RESUMO
A technique is outlined for utilising a polymeric composite reinforced with glass fibres in a three-dimensional mesh as a post-core in aesthetic cases. The clinical procedure involves obtaining an impression of the root canal space, scanning the definitive cast, and milling a fibre-reinforced composite post-core. Subsequently, the intra-radicular post-core is cemented using an adhesive resin cement. The use of custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) fibre-reinforced composite post-core facilitates repairability, provides better adaptation to the root canal space, avoids uneven cement thickness, ensures chemical adhesion to resin cement, and promotes favourable aesthetics when combined with all-ceramic crowns.
Assuntos
Resinas Compostas , Desenho Assistido por Computador , Planejamento de Prótese Dentária , Vidro , Técnica para Retentor Intrarradicular , Humanos , Resinas Compostas/química , Vidro/química , Cimentos de Resina/química , Coroas , Estética Dentária , Retenção em Prótese Dentária , Materiais Dentários/química , CimentaçãoRESUMO
AIM: This study investigated the effectiveness of a drug-modified tissue conditioner in an animal model of denture stomatitis. METHODS AND RESULTS: Wistar rats wore a Candida albicans-contaminated palatal device for 4 days. Next, nystatin (Nys) or chlorhexidine (Chx) were added to a tissue conditioner in their raw or ß-cyclodextrin-complexed (ßCD) forms at their minimum inhibitory concentrations. As controls, one group was not subjected to any procedure (NC), one group used sterile devices, one group had denture stomatitis but was not treated (DS), and another had the devices relined with the tissue conditioner without the addition of any drug (Soft). After 4 days of treatment, treatment effectiveness was assessed visually, histologically, and through CFU count, and myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats from the Soft, Nys, Nys:ßCD, and Chx groups presented a significant decrease in the microbial load compared with the untreated group. Treatment groups showed lower MPO and NAG activity compared to the non-treated group. CONCLUSIONS: The addition of antifungals to a soft tissue conditioner can be a promising approach for denture stomatitis treatment.
Assuntos
Antifúngicos , Candida albicans , Clorexidina , Nistatina , Ratos Wistar , Estomatite sob Prótese , Animais , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/tratamento farmacológico , Ratos , Antifúngicos/uso terapêutico , Antifúngicos/farmacologia , Nistatina/farmacologia , Nistatina/uso terapêutico , Clorexidina/farmacologia , Candida albicans/efeitos dos fármacos , Modelos Animais de Doenças , Masculino , Contagem de Colônia Microbiana , Testes de Sensibilidade Microbiana , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/microbiologia , Peroxidase/metabolismo , Acetilglucosaminidase/metabolismo , beta-CiclodextrinasRESUMO
OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the clinical and mycological effectiveness of mucoadhesives as vehicles for drugs or natural products in the treatment of oral candidiasis. MATERIALS AND METHODS: The search for articles was carried out in the Medline/PubMed, SCOPUS, EMBASE, Web of Science, Cochrane Library, and SciELO databases before August 2023. We selected the studies, extracted the data, evaluated the study quality, graded the evidence, performed the risk of bias, and carried out meta-analysis. RESULTS: A total of 389 potentially relevant articles were identified, and 11 studies (1869 participants) met the inclusion criteria of the systematic review. The overall risk of bias was considered low. The most common presentation of mucoadhesives was tablets, with miconazole being the most frequently drug used in the delivery system. Mucoadhesives demonstrated comparable efficacy with topical or systemic antifungal agents, with no significant differences between treatments in terms of clinical (RR = 0.907; 95CI = 0.3-1.297; p = 0.591; I2 = 64.648) or mycological (RR = 0.95; 95CI = 0.667-1.360; p = 0.789; I2 = 73.271) efficacy. CONCLUSIONS: Mucoadhesives may be a suitable alternative to conventional treatments, with the advantage of reducing the frequency of application by up to 5 times and the daily dosage by up to 20 times.
