Anti-biofilm effectiveness of protocols for cleaning complete dentures in hospitalized patients: a randomized controlled trial

Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.

Oral lichen planus in a young patient: a case report with nine-year follow-up / Líquen plano oral em paciente jovem: um relato de caso com acompanhamento de nove anos

INTRODUCTION: Oral lichen planus is an inflammatory condition that affects the stratified squamous epithelium of the oral mucosa. It occurs more frequently in female patients and it is rarely observed in children, adolescents, or young adults. This study aims to report a case of oral lichen planus in a young patient with a nine-year followup. CASE REPORT: A 19-year-old man reported to the Dentistry Department with a complaint of an asymptomatic white lesion on the dorsum and left lateral border of his tongue, which had appeared a few weeks before. Two weeks later, a second lesion, very similar to the previous one, appeared on the central region of his tongue. An incisional biopsy was performed. The histological slides were stained with hematoxylin-eosin and the expression of interleukin-1beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) was assessed by immunohistochemistry. No pharmacological treatment was prescribed. The clinical and histopathological findings were suggestive of oral lichen planus. The IL-1ß/TNF-α expression was low. There was a spontaneous regression of the lesions after approximately one year. The nine-year follow-up showed no signs of recurrence. CONCLUSION: This case presents atypical features such as the age of the patient and the spontaneous remission of the lesions.

INTRODUÇÃO: O líquen plano oral é uma condição inflamatória que acomete o epitélio escamoso estratificado da mucosa oral. Ocorre mais frequentemente em pacientes do gênero feminino e é raramente encontrado em pacientes pediátricos ou juvenis. O objetivo do presente estudo é relatar um caso de líquen plano oral em um paciente jovem com acompanhamento de nove anos. RELATO DE CASO: Um rapaz de 19 anos procurou atendimento no Departamento de Odontologia com a queixa de uma lesão branca assintomática em região de dorso e borda lateral esquerda de sua língua, com tempo de evolução de algumas semanas. Duas semanas depois, uma segunda lesão, muito similar à primeira, apareceu na região central de sua língua. Uma biópsia incisional foi realizada. As lâminas histológicas foram coradas com hematoxilina-eosina e a expressão de interleucina-1beta (IL-1ß) e de fator de necrose tumoral alfa (TNF-α) foram avaliadas por imunohistoquímica. Nenhum tratamento farmacológico foi prescrito. Os achados clínicos e histopatológicos foram sugestivos de líquen plano oral. A expressão de IL-1ß/TNF-α foi baixa. Houve uma regressão espontânea das lesões após aproximadamente um ano. O acompanhamento de nove anos não detectou sinais de recorrência. CONCLUSÃO: Esse caso apresenta características atípicas, como a idade do paciente e a remissão espontânea das lesões.

A novel acrylic resin palatal device contaminated with Candida albicans biofilm for denture stomatitis induction in Wistar rats

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.

Surface morphology and in vitro leachability of soft liners modified by the incorporation of antifungals for denture stomatitis treatment

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.

Porosity, water sorption and solubility of denture base acrylic resins polymerized conventionally or in microwave

Abstract 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.

Surface Properties of Temporary Soft Liners Modified by Minimum Inhibitory Concentrations of Antifungals

Abstract Evaluating the addition of minimum inhibitory concentrations (MICs) of antifungals for Candida albicans biofilm on the hardness and roughness of temporary denture soft liners. Specimens (n=8; 36×7×6 mm) of tissue conditioner (Softone) and resilient liner (Trusoft) were produced either without (control) or with incorporation of drugs at MICs: nystatin (0.032 g/mL), chlorhexidine diacetate (0.064 g/mL), ketoconazole (0.128 g/mL), miconazole (0.256 g/mL) and itraconazole (0.256 g/mL). Specimens were stored in distilled water at 37 °C for 24 h, 7 days and 14 days prior to the hardness/roughness measurements. Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). The addition of the antifungals into both materials demonstrated no evident hardness change or decrease of this property compared with the control, except for miconazole in Softone, which increased the hardness after 14 days (p=0.003). The addition of nystatin into both materials, chlorhexidine in Trusoft and ketoconazole in Softone resulted in no significant changes of roughness compared with the control, after 7 days and 14 days (p>0.05). In these periods, itraconazole increased the roughness of both materials (p<0.001). The addition of all antifungals, except for the miconazole in Softone, resulted in no deleterious effects on the materials’ hardness over the evaluation time. The MICs of nystatin in both temporary soft lining materials, ketoconazole in Softone and chlorhexidine in Trusoft resulted in no deleterious effects for roughness up to 14 days.

