Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Restablecimiento de guía anterior con restauraciones adhesivas / Reestablishing of anterior guidance with adhesive restorations

La estética ha llegado a formar una parte muy importante en la odontología actual. Sin embargo, no debemos sobreponer las necesidades estéticas sobre las necesidades funcionales. La pérdida de estructura dental asociada a bruxismo puede ser considerada patológica cuando compromete la guía anterior, la cual es la influencia en los movimientos mandibulares que proveen las superficies contactantes de los dientes maxilares anteriores con los mandibulares anteriores y evita contactos excéntricos dañinos en los dientes posteriores. El objetivo de este reporte de caso es presentar una alternativa conservadora para restablecer tanto la estética como la funcionalidad de una paciente de 34 años de edad que acudió a la Clínica de Prostodoncia de la Universidad Autónoma de Guadalajara en busca de rehabilitación estética de dientes anteriores. Una vez realizada su evaluación inicial se llegó al diagnóstico de pérdida de guía anterior por desgaste patológico asociado a bruxismo. El tratamiento incluyó tratamientos de conductos, remoción de caries y restauraciones mal ajustadas, coronas y carillas para restablecer la guía anterior. Se cumplieron con las expectativas estéticas que tenía la paciente al igual que con las necesidades funcionales que fueron objetivo desde el inicio, logrando un restablecimiento de la guía anterior de manera conservadora (AU)

Esthetics has become a very important part of dentistry today. However, we should not superimpose esthetic needs over functional needs. The loss of tooth structure associated with bruxism can be considered pathologic when it compromises the anterior guidance, which is the influence on mandibular movements that provides the contacting surfaces of the maxillary anterior teeth with the mandibular anterior teeth and avoids damaging eccentric contacts in the posterior teeth. The aim of this case report is to present a conservative way to restore both esthetics and function in a 34-year-old patient who came to the Prosthodontics Clinic of the Universidad Autónoma de Guadalajara in search of an esthetic appearance of her anterior teeth. After her initial evaluation, a diagnosis of anterior guide loss due to pathological wear associated with bruxism was made. Treatment included root canal treatment, removal of caries, and ill-fitting restorations, crowns, and veneers to reestablish the anterior guidance. The aesthetic expectations of the patient have met as well as the functional needs that were aimed from the beginning, achieving a conservative reestablishment of the anterior guidance system (AU)

Influencia de la Morfología Externa de la Raíz de Primeros Premolares Superiores en la Sobreestimación del Espesor Radiográfico Radicular Durante la Preparación para Poste, Evaluados Mediante Tomografía Computarizada Cone Beam / Influence of the External Morphology of the Root of Upper First Premolars on the Overestimation of Radiographic Root Thickness During Post Preparation, Evaluated by Cone Beam Computed Tomography

La investigación tuvo como objetivo determinar la influencia de la morfología externa de la raíz de primeros premolares superiores en la existencia de sobreestimación radiográfica durante la preparación para poste. Con este fin se realizó un estudio transversal in vitro, donde 60 premolares superiores uniradiculares fueron instrumentadas con fresas Gates Glidden y Pesso de calibre 1, 2 y 3. Seguidamente se obtuvieron imágenes radiográficas digitales de cada pieza dentaria mediante un aparato posicionador a una distancia constante en sentido vestíbulo lingual, asimismo se realizaron imágenes tomográficas volumétricas de las muestras. En ambas técnicas imagenológicas se midió el espesor a mesial y distal de las piezas. La sobreestimación fue calculada mediante la diferencia de la medida tomográfica menos la radiográfica. Los resultados indicaron que en ambas paredes radiculares hubo diferencia significativa entre las medidas radiográficas y tomográficas (p<0,05), encontrándose en la pared distal diferencias altamente significativas (p<0,001); además se evidenció que la sobreestimación radiográfica fue mayor en la pared distal. El estudio concluyó que existe sobreestimación radiográfica en premolares superiores durante la preparación para poste de un 20,42 % en promedio, siendo la pared distal la estructura que presenta mayor sobreestimación.

SUMMARY: he investigation´s objective was to determine the influence of external morphology of the root of upper first premolars in the existence of radiographic overestimation during preparation for post. An in vitro cross-sectional study was carried out, where 60 single-rooted upper premolars were instrumented with burs. Gates Glidden and Pesso of caliber 1, 2 and 3, then, digital radiographic images of each dental piece were obtained by means of a positioning device at a constant distance in the buccolingual direction; volumetric tomographic images of the samples were also performed. In both imaging techniques, the mesial and distal thickness of the pieces was measured. The overestimation was calculated by the difference of the tomographic measurement minus the radiographic one. The results indicated that in both root walls there was a significant difference between the radiographic and tomographic measurements (p<0.05), with highly significant differences being found in the distal wall (p<0.001); In addition, it was evidenced that the radiographic overestimation was greater in the distal wall. The study concluded that there is radiographic overestimation in upper premolars during post preparation of 20.42% on average, with the distal wall being the structure that presents the greatest overestimation.