Assuntos
Antifúngicos , Candidíase Bucal , Sistemas de Liberação de Medicamentos , Candidíase Bucal/tratamento farmacológico , Humanos , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Miconazol/administração & dosagem , Miconazol/uso terapêutico , Adesivos , Comprimidos , Mucosa Bucal/microbiologiaRESUMO
As próteses parciais removíveis (PPRs) são uma alternativa de tratamento viável na prática clínica para reabilitar arcos parcialmente desdentados. Entretanto, o planejamento dessas próteses e preparo bucal prévio são frequentemente negligenciados. O presente artigo tem como objetivo relatar o caso clínico de uma reabilitação oral com PPRs superior e inferior após abordagem multidisciplinar, de modo a enfatizar as fases de um planejamento criterioso e de preparo prévio dos dentes pilares, visando o sucesso e a longevidade da reabilitação. Paciente do sexo masculino de 57 anos de idade compareceu à clínica da Faculdade de Odontologia de Bauru, Universidade de São Paulo, queixando-se da estética de seu sorriso e de algumas ausências dentárias. O indivíduo utilizava uma PPR provisória inferior insatisfatória e apresentava perda de dimensão vertical de oclusão (DVO). Após o exame clínico, radiográfico e estudo do caso em articulador semi-ajustável, realizou-se o planejamento com abordagens restauradoras, endodônticas, periodontais e protéticas. Após tratamento periodontal, foi realizada endodontia dos elementos 12, 15 e 47, confecção de núcleos e coroas nos dentes 12 e 15, restauração a nível gengival para apoio residual no dente 47, restaurações nos dentes 11, 13, 22, 24 e 44 e, por fim, a confecção das PPRs superior e inferior. A abordagem multidisciplinar utilizada neste caso clínico viabilizou o restabelecimento da DVO e possibilitou o sucesso da reabilitação protética(AU)
Removable partial dentures (RPDs) are a viable treatment alternative in clinical practice to rehabilitate partially edentulous arches. However, the planning of these dentures and prior oral preparation are often neglected. This article aims to report the clinical case of an oral rehabilitation with upper and lower RPDs after a multidisciplinary approach, to emphasize the phases of careful planning and prior preparation of the abutment teeth, aiming at the success and longevity of the rehabilitation. A 57-year-old male patient came to the clinic of the Bauru School of Dentistry, University of São Paulo, complaining about the esthetics of his smile and some missing teeth. The subject was using an unsatisfactory lower provisional prosthesis and had a loss of vertical dimension of occlusion (OVD). After the clinical and radiographic examination and the case study in a semi-adjustable articulator, planning was carried out with restorative, endodontic, periodontal and prosthetic approaches. After periodontal treatment, endodontics were performed on elements 12, 15 and 47, creation of cores and crowns on teeth 12 and 15, restoration at the gingival level for residual support on tooth 47, restorations on teeth 11, 13, 22, 24 and 44 and, finally, the making of the upper and lower PPRs. The multidisciplinary approach used in this clinical case enabled the restoration of the OVD and enabled the success of the oral rehabilitation(AU)
Assuntos
Humanos , Masculino , Adulto , Dimensão Vertical , Arcada Edêntula/terapia , Planejamento de Prótese Dentária , Prótese Parcial Removível , Dentaduras , Arcada Edêntula , Coroas , Estética DentáriaRESUMO
Background:Soft drinks are drinks high in sugar and acidity, but low in nutritional benefits. Despite its great popularity, its consumption is alerted due to the numerous systemic harm caused. Aim:This work aims to provide information and critically review the literature on the risk of soft drink consumption in an integrative view with nutritional, dental, and medical aspects. Methods:A search was carried out based on the identification of the theme, determination of inclusion and exclusion criteria, selection of databases for research and, finally, the reading, interpretation, and discussion of the selected sources. A search was conducted using the keywords: "soft drinks" AND "obesity" OR "dental erosion" OR "diabetes" OR "hypertension" OR "mental health" OR "multimorbidities" in databases PubMed, SciELO, and LILACS between 2017 and 2022. Results:Seventy-six studies were included in the article after the qualitative synthesis. Conclusion:We conclude that the high consumption of soft drinks is associated with oral and general diseases. Therefore, a multi-professional approach to guide patients to moderate the consumption of these beverages is extremely important.