Resumo Avaliar a adição de antifúngicos nas mínimas concentrações inibitórias (MCIs) para o biofilme de Candida albicans sobre a dureza e rugosidade da reembasadores resilientes temporários. Foram confeccionados corpos de prova (n=8; 36×7×6 mm) a partir de um condicionador de tecido (Softone) e um reembasador resiliente (Trusoft), sem (controle) ou com a incorporação de fármacos nas MCIs: nistatina (0,032 g/mL), diacetato de clorexidina (0,064 g/mL), cetoconazol (0,128 g/mL), miconazol (0,256 g/mL) e itraconazol (0,256 g/mL). Os corpos de prova foram armazenados em água destilada a 37 °C durante 24 h, 7 dias e 14 dias antes das mensurações de dureza e rugosidade. Os dados foram analisados por ANOVA 3-fatores e teste de Tukey HSD (α=0,05). A adição dos antifúngicos em ambos os materiais não demonstrou nenhuma alteração evidente na dureza ou diminuiu esta propriedade em comparação com o controle, exceto para o miconazol no Softone que aumentou a dureza após 14 dias (p=0,003). A adição de nistatina aos dois materiais, clorexidina no Trusoft e cetoconazol no Softone não resultou em alterações significativas de rugosidade em comparação com o controle após 7 e 14 dias (p>0,05). Nestes períodos, o itraconazol aumentou a rugosidade de ambos os materiais (p<0,001). A adição de todos os antifúngicos, exceto para o miconazol no Softone, não resultou em efeitos deletérios sobre a dureza dos materiais ao longo do tempo de avaliação. As MCIs de nistatina em ambos os materiais reembasadores resilientes temporários, cetoconazol no Softone e clorexidina no Trusoft não produziram efeitos deletérios para a rugosidade em até 14 dias.

Porosity of temporary denture soft liners containing antifungal agents

ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.

Surface properties of multilayered, acrylic resin artificial teeth after immersion in staining beverages

AbstractObjective To evaluate the effect of staining beverages (coffee, orange juice, and red wine) on the Vickers hardness and surface roughness of the base (BL) and enamel (EL) layers of improved artificial teeth (Vivodent and Trilux).Material and Methods Specimens (n=8) were stored in distilled water at 37°C for 24 h and then submitted to the tests. Afterwards, specimens were immersed in one of the staining solutions or distilled water (control) at 37°C, and the tests were also performed after 15 and 30 days of immersion. Data were analyzed using 3-way ANOVA and Tukey’s test (α=0.05).Results Vivodent teeth exhibited a continuous decrease (p<0.0005) in hardness of both layers for up to 30 days of immersion in all solutions. For Trilux teeth, similar results were found for the EL (p<0.004), and the BL showed a decrease in hardness after 15 days of immersion (p<0.01). At the end of 30 days, this reduction was not observed for coffee and water (p>0.15), but red wine and orange juice continuously reduced hardness values (p<0.0004). Red wine caused the most significant hardness changes, followed by orange juice, coffee, and water (p<0.006). No significant differences in roughness were observed for both layers of the teeth during the immersion period, despite the beverage (p>0.06).Conclusions Hardness of the two brands of acrylic teeth was reduced by all staining beverages, mainly for red wine. Roughness of both layers of the teeth was not affected by long-term immersion in the beverages.

Overlay removable partial denture as temporary restoration of vertical dimension of occlusion in a bruxist patient / Overlay removível como tratamento provisório para restabelecimento da dimensão vertical de oclusão de paciente bruxista

