xlink:href="JMedLife-06-86-g008"></graphic></fig><p> Obtaining the surgical guide. In a first phase, we have obtained the impression of the mandibular denture with irreversible hydrocolloid- alginate (<bold><xref ref-type="fig" rid="F10">Fig. 10</xref></bold>). The denture was in the patient’s mouth. After the casting (<bold><xref ref-type="fig" rid="F11">Fig. 11</xref></bold>), we made a transparent occlusal guard that was used as a surgical guide to position optimally the mini-implants, using the whole information obtained using the ortopantomography and teleradiography (<bold><xref ref-type="fig" rid="F12">Fig. 12</xref></bold>).</p><fig id="F9" position="float"><label>Fig. 9</label><caption><p>Profile teleradiography with the radiopacised denture</p></caption><graphic xlink:href="JMedLife-06-86-g009"></graphic></fig><fig id="F10" position="float"><label>Fig. 10</label><caption><p>The denture’s impression</p></caption><graphic xlink:href="JMedLife-06-86-g010"></graphic></fig><fig id="F11" position="float"><label>Fig. 11</label><caption><p>The plaster cast</p></caption><graphic xlink:href="JMedLife-06-86-g011"></graphic></fig><fig id="F12" position="float"><label>Fig. 12</label><caption><p>The surgical guide</p></caption><graphic xlink:href="JMedLife-06-86-g012"></graphic></fig><p> The clinical phases of the mini implant application using the radio opaque guide</p><p> The placement of the mandibular mini implants was planned after the ortopantomography (<bold><xref ref-type="fig" rid="F13">Fig. 13</xref></bold>) with the mandibular denture covered with the radio opacque paste, in the mouth. The placement of 4 interforaminal mini implants was decided, in a correct relation with the denture’s teeth (<bold><xref ref-type="fig" rid="F14">Fig. 14</xref></bold>).</p><fig id="F13" position="float"><label>Fig. 13</label><caption><p>The placement of the mini implants using the X-ray guide</p></caption><graphic xlink:href="JMedLife-06-86-g013"></graphic></fig><fig id="F14" position="float"><label>Fig. 14</label><caption><p>The placement of the mini implants</p></caption><graphic xlink:href="JMedLife-06-86-g014"></graphic></fig><p> Having in mind the oseous offer, mini implants of 2.8 mm in diameter and lenght of 14 mm were chosen. To place the mini implants the surgical guide, obtaines with the imaging ortopantomographyc method and teleradiographyc was used. </p><p> After the osseous integration of the mini implants, the overdenture’s treatment was done following the protocol, trespectiv the pacient wore for 3 months the conventional dentures, and then the mini implants were loaded by applying the o – rings in the denture’s base. The result was a well integrated implanto- prosthodontic rehabilitation, functionally and esthetically [<bold><xref ref-type="bibr" rid="R6">6</xref>,<xref ref-type="bibr" rid="R7">7</xref></bold>] with the osseous parts, the facial esthetics and antagonic arch, as prooved by the clinical intra- and extra- oral, and the Rx ortopantomographyc control (<bold><xref ref-type="fig" rid="F15">Fig. 15</xref>,<xref ref-type="fig" rid="F16">Fig. 16</xref></bold>).</p><fig id="F15" position="float"><label>Fig. 15</label><caption><p>Rx control after the osseous integration</p></caption><graphic xlink:href="JMedLife-06-86-g015"></graphic></fig><fig id="F16" position="float"><label>Fig. 16</label><caption><p>Intraoral control of the loaded dentures (with the applied o-rings)</p></caption><graphic xlink:href="JMedLife-06-86-g016"></graphic></fig></sec><sec><title>Results and discussions</title><p>The method’s importance is obvious especially in the complex clinical cases, borderline cases, where the diagnosis is specified, simplifies and confirms the clinical diagnosis.</p><p> The method offers information regarding the relationship between the cover soft parts, of the facial skeleton. We have to keep in mind the fact that the soft parts suffer an important fluctuance regarding the thickness at some levels and the profile may be different influenced. The collected data regarding the thickness of the soft part will have a role in establishing the diagnosis and prognostication, sometimes in conducting the treatment.