Assuntos
Bebidas , Bebidas Gaseificadas , Humanos , Bebidas Gaseificadas/efeitos adversos , Obesidade/epidemiologiaRESUMO
This study compared different conditions to establish a rat model of denture stomatitis. Immunocompetent Wistar rats were divided into two groups (n = 35): Tetracycline = administration of 0.83 mg/ml of tetracycline hydrochloride 7 days before induction of denture stomatitis and amoxicillin = administration of 0.156 mg/ml of amoxicillin with clavulanic acid 4 days before induction of denture stomatitis. A suspension of Candida albicans was inoculated on the palate followed by the use of a palatal device contaminated with C. albicans inoculum for 4 days to induce denture stomatitis. As controls, some rats were not submitted to any procedure or used a sterile palatal device for 4 days. The development of denture stomatitis was confirmed by visual analysis, colony-forming units per milliliter (CFU/ml) count, histopathological and immunohistochemical analyses, and through myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats were euthanized right after device removal (T0), 4 (T4), or 6 (T6) days after device removal. Tetracycline improved the development of the disease, with more severe clinical signs at T0. Similar results were observed in the CFU/ml count and in the histometric and immunohistochemical analyses. Higher MPO expression was detected in the palates of the tetracycline group (P = .006). Despite the subtle differences between antibiotics, tetracycline showed better results in inducing and maintaining denture stomatitis for at least 4 days after device removal.
Denture stomatitis is an oral inflammatory disease with high recurrence rates. Different animal models have been reported in the literature, but some gaps still need to be addressed. A reproducible in vivo model should be established to test new treatment approaches.
Assuntos
Candidíase Bucal , Doenças dos Roedores , Estomatite sob Prótese , Ratos , Animais , Estomatite sob Prótese/patologia , Estomatite sob Prótese/veterinária , Antibacterianos , Ratos Wistar , Candida albicans , Amoxicilina , Tetraciclinas , Candidíase Bucal/veterináriaRESUMO
ABSTRACT Numerous pathogens, including SARS-CoV-2, can remain viable on surfaces over days, which favors cross-contamination. Preventive measures are essential to prevent infections and control the spread of COVID-19. Fox ruler is an essential device in the clinical planning of complete dentures and the contact with the patient's oral fluids during handling is unavoidable. Despite its importance, the conventional polycarbonate Fox ruler is easily damaged in the sterilization process. Therefore, the purpose of this article is to propose the use of a disposable Fox ruler. The confection is carried out in a simple way with wooden toothpicks joined by cyanoacrylate glue, following the same shape as the conventional one, but with the additional advantage of being made in an individual size according to the upper edge. The proposed disposable Fox ruler makes it possible to obtain the parallelism of the upper wax roller with the bipupillary line and with the Camper plane. Therefore, the disposable device described in this article was able to perform the same functions as the conventional one, in a practical way, without risks of cross contamination and with low cost.
RESUMO Vários patógenos, incluindo SARS-CoV-2, são capazes de permanecer viáveis em superfícies durante dias, o que favorece a contaminação cruzada. Medidas preventivas são essenciais para prevenir infecções e controlar a propagação da COVID- 19. A régua de Fox é um dispositivo essencial no planejamento clínico de próteses totais e é inevitável o contato com os fluidos orais do paciente, durante seu manejo. Apesar de sua importância, a régua de Fox convencional de policarbonato é facilmente danificada com o processo de esterilização. Portanto, o objetivo deste artigo é propor a utilização de uma régua Fox descartável. A confecção é feita de forma simples com palitos de madeira unidos por cola de cianoacrilato, seguindo o mesmo formato do convencional, mas com a vantagem adicional de ser produzida em tamanho individualizado de acordo com o rebordo superior. A régua Fox descartável proposta permite obter o paralelismo do rolete de cera superior com a linha bipupilar e com o plano de Camper. Portanto, o dispositivo descartável descrito neste artigo foi capaz de desempenhar as mesmas funções do convencional, de forma prática, sem riscos de contaminação cruzada e com baixo custo.
