Dental implant and abutment in PEEK: stress assessment in single crown retainers on anterior region.

OBJECTIVE: Stress distribution assessment by finite elements analysis in poly(etheretherketone) (PEEK) implant and abutment as retainers of single crowns in the anterior region. MATERIALS AND METHODS: Five 3D models were created, varying implant/abutment manufacturing materials: titanium (Ti), zirconia (Zr), pure PEEK (PEEKp), carbon fiber-reinforced PEEK (PEEKc), glass fiber-reinforced PEEK (PEEKg). A 50 N load was applied 30o off-axis at the incisal edge of the upper central incisor. The Von Mises stress (σvM) was evaluated on abutment, implant/screw, and minimum principal stress (σmin) and maximum shear stress (τmax) for cortical and cancellous bone. RESULTS: The abutment σvM lowest stress was observed in PEEKp group, being 70% lower than Ti and 74% than Zr. On the implant, PEEKp reduced 68% compared to Ti and a 71% to Zr. In the abutment screws, an increase of at least 33% was found in PEEKc compared to Ti, and of at least 81% to Zr. For cortical bone, the highest τmax values were in the PEEKp group, and a slight increase in stress was observed compared to all PEEK groups with Ti and Zr. For σmin, the highest stress was found in the PEEKc. Stress increased at least 7% in cancellous bone for all PEEK groups. CONCLUSION: Abutments and implants made by PEEKc concentrate less σvM stress, transmitting greater stress to the cortical and medullary bone. CLINICAL RELEVANCE: The best stress distribution in PEEKc components may contribute to decreased stress shielding; in vitro and in vivo research is recommended to investigate this.

Effects of disinfection with a vinegar-hydrogen peroxide mixture on the surface characteristics of denture acrylic resins.

OBJECTIVE: This study aimed to investigate changes in the surface characteristics of two denture resins when disinfected with a vinegar-hydrogen peroxide (VHP) mixture. MATERIALS AND METHODS: Microwave-polymerized or 3D printed acrylic resin disks were immersed for 900 min (simulating 90 daily uses) in the following solutions (N = 10): water; 0.5% sodium hypochlorite; hydrogen peroxide and water dilution (1:1 ratio); vinegar and water dilution (1:1 ratio); and VHP mixture. Surface roughness, Knoop microhardness, surface free energy, and scanning electron microscopic images were assessed before and after the immersions. Results were compared using the 2-way ANOVA for repeated measures and Tukey test, at 5% significance. RESULTS: Surface roughness and microhardness did not differ (P > .05) among the solutions and times. Surface free energy and its dispersive component increased (P < .05) for all solutions. All solutions, except for water and VHP mixture, degraded microtopography. CONCLUSIONS: The VHP mixture was not deleterious to conventional and 3D-printed resin surfaces. CLINICAL RELEVANCE: Conventional and 3D printed resin dentures can be disinfected with a VHP mixture in a 1:1 ratio because this mixture does not substantially affect the surface characteristics after 90 daily immersions. On the contrary, sodium hypochlorite, hydrogen peroxide, and vinegar solutions, even in low concentrations, should be used with caution for denture disinfection because they may alter the resin microtopography over time.

Performance of complete dentures fabricated with the simplified and the traditional technique: A randomized clinical trial.