The reestablishment of the vertical dimension of occlusion is an important phase during prosthodontics treatment. Its reduction can be a consequence of severe bruxism, and patient rehabilitation requires complex, expensive, and long treatments. In this context, an overlay removable partial denture is a viable alternative, as it represents a simple manufactured reversible treatment. As a temporary treatment, it does not require tooth wear, reestablishes vertical dimension of occlusion, and allows the patient to adapt to this new dimension until the definitive rehabilitation treatment can be planned and finished. This case report describes the temporary rehabilitation of a maxillary complete edentulous bruxist patient with excessive tooth wear on his lower jaw, seeking treatment at the Removable Prosthodontics Department at State University of Ponta Grossa to replace his upper complete denture. A new complete denture was made ​​and the implementation of an overlay removable partial denture was proposed to be made to the lower arch, which provided aesthetics and function to the patient until the completion of the definitive work. The patient was instructed and guided about the causal factors and consequences of his parafunctional habit and was taught methods for self-perception to control frequency. For the final rehabilitation, ​​a new maxillary complete denture with metal occlusal surfaces will be made as well as metaloceramic crowns with metal occlusal using intraradicular retention with cast posts. An occlusal splint will be inserted in the lower jaw as supportive therapy to control the parafunctional habit.

O restabelecimento da dimensão vertical de oclusão é uma etapa importante e indispensável durante a realização de trabalhos protéticos. Sua diminuição pode ser consequência do bruxismo severo e a reabilitação dos pacientes exige a realização de tratamentos complexos, de alto custo e tempo prolongado para execução. Neste contexto, a prótese parcial removível overlay é uma alternativa viável, pela reversibilidade do tratamento e simplicidade de execução. Como tratamento provisório, não necessita de preparo dental, restabelece a dimensão vertical de oclusão e permite que o paciente se adapte a esta nova dimensão, até que seja planejado e executado o tratamento reabilitador definitivo. O presente caso clínico descreve a reabilitação provisória de um paciente bruxista, desdentado total superior, com desgaste dental excessivo na arcada inferior que procurou tratamento na Clínica de Prótese Removível da Universidade Estadual de Ponta Grossa para substituição de sua prótese total superior. Uma nova prótese total foi confeccionada e proposta a execução de uma prótese parcial removível overlay para o arco inferior, a qual devolveu estética e função ao paciente até a realização do trabalho definitivo. O paciente foi instruído e orientado sobre os fatores desencadeantes e consequências de seu hábito parafuncional e conscientizado no intuito da autopercepção para controle da frequência. Para a reabilitação final, será confeccionada uma nova prótese total superior com superfícies oclusais metálicas, coroas metalocerâmicas com oclusal em metal utilizando retenção intracanal com núcleos metálicos fundidos. Uma placa miorrelaxante será instalada sobre a arcada inferior como terapia de suporte para controle do hábito parafuncional.

Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy / Temporomandibular disorders in patients with removable partial dentures: prevalence according to Kennedy classification

Objetivo: O objetivo deste estudo foi determinar a prevalência das desordens temporomandibulares em pacientes com prótese parcial removível, de acordo com a classificação de Kennedy. Método: A população estudada consistiu de pacientes que procuraram tratamento na Universidade Estadual de Ponta Grossa. Os pacientes selecionados eram usuários de prótese total superior e prótese parcial removível inferior, e esse uso, à época do estudo, fazia entre 1 e 5 anos. Os pacientes foram divididos em cinco grupos (n = 15): G1: usuários de prótese total superior e prótese parcial removível inferior Classe I (Kennedy); G2: usuários de prótese total superior e prótese parcial removível inferior Classe II (Kennedy); G3: usuários de prótese total superior e prótese parcial removível inferior Classe III (Kennedy); G4: usuários de prótese total superior e prótese parcial removível inferior Classe IV (Kennedy), e G5: pacientes totalmente dentados (grupo controle). O questionário de Fonseca foi aplicado para verificar o grau de DTM. O teste qui-quadrado (α = 0,05) foi usado para avaliar a associação entre as variáveis. Resultado: Nenhuma diferença estatística (P > 0,05) foi encontrada entre os grupos. Em todos os grupos, os pacientes apresentaram DTM leve ou moderada. Conclusão: Os resultados deste estudo clínico mostraram que a presença de DTM em pacientes usuários de prótese não pôde ser correlacionada ao uso de prótese, já que a presença de DTM para pacientes desdentados e dentados apresentou-se semelhante.

