Stefanos Kourtis - Academia.edu (original) (raw)

Papers by Stefanos Kourtis

Journal of clinical and experimental dentistry, 2024

Most of the times the practitioner tends to overlook the role of the interim restorations, thinki... more Most of the times the practitioner tends to overlook the role of the interim restorations, thinking that this is “temporary” phase of the overall procedure and therefore the patient’s expectations, as well as the functional demands should be limited. In complete rehabilitation cases, extensive and long term interim restorations are required, which should not only fulfill the functional criteria but also the esthetic demands of the patient. The role of the interim restorations becomes an important portion in diagnosis and treatment phases, involved in restoring the patient back to optimum oral health, especially in situations in which extensive reconstructive needs, while the selection of the restorative material is an important parameter in the treatment plan. It is of major importance that the restorative dentist has a clear picture of the final result, before initiating the treatment. On the other hand, no elective restorative dentistry should be undertaken without a clear understanding of the patient’s expectations and the limitations of restorative therapy. The purpose of this table clinic is to present a laboratory technique for the fabrication of interim restorations, with several advantages.

Implant placement is considered a safe and predictable treatment option for the rehabilitation of... more Implant placement is considered a safe and predictable treatment option for the rehabilitation of edentulous patients. A prerequisite for successful implant placement is the presence of a sufficient amount of bone to allow for good primary implant stability. Tooth loss leads to resorption of the alveolar crest, resulting in reduction of bone volume in the horizontal and vertical dimensions. Guided bone regeneration (GBR) has been used in implant therapy for some time now and has shown very good clinical results [1,2]. In guided bone regeneration, the use of membranes (resorbable or non-resorbable), fixation pins and bone graft is required, and an extended healing period must be allowed for [3,4]. Last but not least, the cost of the surgical procedure will also be higher. An alternative to horizontal augmentation is the bone-splitting technique. This technique can be applied where the alveolar crest has been resorbed in the horizontal dimension, leaving a dense alveolar process of reasonable height and without any fenestrations [5]. In these cases, the outer labial cortex plate can be separated from the inner cortex using a narrow chisel, resulting in a "green stick" bone fracture. It is necessary to leave the outer cortex attached to the overlying periosteum, so that the use of a flap with minimum periosteal detachment is advocated. The objective of this paper is to describe the surgical and prosthetic steps in treating a patient with a narrow alveolar crest in the posterior area.

The restoration of patients with severe bone loss is a difficult clinical procedure as the team o... more The restoration of patients with severe bone loss is a difficult clinical procedure as the team of health professionals has to restore the missing teeth and the soft and/or hard tissues. The bone loss is usually caused on the alveolar processes and it is usually caused by periodontal disease. In cases of trauma the bone loss may be extended. In such cases the initial treatment is focused on the trauma and the prosthetic treatment is adapted to the clinical situation. The main goal of the treatment is the restoration of the patient in order to improve their quality of life. Patients with trauma show often a low self-esteem and the prosthetic restoration may contribute to a sense of self-confidence and improve function and esthetic result.

The use of resin cements for welding very different additives for compensation to stop gaining gr... more The use of resin cements for welding very different additives for compensation to stop gaining ground day by day. The powders are of improved properties than conventional powders, the most important is the ability to adhesion dental tissues. One of the ways their classification is according to the way polymeric their constraints. This results in three types of resin cements, chemically polymerized, the photopolymerizable and dual-cure cements. Each class combines series advantages and disadvantages and has specific indications and contraindications in the clinical application of cations. The purpose of this paper is to record the properties and, by extension, the indications and contraindications relating to the use of resin cements in each category before order to provide some guidelines for daily clinical practice.

The European journal of prosthodontics and restorative dentistry, 2019

Various materials have been used over time in prosthetic dentistry. However, due to the evolution... more Various materials have been used over time in prosthetic dentistry. However, due to the evolution of science and knowledge, new materials are being brought to the forefront. Polyether ether ketone (PEEK) is a polymer with many potential applications in dentistry. The use of PEEK has become increasingly more common in dental practice; its favorable properties have made it a compelling alternative biomaterial in restorative dentistry. The current trend is moving towards the use of metal-free restorations and biomaterials which exhibit advanced properties in the complex oral environment. This review paper presents and summarizes clinical applications of PEEK in contemporary dentistry.