STATEMENT OF PROBLEM: The simplified technique has been recommended for the fabrication of removable complete dentures. However, a consensus regarding the performance of the simplified and the traditional techniques is lacking. PURPOSE: The purpose of this randomized clinical trial was to compare the performance of prostheses fabricated with the simplified and the traditional techniques. MATERIAL AND METHODS: Sixty participants were recruited and randomized into 2 groups: traditional technique (control group) and simplified technique (experimental group). The assessments were performed before treatment (baseline) and 2 and 4 months after adaptation to the new complete dentures. The variables evaluated were satisfaction, oral health-related quality of life (OHRQoL) by using the Brazilian version of the OHIP-EDENT, the quality of the prostheses, and, for the functional assessment, the masticatory performance and swallowing threshold. The data were analyzed by the Fisher exact test, the Mann-Whitney test, and the generalized equations estimating (GEE) method. RESULTS: At baseline, the mean ±standard deviation quality of the prostheses was 5.3 ±2.3 for the traditional technique and 4.9 ±2.3 for the simplified technique, and at 4 months, it was 9.3 ±0.9 and 9.1 ±0.9, respectively. For masticatory performance, the mean ±standard deviation X50 at baseline was 5.7 ±1.4 for the traditional technique and 5.7 ±0.9 for the simplified technique, and at 4 months, it was 3.8 ±1.2 and 3.7 ±0.9, respectively. The mean ±standard deviation OHRQoL at baseline was 14.1 ±8.6 for the traditional technique and 12.5 ±9.4 for the simplified technique, and at 4 months, it was 3.2 ±4.3 and 2.6 ±5.1, respectively. The mean ±standard deviation satisfaction at baseline was 9.5 ±3.9 for the traditional technique and 9.3 ±4.2 for the simplified technique; after 4 months, it was 14.8 ±2.0 for both techniques. There was a significant improvement (P<.05) for all variables in the study when comparing them at the baseline to those at the evaluation after provision of new complete dentures. There was no significant difference in all analyzed variables (P>.05) between the 2 techniques for prosthesis fabrication. CONCLUSIONS: The simplified technique appears to be a suitable alternative to the traditional technique for the fabrication of complete dentures, with similar performance.

Mechanical and surface properties of Co-Cr alloy produced by additive manufacturing for removable partial denture frameworks.

STATEMENT OF PROBLEM: Conventional analog methods have been replaced with digital methods for removable partial denture (RPD) frameworks. However, limited information is available regarding the build direction of RPD frameworks and its effect on properties. PURPOSE: The purpose of this in vitro study was to evaluate the mechanical and surface properties of the cobalt chromium (Co-Cr) alloy produced at different build angles by the laser powder bed fusion additive manufacturing (AM) technology used for RPD framework fabrication. MATERIAL AND METHODS: Plate-shaped Co-Cr specimens (n=6) were produced by the AM technology and divided into 3 groups depending on the build angle (0, 45, or 90 degrees). The elastic modulus and fracture properties were evaluated by flexural testing. Additionally, 15 disks were printed by using the same parameters of the plates (n=5) to analyze the surface hardness with microhardness testing, and surface properties were determined by surface free energy by using the contact angle and surface roughness measured by using a profilometer. Twelve Co-Cr cylindrical specimens were produced by using the same parameters (n=4), and their microstructure was examined by using an optical microscope. One-way ANOVA was used to evaluate the overall effects of the interaction between groups, and the Tukey test was applied when the interaction was statistically significant (α=.05). RESULTS: The flexural strength showed a statistically significant difference (P<.05), with the peak value exhibited by the 0-degree group. A statistical difference was also observed between the angulation and modulus of elasticity; however, the highest value was exhibited by the 45-degree group. For the fracture topography, all groups observed a dimple-like fracture, although the 45-degree group showed wider cleavage planes of fractures than other angulations. For microhardness, the 0- and 45-degree groups exhibited a statistical difference in relation to the 90-degree group (P<.05). For surface properties, no statistically significant difference (P>.05) was found in any of the evaluated parameters. Dependence on the build angles was evidenced by the molten pool boundaries during observation of the microstructure. CONCLUSIONS: The build angle influenced the flexural strength and microhardness of the Co-Cr alloy produced by AM; however, it does not affect surface free energy and surface roughness.

