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Formatvorlage des Untertitelmasters durch Klicken bearbeiten Dr. Alexandru Eugen David 1 , Prof. univ. Dr. Elena Preoteasa 1 , Conf. univ. Dr. Cătălina Murariu Măgureanu 1 1 UMF “Carol Davila Mandibular movement/function before and after mandibular miniSky1 overdenture by kinesiographic investigation. Case presentation Mandibular implant overdenture is regarded today as a treatment option that better suits patients' expectations; it is a restoration with the appropriate retention which provides great well-being. However, to ensure a successful medical outcome, this treatment needs to ensure optimum dental apparatus functionality. We present the case of a 68 year old female patient, with upper and lower jaw edentulism, treated with conventional dentures, who was especially unhappy with her mandibular denture stability and retention. The treatment plan aimed to correct the major deficiencies of the mandibular denture and to transform the mandibular denture into two miniSKY (bredent medical, Senden, Germany) one-piece implants with a 2.8mm diameter and O-ring system supported overdenture. Ultrasonic kinesiographic recordings of the mandibular kinematics were made by using the JMA system (Jaw Movement Analysis, Zebris, Isny im Allgäu, Germany) during the following treatment phases: before deficiencies were corrected, after correction, after implant insertion and soft lining of the area corresponding to the ball attachment of the implant and after applying the O-rings in the overdenture base. Abstract Case description Conclusion During initial kineziographic recording the following were noticed: diverted opening and closing movement of the mouth, lateral and propulsion movements are limited, Posselt's sagittal and frontal diagrams are modified. After correcting areas of base overextension and occlusal deficiencies (VDO, position of artificial teeth) an improvement in the appearance of the recordings was noticed: there was a higher range of motion in lateral and propulsion movements, but also a decrease in the condyles` sagittal projection, in maximum opening of the mouth and lower jaw movement velocity. After inserting the mini implants and soft material lining, kineziographic recordings observed an increase in the range of all movements: opening / closing mouth, propulsion, laterality, an increase in opening and closing velocity of the mouth, as well as an improvement in Posselt 's sagittal and frontal diagrams. The maximum values of all variables were recorded three months after implant insertion, with overdenture soft liner and using adhesive on both dentures for stabilisation. After applying the O-rings on the mandibular overdenture, values have remained high even without the use of adhesive on any of the dentures. Three months after implant insertion, a decrease in the values of all variables was noted, which could be attributed to the reduction in stability of the maxillary denture. Using kineziographic investigation, objective changes in mandibular kinematics are exposed after each stage of treatment and mandibular kinematics confirm improvement due to better stability of the mandibular prosthesis. This was transformed into a mini1SKY supported overdenture by increasing the range of motion of border movements and movement velocity, by better modifying the Posselt's diagrams and by better coordination between rotation and translation movements of the condyles. Objective data collected via kinesiograph confirmed the benefits of the treatment with mini1SKY implant overdenture; in this clinical case it was also subjectively reported by the patient. Kinesiographic examination proved effective in spotting and correcting deficiencies of dentures, which is essential for obtaining functional implant or mini implant supported overdentures. Initial kinesiographic registration with complete dentures and adhesive applied Kinesiographic registration with overdenture soft lined and adhesive applied Kinesioigraphic registration of the overdentures after three months Kinesiographic registration of the overdenture with o-rings inserted

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Page 1: Mandibular movement/function before and after mandibular ...bredentfiles.imosnet.de/scientific_clinical_cases/... · Mandibular movement/function before and after mandibular miniSky1

Formatvorlage des Untertitelmasters durch Klicken bearbeiten

Dr. Alexandru Eugen David1, Prof. univ. Dr. Elena Preoteasa1, Conf. univ. Dr. Cătălina Murariu Măgureanu1

1UMF “Carol Davila

Mandibular movement/function before and after mandibular miniSky1 overdenture by kinesiographic investigation.

Case presentation

Mandibular implant overdenture is regarded today as a treatment option that better suits patients' expectations; it is a restoration with the appropriate retention which provides great well-being. However, to ensure a successful medical outcome, this treatment needs to ensure optimum dental apparatus functionality. We present the case of a 68 year old female patient, with upper and lower jaw edentulism, treated with conventional dentures, who was especially unhappy with her mandibular denture stability and retention. The treatment plan aimed to correct the major deficiencies of the mandibular denture and to transform the mandibular denture into two miniSKY (bredent medical, Senden, Germany) one-piece implants with a 2.8mm diameter and O-ring system supported overdenture. Ultrasonic kinesiographic recordings of the mandibular kinematics were made by using the JMA system (Jaw Movement Analysis, Zebris, Isny im Allgäu, Germany) during the following treatment phases: before deficiencies were corrected, after correction, after implant insertion and soft lining of the area corresponding to the ball attachment of the implant and after applying the O-rings in the overdenture base.

Abstract

Case description

Conclusion

During initial kineziographic recording the following were noticed: diverted opening and closing movement of the mouth, lateral and propulsion movements are limited, Posselt's sagittal and frontal diagrams are modified. After correcting areas of base overextension and occlusal deficiencies (VDO, position of artificial teeth) an improvement in the appearance of the recordings was noticed: there was a higher range of motion in lateral and propulsion movements, but also a decrease in the condyles` sagittal projection, in maximum opening of the mouth and lower jaw movement velocity. After inserting the mini implants and soft material lining, kineziographic recordings observed an increase in the range of all movements: opening / closing mouth, propulsion, laterality, an increase in opening and closing velocity of the mouth, as well as an improvement in Posselt 's sagittal and frontal diagrams. The maximum values of all variables were recorded three months after implant insertion, with overdenture soft liner and using adhesive on both dentures for stabilisation. After applying the O-rings on the mandibular overdenture, values have remained high even without the use of adhesive on any of the dentures. Three months after implant insertion, a decrease in the values of all variables was noted, which could be attributed to the reduction in stability of the maxillary denture.

Using kineziographic investigation, objective changes in mandibular kinematics are exposed after each stage of treatment and mandibular kinematics confirm improvement due to better stability of the mandibular prosthesis. This was transformed into a mini1SKY supported overdenture by increasing the range of motion of border movements and movement velocity, by better modifying the Posselt's diagrams and by better coordination between rotation and translation movements of the condyles. Objective data collected via kinesiograph confirmed the benefits of the treatment with mini1SKY implant overdenture; in this clinical case it was also subjectively reported by the patient. Kinesiographic examination proved effective in spotting and correcting deficiencies of dentures, which is essential for obtaining functional implant or mini implant supported overdentures.

Initial kinesiographic registration with complete dentures and adhesive applied

Kinesiographic registration with overdenture soft lined and adhesive applied

Kinesioigraphic registration of the overdentures after three months

Kinesiographic registration of the overdenture with o-rings inserted