Alfonso Sánchez-Ayala

State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil

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Publications (31)18.55 Total impact

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    ABSTRACT: Rehabilitation of patients with anterior conoid teeth may present a challenge for the clinician, especially when trying to mimic the nature with composite resins. This clinical report exemplifies how a patient with conoid upper lateral incisors was rehabilitated with minimally invasive adhesive restorations. Following diagnostic wax-up and cosmetic mock-up, no-prep veneers and ceramic fragments (partial veneers) were constructed with feldspathic porcelain. This restorative material presents excellent reproduction of the optical properties of the dental structure, especially at minimal thicknesses. In this paper, the details about the treatment are described. A very pleasing outcome was achieved, confirming that minimally invasive adhesive restorations are an excellent option for situations in which the dental elements are healthy, and can be modified exclusively by adding material and the patient does not want to suffer any wear on the teeth.
    Full-text · Article · Nov 2015
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    ABSTRACT: Objective: To test the hypothesis that maxillary development may be affected by occlusal support. Materials and methods: The sample was composed by Wistar rats (5 weeks old) divided into three groups: Control (n = 10), extraction of mandibular molar teeth - left side (n = 10), extraction mandibular molar teeth - left and right sides (n = 10). The rats were sacrificed 8 weeks postextraction. Cone beam computed tomography scan images were taken for posterior measurement of maxillary length and width. Data were analyzed by one-way analysis of variance (Tukey test as post-hoc test). Results: Maxillary length was significantly shorter (P < 0.005) in both groups after tooth extraction. No difference was observed regarding maxillary width and body weight. Conclusion: Reduced occlusal support may impair the development of the maxilla in rats.
    Full-text · Article · Oct 2015 · European journal of dentistry
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    ABSTRACT: Ectodermal dysplasia is described as heritable conditions that involve anomalies of structures derived from the ectoderm, including hypodontia. In the cases of edentulous young patients, who did not finish their craniofacial growth, treatment with conventional complete denture is a suitable alternative. The aim of this study was to report a case of mandibular edentulism treated with conventional complete denture in a thirteen-year-old patient diagnosed with hidrotic ectodermal dysplasia. Typical features, such as frontal bossing, depressed nasal bridge, protuberant lips, scarce hair, and brittle nails, were visualized during the extraoral examination. The intraoral inspection and radiographic analysis revealed oligodontia, dental malformation, and prolonged retention of deciduous teeth at maxilla and total edentulism at mandible. A conventional complete denture was planned and constructed following the same steps of technique as recommended in adults. Although this option is not a definitive treatment, the patient and his parents were satisfied with his improvement in chewing and speech, as well as with the aesthetic benefits.
    Full-text · Article · Oct 2015
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    ABSTRACT: Apexification is a process of forming a mineralized apical barrier and had been performed by using calcium hydroxide paste, due to its biological and healing performances in cases of existent trauma. This clinical report aims to report the results of a 16-year follow-up study of an apexification treatment applied to nonvital tooth 22 of a healthy 8-year-old male after a trauma. Clinical inspection of the tooth showed fractures of the incisal edge and mesial angle, absence of coronal mobility, and negative pulp vitality under cold testing. Radiographic analysis of the root revealed incomplete apex formation. The possibility of fracture into the root or luxation injury was rejected, and the diagnosis of pulp necrosis was verified. Apexification by calcium hydroxide and subsequent endodontic treatment were planned. Initial formation of the mineralized apical barrier was observed after 3 months, and the barrier was considered to be completed after 8 months. Clinical, radiographic, and CBCT examinations after 16 years verified the success of the treatment, although the choice of calcium hydroxide for apexification treatment is discussed.