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Aim: To report on a surgical procedure with osteotomy in the posterior region of the maxilla and lifting of the maxillary sinus floor for the installation of implants and rehabilitation with implant-supported crowns. Case report: A 54-year-old female patient was admitted to the dental clinic, complaining that she was dissatisfied with her smile and the missing teeth. After the clinical, radiographic, and tomographic examinations, a well as a case study of a semi-adjustable articulator, multidisciplinary planning was carried out using surgical, endodontic, periodontic, orthodontic, and prosthetic approaches. A lack of interocclusal space was observed in the posterior region of the maxilla. After osteotomy in tuberosity, maxillary sinus lift using an autogenous bone graft was performed, and three implants were installed. After the osseointegration period, provisional crowns were placed, followed by definitive metal-ceramic crowns. Conclusion:The surgical techniques used in this clinical case made it possible to install implants in a single clinical session for prosthetic rehabilitation.
Introdução: A reabilitação oral envolve um tratamento integrado, que inclui diversas especialidades odontológicas para restabelecer os aspectos estéticos e funcionais, resultando também na satisfação do paciente. Objetivo: O objetivo foi relatar um procedimento cirúrgico com osteotomia na região posterior da maxila e levantamento do assoalho do seio maxilar para instalação de implantes e reabilitação com coroas implantossuportadas. Relato de caso: Paciente do sexo feminino, 54 anos, apresentou-se ao ambulatório queixando-se de insatisfação com o sorriso e com a falta de dentes. Após os exames clínicos, radiográficos, tomográficos e estudo de caso em articulador semi-ajustável, foi realizado o planejamento multidisciplinar com abordagens cirúrgica, endodôntica, periodontal, ortodôntica e protética. Observou-se falta de espaço interoclusal na região posterior da maxila. Após a osteotomia na tuberosidade, foi realizada a elevação do seio maxilar com enxerto ósseo autógeno e foram instalados três implantes. Posteriormente, no período de osseointegração, foram colocadas coroas provisórias e, posteriormente, coroas metalocerâmicas definitivas. Conclusão: As técnicas cirúrgicas utilizadas neste caso clínico possibilitaram a instalação de implantes em uma única sessão clínica para a reabilitação protética.
Assuntos
Osteotomia , Cirurgia Bucal , Implantes Dentários , Prótese Dentária , Seio MaxilarRESUMO
This systematic review aimed to evaluate the antifungal effectiveness of polymethylmetacrylate (PMMA) modified by nanoparticles (NPs) and to compare it with conventional acrylic resins for denture bases. The present study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were performed using PubMed, SCOPUS, SciELO, EMBASE, and LILACS. Eligibility criteria were as recommended by PRISMA. The studies presented great variability regarding NP type, synthesis method, antifungal evaluation method, and antifungal effect. The most commonly used NPs were silver (AgNP) and zinc oxide (ZnONP), ranging in size from 10 to 100 nm. The incorporation methods were mechanical or agitated. Despite PMMA modification by ZnONP being shown in vitro to be a combination with the best antifungal effect, future studies are still needed to determine the minimum inhibitory concentration for Candida spp. and assess its biocompatibility before the protocol is clinically tested.
