Mål: Målet med den retrospektiva studien var att bedöma den kliniska kvaliteten av metallkeramiska broar i titan-porslin (Ti) och kobolt-krom-porslin (Co-Cr) med en minsta uppföljningstid på två år.Material och metod: 49 patienter behandlades med metallkeramiska broar i Ti och Co-Cr på avdelningen för Oral Protetik på Odontologiska fakulteten i Malmö under perioden 2007-2010. År 2012 kontaktades dessa patienter efter att tandteknikerfakturor gåtts igenom. 21 patienter (10 män och 11 kvinnor), med en medelålder på 59,2 år och 25 broar (13 Ti och 12 Co-Cr), deltog i studien. Broarnas kliniska kvalitet bedömdes med hjälp av en modifierad version av California Dental Association (CDA) kvalitetbedömningssystem. En bedömning av lyckande- och överlevnadsfrekvens genomfördes. Statistisk analys gjordes med hjälp av Fishers’ exact test vid bedömning av skillnaden mellan grupperna. För bedömning av skillnaden mellan bedömarna beräknades kappa värdet.Resultat: Det förelåg ingen statistiskt signifikant skillnad mellan grupperna vad gäller bedömningen med CDA kvalitetbedömningssystem. Sju broar i Ti-gruppen, och åtta i Co-Cr-gruppen bedömdes som ”acceptable”. Sex Ti-broar och tre Co-Cr-broar bedömdes vara i behov av revision (”correct/replace”). Överlevnadsfrekvensen var 81,3 % för Ti-broarna och 92,3 % för Co-Cr-broarna. Tre Ti-broar och två Co-Cr-broar hade frakturer i fasadporslinet – s.k. "chip-off”-frakturer. Inom vardera grupp fanns en bro med karies på stödtänderna.Slutsatser: Broarna visade acceptabel kvalitet inom båda grupperna. Med tanke på begränsningarna för den här studien bör försiktighet vidtas när man drar slutsatser utifrån resultaten. / Aim: The aim of this retrospective study was to evaluate the clinical quality of titanium (Ti) metal-ceramic and cobalt-chromium (Co-Cr) metal-ceramic fixed dental prostheses(FDPs) with a minimum follow up period of 2 years.Methods: In 2012, 49 patients treated with FDPs during 2007-2010 at the Department of Prosthetic Dentistry, Faculty of Odontology, Malmö University, Sweden, were contacted after auditing dental technician bills. Twenty-one patients with a mean age of 59.2 years with 25 FDPs (13 Ti and 12 Co-Cr FDPs) agreed to participate in the study (10 men and 11 women). Evaluation of the metal-ceramic FDPs was made using a modified version of the California Dental Association (CDA) evaluation system. Success and survival rates were assessed. Statistical analysis was performed using Fisher’s exact test for differences between groups and for inter-examiner reliability the kappa value was calculated.Results: The two groups did not differ significantly concerning the ratings according to the CDA evaluation system. Seven FDPs in the Ti group were evaluated as acceptable while there were 8 in the Co-Cr group. Six Ti and 3 Co-Cr FDPs were evaluated as correct/replace. The survival rate for the Ti FDPs was 81.3% and for the Co-Cr FDPs 92.3%. Three Ti FDPs showed chip-off fractures while two were recorded in the Co-Cr group. In either group one FDP exhibited caries on the abutment teeth.Conclusions: Within the limitations of this study the clinical quality of the fixed dental prostheses was acceptable in both groups.