The rehabilitation of the edentulous maxilla with fixed implant-supported restorations is a chall... more The rehabilitation of the edentulous maxilla with fixed implant-supported restorations is a challenging task for the clinician but very frequently demanded by patients. Prosthetically driven implant placement simplifies the design of the restoration, but severe bone resorption may prohibit the ideal positioning of implants. Bone grafting is often required to improve the bone substrate and to allow proper implant placement. The posterior maxilla can be treated by sinus floor elevation, while alveolar ridge atrophy in the anterior jaw may be improved by horizontal augmentation. The restoration must replace the missing soft and hard tissue, so the use of gingiva-coloured polymer material is often required. The objective of this article is to describe the clinical and laboratory stages of the rehabilitation of a completely edentulous patient with a fixed implant-supported prosthesis. A bilateral sinus lift and horizontal augmentation of the maxilla with bone graft from the iliac crest w...

The Open Dentistry Journal

Aim: This multicenter study examined the relationship, possible interactions, and intermittent ef... more Aim: This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia. Materials and Methods: Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone ​​(FSH) values, estradiol, and clinical risk factors. Results: Participants had a ...

The restoration of endodontically treated teeth is a common task for the clinician. After complet... more The restoration of endodontically treated teeth is a common task for the clinician. After completing endodontic treatment the tooth must be restored to fulfill clinical function. The necessity of restoration of an endodontically treated tooth must be taken under consideration even before starting endodontic procedure. Endodontically treated teeth have usually lost a major part of dental tissues due to caries and endodontic procedures. The use of a root post and core does not contribute to increased mechanical stability, as it was believed in the past. On the contrary the use of root posts may further weaken the existing tooth structure because of further dentine removable. The main clinical objective in the use of posts and cores is to ensure proper retention for a core material in order to allow prosthetic restoration of the remaining tooth. Endodontic posts are classified according to their fabrication procedure to refabricated and individually constructed. From a material point o...

The use osseointegrated implants are widespread today. The first implant-supported prosthetic res... more The use osseointegrated implants are widespread today. The first implant-supported prosthetic restorations based on four to six implants placed in the mandible between geneiakon bore and extended overhangs, bilaterally, distally, to ensure posterior occlusal contacts. These restorations were known as Hybrid Bridges (Hybrids) or Still Complete Dentures (Fixed Complete Dentures). Nowadays, this type of restorations are still to be one of the choices of dentist in a treatment plan with implants, especially when anatomical reasons, combined with the reluctance of the patient to undergo reconstructive surgery, making it difficult or impossible the Locality -financing of prosthetic implants in the desired positions. Corresponding factors leading to the use of brackets and implant-supported bridges restore partial edentulous. From the clinical and laboratory research carried out so far, it can be concluded that the appropriate design, combined with correct occlusal control, contribute to l...

Journal of Osseointegration, 2019

Aim The aim of this study was to assess bone changes along implants after immediate or delayed lo... more Aim The aim of this study was to assess bone changes along implants after immediate or delayed loading, using subtractions of digital images originated from cropped panoramic radiographs and visual evaluation. Materials and methods Eleven patients received 4 Ankylos implants interforaminal in the mandible. In 7 patients the implants were loaded immediately and 4 followed delayed loading. All patients were restored with a telescopic overdenture with Syncone abutments. From each patient 3 panoramic radiographs (PRs) were obtained: upon delivery of the restoration (T1), 6 months later (T2) and after 3 years (T3). 33 implants were finally selected. The radiographs were analyzed using the Emago® Software. The grey scale values were measured either manually (Stage A) or automatically (Stage B) in six areas (neck, middle and apex; both mesially and distally) along the implants’ sides to evaluate the bone density during clinical function. Images were also visually evaluated by five observer...

International Journal of Implant Dentistry, 2021

Background The replica technique with its modifications (negative replica) has been used for the ... more Background The replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven. The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners. Methods One hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abut...