Longevidade de laminados cerâmicos em preparos conservadores: revisão da literatura / Longevity of veneer in conservatine preparations: literature review

Com o objetivo de melhor aproveitamento clínico, durabilidade, estética e possibilidade de devolução de forma e função, observa-se um aumento no número de procedimentos restauradores indiretos, juntamente com o uso de cerâmicas odontológicas. O desgaste da estrutura dental é necessário, mas em excesso pode reduzir a durabilidade da união e da restauração devido à exposição da dentina que, diferen- temente do esmalte, tem menor capacidade de adesão ao material cimentante. Neste contexto, o presente trabalho teve como objetivo a revisão e discussão da durabilidade dos laminados cerâmicos. Foi realizado uma revisão bibliográfica, utilizando os repositórios: Pub- Med, SciELO e Periódicos CAPES. Como critério de inclusão, os artigos deverão ter no máximo 10 anos de publicação e serem relevantes em termos de delineamento das informações desejadas. Foram adotados os escritos na língua inglesa, espanhola e portuguesa. Informações presentes em livros foram adicionadas, considerando os 10 anos estipulados. Dentro destes critérios, um total de 28 artigos, 2 TCC e 4 livros foram consultados. Observou-se que há uma heterogeneidade entre os desenhos de estudos de pesquisa na literatura consultada e, poucos estudos conclusivos quanto a longevidade das facetas laminadas de porcelana além de 20 anos, havendo uma limitação em termos de tamanho da amostra e duração do acompanhamento. Concluiu-se que, apesar da longevidade não depender de situações iso- ladas e sim de um conjunto de fatores, é preferível o uso de cimento resinoso autoadesivo, aliado à facetas reforçadas por dissilicato de lítio e, os preparos com recobrimento de incisal apresentam a melhor opção.

Influencia del tallado en la lisura superficial del esmalte / The influence of carving on surface smoothness of enamel

Al momento de realizar una preparación dental existen diferentes alternativas. Dentro del instrumental rotatorio hay dos opciones: la turbina dental (ultra-velocidad) y el micromotor acoplado a un contra-ángulo multiplicador (alta velocidad). El propósito de este estudio fue evaluar cualitativamente la diferencia en la lisura superficial sobre esmalte, que se genera al desgastarlo, utilizando para esto, una turbina dental y un micromotor eléctrico acoplado a un contra-ángulo multiplicador 1:5 (anillo rojo). Se realizó un análisis cualitativo sobre una muestra de 24 superficies de esmalte obtenidas de 12 premolares extraídos por indicación ortodóntica, los cuales fueron preparados y observados al microscopio óptico. Luego de observar las 24 superficies al microscopio se pudo constatar una mayor lisura superficial sobre el esmalte al utilizar micromotor eléctrico acoplado a contraángulo multiplicador en comparación con turbina (AU)

Fracture resistance and strain analysis of zirconia copings with vertical knife edge and three horizontal finish line designs; chamfer, deep chamfer and shoulder with two cementation techniques / Resistência à fratura e análise de deformação de copings de zircônia com término cervical em lâmina de faca e três términos horizontais; chanfro, chanfro largo e ombro com duas técnicas de cimentação

Objective: The purpose of this in vitro study is to evaluate the effect of four finish line configurations and two cement types on the fracture resistance of zirconia copings. Material and Methods: Forty yttrium tetragonal zirconia polycrystals copings were manufactured on epoxy resin dies with four preparation designs: knife edge, chamfer, deep chamfer 0.5, 1 mm and shoulder 1 mm. The copings were cemented with two cement types (glass ionomer and resin cement); (n = 5). Two strain gauges were attached on each coping before they were vertically loaded till fracture with a universal testing machine. Data were analyzed by 2-way analysis of variance ANOVA (p < .05). Fractured specimens were examined for mode of failure with digital microscope. Results: Knife edge showed the highest mean fracture resistance (987.04 ± 94.18) followed by Chamfer (883.28 ± 205.42) followed by Shoulder (828.64 ± 227.79) and finally Deep chamfer finish line (767.66 ± 207.09) with no statistically significant difference. Resin cemented copings had higher mean Fracture resistance (911.76 ± 167.95) than glass ionomer cemented copings (821.55 ± 224.24) with no statistically significant difference. Knife edge had the highest strain mean values on the buccal (374.04 ± 195.43) and lingual (235.80 ± 103.46) surface. Shoulder finish line showed the lowest mean strain values on the buccal (127.47 ± 40.32) and lingual (68.35 ± 80.68) with no statistically significant difference. Resin cemented copings had higher buccal (295.05 ± 167.92) and lingual (197.38 ± 99.85) mean strain values than glass ionomer copings (149.14 ± 60.94) and (90.27 ± 55.62) with no statistically significant difference. Conclusion: Vertical knife edge finish line is a promising alternative and either adhesive or conventional cementation can be used with zirconia copings (AU)