Objective: The aim of this study was to determine the prevalence of temporomandibular disorders in patients with removable partial dentures according to Kennedy classification. Method: The population consisted of patients who required care at the State University of Ponta Grossa. The patients wore complete upper and lower removable partial dentures between 1 to 5 years. The patients were divided into five groups (n = 15): G1: wearer of complete maxillary denture opposed by a Class I (Kennedy) removable partial denture; G2: wearer of complete maxillary denture opposed by a Class II (Kennedy) removable partial denture; G3: wearer of complete maxillary denture opposed by a Class III (Kennedy) removable partial denture; G4: wearer of complete maxillary denture opposed by a Class IV (Kennedy) removable partial denture and G5: fully dentate patients (control group). Fonseca's questionnaire was applied to verify the level of TMD. The qui-square test (α = .05) was used to analyze association between the variables. Result: No statistical difference (P > 0.05) was found among groups. All groups showed mild or moderate TMD. Conclusion: The findings from this clinical study showed that the presence of TMD in wearers of removable partial denture could not be correlated to the classification of Kennedy, since the presence of TMD for edentulous patients and dentate patients appeared similar.

Montagem de modelos de próteses removíveis em articulador semiajustável / Mounting casts from removable prostheses in semi adjustable articulator

Introdução: O relacionamento dos modelos de diagnóstico ou de trabalho em articulador semiajustável é um dos procedimentos mais importantes no tratamento reabilitador com próteses removíveis parciais ou totais. Objetivo:  Este trabalho descreve as diversas etapas da montagem em articulador semiajustável em situações de dois pacientes com arcos parcial ou totalmente edêntulos. Material e método: Foram discutidos os materiais e as técnicas que são indicados para registro das relações intermaxilares, inclusive em situações diferentes dos casos apresentados. Conclusão: A montagem de modelos de pacientes parcialmente edêntulos em articulador é de grande importância e apresenta uma ampla variação de indicação de acordo com diferentes situações.

Introduction: Articulating preliminary or working casts in semiadjustable articulators is one of the most important procedures in the prosthetic rehabilitation of partially and fully edentulous patients. Objective: This work described the several steps involving mounting casts in semiadjustable articulator in cases of two patients presenting partial and fully edentulous arcs. Material and method: It was discussed the recommended material and techniques for recording the maxilomandibular positions, including a range of situations different from the presented cases. Conclusion: The fitting of models of the edentulous patients in articulator is of great importance and presents a wide range of indication according to different situations.

Prevalência das desordens temporomandibulares em graduandos da Universidade Estadual de Ponta Grossa / Prevalence of temporomandibular disorders in university students at the State University of Ponta Grossa

Objetivo: Determinar a prevalência das DTM em graduandos de Odontologia da Universidade Estadual de Ponta Grossa. Materiais e Métodos: Foram examinados 153 estudantes de todos os períodos, com idades entre 17 e 25 anos. Foram excluídos os graduandos em tratamento ortodôntico e aqueles com doenças sistêmicas graves, tais como neoplasias. Para determinação da prevalência e obtenção do diagnóstico das DTM foi utilizada uma ficha clínica composta por questionário de saúde e exame físico detalhados. Durante o exame físico, foi realizada a palpação bidigital e auscultação das articulações temporomandibulares, bem como a análise dos movimentos mandibulares e da amplitude de abertura bucal. Também foi realizada a palpação bidigital dos músculos mastigatórios e associados. Os dados foram analisados pelo teste Qui-quadrado (χ2) ao nível de significância de 99% (α=0,01). Resultados: Os resultados mostraram que 39% dos graduandos apresentaram algum tipo de DTM (p=0,004), sendo que 73% eram do gênero feminino (p<0,001). Foi observada uma porcentagem de 93% de desordens articulares e 7% de desordens musculares, tendo sido 78% isoladas e 22% associadas (p<0,001). A DTM articular mais prevalente, independente do gênero, foi o deslocamento do disco com redução (68%) (p<0,001). Conclusão: A partir da análise dos dados, concluiu-se que quase metade dos pacientes avaliados apresentou algum tipo de DTM e que a grande maioria foi do gênero feminino. Além disso, observou-se que a DTM articular foi a mais prevalente.

