Determination of final occlusal vertical dimension by cephalometric analysis

Introduction: Most of techniques for determining the occlusal vertical dimension (OVD) of edentulous patients are based on soft tissues references, which lead to measurement discrepancies. Objective: To propose a method to obtain the OVD of edentulous patients during the confection of complete dentures considering the lower facial height established by Ricketts (LFHr) or the lower facial height obtained from cephalometric analysis of dentulous patients (LFHd). Material and methods: The OVD of 11 edentulous patients was determined by the association of 3 clinical methods. On each patient's bite plates a metallic ball was fixed and the patient was submitted to lateral radiographic to obtain the lower facial height (LFHe) from cephalometric analysis. Additionally, from 40 lateral cephalograms of dentulous patients the LFHd was obtained. After that, the distance between metallic balls (DMB, in mm) was calculated to verify the linear difference when LFHe was changed to LFHd or LFHr, which provided the amount of wax to be added or removed from the bite plates, establishing a new method of OVD determination. LFHe, LFHd and LFHr values were submitted to t e z statistical tests and DMB differences were analyzed by Student's t-test (α=0.05). Results: LFHr (47.0±4.0o a) was statistically higher than LFHd (44.9±5.6o b) and LFHe (43.5±3.5o b). There was statistical difference on linear discrepancies calculated between the LFHe and LFHd (1.7±4.1mm a) or LFHr (4.2±4.1mm b). Conclusion: The use of the cephalometric analysis showed to be a useful auxiliary tool in determining the intermaxillary relationship. However, this method must be associated with different clinical methods of OVD determination and it is recommended that regional references are used to calculate the linear discrepancies.

Cuspal movement related to different polymerization protocols.

OBJECTIVE: The aim of this study to investigate the effects of different polymerization protocols on the cuspal movement in class II composite restorations. MATERIALS AND METHODS: Human premolar teeth were prepared with class II cavities and then restored with composite and three-step and two-step etch-and-rinse adhesive systems under different curing techniques (n = 10). It was used a light- emitting-diode curing unit and the mode of polymerization were: standard (exposure for 40 seconds at 700 mW/cm(2)), pulse-delay (initial exposure for 6 seconds at 350 mW/cm(2) followed by a resting period of 3 minutes and a final exposure of 37 seconds at 700 mW/cm(2)) and soft-start curing (exposure 10 seconds at 350 mW/cm(2) and 35 seconds at 700 mW/cm(2)). The cuspal distance (µm) was measured before and after the restorative procedure and the difference was recorded as cuspal movement. The data were submitted to two-way ANOVA and Bonferroni test (p < 0.05). RESULTS: The type of adhesive system did not influenced the cuspal movement for all the curing methods. Standard protocol showed the highest values of cuspal movement and was statistically different from the pulse-delay and soft-start curing modes. CONCLUSION: Although the cuspal displacement was not completely avoided, alternative methods of photocuring should be considered to minimize the clinical consequences of composites contraction stress.

Comparative evaluation of the accuracy of pick up transfer impressions performed with two different types of trays

Introduction: The success of implant-supported prostheses is related to the passive union between the prostheses’ connections and the implants, so it is necessary to obtain an accurate working cast. Objective: To evaluate the accuracy of the transfer impressions of implants performed with individual acrylic resin trays and conventional trays using polyvinyl siloxane. Material and methods: To carry out the transfer impressions, a master cast with four external hexagon implants parallel to each other was used. Five impressions were made with individual acrylic resin trays and five other impressions with modified conventional trays, opened in the region of the implants. The linear measurements between the implants were made with a digital caliper with an accuracy of 0.01 mm and the results were statistically evaluated (alpha = %). Results: For the points AB and BC, the measurements obtained with the individual trays were statistically similar to the master cast. For the points CD and DA no statistical differences among the three groups were observed. Conclusion: Given the obtained results and the methodology used, it can be concluded that the impressions performed with individual trays presented higher accuracy compared to the ones obtained with conventional trays.

Customized fiber glass posts. Fatigue and fracture resistance.

PURPOSE: To evaluate the root fracture strength of human single-rooted premolars restored with customized fiberglass post-core systems after fatigue simulation. METHODS: 40 human premolars had their crowns cut and the root length was standardized to 13 mm. The teeth were endodontically treated and embedded in acrylic resin. The specimens were distributed into four groups (n=10) according to the restorative material used: prefabricated fiber post (PFP), PFP+accessory fiber posts (PFPa), PFP+unidirectional fiberglass (PFPf), and unidirectional fiberglass customized post (CP). All posts were luted using resin cement and the cores were built up with a resin composite. The samples were stored for 24 hours at 37 degrees C and 100% relative humidity and then submitted to mechanical cycling. The specimens were then compressive-loaded in a universal testing machine at a crosshead speed of 0.5 mm/minute until fracture. The failure patterns were analyzed and classified. Data was submitted to one-way ANOVA and Tukey's test (alpha = 0.05). RESULTS: The mean values of maximum load (N) were: PFP - 811.4 +/- 124.3; PFPa - 729.2 +/- 157.2; PFPf- 747.5 +/- 204.7; CP - 762.4 +/- 110. Statistical differences were not observed among the groups. All groups showed favorable restorable failures. Fiberglass customized post did not show improved fracture resistance or differences in failure patterns when compared to prefabricated glass fiber posts.