Objetivo: O objetivo deste estudo in vitro é avaliar o efeito de quatro configurações de términos cervicais e dois tipos de cimentos na resistência à fratura de copings de zircônia. Material e Métodos: Quarenta copings de zircônia tetragonal policristalina estabilizada por ítrio foram confeccionados em matrizes de resina epóxi com quatro tipos de términos cervicais: lâmina de faca, chanfro, chanfro largo 0,5, 1 mm e ombro 1 mm. Os copings foram cimentados com dois tipos de cimento (ionômero de vidro e cimento resinoso); (n = 5). Dois extensômetros foram fixados em cada coping antes de serem carregados verticalmente até a fratura com uma máquina de teste universal. Os dados foram analisados por análise de variância ANOVA 2 fatores (p < 0,05). Os espécimes fraturados foram examinados quanto ao modo de falha com microscópio digital. Resultados: A Lâmina de faca apresentou a maior média de resistência à fratura (987,04 ± 94,18) seguida pelo Chanfro (883,28 ± 205,42), pelo Ombro (828,64 ± 227,79) e finalmente o Chanfro largo (767,66 ± 207,09), sem diferença estatisticamente significativa. Os copings cimentados com cimento resinoso apresentaram maior média de resistência à fratura (911,76 ± 167,95) em relação aos copings cimentados com ionômero de vidro (821,55 ± 224,24), sem diferença estatisticamente significativa. A lâmina de faca apresentou os maiores valores médios de deformação na superfície vestibular (374,04 ± 195,43) e lingual (235,80 ± 103,46). O término em ombro apresentou os menores valores médios de deformação na superfície vestibular (127,47 ± 40,32) e lingual (68,35 ± 80,68), sem diferença estatisticamente significativa. Os copings cimentados com resina apresentaram maiores valores médios de deformação na superfície vestibular (295,05 ± 167,92) e lingual (197,38 ± 99,85) do que os copings cimentados com ionômero de vidro (149,14 ± 60,94) e (90,27 ± 55,62), sem diferença estatisticamente significativa. Conclusão: O término cervical em lâmina de faca é uma alternativa promissora e a cimentação adesiva ou convencional pode ser usada na cimentação de copings de zircônia. (AU)

Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dogs

Abstract Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. Objective The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. Methodology The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. Results At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. Conclusions Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.

Influence of angulation and height of tooth preparation on the distribution of tensions in prosthetic crowns for upper central incisor: in silico analysis

Aim: it was to use tridimensional finite element analysis (FEA) to analyze the effect of height and angulation of prosthetic preparations on the distribution of stresses for lithium disilicate prosthetic crowns, the underlying resin cement, and the prosthetic preparation of a superior central incisor. Methods: a CAD modeling software, SolidWorks 2013, was used to generate three-dimensional virtual models comprising the dimensions of the preparation parameters. Three angles (6, 12 and 16 degrees) were simulated on the prepared walls and two wall heights were utilized (4 and 5 mm), for a total of six model groups according to the height and angulation of the walls. A vertical line in the Y-axis was used as a reference for determining the degrees of convergence (inclination of the preparations). The chamfer finish and preparation width were standardized for all groups. Results: the 4 mm preparations behaved more appropriately when the axial wall convergence was approximately 6 degrees. The 5 mm preparations required 12 degrees of angulation. In relation to resin cement, there was better stress distribution when the angle of incisal convergence was between 6 and 12 degrees. An increase to 16 degrees led to a considerable increase in peak stress at the preparation margin. Conclusion: it was concluded that the convergence of the axial walls of coronal preparations with 4 and 5 mm heights should be 6 and 12 degrees, respectively, to avoid high tension spikes in the underlying resin cement

Monobond Etch & Prime, primer acondicionador monocomponente que permite el grabado y la silanización de las superficies cerámicas en un solo paso / Monobond Etch & Prime, first single bottle conditioner for one step etching and silanization of ceramic surfaces