    Preview · Article · Jul 2015
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    ABSTRACT: Aim To assess the histopathological changes of rat palatal mucosa exposed to soft reline materials. Methods Forty-five adult female Wistar rats with controlled living conditions and fed ad libitum were employed. Palatal appliances of heat-polymerized acrylic resin Lucitone 550 were manufactured and worn by forty animals during 14 days. Five animals did not use the appliances (G1) and were used to control the appliance influence. One experimental group (n = 10) used the appliances without any relining material (G2) to control the material effect. Three experimental groups (n = 10) received the following soft reline materials below appliances: Dentusoft (G3), Dentuflex (G4), and Trusoft (G5). Appliances from half of each experimental group(n = 5) was immersed in water bath at 55°C for 10 min before use. Animals were slaughtered and the palates were fixed in 10% buffered formalin. Hematoxylin and eosin stained sections of 5 µm were analyzed by computerized planimetry. Cellular compartment, keratin and total epithelial thickness, and basement membrane length were measured to histopathological description.Analysis of variance and Tukey post-hoc test were used to data examination(α = 0.05). Results For heat-treatment groups, G4 showed less elongated ridges at the basal layer interface (p = 0.037) than G2. When comparing the conditions with and without heat-treatment, only G2 showed a significant decrease in the cellular compartment, keratin layer and total epithelium thickness (p<0.05). Conclusion The post-polymerization for Lucitone 550 was an effective method to reduce the changes in the rat palatal mucosa. The soft reline materials tested did not cause significant histopathological changes in the rat palatal mucosa.
    Full-text · Article · Jun 2014 · PLoS ONE
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    ABSTRACT: The aim of this study was to evaluate the reproducibility of the condensation silicone Optosil Comfort® as an artificial test food for masticatory performance evaluation. Twenty dentate subjects with mean age of 23.3 ± 0.7 years were selected. Masticatory performance was evaluated using the simple (MPI), the double (IME) and the multiple sieve methods. Trials were carried out five times by three examiners: three times by the first, and once by the second and third examiners. Friedman's test was used to find the differences among time trials. Reproducibility was determined by the intra-class correlation (ICC) test (α = 0.05). No differences among time trials were found, except for MPI-4 mm (p = 0.022) from the first examiner results. The intra-examiner reproducibility (ICC) of almost all data was high (ICC ≥ 0.92, p < 0.001), being moderate only for MPI-0.50 mm (ICC = 0.89, p < 0.001). The inter-examiner reproducibility was high (ICC > 0.93, p < 0.001) for all results. For the multiple sieve method, the average mean of absolute difference from repeated measurements were lower than 1 mm. This trend was observed only from MPI-0.50 to MPI-1.4 for the single sieve method, and from IME-0.71/0.50 to IME-1.40/1.00 for the double sieve method. The results suggest that regardless of the method used, the reproducibility of Optosil Comfort® is high.
    Full-text · Article · Jun 2014 · Brazilian oral research
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    Full-text · Dataset · May 2013
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    ABSTRACT: This study compared the microleakage of class V restorations bonded with various one-step self-etching adhesives. Seventy class V resin-based composite restorations were prepared on the buccal and lingual surfaces of 35 premolars, by using: Clearfil S 3 Bond, G-Bond, iBond, One Coat 7.0, OptiBond All-In-One, or Xeno IV. The Adper Single Bond etch-and-rinse two-step adhesive was employed as a control. Specimens were thermocycled for 500 cycles in separate water baths at 5°C and 55°C and loaded under 40 to 70 N for 50,000 cycles. Marginal microleakage was measured based on the penetration of a tracer agent. Although the control showed no microleakage at the enamel margins, there were no differences between groups (p = 0.06). None of the adhesives avoided microleakage at the dentin margins, and they displayed similar performances (p = 0.76). When both margins were compared, iBond® presented higher microleakage (p < 0.05) at the enamel margins (median, 1.00; Q3-Q1, 1.25-0.00) compared to the dentin margins (median, 0.00; Q3-Q1, 0.25-0.00). The study adhesives showed similar abilities to seal the margins of class V restorations, except for iBond®, which presented lower performance at the enamel margin.
    Full-text · Article · May 2013 · Brazilian oral research
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    ABSTRACT: The influence of mandibular movement timing on food breakdown remains unclear. The authors, therefore, sought to relate chewing rate with masticatory performance. Chewing rate, defined as the number of masticatory cycles habitually achieved per minute, was measured in 55 healthy dentulous subjects (age, 22.2 +/- 5.0 years). Subjects were grouped according to obtained values (cycles/minute): slower: < 70; middle: 70-90; and faster: > 90. Masticatory performance was determined through the sieve method, and the estimated comminuted median particle size (X50). Data was analyzed using the one-way ANOVA and chi-square tests (alpha = .05). Subjects with slower chewing rates showed higher (p < .05) masticatory performance (X50 = 3.05 +/- 0.77 mm). X50 was associated with chewing rate when subjects were categorized as better or poorer performers (chi-square = 11.25, p < .005). Thus, chewing rate was related to masticatory performance, with smaller food particles being achieved with a slower chewing rate.