Cleaning of long oval canals with WaveOne Gold system associated with different irrigant agitation protocols

Aim: The aim of the study was to evaluate the cleaning of mandibular incisors with WaveOne Gold® (WO) under different preparation techniques. Methods: A total of 210 human mandibular incisors were selected and divided into seven groups (n = 30), prepared by WO single-files (Small 20/.07 ­ WOS; Primary 25/.07 ­ WOP; Medium 35/.06 ­ WOM; or Large 45/.05 - WOL) and sequential-file techniques (WOS to WOP; WOS to WOM; and WOS to WOL). Further subdivision was made according to irrigation protocol: control group (manual irrigation - CON), E1 Irrisonic® - EIR, and EDDY® - EDD. Debris removal and the smear layer were evaluated by scanning electron microscopy. Data were analyzed by using Spearman's correlation test. The significance level was set at 5%. Results: For debris and smear layer removal, WOS and WOP, EIR differed from CON and EDD (p <0.05). Conclusion: Regardless of the instrumentation used, the agitation of the irrigant solution provided better cleanability. These findings reinforce the need for agitation techniques as adjuvants in cleaning root canal systems in mandibular incisors

Effect of a vinegar-hydrogen peroxide mixture on the surface properties of a cobalt-chromium alloy: A possible disinfectant for removable partial dentures.

STATEMENT OF PROBLEM: A vinegar-hydrogen peroxide mixture has been reported to be effective in eliminating Candida albicans and Staphylococcus aureus from acrylic resin, and its action has been reported to be comparable with that of sodium hypochlorite or peracetic acid. However, the effects of this mixture on cobalt-chromium alloys remain unknown. PURPOSE: The purpose of this in vitro study was to evaluate the surface roughness, Knoop microhardness, surface free energy, and wettability of a cobalt-chromium alloy when exposed to a vinegar-hydrogen peroxide mixture. MATERIAL AND METHODS: Fifty specimens of cobalt-chromium alloy were fabricated and immersed for 900 minutes, simulating 3 months of a daily 10-minute immersion in the following chemical agents (n=10): distilled water (W); 0.5% sodium hypochlorite (H); 3% hydrogen peroxide and water dilution in 1:1 ratio (HP); white-wine vinegar and water dilution in 1:1 ratio (V); and vinegar and hydrogen peroxide mixture in 1:1 ratio (VHP). Surface roughness, Knoop microhardness, surface free energy, and wettability were measured with single blinding before and after immersions. Data were statistically analyzed by using 2-way repeated measures ANOVA (α=.05). RESULTS: The vinegar-hydrogen peroxide mixture did not affect the surface roughness or Knoop microhardness. However, 0.5% sodium hypochlorite significantly increased the roughness and decreased microhardness. Surface free energy and wettability increased after immersions, regardless of the types of solution. CONCLUSIONS: Immersion in a vinegar-hydrogen peroxide mixture did not affect the surface characteristics of a cobalt-chromium alloy.

Effect of macrogeometry and bone type on insertion torque, primary stability, surface topography damage and titanium release of dental implants during surgical insertion into artificial bone.

This study investigated the influence of implant macrogeometry and bone type on insertion torque (IT), primary stability (ISQ), surface topography damage, and the amount of titanium (Ti) released during insertion. Forty implants with different macrogeometries (Facility - Cylindrical with spiral-shaped threads; Alvim - Tapered with buttress-shaped threads) were inserted into artificial bone types I-II and III-IV. Surface morphology was evaluated by Scanning Electron Microscope (SEM) and roughness parameters with Laser Scanning Confocal Microscopy (LSCM) before and after insertion (AI). Implant macrogeometry was characterized by LSCM. The chemical composition of bone beds was determined by SEM associated with Energy Dispersive X-Ray Spectroscopy. The amount of Ti released was analyzed with Energy Dispersive X-Ray Fluorescence. Alvim had greater IT and ISQ than Facility. Bone types I-II require higher IT of implants. Alvim also had greater internal threads angle, higher initial roughness, and significant reduction of roughness AI, compared to Facility. The functional surface height reduced AI, especially in flank and valley of threads. Height of surface roughness of Alvim and Facility implants was similar AI. Implants surface morphology changes and metallic particles on bone beds were observed after implant insertion, mainly into bone types III-IV. Implants inserted into bone types I-II showed less surface damage. Alvim implants released more Ti (37.52 ± 25.03 ppm) than Facility (11.66 ± 28.55 ppm) on bone types III-IV. The implant macrogeometry and bone types affect IT, ISQ, surface damage, and Ti amount released during insertion. Alvim implants were more wear susceptible, releasing higher Ti concentration during insertion into bone types III-IV.