Las propiedades mecánicas de los materiales, han hecho que la técnica de cementación de las carillas sea tan cambiante y tan estudiada. Esta técnica ha sido modifi cada basados en investigaciones de diversos estudios clínicos. Lo cambiante de la técnica, no solamente es para el substrato del órgano dental, sino también para el material de la cerámica elegida. Esto confunde al clínico al estar modifi cando los procedimientos de cementación. En años recientes, como resultado del rápido progreso en la tecnología CAD/CAM, existe una gran cantidad de nuevas cerámicas y materiales híbridos en el mercado odontológico, esto se refl eja en benefi cios para los pacientes, al poder seleccionar distintas clases de materiales restaurativos. A su vez, las indicaciones se han expandido, esto hace que se incremente la difi cultad para los clínicos y ceramistas para mantenerse actualizados en la selección del material, lo que es más importante en los protocolos correctos de adhesión para el tratamiento en distintas superfi cies. En este artículo, se presenta el reporte de un caso clínico a nueve meses de seguimiento con la fi nalidad de evaluar la efi cacia del nuevo acondicionador monocomponente, para grabar y silanizar en un solo paso para Disilicato de Litio (DL), el nuevo Monobond Etch & Prime (MBEP) en el mismo frasco contiene la cantidad sufi ciente de ácido acondicionador y silano. Esto simplifi ca los procedimientos de adhesión, reduciendo no sólo el número de pasos, sino también el tiempo de trabajo (AU)

The mechanical properties of the materials have made the technique of veneer cementation, so changing and so studied. This technique has been modifi ed due to several clinical studies; especially in investigations that have been carried out in this respect. The changes made in the cementation technique, have not been only for the substrate of the dental organ, but also for the chosen ceramic material. This confuses the clinician by modifying the cementing procedures. In recent years, as a result of the rapid progress in CAD/CAM technology, a large number of new ceramics and hybrid materials, have been introduced into the dental market. This is refl ected in benefi t to the patients, because we have more opportunities to off er diff erent kinds of restorative materials; and at the same time, their indications have expanded, but this, increases the diffi culty for clinicians and ceramists to stay up-to-date on material selection, and the most important in the correct adhesion protocols for the treatment of diff erent surfaces. This paper presents, a nine months clinical case report to evaluate the effi cacy of the new monocomponent conditioner, for etching and silanizing in a single step the Lithium Disilicate (LD), the new Monobond Etch & Prime (MBEP), contains in the same bottle suffi cient amount of conditioning acid and silane. This simplifi es the adhesion procedures by reducing, not only the number of steps but also the working time (AU)

Diferencia entre las medidas radiográficas y anatómicas de conductos, posterior a la preparación para la colocación de postes / Difference between radiographic and anatomical measurements of canals, after preparation for the placement of a post

Antecedentes: Las radiografías periapicales presentan distorsiones que podrían conducir a un mayor desgaste de la estructura dental aumentando el riesgo de debilitamiento y de perforación o fractura vertical cuando se realiza la preparación del conducto radicular para la colocación de postes. Objetivo: El objetivo de la presente investigación es determinar la diferencia entre las medidas del espesor radiográfi co y el espesor anatómico mediante un calibrador de la dentina residual, luego de la preparación para poste en conductos ovales de premolares. Material y métodos: 50 premolares fueron tratados endodóncicamente y posteriormente fueron desobturados con fresas Pesso #1 y 2 dejando 4 mm de sellado apical, se realizó la toma radiográfi ca y se comparó con medidas realizadas con un calibrador digital. Las medidas fueron comparadas con una t de Student. Resultados: Las medidas radiográfi cas fueron 24.63% más grandes en comparación con las medidas del calibrador. Las medidas radiográfi cas no fueron signifi cativamente mayores en comparación con las del calibrador digital. Conclusiones: La radiografía periapical presenta una sobrestimación de la medida de la dentina residual, por lo tanto se debe escoger el protocolo más conservador para obtener resultados predecibles y exitosos (AU)

Background: Periapical radiographs have distortions that lead to greater wear of the dental structure, increasing the risk of weakening, perforation or vertical fracture when the root canal is preparation for post placement. Objective: The investigation is to determine the diff erence between the measurements of the radiographic thickness and the anatomical thickness by means of a calibrator of the residual dentine after the preparation for post placement. Material and methods: Root canal treatment was performed in 50 premolars and was unsealed with Pesso #1 and 2 leaving 4 mm of the apical seal, the radiographic was made and compared with measurements made with a digital calibrator. The measurements were compared with a Student t. Results: The radiographic measurements were 24.63% larger than the caliper measurements. The radiographic measurements were signifi cantly higher in comparison with the digital calibrators. Conclusions: The periapical radiography presents an overestimation residual dentin measurement, therefore the most conservative protocol should be chosen to obtain predictable and successful results (AU)

Dentin pretreatment and adhesive temperature as affecting factors on bond strength of a universal adhesive system

