Criteria for choosing prosthetic biomaterials according to their physicochemical properties for anterior and posterior sectors. a comprehensive review.

Objective: To describe the existing knowledge about metal-free prosthetic biomaterials according to their physicochemical properties and based on this, define criteria for their placement in both the anterior and posterior sectors. Materials and methods: A digital search was carried out in the databases: PubMed/Medline, Scopus, Web of Science and Google Scholar of the literature published in the English language without time restrictions and included original articles such as case reports, retrospective and prospective studies, narrative, comprehensive, systematic reviews and meta-analysis. Meanwhile, short communications, editorials and articles in a language other than English were excluded. Results: 40 articles were evaluated, published between 2000 and 2023. The main characteristics and physicochemical properties of ceramic biomaterials such as zirconia, feldspathic based ceramics, lithium disilicate and alumina, among others, were analyzed and summarized. In addition, certain criteria were defined based on the available scientific evidence on the use of different ceramic systems both in the anterior sector and in the posterior sector for patients who need some type of prosthetic restoration. Conclusions: Among the different metal-free materials used for the construction of fixed dental prostheses, zirconia has been shown to have better aesthetic, biomechanical and biocompatibility properties, which makes it a candidate material for the rehabilitation of partially edentulous patients.

Objetivo: Describir el conocimiento existente sobre los biomateriales protésicos libres de metal, según sus propiedades fisicoquímicas, y definir, con base en ello, criterios para su colocación tanto en el sector anterior como en el posterior. Materiales y métodos: Se realizó una búsqueda digital en las bases de datos PubMed/Medline, Scopus, Web of Science y Google Scholar de la literatura publicada en idioma inglés, sin restricciones de tiempo. Se incluyó artículos originales como reportes de casos, estudios retrospectivos y prospectivos, revisiones y metanálisis narrativos, exhaustivos y sistemáticos. Por otra parte, se excluyeron comunicaciones breves, editoriales y artículos en idioma distinto al inglés. Resultados: Se evaluaron 40 artículos, publicados entre 2000 y 2023. Se analizaron y resumieron las principales características y propiedades fisicoquímicas de biomateriales cerámicos, como circonia, cerámicas de base feldespática, disilicato de litio y alúmina, entre otros. Además, se definieron ciertos criterios basados en la evidencia científica disponible sobre el uso de diferentes sistemas cerámicos, tanto en el sector anterior como en el posterior, para pacientes que necesitan algún tipo de restauración protésica. Conclusiones: Entre los diferentes materiales libres de metales utilizados para la construcción de prótesis dentales fijas, la circonia ha demostrado tener mejores propiedades estéticas, biomecánicas y de biocompatibilidad, lo que la convierte en un material candidato para la rehabilitación del paciente parcialmente edéntulo.

Aesthetic oral rehabilitation of the upper-anterior sector with supra-nano filling resin in a patient with woolly hair syndrome: case report.

BACKGROUND: Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE: To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE: A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION: The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.

Is Periodontal and Peri- Implant Disease Associated with Fixed Partial Denture Use? A 25-year Prospective Case Series.

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs). METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05). RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses. CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

Rehabilitation of a Full-Arch Patient with Cemented Metal-Ceramic Multiple Prostheses on Implants: A Case Report / Reabilitação de paciente de arco completo com Próteses Múltiplas Metalocerâmicas Cimentadas sobre Implantes ­ relato de caso

Objective: To report a clinical case of a female patient rehabilitated with Cemented Metal-Ceramic Multiple Prostheses on Implants in the upper arch. Materials and Methods: A multidisciplinary approach was employed, utilizing various clinical skills to achieve satisfactory outcomes in the rehabilitation of a fully edentulous patient. The treatment plan involved the use of cemented metal-ceramic prostheses, with a focus on optimizing the positioning of the crown margins to ensure periodontal health. Results: The use of cemented metal-ceramic multiple prostheses effectively addressed the patient's aesthetic concerns by eliminating screw access holes and ensuring the continuity of the ceramic material. The supragingival positioning of the crown margins prevented excess cement in the peri-implant sulcus, promoting periodontal health. The final prostheses provided excellent aesthetics and functionality, leading to enhanced patient satisfaction. Conclusion: The choice of cemented implant-supported prostheses represents a highly effective approach for treating edentulism. This method offers clinical benefits, such as increased retention and improved esthetic outcomes, while also positively impacting the patient's quality of life (AU)