DENTAL ANXIETY: DIAGNOSTIC CLASSIFICATION AND METHODS OF CONFRONTATION Fear towards the dentist i... more DENTAL ANXIETY: DIAGNOSTIC CLASSIFICATION AND METHODS OF CONFRONTATION Fear towards the dentist is a matter that seems to concern 5% of the population and has an impact to patients’ quality of life due to its effect to their mental health. Therefore, inevitably, it plays a determining role in successfully completing dental treatments. The objective of this paper is to classify dental phobia, to analyze human behavior according to several psychosocial parameters and to refer to the primary psychological and drug based methods of treatment. According to D.S.M. IV-TR of the American Psychiatric Association (APA),there are 17 categories of psychiatric disorders. The most common are stress disorders, whose subcategory is special phobia. A dentist should be able to treat each patient as a separate personality, forming the therapy plan according to each patient’s special characteristics. Consequently, a clinical doctor owes to take under consideration the patient’s basic need, which is pai...

Finding the most stable position for the stomatognathic system is one of the most important steps... more Finding the most stable position for the stomatognathic system is one of the most important steps of almost all dental procedures. As stable position of the stomatognathic system is defined as the ideal relationship of the lower jaw against the cranium. This position allows for functioning without pain and symptoms of dysfunction. Maybe for small dental procedures focusing on just one tooth or even a quadrant, the identification of the most stable position of the stomatognathic system does not be as crucial. In prosthetic cases though, that involve a hole dental arch or even both, finding and recording the most stable relationship of the upper and lower jaw at the same time with the most stable position of the temporomandibular joints, should be the first clinical approach of the treatment plan. In such cases often the clinician has to determine and record the vertical dimension of occlusion (VDO) in order to provide the needed prosthetic space. The VDO can either be raised or decre...

The Journal of Prosthetic Dentistry, 2016

Rehabilitating a completely edentulous maxilla with an implant-retained prosthesis is challenging... more Rehabilitating a completely edentulous maxilla with an implant-retained prosthesis is challenging. The resorptive pattern of the alveolar crest leads to hard and soft tissue defects that cannot always be addressed with augmentation procedures. 1-3 Deficiencies in the horizontal plane and a prosthetically unfavorable implant position may compromise esthetics, phonetics, and function. 1,4 Lip support is usually achieved with pink ceramic or acrylic resin. 2 An edentulous maxilla can be restored with an implant overdenture or a fixed implant prosthesis. 2,5 Maxillary implant overdentures are associated with more technical complications and biological problems than a fixed implant-supported prosthesis. A higher incidence of postinsertion maintenance (clip or attachment replacement/ reactivation) and mucosal inflammation has been reported. 1,4,6-8 Fixed implant-supported maxillary prostheses give greater patient satisfaction and a lower incidence of prosthetic complication. 1,4 An implant-supported fixed prosthesis with metal superstructure and acrylic resin gingiva has been extensively used in the treatment of the edentulous mandible. 2,9 Although long-term survival rates are well documented, technical complications are prosthetic screw loosening and/or fractures, abutment fractures, and fracture or wear of acrylic resin teeth. 2,9-11 Fabrication is more demanding in the maxilla. Large interabutment spaces can disrupt speech and oral hygiene under flange extensions and around abutments is difficult. 2,10,11 Ease of oral hygiene and retrievability of the prosthesis during the maintenance phase are essential for long-term success. This report describes the clinical and laboratory stages in fabricating a 2-piece fixed screwretained prosthesis on multiple divergent implants in a resorbed maxilla.

Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 2020

OBJECTIVE The purpose of this study was to evaluate the effect of three different methods of fibe... more OBJECTIVE The purpose of this study was to evaluate the effect of three different methods of fiber reinforcement (glass fibers preimpregnated, glass fibers nonpreimpregnated, and polyethylene fibers) on the flexural strength and modulus of elasticity of poly-methyl-methacrylate resin (PMMA) and Bis-Gma materials. MATERIALS AND METHODS A total of 60 specimens of autopolymerizing PMMA resin specimens were fabricated using a stainless steel matrix with dimensions of (37.5± 2) × (3 ± 0.1) × (3 ± 0.1) mm according to the standards of ISO 10477. The autopolymerizing resins used in this study were: (a) JET, (b) TRIM, (c) PROTEMP. The fibers used in this study were STICK (Glass fiber preimpregnated), POLYDENTIA (Glass fiber nonpreimpregnated), RIBBOND (Polyethylene fiber). The specimens were tested by three-point bending test and the flexural strength and modulus of elasticity were recorded. The data of each resin type were analyzed by analysis of variance using a significance level of 0.05...