Abstract Objectives: To evaluate the effects of dentin pretreatment and temperature on the bond strength of a universal adhesive system to dentin. Material and Methods: Ninety-six extracted non-carious human third molars were randomly divided into 12 groups (n=8) according to Scotchbond Universal Adhesive (SbU) applied in self-etch (SE) and etch-and-rinse (ER) mode, adhesive temperature (20°C or 37°C) and sodium bicarbonate or aluminum oxide air abrasion. After composite build up, bonded sticks with cross-sectional area of 1 mm2 were obtained to evaluate the microtensile bond strength (μTBS). The specimens were tested at a crosshead speed of 0.5 mm/min on a testing machine until failure. Fractured specimens were analyzed under stereomicroscope to determine the failure patterns in adhesive, cohesive (dentin or resin) and mixed fractures. The microtensile bond strength data was analyzed using two-way ANOVA and Tukey's test (α=5%). Results: Interaction between treatment and temperature was statistically significant for SbU applied in self-etch technique. Both dentin treatments showed higher bond strength for ER mode, regardless of adhesive temperature. When compared to control group, sodium bicarbonate increased bond strength of SbU in SE technique. Adhesive temperature did not significantly affect the μTBS of tested groups. Predominantly, adhesive failure was observed for all groups. Conclusions: Dentin surface treatment with sodium bicarbonate air abrasion improves bond strength of SbU, irrespective of adhesive application mode, which makes this approach an alternative to increase adhesive performance of Scotchbond Universal Adhesive to dentin.

Resistencia a la tracción de coronas cementadas con lonomero de vidrio en dos preparaciones dentarias / Tensile strength of crowns glass ionomer cemented two dental preparations

El objetivo: del presente estudio fue evaluar el efecto del tipo de superficie de la preparación dentaria en relacion a la resistencia a la tracción de coronas metálicas completas cementadas con ionomero de vidrio sobre preparaciones dentarias con superficies pulidas y no pulidas. Material y métodos: Se realizaron 20 coronas metálicas en 20 piezas dentarias preparadas, las cuales se dividieron en dos grupos de 10 cada una, estas fueron sometidas a la prueba de tracción con la máquina de tracción Hounsfield, para determinar la fuerza de tracción necesaria para dislocarla. Resultados: mostraron que las preparaciones dentarias con superficies no pulidas (607.03N) mejoran la resistencia a la tracción en cornparación de las pulidas (359.90 N.

The purpose of the present study was to evaluate the effect of the type of surface of the dental preparation in the tensile strength of complete metal crowns cemented with glass ionomer as much in dental preparations with polished and not polished surfaces. 20 dental pieces were taken; teeth were divided in two groups of 10 teeth each. They were put under the test of traction with the Hounsfield traction machine. The results showed that the dental preparations with not polished surfaces (607.03 N) improve the tensile strenght in comparison of the polished ones (359.90 N).

A comparative leakage study on Er, Cr: YSGG laser- and bur- prepared Class V cavities restored with a low-shrinkage composite using different filling techniques

Aim: To evaluate the leakage on Er,Cr:YSGG laser- and bur- prepared Class V cavities restoredwith a silorane-based composite resin using different insertion techniques Methods: 40 cavitieswere outlined according to: the type of instrument [Er,Cr:YSGG laser (3.0 W power, energy perpulse of 150 mJ, fluence of 53.57J/cm2, pulse duration of 140-200 μs, 20 Hz repetition rate and55/65% air/water spray) or diamond bur]; and the type of filling technique (bulk increment orincremental). Four experimental groups were obtained (n=10): G1- diamond bur (DB) andincremental (I); G2- DB and bulk increment (BI); G3- Er,Cr:YSGG and I; and G4- Er,Cr:YSGGand BI. Specimens were restored with a silorane-based composite resin (Filtek P90, 3M/ESPE),subjected to 500 thermal cycles, sealed, infiltrated with 2% (w/v) methylene blue and sectioned inhalves. Specimen analysis was scored based on a scale. Statistical analyses were done usingthe Kruskal-Wallis and Student Newman-Keuls tests (α=0.05). Results: Statistically significantdifferences were observed between G2 and G4 (p=0.003) and between G1 and G2 (p=0.028).The filling technique did not influence the pattern of dye leakage in the cavity walls (p=0.151).Conclusions: Less leakage was observed when Er,Cr:YSGG cavities were restored withsilorane-based composite resin, using the bulk increment technique. Nevertheless, cavities doneusing diamond bur have less leakage only when incrementally restored.