Implant functionalization with mesoporous silica: A promising antibacterial strategy, but does such an implant osseointegrate?

OBJECTIVES: New strategies for implant surface functionalization in the prevention of peri-implantitis while not compromising osseointegration are currently explored. The aim of this in vivo study was to assess the osseointegration of a titanium-silica composite implant, previously shown to enable controlled release of therapeutic concentrations of chlorhexidine, in the Göttingen mini-pig oral model. MATERIAL AND METHODS: Three implant groups were designed: macroporous titanium implants (Ti-Porous); macroporous titanium implants infiltrated with mesoporous silica (Ti-Porous + SiO2 ); and conventional titanium implants (Ti-control). Mandibular last premolar and first molar teeth were extracted bilaterally and implants were installed. After 1 month healing, the bone in contact with the implant and the bone regeneration in the peri-implant gap was evaluated histomorphometrically. RESULTS: Bone-to-implant contact and peri-implant bone volume for Ti-Porous versus Ti-Porous + SiO2 implants did not differ significantly, but were significantly higher in the Ti-Control group compared with Ti-Porous + SiO2 implants. Functionalization of titanium implants via infiltration of a SiO2 phase into the titanium macropores does not seem to inhibit implant osseointegration. Yet, the importance of the implant macro-design, in particular the screw thread design in a marginal gap implant surgery set-up, was emphasized by the outstanding results of the Ti-Control implant. CONCLUSIONS: Next-generation implants made of macroporous Ti infiltrated with mesoporous SiO2 do not seem to compromise the osseointegration process. Such implant functionalization may be promising for the prevention and treatment of peri-implantitis given the evidenced potential of mesoporous SiO2 for controlled drug release.

Does implant surface hydrophilicity influence the maintenance of surface integrity after insertion into low-density artificial bone?

OBJECTIVE: To evaluate the influence of hydrophilicity on the surface integrity of implants after insertion in low-density artificial bone and to determine the distribution of titanium (Ti) particles along the bone bed. METHODS: Forty-eight dental implants with different designs (Titamax Ex, Facility, Alvim, and Drive) and surface treatments (Neoporos® and Aqua™) were inserted into artificial bone blocks with density compatible with bone type III-IV. Hydrophobic Neoporos® surfaces were obtained by sandblasting and acid etching while hydrophilic Aqua™ surfaces were obtained by sandblasting, acid etching, and storage in an isotonic 0.9% NaCl solution. The surface integrity was evaluated by Scanning Electron Microscope (SEM) and the surface roughness parameters (Sa, Sp, Ssk, Sdr, Spk, Sk, and Svk) and surface area were measured with Laser Scanning Confocal Microscopy before and after installation. Bone beds were inspected with Digital Microscopy and micro X-Ray Fluorescence (µ-XRF) to analyze the metallic element distribution along the bone bed. RESULTS: Acqua™ implants had higher initial Sa and a pronounced reduction of Sa and Sp during insertion, compared to NeoPoros® implants. After insertion, Sa and Sp of Acqua™ and NeoPoros® implants equalized, differing only between designs of Acqua™ implants. Surface damage was observed after insertion, mainly in the apical region. Facility implants that are made of TiG5 released fewer debris particles, while the highest Ti intensity was detected in the cervical region of the Titamax Ex Acqua™ and Drive Acqua™ implants. SIGNIFICANCE: Physicochemical modifications to achieve surface hydrophilicity created a rougher surface that was more susceptible to surface alterations, resulting in more Ti particle release into the bone bed during surgical insertion. The higher Ti intensities detected in the cervical region of bone beds may be related to peri-implantitis and marginal bone resorption.

Glucose effect on Candida albicans biofilm during tissue invasion.