Prevalência das desordens temporomandibulares em pacientes assistidos nas diferentes clínicas do Departamento de Odontologia da Universidade Estadual de Ponta Grossa / Prevalence of temporomandibular disorders in patients treated in different clinics of the Department of Dentistry of the Ponta Grossa State University

Objetivo: O objetivo desse estudo foi determinar a prevalência das Desordens Temporomandibulares(DTM) em pacientes atendidos nas diferentes clínicas do Departamento de Odontologiada Universidade Estadual de Ponta Grossa (PR). Material e Método - Os pacientes selecionados assinaram o termo de consentimento livre e esclarecido e a pesquisa foi aprovada pelo Comitê deÉtica e Pesquisa da Universidade Estadual de Ponta Grossa. Foram examinados 107 pacientes comidade entre 18 e 56 anos, os quais foram avaliados de acordo com o Critério de Diagnóstico das Desordens Temporomandibulares (RDC/TMD). Os resultados foram avaliados por meio do testequi-quadrado (χ2) ao nível de significância de 99%. Resultados - Os resultados mostraram que 52,3% dos pacientes apresentaram algum tipo de DTM, sendo que 68,2% eram do gênero feminino(p=0,0013). Das DTMs observadas, 78% eram desordens articulares e 22% eram desordens musculares, tendo sido 74,4% isoladas e 25,6% associadas (p=0,0000). Independente do gênero,a DTM articular mais prevalente (n=74) foi o deslocamento do disco com redução (p=0,0000) ea DTM muscular (n=24) mais prevalente foi a dor miofascial (p=0,0001). Conclusão - A partirda análise dos dados, concluiu-se que cerca da metade dos pacientes avaliados apresentou algumtipo de DTM e que a grande maioria foi do gênero feminino. Além disso, observou-se que a DTM articular foi mais prevalente que a muscular.

Objectives: The aim of this study was to determine the prevalence of TemporomandibularDisorders (TMD) in patients from different clinics of the Department of Dentistry of the PontaGrossa State University. Material and Method -The selected patients received informed consentterm authorizing the research, witch was approved by the Ethics and Research Committee of thePonta Grossa State University. 107 patients, with ages between 18 and 56 years were examinedaccording to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Thechi-squared test (x²) was applied to significance level of 99%. Results - The results showed that52,3% of patients presented some category of TMD, even though 68,2% were women (p=0,0013).It was observed a percentage of 78% of articular disorders and 22% of muscular disorders,being 74,4% isolated and 25,6% associated (p=0,0000). Regardless of gender, the most prevalent articular TMD (n=74) was the disc displacement with reduction (p=0,0000) and the most prevalent muscular TMD (n=24) was the myofascial pain (p=0,0001). Conclusion - From the results, was concluded that there about half of the evaluated patients presented some kind of TMD and most ofthem were of female gender. Furthermore, observed that the articular TMD was more prevalentthan the muscular one.

Efeito do ciclo de polimerização sobre a dureza de resinas acrílicas para base de prótese polimerizadas convencionalmente ou em micro-ondas / Effect of polymerization cycle on hardness of denture base acrylic resins polymerized by conventional water bath or microwave irradiation

Introdução: O tempo de polimerização reduz-se significativamente com a utilização do micro-ondas e esse método pode polimerizar com eficiência as resinas acrílicas para base de prótese. O objetivo deste estudo foi avaliar o efeito de ciclos de polimerização, em banho de água aquecida(B) e em micro-ondas (M), sobre a dureza de resinas acrílicas formuladas para serem processadas convencionalmente (Vipi Cril®-VC) ou por micro-ondas (Vipi Wave®-VW). Material e Métodos- Corpos de prova (n=8) foram confeccionados nas dimensões de 64x10x3,3 mm e armazenados em água destilada em estufa a 37ºC por 48h. Amostras de cada material termopolimerizável convencional(VC) ou para micro-ondas (VW) foram divididas aleatoriamente em dois grupos: ciclos de polimerização recomendados pelo fabricante em banho de água aquecida (VCB e VWB) ou em micro-ondas (VCM e VWM). As mensurações de dureza (VHN) foram realizadas utilizando-se um microdurômetro Vickers com carga de 50g durante 10s. Os resultados foram submetidos à ANOVA2 fatores seguida pelo teste de Tukey (α=0,05). Resultados - Independentemente do ciclo utilizado,não houve diferença estatisticamente significante entre os materiais avaliados (P=0,38). Foram observados valores de dureza maiores (P=0,00003) quando os ciclos de polimerização das resinas acrílicas foram invertidos (VCM=48,2>VCB=32,9; VWB=50,5>VWM=24,1). Conclusões - As resinas acrílicas apresentaram valores de dureza sem diferença significativa quando polimerizadas de acordo com as instruções do fabricante. A polimerização da resina Vipi Cril em micro-ondas e da resina Vipi Wave em banho de água resultou em valores de dureza superiores.

