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Clinical application
© 2004 Dyna Dental Engineering BV
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Mark the Muchor anchors with the Dyna Muchor marker
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Position the denture in the mouth of the patient and push gently
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The marks clearly visible
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Drilling guide optional
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Give anesthesia only at the position of the marks
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Prepare the sites with the Muchor dentist drill. Verify with a Muchor anchor.
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After bone preparation
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Situation after preparation of the mucosa
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Place the denture with the Muchor anchors and leave for 72 hours in the mouth. Give the patient painkillers. If indicated let patient rinse with chlorhexidine. Š 2004 Dyna Dental Engineering BV
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UNICID Universidade Cidade de São Paulo
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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To increase the stability and retention during the healing period a denture adhesive can be used.
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To prevent pain during inserting the denture give the patient a Corsodyl gel containing a anesthesia (e.g. Xylocain 2%)
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1 week after treatment
2 weeks after treatment
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Situation after healing period
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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A night guard is preferred
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CEIO-UNICID NAPEMM Núcleo de Apoio à Pesquisa em Engenharia de Tecidos, Materiais e Mineralização Biológica, FOB-USP © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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DAHL E NORDGREN ( 1942 ) 30 clinical cases with more than 10 year success
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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LEW E KESTENBAUM ( 1953 ) Metalic buttons for edentulous patients
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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CRANIN E CRANIN ( 1958 ) Intramucosal devices in different sizes made out of non reactive metal
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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CRANIN E CRANIN ( 1961 ) Technique improvement by using the intramucosal devices also in partial dentures © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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DAHL ( 1966 ) “... Intramucosal devices have shown after a clinical study of 25 years a satisfactory retention on upper dentures...” © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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WEISS E JUDY ( 1973 ) Introduction of a new shape for the intramucosal devices
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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BABBUSH ( 1976 ) “ modification of design and fabrication of precision insertion instruments for mucosa inserts have made this an useful procedure for patients with denture retention problems” © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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MISCH ( 1982 ) •“… stressed the role of the inserts in preventing the need of often relining of the dentures and the fact that there has never been reported evidence of dysplastic changes in the epithelium around an intramucosal insert.” © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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LATELY The dental market has presented a new ceramic insert, responsable for the ideal biocompatiblity and tissue response. © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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RESEARCH PROTOCOL MULTI-CENTRE CLINICALTRIAL
DYNA-DHJP/OC01 08/02/2000 © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Goncalves
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HISTOLOGICAL ANALYSIS AFTER 6 – 12 and 24 MONTHS
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Goncalves
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves © 2004 Dyna Dental Engineering BV
Hyperkeratinized epithelium
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HISTOLOGICAL FINDINGS MICROSCOPIC EXAMINATION The histological cuts revealed a mucosa fragment capped by a stratified pavement epithelium hyperkeratinized showing acanthosis.The lamina propria is composed by a dense connective tissue, with a discrete and diffuse inflammatory infiltrate, mostly mononuclear. © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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The histological picture is showing the cronic response of long period, probably due to the loanding and stress distributed on the 1 epithelium (picture 1). © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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In this case the epithelium presented the increase of parakeratinization, hyperplasia (epithelium layers became thicker), and acanthosis (flatten epithelium crests), see 2 pictures 2 and 3. © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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In this case the epithelium presented the increase of parakeratinization, hyperplasia (epithelium layers became thicker), and acanthosis (flatten epithelium crests), see 23 pictures 2 and 3. © 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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It has also shown a discrete inflammatory infiltrate at the lamina propria region (picture 2) and increase of lamina propria and submucosa collagenization (picture 4 and 5). © 2004 Dyna Dental Engineering BV
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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It has also shown a discrete inflammatory infiltrate at the lamina propria region (picture 2) and increase of lamina propria and submucosa collagenization (picture 4 and 5). © 2004 Dyna Dental Engineering BV
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© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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BIOPSY FOR HYSTOLOGICAL STUDY AFTER 2 YEARS OF MUCHOR DENTURE USE •Epithelium with hyperplasia (thicker epithelial layers) •Hyperkeratosis •Acanthosis
•Collagenization •Discrete inflammatory infiltrate •Normal characteristics for the region © 2004 © 2004 DynaDyna Dental Dental Engineering Engineering BV BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Bone resorption evaluation
© 2004 © 2004 DynaDyna Dental Dental Engineering Engineering BV BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Cells culture and adhesion •Cells line: Balb/C 3T3 #35 (fibroblasts);
•Cells expansion : 1,0 x 104 cells/material in DMEM+10% bovine fetal serum
• Period: 7 days.
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Central Area – Magnification X 92, 10kV, 9 mm
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Central Area Magnification: X 500, 10kV, 9 mm
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Border – Magnification : X 1.000, 10kV, 8 mm
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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Border - Magnification: X 2.000, 10kV, 8 mm
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves
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CURRENT CONCEPTS • • • • • •
Concepts of the total prostheses – dentures Importance of a balanced occlusion Possibility of the alveolar bone preparation Postoperative care 8 Muchor anchors for full upper denture Do not smoke during healing period
© 2004 Dyna Dental Engineering BV
© 2004 CEIO-UNICID Prof. Dr. F. Gonçalves