OBJECTIVE: To evaluate, in vitro, the effect of two glucose concentrations (0.1 mM and 1.0 mM, simulating glucose concentration in saliva of healthy and diabetic individuals) on Candida albicans biofilm grown on epithelial monolayer. MATERIAL AND METHODS: C. albicans was inoculated on epithelial monolayers supplemented with 0.1 mM, 1.0 mM or no glucose. Control groups without C. albicans were also evaluated. Tissue response was assessed through the production of Interleukin-1α, Interleukin-8, Interleukin-6, Interleukin-10 and tumor necrosis factor-α. The complex of monolayer and biofilms were evaluated by quantitative reverse transcription polymerase chain reaction for expression of E-cadherin (CDH1), Caspase-3 (CASP3), ß-defensin-1 (DEFB-1) and ß-defensin-3 (DEFB-3). The biofilm architecture was visualized by confocal laser scanning microscopy. RESULTS: The production of Interleukin-1α and Interleukin-8 were increased in the presence of C. albicans (p < 0.05). Glucose did not interfere in the release of any cytokine evaluated. C. albicans downregulated transcripts for CDH1 (p < 0.05). Glucose did not induce a significant change in CDH1, CASP3, DEFB-1 and DEFB-3 messenger RNA expression. The biofilms were more structured in the presence of glucose, but no difference in the diffusion of hyphae through the epithelial cells were observed. CONCLUSIONS: The data suggest that glucose concentration does not affect the behavior of C. albicans during tissue invasion and other mechanisms must be related to the greater susceptibility of diabetic individuals to candidiasis.

Effect of Vehicle and Agitation Methods on the Penetration of Calcium Hydroxide Paste in the Dentinal Tubules.

INTRODUCTION: The aim of this ex vivo study was to analyze the effect of different vehicles combined with agitation methods on the penetration of calcium hydroxide (CH) paste in the dentinal tubules. METHODS: Sixty freshly extracted, single-rooted human premolars were prepared using WaveOne Gold (Dentsply Sirona, York, PA) and randomized into 6 experimental groups (n = 10) according to the vehicle and method of paste agitation as follows: propylene glycol (PG) + Lentulo, PG + Lentulo + ultrasound, PG + Lentulo + sonic, distilled water (DW) + Lentulo, DW + Lentulo + ultrasonic, and DW + Lentulo + sonic. The CH paste was manipulated with sodium fluorescein dye and was inserted to completely fill the root canal. Two 1-mm thick sections at 2 mm and 5 mm from the apex of each root were obtained. The sections were scanned using confocal laser scanning microscopy, and the images were analyzed using ImageJ software (Bethesda, MD) to calculate the percentage penetration and maximum penetration depth of CH paste. Statistical analysis was performed using 1-way analysis of variance and Tukey honestly significant difference post hoc tests. RESULTS: No statistically significant differences between study factors at a distance of 2 mm from the apex were observed (P > .05). However, at 5 mm, a significant difference between the vehicles (P < .05) in percentage penetration was demonstrated with higher means for PG. CONCLUSIONS: Vehicles interfered with the penetration of CH in the dentinal tubules at 5 mm from the apex with better results for PG.

In situ analysis of gelatinolytic activity in human dentin.

Matrix metalloproteinases (MMPs) such as gelatinases are differentially expressed in human tissues. These enzymes cleave specific substrates involved in cell signaling, tissue development and remodeling and tissue breakdown. Recent evidences show that gelatinases are crucial for normal dentin development and their activity is maintained throughout the entire tooth function in the oral cavity. Due to the lack of information about the exact location and activity of gelatinases in mature human dentin, the present study was designed to examine gelatinolytic levels in sound dentin. In situ zymography using confocal microscopy was performed on both mineralized and demineralized dentin samples. Sites presenting gelatinase activity were identified throughout the entire biological tissue pursuing different gelatinolytic levels for distinct areas: predentin and dentinal tubule regions presented higher gelatinolytic activity compared to intertubular dentin. Dentin regions with higher gelatinolytic activity immunohistochemically were partially correlated with MMP-2 expression. The maintenance of gelatinolytic activity in mature dentin may have biological implications related to biomineralization of predentin and tubular/peritubular dentinal regions, as well as regulation of defensive mechanisms of the dentin-pulp complex.

Short implants to support mandibular complete dentures - photoelastic analysis.