Restauração unitária de cerâmica em dente anterior: relato de caso / Unitary restoration of ceramic in anterior tooth: case report

Laminados de cerâmica são recomendados para dentes que exigem alto padrão estético, como os dentes anteriores, recobrindo com material estético, dentes com alteração de cor, forma ou função. Este trabalho tem como objetivo descrever a sequência clínica dos procedimentos para confecção de uma restauração unitária cerâmica em dente anterior. Paciente H.D.C., sexo feminino, 24 anos, apresentou-se à clínica do Curso de Odontologia da UFMA com queixa estética no elemento 21. No exame clínico, verificou-se a presença de escurecimento dental, causado por traumatismo. Em uma primeira sessão clínica, foi realizado procedimento de moldagem para confecção de restauração provisória posteriormente à execução do preparo. Realizou-se a seleção de cor, o preparo dentário para faceta de cerâmica pura, a moldagem do preparo e, em seguida, confeccionou-se a restauração provisória à base de bis-acrilato, com o auxílio de uma matriz de silicone. Foi realizado o acabamento e polimento da provisória. Em uma nova sessão clínica, foi realizado o ajuste da restauração cerâmica e os procedimentos de cimentação adesiva. O resultado final alcançado possibilitou a restituição da forma, função e estética adequadas

Ceramic laminate veneers are prostheses recommended to teeth that require a good aesthetic, as anterior teeth, covering with aesthetic material teeth with color, shape or function alteration. The aim of this paper is to describe the sequence of clinical procedures for making a unitary ceramic restoration in anterior tooth. Patient H.D.C., female, 24 years old, presented herself to the clinic of the Faculty of Dentistry - UFMA with esthetic complaint of the element 21. On clinical examination, there was the presence of tooth darkening, caused by trauma. It was proposed as initial treatment the manufacture of a ceramic laminate. In a single clinical session, it was performed molding procedure for making temporary restoration after the execution of the tooth preparation. We performed the color selection, preparation dental ceramic veneering, the molding of the tooth preparation and, subsequently, was made the provisional restoration with bis-acrylate, using the technique of the silicone matrix. It was conducted the finishing and polishing of the provisional restoration. The result achieved enabled the restoration of form, function and aesthetics appropriate

Uso de pontas CVD acopladas ao ultrassom para preparo cavitário / Use of CVD tips coupled to the ultrasound for cavity preparation

As pontas diamantadas CVD produzidas por método de deposição de uma camada única de diamantes sobre uma haste de molibdênio foram desenvolvidas para o acoplamento ao ultrassom para a realização de preparos cavitários. Assim, o objetivo desse caso clínico foi apresentar a utilização das pontas CVD para preparo cavitário e acabamento da restauração em resina composta. A ponta CVD permite a realização de preparos cavitários conservativos, tendo como vantagens menor ruído e sensibilidade durante o porcedimento, o que aumenta o conforto do paciente. Com a técnica é possível confeccionar uma cavidade com preservação dos substratos dentinários, causando menores danos às estruturas subjacentes, prevenindo iatrogenias, levando a um preparo com melhor acabamento das paredes. Observou-se que o preparo cavitário apresentou-se conservativo, indicando o uso de sistemasadesivos e resina composta. Entretanto, verificou-se maior tempo empregado para a remoção da restauração de amálgama antiga, regularização do preparo cavitário e para o acabamento da restauraçãode resina composta. Pode-se concuir que as pontas diamantadas CVD acopladas em ultrassom podem ser empregadas para preparo cavitário e nos procedimentos de acabamento de restaurações em resina compsota, trazendo benefícios à preservação das estruturas dentárias hígidas e conforto ao paciente

CVD diamond tips produced by deposition of a single layer of diamond on a molybdenum rod were developed for coupling to the ultrasound to cavity preparation. Thus, the purpose of this clinical case was to report the use of CVD diamond tips for cavity design and resin composite finishing procedures. The CVD tip allows conservative cavity preparations, with the advantage of lesser noise and sensitivity during the procedure, which increases the comfort of the patient. It provides cavity designs with dental structure preservation, causing minor damage to underlying structures, preventing iatrogenic complications, leading to a cavity preparation with a better finishing. It was observed a conservative cavity design, allowing the use of adhesive system and resin composite restoration. However, a higher preparation time was necessary to remove the previous amalgam restoration, to regularize the cavity design and for resin composite restoration finishing procedures. It can be concluded that CVD diamond tips coupled in ultrasound device may be used for cavity design and for resin composite restoration finishing procedures, bringing benefits for preservation of healthy dental structures and for patient comfort

Reemplazo de postes metálicos por postes de base orgánica reforzados con fibras de cuarzo: presentación de un caso / Replacement of metallic posts by organic-based quartz fiber posts: report of a case

Los postes de base orgánica reforzados con fibras opseen ventajas, no sólo mecánicas, sino también estéticas. Algunas situaciones clínicas nos permiten colocar un poste de base orgánica, mientras otras nos indican la necesidad de cambiar los postes existentes. En este último caso, la técnica de desgaste centralizada constituye una alternativa clínica posible. Cuando el conduccto tiene un diámetro mayor al del poste de mayor diámetro, utilizar postes accesorios y personalizar los postes en una técnica combinada, puede resultar una solución óptima, en casos de inexistente remanente dentario coronario.