    Full-text · Article · Apr 2013 · Cranio: the journal of craniomandibular practice
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    ABSTRACT: Purpose: To analyze masticatory function after a short adaptation period relative to occlusal support length reduction in free-end removable partial denture (RPD) wearers. Materials and methods: Twenty-three patients (55.2 ± 8.4 years) were rehabilitated with maxillary complete and mandibular free-end RPDs extending to the second molars. Five occlusal support length conditions were determined by removing artificial teeth from the RPDs: full occlusal support (control); occlusal support to the first molars, second premolars, and first premolars; and no occlusal support. To explore a probable short-term adaptation to occlusal support length reduction, participants wore their dentures at each condition for a period of 1 week before starting masticatory function assessment. For this purpose, masticatory performance, masticatory efficiency, chewing rate, selection chance, and breakage function were evaluated at each condition using the sieving method. Data were analyzed using repeated-measures ANOVA and post hoc Dunnett tests (α = 0.05). Results: Masticatory performance and masticatory efficiency for 2 to 4 mm particles under the condition of occlusal support to the first molars and second premolars were similar to control values (p > 0.05). Masticatory efficiency relative to particles smaller than 2 mm was also seen at the condition of support length to the first premolars (p > 0.05). Chewing rates showed adaptation only at the condition of support length to the first molars (p > 0.05). A similar trend was noted for the selection chance of 8-mm particles, and breakage function for 8- and 2.4-mm particles (p > 0.05). Conclusion: After a 1-week adaptation period to free-end RPDs with occlusal support lengths reduced to the premolars, participants were able to achieve adequate masticatory function.
    No preview · Article · Feb 2013 · Journal of Prosthodontics
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    ABSTRACT: The aim of this case report was to describe the surgical removal of an extensive mandibular torus and the conventional prosthetic treatment that was performed. During surgery, the torus was exposed by a intrasulcular lingual incision from molar to contralateral molar side and displacement of the mucoperiosteal flap. The bone volume was carefully removed in three separate blocks by sculpting a groove in the superior lesion area and chiseling. After a 30-day postoperative period, a prosthetic treatment was performed using a conventional distal extension removable partial denture. The patient's esthetic and functional expectations were achieved. The surgical procedure and prosthetic treatment performed in the treatment of the mandibular torus in this clinical case is a viable treatment that produces few complications and re-establishes normal masticatory function.
    No preview · Article · Jan 2013 · General dentistry
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    ABSTRACT: Purpose: The aim of this cross-sectional study was to investigate the relationship between body fat and masticatory function. Materials and methods: One hundred dentate and partially edentulous participants (33 male; mean age, 39.7 ± 16.6 years) were selected. Body fat was established through body mass index (BMI). Masticatory function was evaluated by quantifying occlusal pairs and determining masticatory efficiency and swallowing threshold with the sieving method. During the swallowing threshold test, chewing rate was registered. Masticatory ability was also evaluated with a 5-point Likert scale questionnaire. Data were analyzed with Spearman and chi-square tests, as well as binary logistic regression analysis for the presence of increased BMI (α= 0.05). Results: Age (rho = 0.517), occlusal pairs (chi-square = 26.353), masticatory efficiency (chi-square = 30.935), masticatory ability (chi-square = 25.132; p < 0.001), and swallowing threshold (chi-square = 8.730; p < 0.005) were related to BMI. Age (odds ratio, OR = 1.048, 95% CI = 1.008 to 1.089) and lower masticatory efficiency (OR = 4.792, 95% CI = 1.419 to 16.183) were predictive of increased body fat (p < 0.05). Gender (chi-square = 0.402, p= 0.526) and chewing rate (rho =-0.158, p= 0.117) were not related to BMI. Conclusions: These results suggest that people with lower masticatory efficiency may be at risk for increased body fat.