Assuntos
Nanopartículas , Estomatite sob Prótese , Candida albicans , Bases de Dentadura , Humanos , Polimetil Metacrilato , Estomatite sob Prótese/prevenção & controleRESUMO
Aim: The aim of this study was to compare the microtensile bond strength (µTBS) and the characteristics of the adhesive interface of Scotchbond Universal - SU etch-and-rise mode (3M ESPE) and Adper Scotchbond Multi-Purpose - MP (3M ESPE) to dentin over time. Methods: Class I cavity preparations were performed in 60 human molars that were randomly divided according to the dentin bonding system (DBS) used (n=30): (1) Acid conditioning + SU and (2) Acid conditioning + MP. For bonding strength (BS) analysis, 30 teeth (n = 15) were sectioned into sticks and submitted to the microtensile test in a universal testing machine after 24 hours and 12 months. The adhesive interface of the others 30 teeth was analyzed in a confocal microscope after 24 hours and 12 months. The data of µTBS were analyzed by two-way repeated measures ANOVA and Tukey's HSD (α = 0.05). Results: SU presented the lowest DBS compared to MP (p=0.000). Time did not influenced DBS for both adhesive systems (p=0.177). Confocal microscopy analysis showed no cracks between both adhesive systems tested. Conclusion: The results indicate that MP - µTBS showed a better performance compared to SU in total-etch mode
Assuntos
Humanos , Adesivos Dentinários , Microscopia Confocal , Dentina , MetacrilatosRESUMO
Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. OBJECTIVE: This study describes a protocol to obtain and to contaminate a palatal device with Candida albicans biofilm that could be used for an animal model of denture stomatitis. METHODOLOGY: Acrylic resin devices (N=41) were obtained from impressions of the palates of Wistar rats with individual trays and polyether. The efficacy of microwave irradiation (MW), ultraviolet light (UV), or ultrasonic bath (US) was assessed by colony viability and spectrophotometric analyses (n=5) in order to select the most appropriate method for sterilizing the devices. Then, different devices (n=5) were contaminated with C. albicans and evaluated by CFU/mL determination, scanning electron microscopy, and laser confocal microscopy. Device stabilization was assessed with either autopolymerizing acrylic resins or a self-adhesive resin cement (n=2). The spectrophotometric data were analyzed by one-way ANOVA followed by the Tukey's HSD post-hoc test (α=0.05). RESULTS: MW was the only method capable of sterilizing the devices, and the contamination protocol developed a mature and viable C. albicans biofilm (~1.2 x 106 CFU/mL). The self-adhesive resin cement was the best stabilization material. CONCLUSIONS: This acrylic resin palatal device was designed to be similar to the clinical situation of contaminated prostheses, with easy manufacturing and handling, effective stabilization, and satisfactory contamination. Thus, the acrylic device can be a valuable tool in the development of denture stomatitis in rats.
Assuntos
Candida albicans , Estomatite sob Prótese , Resinas Acrílicas , Animais , Biofilmes , Bases de Dentadura , Palato , Ratos , Ratos WistarRESUMO
OBJECTIVE: To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm. METHODOLOGY: Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (µg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05). RESULTS: Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001). CONCLUSIONS: The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.
Assuntos
Reembasadores de Dentadura , Estomatite sob Prótese , Antifúngicos , Candida albicans , Humanos , Cetoconazol , Teste de Materiais , Nistatina , Estomatite sob Prótese/tratamento farmacológico , Propriedades de SuperfícieRESUMO
O objetivo foi revisar a literatura e discutir os conceitos oclusais em reabilitações orais com próteses totais, enfatizando as vantagens e as necessidades de cada esquema oclusal. Realizou-se uma busca nas bases de dados PubMed, SciELO, Google Scholar e em li-vros didáticos com as palavras-chave "Oclusão Dentária", "Oclusão Dentária Balanceada", "Orientação de Canino", "Planejamento de Dentadura", "Planejamento de Prótese Dentá-ria" e "Prótese Total" e com os operadores booleanos AND (E), OR (OU), NOT (MENOS). Dentro dos esquemas oclusais disponíveis para o planejamento protético, a oclusão balan-ceada bilateral (OBB) e a oclusão guiada pelo canino (OGC) foram as mais estudadas e discutidas na desoclusão de próteses totais. Os estudos indicam que o tipo de oclusão pode interferir na atividade muscular do sistema estomatognático, na eficiência mastigatória, na reabsorção óssea, na retenção e estabilidade das próteses removíveis e na satisfação do pa-ciente. Na literatura examinada, foi perceptível a recomendação da OGC como o esquema oclusal de preferência no planejamento das próteses totais, pois os resultados dos estudos indicam menor atividade muscular durante a mastigação, melhor retenção e estabilidade da prótese total. A OGC é o esquema oclusal mais simples e fácil de ser obtido comparada à OBB, beneficia a fonética, é esteticamente preferida pelos pacientes e, em termos de qua-lidade de vida, autopercepção da força mastigatória e oclusal, tem se mostrado satisfatória. Conclui-se que a OGC pode ser recomendada como um esquema oclusal favorável para as reabilitações orais com próteses totais.Descritores: Oclusão Dentária. Oclusão Dentária Balanceada. Orientação de canino. Pró-tese Total. Planejamento de Prótese Dentária.