Journal of clinical and experimental dentistry, 2024

Most of the times the practitioner tends to overlook the role of the interim restorations, thinki... more Most of the times the practitioner tends to overlook the role of the interim restorations, thinking that this is “temporary” phase of the overall procedure and therefore the patient’s expectations, as well as the functional demands should be limited. In complete rehabilitation cases, extensive and long term interim restorations are required, which should not only fulfill the functional criteria but also the esthetic demands of the patient. The role of the interim restorations becomes an important portion in diagnosis and treatment phases, involved in restoring the patient back to optimum oral health, especially in situations in which extensive reconstructive needs, while the selection of the restorative material is an important parameter in the treatment plan. It is of major importance that the restorative dentist has a clear picture of the final result, before initiating the treatment. On the other hand, no elective restorative dentistry should be undertaken without a clear understanding of the patient’s expectations and the limitations of restorative therapy. The purpose of this table clinic is to present a laboratory technique for the fabrication of interim restorations, with several advantages.

Implant placement is considered a safe and predictable treatment option for the rehabilitation of... more Implant placement is considered a safe and predictable treatment option for the rehabilitation of edentulous patients. A prerequisite for successful implant placement is the presence of a sufficient amount of bone to allow for good primary implant stability. Tooth loss leads to resorption of the alveolar crest, resulting in reduction of bone volume in the horizontal and vertical dimensions. Guided bone regeneration (GBR) has been used in implant therapy for some time now and has shown very good clinical results [1,2]. In guided bone regeneration, the use of membranes (resorbable or non-resorbable), fixation pins and bone graft is required, and an extended healing period must be allowed for [3,4]. Last but not least, the cost of the surgical procedure will also be higher. An alternative to horizontal augmentation is the bone-splitting technique. This technique can be applied where the alveolar crest has been resorbed in the horizontal dimension, leaving a dense alveolar process of reasonable height and without any fenestrations [5]. In these cases, the outer labial cortex plate can be separated from the inner cortex using a narrow chisel, resulting in a "green stick" bone fracture. It is necessary to leave the outer cortex attached to the overlying periosteum, so that the use of a flap with minimum periosteal detachment is advocated. The objective of this paper is to describe the surgical and prosthetic steps in treating a patient with a narrow alveolar crest in the posterior area.

The restoration of patients with severe bone loss is a difficult clinical procedure as the team o... more The restoration of patients with severe bone loss is a difficult clinical procedure as the team of health professionals has to restore the missing teeth and the soft and/or hard tissues. The bone loss is usually caused on the alveolar processes and it is usually caused by periodontal disease. In cases of trauma the bone loss may be extended. In such cases the initial treatment is focused on the trauma and the prosthetic treatment is adapted to the clinical situation. The main goal of the treatment is the restoration of the patient in order to improve their quality of life. Patients with trauma show often a low self-esteem and the prosthetic restoration may contribute to a sense of self-confidence and improve function and esthetic result.

The use of resin cements for welding very different additives for compensation to stop gaining gr... more The use of resin cements for welding very different additives for compensation to stop gaining ground day by day. The powders are of improved properties than conventional powders, the most important is the ability to adhesion dental tissues. One of the ways their classification is according to the way polymeric their constraints. This results in three types of resin cements, chemically polymerized, the photopolymerizable and dual-cure cements. Each class combines series advantages and disadvantages and has specific indications and contraindications in the clinical application of cations. The purpose of this paper is to record the properties and, by extension, the indications and contraindications relating to the use of resin cements in each category before order to provide some guidelines for daily clinical practice.

The European journal of prosthodontics and restorative dentistry, 2019

Various materials have been used over time in prosthetic dentistry. However, due to the evolution... more Various materials have been used over time in prosthetic dentistry. However, due to the evolution of science and knowledge, new materials are being brought to the forefront. Polyether ether ketone (PEEK) is a polymer with many potential applications in dentistry. The use of PEEK has become increasingly more common in dental practice; its favorable properties have made it a compelling alternative biomaterial in restorative dentistry. The current trend is moving towards the use of metal-free restorations and biomaterials which exhibit advanced properties in the complex oral environment. This review paper presents and summarizes clinical applications of PEEK in contemporary dentistry.