Three-year follow up of customized glass fiber esthetic posts.

Customized glass fiber posts that is well adjusted into the root canal and have mechanical properties similar to those of dentin may be a suitable treatment for severely compromised endodontically treated teeth. This article reports a 3-year follow up of severely damaged endodontically treated teeth restored with unidirectional fiber glass customized post and core system instead of a conventional fiber post. The fabrication of this glass fiber customized post is a simple technique, providing an increased volume of fibers into the root canal, and an adequate polymerization of the post-core system. Over a three-year period, the treatments demonstrated good clinical and radiographic characteristics, with no fracture or loss of the post and/or crown. This technique can be considered effective, less invasive, and suitable for restore endodontically treated teeth.

Multidisciplinary approach of a crown-root fracture using intentional replantation: a case report.

Crown-root fractures are complex traumatic injuries that require multidisciplinary management and afford uncertain prognosis. The purpose of this clinical article was to report the case of crown-root fracture where a multidisciplinary approach was successfully executed. A 10-year-old male patient who suffered a complicated crown-root fracture on a permanent maxillary central incisor was treated using an intentional 180°-rotation replantation technique, followed by endodontic therapy and restoration with resin composite. Two years after the initial treatment, the case was stable and the tooth was restored with a resin core and a ceramic crown. This article describes how adequate multidisciplinary treatment planning, coordination, and execution are necessary for similar cases to be properly managed. It can be concluded that the intentional replantation with 180°-rotation allowed a more conservative approach, showing, in this case, a clinical success without resorption.

Adaptação marginal em prótese livre de metal, observada por meio de microscopia eletrônica de varredura, após três anos em função / Marginal fit of metal-free crown, observed in scanning electron microscope after three years in function

Introdução: As cerâmicas são consideradas uma excelente alternativa como material estético restaurador, entretanto questões relevantes, como adaptação marginal, exigem um maior critério na confecção quando comparadas aos sistemas convencionais. Objetivo: Este trabalho avaliou a adaptação marginal de uma coroa In-Ceram confeccionada sobre um dente que, após 3 anos, teve sua extração indicada pela ortodontia. Material e métodos: A avaliação deu-se por meio de microscópio eletrônico de varredura. Resultados e conclusão: Foram encontrados valores de falta de adaptação entre 157 e 390 um, obtendo uma média estatística acima do considerado aceitável clinicamente pela literatura.

Introduction: Ceramics are considered an excellent choice as esthetic restorative material, but relevant questions like marginal fit require more attention in manufacturing than conventional systems. Objective: This work evaluated the marginal adaptation of an In-Ceram crown over a tooth that, after three years, had been indicated to extraction by orthodontics. Material and methods: The evaluation was by mean scanning electron microscope. Results and conclusion: It was found values of gaps between 157 and 390 um, getting a statistic average considered greater than the accepted by literature.

Evaluation of the marginal adaptation of a fibre glass reinforced resin crown using a scanning electronic microscope / Avaliação da adaptação marginal de coroa deresina reforçada com fibra de vidro emmicroscópio eletrônico de varredura

Introduction and objective: Dental prostheses manufactured using reinforced resins are an alternative to the rehabilitative treatment of one or more dental elements. With the aim of forecasting the longevity of these prosthetic pieces, this study evaluated the marginal adaptation of a complete crown made from fibreglass reinforced resin. Material and methods: A tooth having orthodontic indication for extraction was prepared and a prosthetic piece was cemented over it so that, 48 hours later, the extraction could take place. The ensemble was taken in a laboratory and was examined using a scanning electron microscope (SEM). There were made 30 readings in a 8mm toothcement-restoration interface and revealed various gaps throughout the sample. Results: The lowest value found was 15,82 µm and the highest was 72,81 µm showing an average value of 40,82 µm. Conclusion: The gaps were within the limits of clinical tolerance and considering the clinical difficulty in making the prosthetic piece, the treatment was shown to be satisfactory with regard to marginal adaptation.

Introdução e objetivo: As próteses fabricadas com resinas reforçadas são alternativas para o tratamento reabilitador de um ou mais elementos dentários. Objetivando prever a longevidade dessas peças, este trabalho avaliou a adaptação marginal de uma coroa total confeccionada com resina reforçada com fibra de vidro. Material e métodos: Um dente com indicação ortodôntica de exodontia foi preparado e sobre ele uma peça protética foi cimentada para que, 48 horas depois, a extração fosse executada. O conjunto foi levado ao laboratório para leitura em microscópio eletrônico de varredura (MEV). Foram feitas 30 leituras em uma interface de dente-cimento-restauração de 8 mm e reveladas diferentes gaps em toda a amostra. Resultados: O menor valor achado foi de 15,82 µm, e o maior de 72,81 µm, resultando em uma média de 40,82 µm. Conclusão: As gaps estavam dentro dos limites de tolerância clínica e, considerando a dificuldade clínica de produção da peça protética, o tratamento mostrou-se satisfatório no que concerne à adaptação marginal.