Introduction: The processing time is significantly reduced with using microwave and this method can efficiently polymerize denture base acrylic resins. The aim of this study was to evaluate the effect of water-bath (W) and microwave (M) polymerization cycles on hardness of water-bath (VipiCril®-VC) or microwave-polymerized acrylic resin (Vipi Wave®-VW). Material and Methods -Specimens (n=8) of the heat-polymerized denture base acrylic resins were made (64x10x3.3 mm)and stored in distilled water at 37ºC during 48h. After that, specimens of water-bath polymerized(VC) or microwave processed (VW) materials were randomly divided into two groups according to the polymerization cycles recommended by the manufacturer: water-bath (VCW and VWW)or microwave irradiation (VCM and VWM). Hardness measurements (VHN) were made with ahardness tester operated under a 50-g load and a 10-second dwell time. Results were analyzed with 2-way ANOVA and Tukey’s test (α=0.05). Results - Regardless of polymerization cycle,no significant difference was observed between the evaluated materials (P=0.38). The highest hardness values (P=0.00003) were obtained when the polymerization cycles were inverted(VCM=48.2>VCB=32.9; VWB=50.5>VWM=24.1). Conclusions - Vipi Cril and Vipi Wave acrylic resins showed hardness values without significant difference after being polymerized according to the manufacturer’s instructions. Higher hardness values were obtained in Vipi Cril microwavepolymerized and in Vipi Wave water-bath polymerized specimens.

Efeito da termociclagem sobre a rugosidade de reembasadores resilientes / Effect of thermocycling on surface roughness of soft denture liners

Objetivo: Este estudo buscou avaliar o efeito do armazenamento em água e da termociclagem sobre a rugosidade de reembasadores resilientes. Material e método: Quatro reembasadores resilientes (Ufi-gel P, Dentuflex, Trusoft e Dentusoft) foram selecionados. Os materiais foram preparados de acordo com as instruções dos fabricantes e colocados em matrizes vazadas com 20 mm de diâmetro e 5 mm de espessura. Cinco corpos de prova de cada resina foram fabricados e a rugosidade superficial (Ra) foi avaliada de acordo com os seguintes grupos experimentais: GC (grupo controle): imediatamente após a confecção das amostras; GA: após armazenamento em água destilada a 37 °C por 24 horas; GT: após termociclagem. Os resultados foram submetidos à análise de variância de dois fatores, seguida do teste de Tukey (a = 0,05). Resultado: A resina Ufigel P apresentou menores valores de rugosidade (p = 0,000368) em relação aos outros materiais. No período inicial de avaliação (GC) e após 24 horas de armazenamento em água (GA), não houve alteração da rugosidade para todos os materiais testados (p > 0,05). Após a termociclagem, houve aumento significativo da rugosidade apenas para o reembasador Dentusoft (p = 0,000368). Conclusão: A ciclagem térmica aumentou os valores de rugosidade para a resina Dentusoft, não havendo qualquer alteração para os demais materiais.

Purpose: This study evaluated the effect of storage in water and thermocycling on roughness of reline materials. Material and method: Four reline materials (Ufi-gel P, Dentuflex, Trusoft and Dentusoft) were selected. The materials were prepared according to the manufacturers' instructions and were placed in stainless steel moulds (20 mm in diameter and 5 mm thick). Five samples of each resin were made (n = 5) and roughness (Ra) analyses according to the following experimental conditions: GC (control group): immediately after specimen preparation; GA: after storage in distilled water at 37 °C for 24 hours; GT: after thermocycling. Data were submitted to 2-way ANOVA followed by Tukey's test (a = 0.05). Result: Ufigel P resin had smaller surface roughness values (p = 0.000368) than the other ones. The initial period of evaluation (GC) and storage in water (GA) did not change roughness of the tested materials (p > 0.05). There was a significant increase in roughness after thermocycling only for Dentusoft (p = 0.000368). Conclusion: Thermocycling increased the roughness of the Dentusoft, with no change to the other materials.