Análise in vivo da adaptação de apoios em prótese parcial removível / In vivo analysis of adaptation in support of removable partial denture

A confecção das Próteses Parciais Removíveis (PPR) na Universidade tem como orientação a adequação às necessidades dospacientes, ao mesmo tempo em que proporciona aos alunos um aprendizado voltado para a qualidade do trabalho protético. O objetivo desse trabalho foi avaliar a adaptação dos apoios de PPR nos seus respectivos nichos, executados por 20 alunos da Disciplina de PPR da Faculdade de Odontologia da UFF, utilizando como método a moldagem do descanso sob o apoio. Foram selecionados na Clínica da FO-UFF, 20 pacientes num total de 36 arcos a serem reabilitados com PPR cujo planejamento incluísse descansos em pré-molares e molares. Os preparos (n=100) com dimensões de 1/3 da largura vestíbulo-lingual do dente e profundidade 1,2 mm. As armações metálicas (Co-Cr) foram confeccionadas por único laboratório. Após a prova e ajustes, seguiu-se o registro da adaptação dos apoios com moldagem do descanso com silicona de condensação de baixa densidade. Removidos os excessos e examinados quanto a integridade com lupa foram obtidas imagens em microscópio óptico de cada corpo de prova. A presença de pelo menos uma perfuração no molde do nicho foi um indicativo de que houve adaptação do apoio no nicho. Observou-se que 78% dos moldes avaliados apresentavam perfurações, sendo que 35% delas ocorreram na borda do apoio, 3% no corpo do apoio e 40% em ambos. Os apoios desadaptados em número de 22 apresentaram uma média de 0,11 e desvio padrão de 0,88 entre os alunos. Os resultados mostram prevalência de adaptados e refletem a aprendizagem dos alunos.

Fabrication of Removable Partial Dentures (RPD) at the University is guided by meeting the needs of patients and simultaneouslyproviding students with an opportunity to learn with emphasis on the quality of the prosthetic work. The aim of this study was to evaluate the fit of RPD rests in their respective niches, performed by 20 students of the RPD Course at the UFF School ofDentistry, using the method of casting beneath the RPD rest on the retentive niche. At the FO-UFF Clinic, 20 patients were selected, representing a total of 36 dental arches to be rehabilitated with RPDs, whose planning would include RPD rests inpremolars and molars. The dimensions of preparations (n=100) were 1/3 of the vestibular-lingual width of the tooth and depth of1.2 mm. Metal frameworks (Co-Cr) were fabricated by a single laboratory. Try-in and adjustments were followed by registering the fit of the RPD rests by preparing casts of the retentive niches with low density condensation silicone. After excesses were removed and integrity was examined using a loupe, images of each test specimen were obtained by optical microscope. Thepresence of at least one perforation in the cast of the niche was an indication that the RPD rest fitted into the niche. It was observed that 78% of the casts evaluated presented perforations, with 35% of these occurring at the niche margin, 3% in the bodyof the niche and 40% in both sites. The 22 misfitting niches presented a mean of 0.11 and standard deviation of 0.88 among the students. The results showed prevalence of fitting, and reflected student learning.

Algoritmo matemático para cuantificar directamente el ángulo de convergencia en preparaciones de dientes artificiales / Mathematical algorithm to directly quantify the convergence angle in tooth preparations dyes

El objetivo de este trabajo fue determinar un algoritmo matemático para cuantificar directamente el ángulo de convergencia (AC) en troqueles de preparaciones dentarias. El modelo experimental consistió en preparaciones coronarias simuladas sobre troqueles de yeso, en el cual el AC fue calculado por tres formulas trigonométricas. Las formulas fueron obtenidas de un modelo matemático en el cual la preparación coronaria representa una forma de pirámide truncada, la cual permite una proyección triangular en un plano. Fueron realizadas 60 mediciones in situ sobre las paredes de 15 troqueles. Se obtuvo una imagen de cada troquel usando una cámara digital (Schick® CDR). El AC fue medido usando la herramientas del software (Control). Los datos fueron analizados estadísticamente y se aplicaron test de propagación de errores. Los ángulos calculados con las tres fórmulas matemáticas ([F1], [F2] y [F3]) mostraron un alto nivel de correlación con el grupo control excepto para dos muestras. Dentro de las limitaciones de este estudio podemos concluir que a través de este algoritmo matemático, es posible cuantificar directamente el AC de las preparaciones coronarias en troqueles. Actualmente la evaluación de los AC tanto en preparaciones realizadas por alumnos de pregrado de odontología como por dentistas, se hacen de manera subjetiva. Las tres fórmulas presentadas en el algoritmo tiene una correlación alta para cuantificar el AC en troqueles. La [F3], es la que mas correlación logra en todas las muestras (0,89).