</p><p>These imaging exams may help to establish the treatment, offering information regarding the most adequate treatment type and its efficiency in time. </p><p> The teleradiography may offer a valuable esthetic prognostication, as Tigelkamp noticed “the profile changes don’t correspond always to the operator’s illusions, to the imagined picture speaking about the maxillary changes, although, generally the soft parts are almost like the osseous profile and their changes are similar to the skeletal ones" [<bold><xref ref-type="bibr" rid="R3">3</xref></bold>].</p><p> The profile teleradiographie’s references (instructions), in full edentulism cases, may be general (diagnosis) or local, especially for a step of the treatment. </p><p> As general indications, we remind: </p><p>• The establishment with certitude of the intermaxilary relationships, mandibular prognathism/ retrognathism;</p><p>• The skeletal asymmetries highlight;</p><p> • Appreciations about the soft part’s contour.</p><p> As local indications, we remind:</p><p> • The periodic control of the clinical value of the complete dentures [<bold><xref ref-type="bibr" rid="R1">1</xref></bold>];</p><p> • The orientation of the prosthodontic occlusal plane in the office and laboratory;</p><p> • The dimension of the lower segment of the face, reported to the figure and crane.</p><p> • Evaluation of the correct position of the anterior artificial teeth (incisors) and physiologic occlusal space</p><p> • The radiologic confirmation of a correct relation mandibulo-cranial, with a study of the condylian trajectory and mandibular positions</p><p> The lateral teleradiography with the complete dentures on occlusion which artificial teeth are visible by the application of the radio opaque silicon paste allows studying the following cephalometric parameters:</p><p> 1. The face’s depht related to the facial angle;</p><p> 2. The anterior face’s height related to the facial axis;</p><p> 3. The facial convexity analised by the reference of the point A to the N-Pg plane; </p><p> 4. The position of the front teeth related to the A-Pg ;</p><p> 5. The inferior incisors’s inclination is measures reported to A-Pg line</p><p> 6. The position of the lips towards Ricketts esthetic line;</p><p> 7. The garanty of the right positionning of artificial teeth, determined by objective criterias as evidenced in littérature [8,9], respecting the relation between artificial teeth, anatomical structures associated with the right placement of mini implants represent a challenge for the doctors. This is the main advantage of this original method allowing the visualisatin on the same image of the 3 elements involved: artificial teeth, anatomical structures and implants position.</p></sec><sec><title>Conclusions</title><p>The usefull interest oh the teleradiography with radio opac substance is certainly evident on conventionnal complete denture and especially on implants overdentures, these 2 radiological investigations may eeven some times replace the more invasive and cost full computer tomograph technique. These methods provides :</p><p> 1. Visualisation of the right teeth positionning and even the relation between the overdenture base and the support structures.</p><p> 2. The optimal positionning of implants/mini implants related to anatomical structures and prosthetic requirements.</p><p> 3. The use of the conventionnal denture for the realisation of the surgical guide allows the correct implants placement prosthetically and anatomical driven.</p><p> 4. This is an easy method, accessible to any patient and practicionner, with minimal costs, providing important benefits to the successfull therapy of the complete edentulism.</p><p> 5. These imaging techniques confer to the therapy of full edentulism the evidence-based arguments recquired by modern dentistry standards.</p><p> 6. Easy, accessible and minimal costs techniques with large applicability on the implant prosthetic procedures.