    No preview · Article · Oct 2012 · Journal of Prosthodontics
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    ABSTRACT: The aim of this study was to determine the influence of occlusal support length (OSL) of free-end removable partial dentures (RPDs) on masticatory function. Twenty-three subjects (mean age: 55.2 ± 8.4 years) who were edentulous in the maxilla and classified as Kennedy Class I in the mandible were selected. Subjects received new maxillary complete dentures and mandibular RPDs. Five OSL conditions were determined by RPD artificial tooth wear: full occlusal support (L1, control), OSL to first molar (L2), OSL to second premolar (L3), OSL to first premolar (L4), and absence of occlusal support (L5). Masticatory performance and efficiency were evaluated using the sieve method. Chewing rate was defined as the number of masticatory cycles per minute. Bolus selection opportunities and bolus breakage function were evaluated using the one-chew method. Qualitative and quantitative measurements of masticatory cycle patterns were recorded kinesiographically. Data were analyzed using repeated-measures analysis of variance and Friedman and Fisher exact tests (α = .05). Masticatory performance and efficiency decreased (P < .05) from L1 (5.46 ± 0.64 mm and 51.21% ± 19.44%, respectively) to L5 (6.24 ± 0.44 mm and 24.50% ± 15.98%, respectively). Chewing rate was higher for L4 than L1 (P < .05). Bolus selection chances and bolus breakage function decreased as OSL was reduced (P < .05); however, there were no differences in masticatory cycle pattern among the OSL conditions (P > .05). Reduction of OSL altered masticatory function, thereby decreasing masticatory performance and efficiency resulting from a lower capacity to select and break down food.
    No preview · Article · Sep 2012 · The International journal of prosthodontics
  • A. SANCHEZ-AYALA · R.C.M. RODRIGUES GARCIA
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    ABSTRACT: Objective: To analyze the role of denture teeth in masticatory function adaptability of partially edentulous. Method: Twenty-three edentulous subjects were rehabilitated with maxillary complete denture and mandibular free-end removable partial denture (RPD), restoring arches to the artificial second molars (control). Four categories were determined by removing RPD teeth: (1) RPD arch to first molars, (2) to second premolars, (3) to first premolars, and (4) absence of RPD teeth. Masticatory function was evaluated as masticatory performance, masticatory efficiency, chewing rate, selection chance, and breakage function by Optocal comminution and the sieving method. Masticatory cycle pattern was also analyzed by kinesiography. As baseline measurement, the impact of each category on masticatory function was evaluated. After that, the adapting to each category was weekly assessed. Data were compared using repeated measures ANOVA and post-hoc Dunnett tests (α = 0.05). Result: All categories showed lower values for masticatory function variables at baseline than control (p < 0.05), except for masticatory cycle pattern (p > 0.05). In the category to second premolars, subjects adapted their masticatory performance and efficiency to particles from 2 to 4 mm and showed similar values to control condition (p > 0.05). Masticatory efficiency adaptation to particles smaller than 2 mm was also seen in the category to first premolars (p > 0.05), and results of chewing rate showed adaptation only for category to first molars (p > 0.05). Adaptation was also noted for selection chance of particles sized 8 mm in the category to first molars (p > 0.05). Breakage function data revealed adaptation for particles sized 8 and 2.4 mm (p > 0.05) for the same previous condition. Conclusion: The sudden removal of denture teeth from RPD resulted in altered masticatory function. However, subjects were able to adapt their masticatory function to RPD arch up to premolars.
    No preview · Conference Paper · Jun 2012
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    ABSTRACT: Objective: The aim of this study was to evaluate the effect of unilateral and bilateral loss of posterior occlusal support on the expression of type II collagen, interleukin-1β and VEGF in the condylar cartilage of growing rats. Design: Thirty female Wistar rats (5 weeks old) were randomized into three groups: control, unilateral extraction of mandibular molar teeth, bilateral extraction of mandibular molar teeth. Animals were sacrificed 8 weeks after tooth extraction and the temporomandibular joints were prepared for immunohistochemical analysis. Results: Bilateral molar extraction increased the expression of interleukin-1β (P<0.01) and VEGF (P<0.01), while unilateral extraction increased the expression of interleukin-1β (P<0.05) and type II collagen (P<0.01). The expression of VEGF was higher on the extracted than on the non-extracted side (P<0.01) after unilateral extraction. Conclusion: Loss of posterior occlusal support alters the expression of type II collagen, interleukin-1β and VEGF in the condylar cartilage of rats. The expression pattern of these proteins is different when loss of occlusal support was bilateral or unilateral, including differences between extracted and non-extracted sides.