Tratamento de superfície de cerâmica pura para cimentação com cimentos resinosos / Surface conditioning of all-ceramic systems for bonding to resin cements

A realização do tratamento de superfície em cerâmica pura visa criar microirregularidades internas para aumentar a resistência mecânica da interface de união com o cimento resinoso. O objetivo desse trabalho de revisão de literatura foi determinar o melhor tratamento de superfície para os sistemas IPS Empress, IPS Empress 2, In-Ceram Alumina, In-Ceram Zirconia e Procera All-Ceram. Foi possível observar que as cerâmicas reforçadas por leucita ou dissilicato de lítio são facilmente condicionadas com ácido hidrofuorídrico seguido por silanização. A associação de silicatização, silanização e cimentação com cimentos resinosos à base de monômero fosfatado proporciona altos valores de resistência de união para cerâmicas à base de óxido de alumina ou óxido de alumina e zircônio e aluminizada densamente sinterizada.

Surface conditioning methods of all-ceramic systems are used to create micromechanical interlocking to enhance the bond strength of resin cement to the ceramic surface. The aim of this literature review was to recognize the most reliable surface conditioning method for durable bond of resin cement to IPS Empress, IPS Empress 2, In-Ceram Alumina, In-Ceram Zirconia, and Procera All-Ceram. It was found that leucite- and lithium disilicate-based ceramics are easily etched by hydrofuoridric acid followed by silanization. The association of silica coating, silanization, and resins containing phosphate monomers showed high bond strength values for glass-infltrated alumina, glass-infltrated zirconia, and densely-sintered high-purity aluminum-oxide ceramics.

Associação entre otalgia, zumbido, vertigem e hipoacusia com desordens temporomandibulares / Association between otalgia, tinnitus, vertigo and hypoacusia, with temporomandibular disorders

Devido à coexistência de sinais e sintomas não específicos com outros bem estabelecidos no contexto das desordens temporomandibulares,torna-se difícil para o clínico decidir o que realmente deve ser incluído no diagnóstico e plano de tratamento. Este trabalho teve por objetivo avaliar, por meio de uma revisão da literatura, a importância da ocorrência dos sintomas aurais de otalgia, zumbido, vertigem e hipoacusia em pacientes com desordem temporomandibular. Ainda que muitas teorias tenham sido relatadas para explicar a relação entre os sintomas aurais e as desordens temporomandibulares, a ampla variação entre os resultados dos estudos revisados dificulta o estabelecimento da prevalência desses sintomas concomitantemente às desordens temporomandibulares. Além disso, essa ocorrência não necessariamente implica em uma relação de causa-efeito. Devido às dificuldades de diagnóstico da relação entre os achados, diferentes tipos de tratamentos devem ser considerados para que os sintomas não específicos das desordens temporomandibulares também sejam efetivamente controlados. É imprescindível que o cirurgião-dentista conheça as possíveis etiologias dos sintomas aurais para saber se há uma provável associação com as desordens temporomandibulares e, assim, incluí-los no plano de tratamento.

Because nonespecific symptoms and signs are associated with others well-established in the temporomandibular disorders, it is difficult for the clinician to decide what symptoms and signs should be considered during the diagnosis and the treatment plan. Therefore, the aim of this literature review was to evaluate the prevalence of aural symptoms (otalgias, tinnitus, dizziness and deafness) in patients with orofacial pain. Although several hypotheses have been proposed to explain the association between aural symptoms and temporomandibular disorders, the results of the previous studies differed in magnitude. For this reason, it is difficult to establish the prevalence of these aural symptoms concomitantly with temporomandibular disorders. Moreover, such relationship does not necessarily imply a cause-effect relationship. Because of the diagnosis complexity, different treatments must be considered, so the nonespecific symptoms of temporomandibular disorders can be effectively controlled as well. It is crucial for the the clinician to be aware of the possible etiology of aural symptoms, so he should determine if such symptoms may be associated with temporomandibular disorders and thus include them in the treatment.