The rehabilitation of the edentulous maxilla with fixed implant-supported restorations is a chall... more The rehabilitation of the edentulous maxilla with fixed implant-supported restorations is a challenging task for the clinician but very frequently demanded by patients. Prosthetically driven implant placement simplifies the design of the restoration, but severe bone resorption may prohibit the ideal positioning of implants. Bone grafting is often required to improve the bone substrate and to allow proper implant placement. The posterior maxilla can be treated by sinus floor elevation, while alveolar ridge atrophy in the anterior jaw may be improved by horizontal augmentation. The restoration must replace the missing soft and hard tissue, so the use of gingiva-coloured polymer material is often required. The objective of this article is to describe the clinical and laboratory stages of the rehabilitation of a completely edentulous patient with a fixed implant-supported prosthesis. A bilateral sinus lift and horizontal augmentation of the maxilla with bone graft from the iliac crest w...

The Open Dentistry Journal

Aim: This multicenter study examined the relationship, possible interactions, and intermittent ef... more Aim: This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia. Materials and Methods: Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone ​​(FSH) values, estradiol, and clinical risk factors. Results: Participants had a ...

The restoration of endodontically treated teeth is a common task for the clinician. After complet... more The restoration of endodontically treated teeth is a common task for the clinician. After completing endodontic treatment the tooth must be restored to fulfill clinical function. The necessity of restoration of an endodontically treated tooth must be taken under consideration even before starting endodontic procedure. Endodontically treated teeth have usually lost a major part of dental tissues due to caries and endodontic procedures. The use of a root post and core does not contribute to increased mechanical stability, as it was believed in the past. On the contrary the use of root posts may further weaken the existing tooth structure because of further dentine removable. The main clinical objective in the use of posts and cores is to ensure proper retention for a core material in order to allow prosthetic restoration of the remaining tooth. Endodontic posts are classified according to their fabrication procedure to refabricated and individually constructed. From a material point o...

The use osseointegrated implants are widespread today. The first implant-supported prosthetic res... more The use osseointegrated implants are widespread today. The first implant-supported prosthetic restorations based on four to six implants placed in the mandible between geneiakon bore and extended overhangs, bilaterally, distally, to ensure posterior occlusal contacts. These restorations were known as Hybrid Bridges (Hybrids) or Still Complete Dentures (Fixed Complete Dentures). Nowadays, this type of restorations are still to be one of the choices of dentist in a treatment plan with implants, especially when anatomical reasons, combined with the reluctance of the patient to undergo reconstructive surgery, making it difficult or impossible the Locality -financing of prosthetic implants in the desired positions. Corresponding factors leading to the use of brackets and implant-supported bridges restore partial edentulous. From the clinical and laboratory research carried out so far, it can be concluded that the appropriate design, combined with correct occlusal control, contribute to l...

Journal of Osseointegration, 2019

Aim The aim of this study was to assess bone changes along implants after immediate or delayed lo... more Aim The aim of this study was to assess bone changes along implants after immediate or delayed loading, using subtractions of digital images originated from cropped panoramic radiographs and visual evaluation. Materials and methods Eleven patients received 4 Ankylos implants interforaminal in the mandible. In 7 patients the implants were loaded immediately and 4 followed delayed loading. All patients were restored with a telescopic overdenture with Syncone abutments. From each patient 3 panoramic radiographs (PRs) were obtained: upon delivery of the restoration (T1), 6 months later (T2) and after 3 years (T3). 33 implants were finally selected. The radiographs were analyzed using the Emago® Software. The grey scale values were measured either manually (Stage A) or automatically (Stage B) in six areas (neck, middle and apex; both mesially and distally) along the implants’ sides to evaluate the bone density during clinical function. Images were also visually evaluated by five observer...

International Journal of Implant Dentistry, 2021

Background The replica technique with its modifications (negative replica) has been used for the ... more Background The replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven. The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners. Methods One hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abut...