    Full-text · Article · Jun 2012 · Archives of oral biology
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    ABSTRACT: To evaluate the effect of thermo-mechanical cycling (TMC) on the microleakage (μL) and axial gap width (AG) of Class V bonded restorations in premolars using self-etching adhesive systems. The bond strength of composite restorations to dentin (μTBS) using the same adhesives was also evaluated in third molars after water storage: 24 h and 6 months. The research hypotheses were tested for the results of two self-etching adhesives in comparison when a conventional two-step adhesive was used: (1) the μL and AG would be lower, regardless of TMC; (2) the μTBS of self-etching adhesives would be higher, irrespective of evaluation times. Sixty Class V composite restorations were made in 30 premolars and bonded with Adper Single Bond 2 (ASB2), AdheSE (ASE), and Adper Prompt L-Pop (APL-P) (n=20). Dentin μL and AG were immediately measured for half of the sample. The other half was evaluated after TMC. Eighteen third molars were also selected and bonded using the same adhesives to test the μTBS to dentin. Specimens were evaluated after 24 h and 6 months of water storage. No differences in μL and AG were found among the groups (P>.05). The μTBS mean values were: ASB2>ASE>APL-P (P<.05); only Adper Single Bond 2 presented a significantly lower μTBS after water storage (P<.05). The bonding approach does not influence the microleakage and interfacial gap extension. Despite the decrease in the mean values, the bond strength to dentin of the conventional, two-step adhesive remains high after 6 months of water storage.
    Full-text · Article · Apr 2012
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    ABSTRACT: To relate occlusal state, masticatory performance and non-ulcerative functional dyspepsia. In spite of the relationship between gastric disturbances and number of present teeth being recognised, the influence of the number of occlusal pairs and masticatory performance, expressed as median particle size, has not been considered. Thirty-eight subjects (mean age = 71.8 ± 7.7 years) diagnosed with non-ulcerative functional dyspepsia were selected. A further 38 healthy subjects (mean age = 71.9 ± 7.0 years) acted as controls. Subjects were subdivided according to their number of occlusal pairs: (1) 0-4, (2) 5-9 and (3) 10-14. Masticatory performance was evaluated by using the sieving method. Data were analysed using 2-way anova and Bonferroni post-hoc, Chi-square and Odd ratio tests. Subjects presenting with non-ulcerative functional dyspepsia and 0-4 occlusal pairs showed the lowest masticatory performance (p < 0.01). No association between the dyspepsia and the number of occlusal pairs (χ(2) = 0.48, p = 0.785) was observed, however results showed association between functional dyspepsia and masticatory performance (χ(2) = 4.07, p = 0.0437) presenting an odds ratio = 3.46 (Confidence Interval = 0.99-12.10). Changes in masticatory performance were associated with the presence of non-ulcerative functional dyspepsia.
    No preview · Article · Dec 2011 · Gerodontology
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    ABSTRACT: Purpose: The aim of this case-control study was to investigate the role female hormone fluctuation plays in maximum occlusal force and masticatory performance in female subjects presenting disc displacement with reduction (DDR) and matched controls. Materials and Methods: Sixty-five subjects were initially recruited; however, 4 of them were excluded during the study. The final sample included 14 subjects with DDR taking oral contraceptives, 16 control subjects without DDR taking oral contraceptives, 14 normally cycling subjects with DDR, and 17 normally cycling subjects without DDR. DDR was diagnosed by means of the Research Diagnostic Criteria for Temporomandibular Disorders axis I, and subjects without pain were selected. Maximum occlusal force was measured bilaterally in the molar region using a force transducer, and masticatory performance was analyzed using the artificial material comminution and sieving method. Variables were evaluated in four phases of three menstrual cycles, identified by ovulation testing. Data were submitted to the Mauchly sphericity test and PROC MIXED procedure of the SAS statistical program for repeated measures. Multiple comparisons were made using the Tukey-Kramer test (P ⋜ .05). Results: Comparisons among menstrual cycle phases showed no differences in occlusal force (P = .44) or masticatory performance (P = .09) for all volunteers. Subjects without DDR showed greater occlusal force (P = .01). No difference in occlusal force was found between subjects regardless of whether they took contraceptives (P = .15). Similarly, masticatory performance values did not differ among subjects with or without DDR (P = .09) or among those taking or not taking contraceptives (P = .29). Conclusion: Hormonal fluctuation did not influence mastication. Int J Prosthodont 2011;24:320-327.