</p></sec></body><back><ref-list><ref id="R1"><label>1</label><element-citation publication-type="book"><person-group person-group-type="compiler"><name><surname>Meleşcanu </surname><given-names>M</given-names></name></person-group><source>Teleradiografia de profil în tratamentul edentatului total</source><year>2008</year><publisher-loc>Bucureşti</publisher-loc><publisher-name>Editura Universitară "Carol Davila"</publisher-name></element-citation></ref><ref id="R2"><label>2</label><element-citation publication-type="book"><person-group person-group-type="compiler"><name><surname>Whaites</surname><given-names>E</given-names></name></person-group><source>Essentials of Dental Radiography and Radiology</source><year>2002</year><publisher-loc>London</publisher-loc><publisher-name>Churchill Livingstone</publisher-name></element-citation></ref><ref id="R3"><label>3</label><element-citation publication-type="book"><person-group person-group-type="compiler"><name><surname>Dorobăt </surname><given-names>V</given-names></name><name><surname>Stanciu </surname><given-names>D</given-names></name></person-group><source>Ortodontie si ortopedie dento-facială</source><year>2003</year><publisher-loc>Bucuresti</publisher-loc><publisher-name>Editura medical</publisher-name></element-citation></ref><ref id="R4"><label>4</label><element-citation publication-type="book"><person-group person-group-type="compiler"><name><surname>Preoteasa </surname><given-names>E</given-names></name></person-group><source>Examinarea edentatului total în vederea protezării totale</source><year>1999</year><publisher-loc>Bucuresti</publisher-loc><publisher-name>Editura Cerma</publisher-name></element-citation></ref><ref id="R5"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Juodzbalys </surname><given-names>G</given-names></name><name><surname>Wang </surname><given-names>HL</given-names></name></person-group><article-title>Guidelines for the Identification of the Mandibular Vital Structures: Practical Clinical Applications of Anatomy and Radiological Examination</article-title><source>Methods. J. Oral Maxillofac. Res</source><year>2010</year><volume>1</volume></element-citation></ref><ref id="R6"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Preoteasa </surname><given-names>E</given-names></name><name><surname>Meleşcanu-Imre</surname><given-names>M</given-names></name><name><surname>Preoteasa</surname><given-names>CT</given-names></name></person-group><article-title>Aspects of oral morphology as decision factors in mini-implant supported overdenture</article-title><source>Rom J Morphol Embryol</source><year>2010</year><volume>51</volume><fpage>309</fpage><lpage>314</lpage><pub-id pub-id-type="pmid">20495749</pub-id></element-citation></ref><ref id="R7"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Preoteasa</surname><given-names>E</given-names></name><name><surname>Marin </surname><given-names>M</given-names></name><name><surname>Imre </surname><given-names>M</given-names></name></person-group><article-title>Patient’s satisfaction with conventional dentures and mini implant anchored overdenture</article-title><source>Revista Medico-chirurgicala a societatii de medici si Naturisti din Iasi</source><year>2012</year><volume>116</volume><fpage>265</fpage><lpage>270</lpage></element-citation></ref><ref id="R8"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bassi </surname><given-names>F</given-names></name><name><surname>Deregibus </surname><given-names>A</given-names></name><name><surname>Previgliano </surname><given-names>V</given-names></name></person-group><article-title>. Evaluation of the utility of cephalometrics parameters in constructing complete denture, part I-Placement of anterior teeth</article-title><source>Journal of Oral Rehabilitation</source><year>2001</year><volume>28</volume><fpage>234</fpage><lpage>238</lpage><pub-id pub-id-type="pmid">11350578</pub-id></element-citation></ref><ref id="R9"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bassi </surname><given-names>F</given-names></name><name><surname>Rizzatti </surname><given-names>A</given-names></name><name><surname>Schierano </surname><given-names>G</given-names></name></person-group><article-title>Evaluation of the utility of cephalometrics parameters in constructing complete denture part II-Placement of posterior teeth</article-title><source>Journal of Oral Rehabilitation</source><year>2001</year><volume>28</volume><fpage>349</fpage><lpage>353</lpage><pub-id pub-id-type="pmid">11350588</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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