The aim was to review the literature and discuss the occlusal concepts in oral rehabilitation with complete dentures, emphasizing the advantages and needs of each occlusal scheme. A search was carried out on the databases PubMed, SciELO, Google Scholar and in textbooks, using "Dental Occlusion"; "Dental Occlusion Balanced"; "Canino guidance"; "Denture complete"; and "Denture design" as keywords and the Boolean operators AND, OR, and NOT. Among the occlusal schemes available for prosthetic planning, the bilateral balanced occlusion (BBO) and the canine guided occlusion (CGO) were the most studied and discussed in the disocclusion of complete dentures. Studies indicate the type of occlusion can interfere with muscle activity of the stomatognathic system, masticatory efficiency, bone resorption, retention and stability of removable dentures, and patient satisfaction. In the literature examined, the recommendation of the CGO as the preferred occlusal scheme in the planning of complete dentures was noticeable. The results of the studies indicate less muscle activity during mastication, better retention, and stability of the total denture. It is simpler and easier to obtain this occlusal scheme than the BBO. CGO benefits phonetics; it is aesthetically preferred by patients; and, in terms of quality of life, self-perception of masticatory and occlusal strength, has shown to be satisfactory. We conclude that CGO can be recommended as a favorable occlusal scheme for oral rehabilitation with complete dentures.
Assuntos
Oclusão Dentária Balanceada , Prótese Dentária , Oclusão DentáriaRESUMO
Abstract Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. Objective This study describes a protocol to obtain and to contaminate a palatal device with Candida albicans biofilm that could be used for an animal model of denture stomatitis. Methodology Acrylic resin devices (N=41) were obtained from impressions of the palates of Wistar rats with individual trays and polyether. The efficacy of microwave irradiation (MW), ultraviolet light (UV), or ultrasonic bath (US) was assessed by colony viability and spectrophotometric analyses (n=5) in order to select the most appropriate method for sterilizing the devices. Then, different devices (n=5) were contaminated with C. albicans and evaluated by CFU/mL determination, scanning electron microscopy, and laser confocal microscopy. Device stabilization was assessed with either autopolymerizing acrylic resins or a self-adhesive resin cement (n=2). The spectrophotometric data were analyzed by one-way ANOVA followed by the Tukey's HSD post-hoc test (α=0.05). Results MW was the only method capable of sterilizing the devices, and the contamination protocol developed a mature and viable C. albicans biofilm (~1.2 x 106 CFU/mL). The self-adhesive resin cement was the best stabilization material. Conclusions This acrylic resin palatal device was designed to be similar to the clinical situation of contaminated prostheses, with easy manufacturing and handling, effective stabilization, and satisfactory contamination. Thus, the acrylic device can be a valuable tool in the development of denture stomatitis in rats.