    No preview · Article · Jul 2011 · The International journal of prosthodontics
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    ABSTRACT: Objectives: The aim of this study was to relate occlusal support, masticatory cycle pattern and masticatory efficiency of removable partial denture (RPD) wearers. Methods: Eighteen healthy subjects (mean age = 54.2 8.3 years) presenting total maxillary edentulism and partial mandibular edentulism, classified as Kennedy Class I, presenting only anterior teeth were selected. Subjects were rehabilitated with maxillary complete denture and mandibular RPD with occlusal support from first premolars to second molars. According to length of occlusal support, the following groups were determined: full occlusal support (1), shortened occlusal support to first molar (2), to second premolar (3), to first premolar (4), and without occlusal support (5). Kinesigraph equipment was employed to record the masticatory cycles, which was qualitatively analyzed through its frontal and sagittal path configurations. The maximum vertical, horizontal and sagittal excursions and frontal and sagittal areas of masticatory cycle were defined as quantitative pattern. Masticatory efficiency was evaluated by sieve method. Repeated measures one-way ANOVA and Spearman test were used in the statistical interaction (a = 0.05). Results: Occlusal support presented a significant correlation with masticatory efficiency (r = -0.36, p < 0.0001). The full occlusal support group showed higher masticatory efficiency values than group presenting reduced occlusal support to first premolars (p < 0.001) and group without occlusal support (p < 0.0001). Both qualitative and quantitative analyses of masticatory cycle were not related to occlusal support (p > 0.05). Conclusions: Within the limitations of this study, it was concluded that occlusal support of RPD wearers was related to masticatory efficiency. However, different condition of occlusal support did not affect the masticatory cycle pattern.
    No preview · Conference Paper · Mar 2011
  • A. SANCHEZ-AYALA · R.C.M. RODRIGUES GARCIA
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    ABSTRACT: Objectives: This study aimed to evaluate masticatory performance, selection chance, breakage function, and masticatory ability of removable partial denture (RPD) wearers presenting different occlusal support extension. Methods: It was selected eighteen subjects with maxillary edentulism and mandibular Kennedy class I edentulism presenting only anterior teeth. Mean age of subjects was 54.2 8.3 years. Removable complete and partial dentures were accomplished for maxilla and mandible, respectively. Occlusal support of RPD was gradually shortened determining the following cumulative conditions: complete occlusal support, occlusal support until first molar; until second premolar; until first premolar; and absence of occlusal support. Comminution of Optocal test food and sieve method were used for masticatory performance, selection chance and breakage function tests. Masticatory ability was registered using a Likert self-perception questionnaire. Results were submitted to repeated measures one-way ANOVA and Friedman tests (a = 0.05). Results: Subjects presenting complete occlusal support showed higher masticatory performance values than when their occlusal support was reduced until first (p < 0.001) and second (p < 0.0001) premolars, and in absence of occlusal support (p < 0.0001). No difference was found between masticatory performance reached by subjects presenting complete occlusal support and occlusal support until first molar (p > 0.05). Selection chances and breakage function also were reduced progressively as occlusal support was shortened (p < 0.0001). A decreased masticatory ability only was perceived when subjects had occlusal support until first premolar and in absence of occlusal support. Conclusions: Within the limitations of this study, it was suggested that occlusal support of RPD should be extended at least to first molars to prevent a reduction of masticatory function.
    No preview · Conference Paper · Mar 2011