The aim of this study was to determine a mathematical algorithm to directly quantify the convergence angle (AC) dyes tooth preparations. The experimental model system consisted of crown preparations dyes simulated on plaster, which the CA was quantify by three trigonometric formulas. Formulas were obtained from mathematical models representing the crown preparation as a truncated pyramid shape, allowing a triangular projection on the plane. 60 direct measurements were made in situ on the walls of 15 dyes. An image was obtained from each dye using a digital camera (Schick ® CDR). The CA were measured using software tools (Control). The data were statistically analyzed and test data were applied to propagation of errors. The angles calculated with the three math formulas ([F1], [F2] and [F3]) showed a high level of correlation with the control except for two samples. Within the limitations of this study we can conclude that through this mathematical algorithm, it is possible to directly quantify the AC preparation coronary dyes. Currently the evaluation of AC in both preparations made by undergraduate students of dentistry as well as dentists, are made subjectively. The three formulas presented in the algorithm have a high correlation to quantify the AC dyes. The [F3], correlation is the most accomplished in all samples.

Preparos dentais para coroas totais anteriores cerâmicas / Dental preparations for anterior all-ceramic crown restorations

O objetivo deste trabalho é descrever, ilustrar clinicamente e discutir uma forma efetiva, simples e racional de preparos dentais para coroas totais anteriores cerâmicas. Essa técnica visa à confec-ção de preparos dentais por meio da utilização de número reduzido de etapas clínicas e pontas diamantadas. Os princípios biológicos, mecânicos, funcionais e estéticos são atingidos de maneira lógica, dentro dos requisitos regidos pela odontologia estética contemporânea. Ao final da leitura, espera-se que o cirurgião dentista compreenda a configuração das paredes axial e cervical dos preparos para coroas totais anteriores cerâmicas e realize o procedimento de maneira rápida e eficiente. Apesar da citação numérica específica das pontas diamantadas utilizadas, espera-se que o leitor as utilize como referência, lembrando ser mais importante a compreensão de sua configuração geométrica e volume. Outros fabricantes possuem pontas diamantadas com a mesma configuração geométrica das pontas recomendadas nesta técnica. Dessa forma, cabe ao profissional selecionar as pontas diamantadas de acordo com seu fabricante de eleição

The aim of this study is to describe, illustrate and discuss a simple, effective and rational method for preparing anterior all-ceramic restorations. This procedure uses a reduced number of diamond burs and a few clinical steps. The biological, mechanical, functional and aesthetic principles are obtained in a reasonable manner, regarding the requirements’ supported by the contemporary aesthetic dentistry. At the end of reading, it is expected that the professionals understand the design of the axial and cervical dental walls. Finally, the dental preparations will be made in a rapid and efficient manner. Despite the citation of specific diamond burs, it is expected that the reader use them as a reference. The understanding of their geometric configuration and volume are more important than their manufacturer’s reference number. Other manufacturers have diamond burs with the same geometric configuration of those recommended in this technique. Thus, the clinical professional must select the diamond points according to their manufacturer of choice

Tratamentos restauradores indiretos e a importância dos aspectos periodontais / Indirect restorative treatments and the importance of periodontal aspects

Os tratamentos restauradores adesivos indiretos têm sido amplamente estudados e aperfeiçoados nos últimos anos. No entanto, a realização de qualquer procedimento terapêutico exige total respeito aos tecidos periodontais. São inúmeros os fatores que podem influenciar a longevidade de restaurações adesivas indiretas em dentes posteriores. Neste contexto, tem destaque a relação entre os materiais restauradores e os tecidos periodontais. Assim, a finalidade deste artigo, é demonstrar através de relato de caso clínico alguns dos aspectos a serem considerados para que uma boa inter-relação entre tratamentos restauradores e saúde periodontal seja obtida

The indirect adhesive restorative treatments have been widely studied and improved in recent years. The performance of any therapeutic procedure, however, requires full respect to periodontal tissues. There are numerous factors that can influence the longevity of indirect bonded restorations in posterior teeth. In this context, the relationship between restorative materials and periodontal tissues play an important role. Thus, the purpose of this paper is to demonstrate through a clinical report some of the aspects to be considered so a good relationship betweenrestorative treatments and periodontal health is achieved