Det ökade intresset av keramiska material har främst centrerat kring zirkoniabaserade keramer på sistone. Zirkoniabaserade fastsittande broar är ämne för en pågående diskussion. Det finns några få publicerade studier på ämnet men med varierande kvalitet och det finns ingen sammanställning av implantatstödda zirkoniabaserade broar. Syftet med den här studien är att bedöma tillgängliga studier på tidigare nämnda konstruktion och redogöra för resultat från kliniska studier.På elektroniska databaser söktes artiklar på implantatstödda zirkoniabaserade fastsittande broar. Artiklar som också rörde tandstödda konstruktioner inkluderades i sökningen. Sökningen kompletterades med en manuell referenssök på de utvalda fulltextartiklarna. Sökningen resulterade i 4,253 artiklar. Baserat på förutbestämda kriterier inhämtades 5 fulltext artiklar. En av de studierna skilde inte på tandstödda och implantatstödda grupper i resultatet, därför exkluderaderades den från fortsatta analyser. Tre studier redogjorde för helkäkeskonstruktioner, och majoriteten av de inkluderade konstruktionerna var helkäkeskonstruktioner. Tillräcklig data för uträkning av överlevnad och komplikationsrisk var tillgänglig i 4 studier. Analysen bar baserad på 47 implantatstödda konstruktioner. Slutsatsen av litteraturstudien blir att zirkoniabaserade helkäkeskonstruktioner som är implantatstödda kan övervägas som behandling. Resultaten är dock baserade på få studier med relativt få konstruktioner inkluderade, varför tolkning av resultaten bör göras med försiktighet. Fortsatta studier behövs för att konkludera hur den här typen av konstruktioner håller med tiden. / The increasing interest in ceramic materials has mostly centered on zirconia-based ceramics lately. Zirconia-based fixed dental prostheses (FDPs) is an ongoing subject of discussion. There are a few articles published on the subject but with varying quality and there is no review on implant-supported zirconia-based FDPs to be found. The purpose of this study is to evaluate available studies on zirconia-based implant-supported FDPs, reporting the results from clinical studies.Three electronic databases were searched for studies reporting on zirconia-based FDPs. The electronic search was complemented by a hand-search made from the reference lists of the retrieved full-text articles. The search result yielded 4,253 titles. Based on pre-established criteria, 5 full-text articles were obtained. One study did not separate the results between tooth-supported and implant-supported groups, why it was excluded from further analysis. Three studies reported on cross-arch restorations, and the majority of the FDPs included were cross-arch restorations. Sufficient data for calculation of cumulative survival-and complication-rates was available in 4 studies. Analysis was based on 47 implant-supported FDPs. This review concludes that cross-arch implant-supported zirconia-based FDPs could be considered as a treatment alternative. The results are, however, based on small number of studies with relatively few FDPs included thus interpretation of the results should be made with caution. Further studies are needed to evaluate how these types of constructions stand the test of time.

As fissuras palatinas além de envolvem o osso alveolar podem promover a ausência do dente incisivo lateral ou apresenta-lo severamente comprometido. Nesses casos sua reabilitação poderá ser feita por próteses parciais fixas convencionais ou por prótese sobre implantes, geralmente após uma cirurgia de enxerto ósseo na região. Todavia além da estética, se faz necessário investigar sobre o potencial de força oclusal que essas reabilitações proporcionam. Assim, o propósito desse estudo foi avaliar a força máxima de mordida em indivíduos com fissura labiopalatina unilateral reabilitados com prótese parcial fixa convencional e sobre implantes e comparar esses resultados com o lado contralateral e com indivíduos sem fissura. A amostra foi constituída por 50 indivíduos, 25 pacientes com fissura (15 reabilitados com próteses parciais fixas convencionais e 10 sobre implantes) e 25 indivíduos sem fissura com dentes naturais. A força de mordida máxima foi mensurada por um único examinador utilizando o gnatodinamômetro, registrado nas regiões reabilitadas de incisivo lateral e canino, região de molares e incisivos centrais. Os valores médios obtidos, e a análise estatística com os testes t de Student e t de Student pareado permitiram observar que no mesmo indivíduo, a força de mordida do lado não afetado foi estatisticamente superior quando comparado com o lado da fissura reabilitado com prótese (p=0,005). O grupo reabilitado com prótese fixa convencional apresentou a força máxima de mordida estatisticamente igual ao grupo com prótese fixa sobre implante (p=0,781). Considerando os grupos experimental e controle na região de molares os resultados foram estatisticamente iguais (lado afetado p=0,082 e não afetado p=0,066). Na região de incisivo lateral e canino, o lado correspondente ao afetado no grupo-controle, apresentou força máxima de mordida estatisticamente maior que o grupo-experimental (p=0,004), enquanto no lado correspondente ao não afetado os resultados foram iguais. Na região de incisivos centrais o resultado médio do grupo-controle também foi estatisticamente maior que o experimental (p=0,005) / The cleft palate involving the alveolar bone may have the lateral incisor tooth missing or severely compromised. In such cases rehabilitation can be done through fixed dental prostheses or implant-supported fixed dental prostheses, generally after a bone graft surgery in the region. However, beyond aesthetics, it is necessary to investigate the potential for occlusal force that these rehabilitations provide. Thus, the purpose of this study was to evaluate the maximum bite force in subjects with unilateral