Assuntos
Animais , Ratos , Estomatite sob Prótese , Candida albicans , Palato , Resinas Acrílicas , Ratos Wistar , Biofilmes , Bases de DentaduraRESUMO
The aim was to discuss the indications, contraindications, advantages, and disadvantages of Nonmetal clasp dentures (NMCDs), as well as the most relevant properties of its constituent materials. A search was conducted using the keywords: "nonmetal clasp dentures," "thermoplastic resin," "flexible resin removable partial denture," "polyamide," and "nylon" in databases PubMed/Medline, Lilacs, SciELO, and textbooks between 1955 and 2020. Theses and texts without reliable sources of publication were excluded. Once the analysis instruments were determined, the data were analyzed and discussed. NMCDs present high flexibility, easy adaptation to the abutments, color compatibility and biocompatibility with the oral mucosa, and absence of visible metal clasps. However, they need laboratory relining, grinding, and polishing, do not have criteria for its planning, become rougher and stained over time, and are able to traumatize supporting tissues. The association with metal components seems to be an alternative to increase the success of NMCDs by combining esthetics and biomechanical principles of conventional removable partial dentures. The lack of long-term clinical studies makes the professionals to rely solely on previous experiences or on the manufacturers' recommendations. It suggested that NMCDs must be indicated with caution when not used temporarily.
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Considering the high prevalence and recurrence of Candida-associated denture stomatitis (CADS), in vivo studies in animal models are necessary before those in humans to evaluate new therapeutic strategies. This study aimed to review the literature on murine models of CADS induction using acrylic intraoral devices simulating dentures. Rats are recommended as experimental animals in these models as well as the adoption of a pasty diet. For maintenance in the proper position during the experiments, intraoral appliances must be obtained by individual impressions, using and retained exclusively by cementation on the molars. The region of interest for histopathological analysis was standardized as that corresponding to the area between the first molars. However, there is no consensus among the studies on the CADS induction rat models in relation to the Candida albicans inoculation and need for immunosuppression and/or administration of antibacterial drugs of animals. The greatest difficulty of the available models refers to maintaining the course of the lesion for a sufficient period to evaluate the effectiveness of the proposed treatment, considering the rapid and efficient murine immune response to candidal colonization. Therefore, future studies are necessary for the development of a robust and reproducible CADS model.
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Abstract Objective: To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm. Methodology:Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (µg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05). Results: Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001). Conclusions: The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.
Assuntos
Humanos , Estomatite sob Prótese , Reembasadores de Dentadura , Estomatite sob Prótese/tratamento farmacológico , Propriedades de Superfície , Teste de Materiais , Candida albicans , Nistatina , Cetoconazol , AntifúngicosRESUMO
O objetivo deste estudo foi discutir, por meio de uma revisão de literatura, as indicações, contraindicações, vantagens, desvantagens das alternativas reabilitadoras mais comuns utilizando PPRs e o impacto desses tratamentos na qualidade de vida relacionada à saúde bucal dos pacientes. Foi realizada uma pesquisa ampla na literatura, com a utilização dos termos "Prótese Parcial Removível", "Qualidade de Vida", "Saúde bucal"; "Satisfação do Paciente", no período entre 1990 e 2018, no Medline, Google Scholar, internet e livros didáticos. Foi demonstrado que a reabilitação com PPRs associadas a implantes resultou em melhor qualidade de vida associada à saúde bucal dos usuários, seguida por PPRs retidas por encaixe e PPRs convencionais. Entretanto, o profissional deve considerar as condições sistêmicas, bucais e econômicas de cada paciente, tendo o conhecimento biomecânico bem como a ciência dos benefícios e das desvantagens de cada tipo de tratamento para estabelecer um correto diagnóstico do caso e, assim, indicar o melhor tipo de PPR. Dessa forma, é possível oferecer o melhor tratamento para cada paciente parcialmente edêntulo, devolvendo estética e função de maneira satisfatória de modo a resultar em maior nível de satisfação e qualidade de vida(AU)