Efeito de tratamentos pós-polimerização sobre o peso molecular, o grau de conversão, a temperatura de transição vítrea e a liberação in vitro de monômero residual, plastificante e produtos de degradação de resinas acrílicas para reembasamento imediato / Effect of post-polymerization treatments on molecular weight, degree of conversion, glass transition temperature, and in vitro leachability of residual monomer, plasticizer, and degradation products of hard chairside reline resins

Os objetivos deste estudo foram avaliar: 1. o efeito de tratamentos póspolimerização (MW-irradiação por energia de microondas e WB-imersão em água aquecida) sobre o grau de conversão (DC) de resinas acrílicas para reembasamento imediato (Ufi Gel hard-U, Kooliner-K e Tokuso Rebase Fast-T) e de uma resina acrílica para base de prótese (Lucitone 550-L), submetida a dois ciclos de polimerização (LS-curto e LL-longo) por espectroscopia FT-Raman; 2. o peso molecular (M w) do pré-polímero dos materiais U, K, T e L e das amostras polimerizadas da resina K (controle; MW e WB) por GPC; 3. o efeito de MW e WB na temperatura de transição vítrea (Tg) das resinas para reembasamento imediato (Duraliner II-D, K, New Truliner-N, U e T) e da resina para base de prótese (LS e LL) por DSC; 4. o efeito de WB na liberação de compostos residuais (isobutil metacrilato-IBMA, 1,6-hexanediol dimetacrilato-1,6-HDMA e DBNP-dibutil-n-ftalato) a partir das resinas para reembasamento imediato K, N, U e T para saliva artificial por CLAE; 5. o efeito de WB na liberação de produtos de degradação (ácido metacrílico-MA e ácido benzóico-BA) a partir das resinas para reembasamento imediato K, N, U e T para saliva artificial por CLAE. Amostras do grupo controle não foram submetidas a nenhum tratamento. Os resultados de DC (porcentagem) foram analisados pelo teste de Kruskal-Wallis (_=0,05). Os resultados de Tg (ºC) foram analisados pela análise de variância (ANOVA), seguido pelo teste de Tukey (_=0,05)...

Influence of curing accelerator for cyanoacrylate glues on physical properties of adhesive resins

The objectives of this study were to evaluate the effect of a curing accelerator (CA) on the ultimate tensile strength (UTS) and degree of conversion (DC) of two adhesive systems, Single Bond and Clearfil SE Bond, as well as to identify the composition of the CA hour-glass adhesive resin samples with a cross sectional area of 0,8 mm² at the "neck" were tested in tension using a Universal Testing Machine. Fourier transform infrared spectroscopy (FTIR) was used to analyse thin films of each adhesive resin. All samples were stored in the dark for 24 hours before they were tested. During the UTS and FTIR analyses, the contact of the CA with samples was either avoided or not. The gas chromatography mass spectrocopy (GC-MS) and the nuclear magnetic resonance (NMR) analyses determined the molecular weight and structure of the CA. UTS and DC were analyzed by ANOVA and Tukey's test at 95% of confidence. The use of the CA did not affect the UST (p=0.5996) but increased the DC of the samples (p<0.0001). The compound identified by GC-MS and NMR was N-dimethyl p-toluidine. The application of CA in microtensile bond strength methodology raises concern regarding its effects on poorly polymerized adhesive systems.

Prótese fixa implanto-suportada com carga imediata em paciente desdentado total inferior / Implant-retained mandibular fixed prosthesis with immediate loading in completely edentulous jaw

Com estabilização e cargas oclusais apropriadas, implantes mandibulares podem sersubmetidos à carga imediata em pacientes desdentados totais, sem prejuízos à osseointegração.No caso clínico estudado, o paciente foi submetido à carga imediata, utilizando-se implantes deestágio cirúrgico único e prótese total fixa. Seis implantes foram instalados na região interforaminalcom o auxílio de guia cirúrgico. Posteriormente, foi realizada a moldagem de transferência para aconfecção de uma barra metálica, que possibilitou a instalação da prótese total fixa 48 horas apósa colocação dos implantes. Essa técnica permitiu a obtenção de satisfação do paciente e sucessodo caso com diminuição do tempo de tratamento em relação à técnica convencional.

Mandibular implants can be immediately loaded in totally edentulous patientswith no impairment to osseointegration if appropriate occlusal load and stabilization be used. Inthe present case, the patient was submitted to immediate loading using single-stage implants andfixed prosthodontics. Six implants were placed in the interforaminal region with a surgical guideanatomic for improved implant placement. Following this procedure it was carried out a transferimpression for construction of a metallic bar, which allowed the installation of the screw-retainedfixed prosthesis 48 hours after the osseointegrated implant placement. This technique resulted inpatientÆs satisfaction and success of the case with reduced treatment time when compared to theconventional technique.