cleft lip and palate rehabilitated with fixed dental prostheses or implantsupported fixed dental prostheses and compare the results with the contralateral side and with individuals without cleft. The sample consisted of 50 subjects, 25 patients with cleft (15 rehabilitated with fixed dental prostheses and 10 with implant-supported fixed dental prostheses) and 25 individuals without cleft and with natural teeth. The maximum bite force was measured by means of gnathodynamometer, registered in the rehabilitated lateral incisor and canine region, molars region and incisors regions by a single examiner. The obtained average values, and the statistical analysis with the Student t test and paired Student t test allowed to be observed that on the same individual the bite force on the side that was not affected was statistically superior when compared to the side of the rehabilitated cleft with prosthesis (p=0,005). The rehabilitated group with conventional prostheses presented maximum bite force statistically equal to the group with the implant-supported fixed dental prostheses (p=0,781). Considering the experimental and control groups on the molar regions, the results were statistically equal (affected side p=0,082 e non-affected p=0,066). The lateral incisor and canine region from the correspondent affected side on the control group presented maximum bite force statistically higher than the experimental group (p=0,004), on the non-affected side the results were the same. In the incisor region, the average result of the control group was also statistically higher than the experimental group (p=0,005)

As fissuras palatinas além de envolvem o osso alveolar podem promover a ausência do dente incisivo lateral ou apresenta-lo severamente comprometido. Nesses casos sua reabilitação poderá ser feita por próteses parciais fixas convencionais ou por prótese sobre implantes, geralmente após uma cirurgia de enxerto ósseo na região. Todavia além da estética, se faz necessário investigar sobre o potencial de força oclusal que essas reabilitações proporcionam. Assim, o propósito desse estudo foi avaliar a força máxima de mordida em indivíduos com fissura labiopalatina unilateral reabilitados com prótese parcial fixa convencional e sobre implantes e comparar esses resultados com o lado contralateral e com indivíduos sem fissura. A amostra foi constituída por 50 indivíduos, 25 pacientes com fissura (15 reabilitados com próteses parciais fixas convencionais e 10 sobre implantes) e 25 indivíduos sem fissura com dentes naturais. A força de mordida máxima foi mensurada por um único examinador utilizando o gnatodinamômetro, registrado nas regiões reabilitadas de incisivo lateral e canino, região de molares e incisivos centrais. Os valores médios obtidos, e a análise estatística com os testes t de Student e t de Student pareado permitiram observar que no mesmo indivíduo, a força de mordida do lado não afetado foi estatisticamente superior quando comparado com o lado da fissura reabilitado com prótese (p=0,005). O grupo reabilitado com prótese fixa convencional apresentou a força máxima de mordida estatisticamente igual ao grupo com prótese fixa sobre implante (p=0,781). Considerando os grupos experimental e controle na região de molares os resultados foram estatisticamente iguais (lado afetado p=0,082 e não afetado p=0,066). Na região de incisivo lateral e canino, o lado correspondente ao afetado no grupo-controle, apresentou força máxima de mordida estatisticamente maior que o grupo-experimental (p=0,004), enquanto no lado correspondente ao não afetado os resultados foram iguais. Na região de incisivos centrais o resultado médio do grupo-controle também foi estatisticamente maior que o experimental (p=0,005) / The cleft palate involving the alveolar bone may have the lateral incisor tooth missing or severely compromised. In such cases rehabilitation can be done through fixed dental prostheses or implant-supported fixed dental prostheses, generally after a bone graft surgery in the region. However, beyond aesthetics, it is necessary to investigate the potential for occlusal force that these rehabilitations provide. Thus, the purpose of this study was to evaluate the maximum bite force in subjects with unilateral cleft lip and palate rehabilitated with fixed dental prostheses or implantsupported fixed dental prostheses and compare the results with the contralateral side and with individuals without cleft. The sample consisted of 50 subjects, 25 patients with cleft (15 rehabilitated with fixed dental prostheses and 10 with implant-supported fixed dental prostheses) and 25 individuals without cleft and with natural teeth. The maximum bite force was measured by means of gnathodynamometer, registered in the rehabilitated lateral incisor and canine region, molars region and incisors regions by a single examiner. The obtained average values, and the statistical analysis with the Student t test and paired Student t test allowed to be observed that on the same individual the bite force on the side that was not affected was statistically superior when compared to the side of the rehabilitated cleft with prosthesis (p=0,005). The rehabilitated group with conventional prostheses presented maximum bite force statistically equal to the group with the implant-supported fixed dental prostheses (p=0,781). Considering the experimental and control groups on the molar regions, the results were statistically equal (affected side p=0,082 e non-affected p=0,066). The lateral incisor and canine region from the correspondent affected side on the control group presented maximum bite force statistically higher than the experimental group (p=0,004), on the non-affected side the results were the same. In the incisor region, the average result of the control group was also statistically higher than the experimental group (p=0,005)