DENTAL ANXIETY: DIAGNOSTIC CLASSIFICATION AND METHODS OF CONFRONTATION Fear towards the dentist i... more DENTAL ANXIETY: DIAGNOSTIC CLASSIFICATION AND METHODS OF CONFRONTATION Fear towards the dentist is a matter that seems to concern 5% of the population and has an impact to patients’ quality of life due to its effect to their mental health. Therefore, inevitably, it plays a determining role in successfully completing dental treatments. The objective of this paper is to classify dental phobia, to analyze human behavior according to several psychosocial parameters and to refer to the primary psychological and drug based methods of treatment. According to D.S.M. IV-TR of the American Psychiatric Association (APA),there are 17 categories of psychiatric disorders. The most common are stress disorders, whose subcategory is special phobia. A dentist should be able to treat each patient as a separate personality, forming the therapy plan according to each patient’s special characteristics. Consequently, a clinical doctor owes to take under consideration the patient’s basic need, which is pai...

Finding the most stable position for the stomatognathic system is one of the most important steps... more Finding the most stable position for the stomatognathic system is one of the most important steps of almost all dental procedures. As stable position of the stomatognathic system is defined as the ideal relationship of the lower jaw against the cranium. This position allows for functioning without pain and symptoms of dysfunction. Maybe for small dental procedures focusing on just one tooth or even a quadrant, the identification of the most stable position of the stomatognathic system does not be as crucial. In prosthetic cases though, that involve a hole dental arch or even both, finding and recording the most stable relationship of the upper and lower jaw at the same time with the most stable position of the temporomandibular joints, should be the first clinical approach of the treatment plan. In such cases often the clinician has to determine and record the vertical dimension of occlusion (VDO) in order to provide the needed prosthetic space. The VDO can either be raised or decre...

The Journal of Prosthetic Dentistry, 2016

Rehabilitating a completely edentulous maxilla with an implant-retained prosthesis is challenging... more Rehabilitating a completely edentulous maxilla with an implant-retained prosthesis is challenging. The resorptive pattern of the alveolar crest leads to hard and soft tissue defects that cannot always be addressed with augmentation procedures. 1-3 Deficiencies in the horizontal plane and a prosthetically unfavorable implant position may compromise esthetics, phonetics, and function. 1,4 Lip support is usually achieved with pink ceramic or acrylic resin. 2 An edentulous maxilla can be restored with an implant overdenture or a fixed implant prosthesis. 2,5 Maxillary implant overdentures are associated with more technical complications and biological problems than a fixed implant-supported prosthesis. A higher incidence of postinsertion maintenance (clip or attachment replacement/ reactivation) and mucosal inflammation has been reported. 1,4,6-8 Fixed implant-supported maxillary prostheses give greater patient satisfaction and a lower incidence of prosthetic complication. 1,4 An implant-supported fixed prosthesis with metal superstructure and acrylic resin gingiva has been extensively used in the treatment of the edentulous mandible. 2,9 Although long-term survival rates are well documented, technical complications are prosthetic screw loosening and/or fractures, abutment fractures, and fracture or wear of acrylic resin teeth. 2,9-11 Fabrication is more demanding in the maxilla. Large interabutment spaces can disrupt speech and oral hygiene under flange extensions and around abutments is difficult. 2,10,11 Ease of oral hygiene and retrievability of the prosthesis during the maintenance phase are essential for long-term success. This report describes the clinical and laboratory stages in fabricating a 2-piece fixed screwretained prosthesis on multiple divergent implants in a resorbed maxilla.

Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 2020

OBJECTIVE The purpose of this study was to evaluate the effect of three different methods of fibe... more OBJECTIVE The purpose of this study was to evaluate the effect of three different methods of fiber reinforcement (glass fibers preimpregnated, glass fibers nonpreimpregnated, and polyethylene fibers) on the flexural strength and modulus of elasticity of poly-methyl-methacrylate resin (PMMA) and Bis-Gma materials. MATERIALS AND METHODS A total of 60 specimens of autopolymerizing PMMA resin specimens were fabricated using a stainless steel matrix with dimensions of (37.5± 2) × (3 ± 0.1) × (3 ± 0.1) mm according to the standards of ISO 10477. The autopolymerizing resins used in this study were: (a) JET, (b) TRIM, (c) PROTEMP. The fibers used in this study were STICK (Glass fiber preimpregnated), POLYDENTIA (Glass fiber nonpreimpregnated), RIBBOND (Polyethylene fiber). The specimens were tested by three-point bending test and the flexural strength and modulus of elasticity were recorded. The data of each resin type were analyzed by analysis of variance using a significance level of 0.05...