This study evaluated the stress behavior around short implants in edentulous atrophic mandibles. Six groups included implants with two diameters regular and wide (4 and 5 mm) and three lengths (5, 7 and 9 mm) as follows: Ci9 (9 x 4 mm), Ci7 (7 x 4 mm), Ci5 (5 x 4 mm), Wi9 (9 x 5 mm), Wi7 (7 x 5 mm) and Wi5 (5 x 5 mm). These groups were compared to the control group CG (11 x 4 mm). The analysis was performed with the photoelastic method (n = 6). Each model comprised 4 implants with the same length and diameter connected by a chromium-cobalt bar that simulates a fixed denture. A 0.15 kg force was applied at the end of the cantilever (15 mm), and the maximum shear stress was recorded around the distal and subsequent implants. The stress values were determined, and the quantitative data (Fringes®) were submitted to statistical analysis with one-way ANOVA and the Dunnett test (p < 0.05). It was observed that the reduction in implant length increased stress values with a significant difference (p < 0.05) between CG Ci7 and Ci5, while the increase in implant diameter reduced the stress values without any differences found between short and long implants. Implants with 5 and 7 mm with regular diameter increased stress levels while short implants with larger diameters experienced similar stress to that of longer implants.

Biomechanical Behavior of the Dental Implant Macrodesign.

PURPOSE: The aim of this study was to evaluate the influence of implant macrodesign when using different types of collar and thread designs on stress/strain distributions in a maxillary bone site. MATERIALS AND METHODS: Six groups were obtained from the combination of two collar designs (smooth and microthread) and three thread shapes (square, trapezoidal, and triangular) in external hexagon implants (4 × 10 mm) supporting a single zirconia crown in the maxillary first molar region. A 200-N axial occlusal load was applied to the crown, and measurements were made of the von Mises stress (σvM) for the implant, and tensile stress (σmax), shear stress (τmax), and strain (εmax) for the surrounding bone using tridimensional finite element analysis. The main effects of each level of the two factors investigated (collar and thread designs) were evaluated by one-way analysis of variance (ANOVA) at a 5% significance level. RESULTS: Collar design was the main factor of influence on von Mises stress in the implant and stresses/strain in the cortical bone, while thread design was the main factor of influence on stresses in the trabecular bone (P < .05). The optimal collar design able to produce more favorable stress/strain distribution was the microthreaded design for the cortical bone. For the trabecular bone, the triangular thread shape had the lowest stresses and strain values among the square and trapezoidal implants. CONCLUSION: Stress/strain distribution patterns were influenced by collar design in the implant and cortical bone, and by thread design in the trabecular bone. Microthreads and triangular thread-shape designs presented improved biomechanical behavior in posterior maxillary bone when compared with the smooth collar design and trapezoidal and square-shaped threads.

Short implants to support mandibular complete dentures - photoelastic analysis

Abstract This study evaluated the stress behavior around short implants in edentulous atrophic mandibles. Six groups included implants with two diameters regular and wide (4 and 5 mm) and three lengths (5, 7 and 9 mm) as follows: Ci9 (9 x 4 mm), Ci7 (7 x 4 mm), Ci5 (5 x 4 mm), Wi9 (9 x 5 mm), Wi7 (7 x 5 mm) and Wi5 (5 x 5 mm). These groups were compared to the control group CG (11 x 4 mm). The analysis was performed with the photoelastic method (n = 6). Each model comprised 4 implants with the same length and diameter connected by a chromium-cobalt bar that simulates a fixed denture. A 0.15 kg force was applied at the end of the cantilever (15 mm), and the maximum shear stress was recorded around the distal and subsequent implants. The stress values were determined, and the quantitative data (Fringes®) were submitted to statistical analysis with one-way ANOVA and the Dunnett test (p < 0.05). It was observed that the reduction in implant length increased stress values with a significant difference (p < 0.05) between CG Ci7 and Ci5, while the increase in implant diameter reduced the stress values without any differences found between short and long implants. Implants with 5 and 7 mm with regular diameter increased stress levels while short implants with larger diameters experienced similar stress to that of longer implants.