The purpose of this study was to discuss, through a review of the literature, indications, contraindications, advantages, disadvantages of the most common rehabilitation alternatives using RPDs and the impact of these treatments on patients' oral health quality of life. A broad research was conducted in the literature, using the terms "Partial Removable Prosthesis", "Quality of Life", "Oral Health"; "Patient Satisfaction" in the period between 1990 and 2018, in Medline, Google Scholar, internet and textbooks. It was demonstrated that rehabilitation with RPDs associated with implants resulted in a better oral health quality of life of users, followed by RPDs with attachments and conventional RPDs. However, the professional should consider the systemic, oral and economic conditions of each patient, based on the biomechanical knowledge, as well as the science of the benefits and disadvantages of each type of treatment to establish a correct diagnosis of the case, and thus, indicate the best type of RPD. In this way, it is possible to offer the best treatment for each partially edentulous patient, returning aesthetics and function in a satisfactory manner in order to result in a higher level of satisfaction and quality of life(AU)
Assuntos
Qualidade de Vida , Prótese Parcial Removível , Implantes Dentários , Saúde Bucal , Satisfação do PacienteRESUMO
STATEMENT OF PROBLEM: Specifications for determining acceptable limits of water sorption (WS) and solubility for interim denture resilient liners are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the WS and solubility of interim resilient materials throughout their lifespans. MATERIAL AND METHODS: Specimens (n=10) of 7 tissue conditioners, Coe-Comfort (CC), Softone (ST), Rite-Line (RL), Dura Conditioner (DC), Hydrocast (HC), Dentusoft (DS), and Visco-gel (VG) and 2 interim resilient liners, Trusoft (TS) and Coe-Soft (CS), were submitted to desorption until weight stabilization. Next, they were immersed in distilled water at 37°C for 3, 5, 7, or 14 days and then weighed, dried, and reweighed. Data (%) were analyzed using 2-way ANOVA and the Tukey honestly significant difference (HSD) test (α=.05). RESULTS: VG demonstrated the highest WS (12.06 ±0.93%-16.62 ±0.87%) and solubility (20.30 ±4.26%-23.59 ±2.24%; P<.05) percentages. Low WS values were presented by CC (2.23 ±0.53%-2.99 ±0.49%; P<.05). The WS showed no significant changes for CC, CS, and TS over 14 days (P>.05). SL presented intermediate solubility values (4.09 ±1.60%-8.80 ±1.15%), and the other materials showed values lower than 3.35 ±0.70%. CC, DC, DS, HC, RL, TS, and CS showed no changes in solubility throughout the 14-day trial. CONCLUSIONS: Over the lifespan of a tissue conditioner (7 days), CC, RL, DC, HC, DS, CS, and TS presented suitable in vitro performance. Among the tested materials, CC, CS, and TS were considered best suited for denture relining for up to 14 days.
Assuntos
Reembasadores de Dentadura , Água/química , Absorção Fisico-Química , Técnicas In Vitro , Teste de Materiais , Solubilidade , Propriedades de SuperfícieRESUMO
The proper selection of polymerization cycle is important to prevent overheating of the monomer that could cause degradation, porosity and, consequently, deleterious effects on the denture base properties. Objective This study evaluated the porosity, water sorption and solubility of acrylic resins (Vipi Cril-VC and Vipi Wave-VW) after conventional or microwave polymerization cycles. Material and Methods Specimens (n = 10) were made and cured: 1-WB = 65°C during 90 min + boiling during 90 min (VC cycle - control group); 2-M25 = 10 min at 270 W + 5 min at 0 W + 10 min at 360 W (VW cycle); 3-M3 = 3 min at 550 W; and 4-M5 = 5 min at 650 W. Afterward, they were polished and dried in a dessicator until a constant mass was reached. Specimens were then immersed in distilled water at 37°C and weighed regularly until a constant mass was achieved. For porosity, an additional weight was made with the specimen immediately immersed in distilled water. For water sorption and solubility, the specimens were dried again until equilibrium was reached. Data were submitted to 2 way-ANOVA and Tukey HSD (α=0.05). Results Porosity mean values below 1.52% with no significant difference among groups for both materials were observed. Resins showed water sorption and solubility values without a significant difference. However, there was a significant difference among groups for these both properties (P<0.013). The highest sorption (2.43%) and solubility (0.13%) values were obtained for WB and M3, respectively. Conclusions The conventional acrylic resin could be polymerized in a microwave since both the materials showed similar performance in the evaluated properties. Shorter microwave cycles could be used for both the materials without any detectable increase in volume porosity.