Prosthetic abutment influences bone biomechanical behavior of immediately loaded implants.

This study aimed to evaluate the influence of the type of prosthetic abutment associated to different implant connection on bone biomechanical behavior of immediately and delayed loaded implants. Computed tomography-based finite element models comprising a mandible with a single molar implant were created with different types of prosthetic abutment (UCLA or conical), implant connection (external hexagon, EH or internal hexagon, IH), and occlusal loading (axial or oblique), for both immediately and delayed loaded implants. Analysis of variance at 95%CI was used to evaluate the peak maximum principal stress and strain in bone after applying a 100 N occlusal load. The results showed that the type of prosthetic abutment influences bone stress/strain in only immediately loaded implants. Attachment of conical abutments to IH implants exhibited the best biomechanical behavior, with optimal distribution and dissipation of the load in peri-implant bone.

The role of prosthetic abutment material on the stress distribution in a maxillary single implant-supported fixed prosthesis.

PURPOSE: Evaluate the influence of abutment's material and geometry on stress distribution in a single implant-supported prosthesis. MATERIALS AND METHODS: Three-dimensional models were made based on tomographic slices of the upper middle incisor area, in which a morse taper implant was positioned and a titanium (Ti) or zirconia (ZrN) universal abutments was installed. The commercially available geometry of titanium (T) and zirconia (Z) abutments were used to draw two models, TM1 and ZM1 respectively, which served as control groups. These models were compared with 2 experimental groups were the mechanical properties of Z were applied to the titanium abutment (TM2) and vice versa for the zirconia abutment (ZM2). Subsequently, loading was simulated in two steps, starting with a preload phase, calculated with the respective friction coefficients of each materials, followed by a combined preload and chewing force. The maximum von Mises stress was described. Data were analyzed by two-way ANOVA that considered material composition, geometry and loading (p<0.05). RESULTS: Titanium and zirconia abutments showed similar von Mises stresses in the mechanical part of the four models. The area with the highest concentration of stress was the screw thread, following by the screw body. The highest stress levels occurred in screw thread was observed during the preloading phase in the ZM1 model (931MPa); and during the combined loading in the TM1 model (965MPa). Statistically significant differences were observed for loading, the material×loading interaction, and the loading×geometry interaction (p<0.05). Preloading contributed for 77.89% of the stress (p<0.05). There were no statistically significant differences to the other factors (p>0.05). CONCLUSION: The screw was the piece most intensely affected, mainly through the preload force, independent of the abutment's material.

Salivary pellicles equalise surfaces' charges and modulate the virulence of Candida albicans biofilm.

INTRODUCTION: Numerous environmental factors influence the pathogenesis of Candida biofilms and an understanding of these is necessary for appropriate clinical management. AIMS: To investigate the role of material type, pellicle and stage of biofilm development on the viability, bioactivity, virulence and structure of C. albicans biofilms. METHODS: The surface roughness (SR) and surface free energy (SFE) of acrylic and titanium discs was measured. Pellicles of saliva, or saliva supplemented with plasma, were formed on acrylic and titanium discs. Candida albicans biofilms were then generated for 1.5 h, 24h, 48 h and 72 h. The cell viability in biofilms was analysed by culture, whilst DNA concentration and the expression of Candida virulence genes (ALS1, ALS3 and HWP1) were evaluated using qPCR. Biofilm metabolic activity was determined using XTT reduction assay, and biofilm structure analysed by Scanning Electron Microscopy (SEM). RESULTS: Whilst the SR of acrylic and titanium did not significantly differ, the saliva with plasma pellicle increased significantly the total SFE of both surface. The number of viable microorganisms and DNA concentration increased with biofilm development, not differing within materials and pellicles. Biofilms developed on saliva with plasma pellicle surfaces had significantly higher activity after 24h and this was accompanied with higher expression of virulence genes at all periods. CONCLUSION: Induction of C. albicans virulence occurs with the presence of plasma proteins in pellicles, throughout biofilm growth. To mitigate such effects, reduction of increased plasmatic exudate, related to chronic inflammatory response, could aid the management of candidal biofilm-related infections.