Objetivo: Relatar um caso clínico de uma paciente feminina reabilitada com Próteses Metálicas-Cerâmicas Cimentadas em Implantes na arcada superior. Materiais e Métodos: Foi empregada uma abordagem multidisciplinar, utilizando várias habilidades clínicas para alcançar resultados satisfatórios na reabilitação de um paciente totalmente edêntulo. O plano de tratamento envolveu o uso de próteses metálicas-cerâmicas cimentadas, com foco na otimização do posicionamento das margens das coroas para garantir a saúde periodontal. Resultados: O uso de próteses metálicas-cerâmicas cimentadas abordou efetivamente as preocupações estéticas da paciente ao eliminar os orifícios de acesso para parafusos e garantir a continuidade do material cerâmico. O posicionamento supragengival das margens das coroas preveniu o excesso de cimento no sulco peri-implantar, promovendo a saúde periodontal. As próteses finais proporcionaram excelente estética e funcionalidade, resultando em maior satisfação do paciente. Conclusão: A escolha de próteses suportadas por implantes cimentadas representa uma abordagem altamente eficaz para o tratamento da edentulismo. Este método oferece benefícios clínicos, como maior retenção e melhores resultados estéticos, além de impactar positivamente a qualidade de vida do paciente(AU)

Rendimiento Clínico de las Restauraciones Adhesivas con Resina Compuesta en Casos de Pacientes con Desgaste Severo e Incremento de Dimensión Vertical: Revisión de Literatura Sistematizada / Clínical Performance of Adhesive Restorations with Composite Resin in Cases of Patients with Severe Wear and Increased Vertical Dimension: Systematized Literature Review

El desgaste dental severo se describe como la pérdida sustancial de la estructura dental, con exposición de la dentina y pérdida significativa de igual o más de 1/3 de la corona clínica. El uso de materiales compuestos de resina permite al clínico ser más conservador, debido a su aplicación mínimamente invasiva. Además de ello, son relativamente económicas, proporcionan buena estética general, así como un buen rendimiento y facilidad en la reparación. El objetivo de esta revisión de literatura sistematizada es recopilar información disponible en la literatura referente a cuál es el rendimiento clínico de las restauraciones adhesivas con resina compuesta en casos de pacientes con desgaste severo e incremento de la dimensión vertical como objetivo rehabilitador. Se analizaron artículos entre los años 2000 y 2022, seleccionando cuatro bases de datos (Pubmed, Scopus, Scielo y Web of Science). Para identificar los descriptores se utilizó los Medical subject headings (Mesh): Tooth Wear, Composite Restorations, Resin y Oral Rehabilitation. No se aplicó restricciones de idioma, país de origen, autor o lugar de publicación donde se realizó el estudio. Como resultado de la búsqueda se obtuvieron 71 artículos, de los cuales se seleccionaron 5 que cumplieron con los criterios de elegibilidad para ser considerados en la revisión de literatura sistematizada. Se encontró un promedio de tasa de éxito ente el 89,4 % - 100 % en un promedio total de 5.2 años de seguimiento. Se puede concluir, hasta donde se tiene conocimiento en la literatura científica disponible, que el tratamiento de restauraciones adhesivas con resinas compuestas en pacientes con desgaste severo es recomendable, enfocado en un periodo a corto-mediano plazo (3-5 años), siendo una opción de tratamiento económica y mínimamente invasiva.

Severe tooth wear is described as the substantial loss of tooth structure, with dentin exposure and significant loss of equal to or more than 1/3 of the clinical crown. The use of resin composite materials allows the clinician to be more conservative, due to its minimally invasive application. In addition to this, they are relatively inexpensive, provide good general aesthetics, as well as good performance and ease of repair. The objective of this systematic literature review is to collect information available in the literature regarding the clinical performance of adhesive restorations with composite resin in cases of patients with severe wear and increase in the vertical dimension as a rehabilitation objective. Articles between the years 2000 and 2022 were analyzed, selecting four databases (Pubmed, Scopus, Scielo and Web of Science). To identify the descriptors, the Medical subject headings (Mesh) were used: Tooth Wear, Composite Restorations, Resin and Oral Rehabilitation. No language, country of origin, author or place of publication restrictions where the study was conducted were applied. As a result of the search, 71 articles were obtained, of which 5 were selected that met the eligibility criteria to be considered in the systematic literature review. An average success rate between 89.4 % - 100 % was found in a total average of 5.2 years of follow-up. It can be concluded, to the best of our knowledge in the available scientific literature, that the treatment of adhesive restorations with composite resins in patients with severe wear is recommendable, focused on a short-medium term period (3-5 years), being a Inexpensive and minimally invasive treatment option.

Cirugía virtual guiada para rehabilitación implantosoportada de maxilar edéntulo con carga inmediata / Virtual guided surgery for implantsupported rehabilitation of the edentulous maxilla with immediate loading

Objetivo: Presentar el relato de un caso clínico de cirugía virtual guiada para rehabilitación implantosoportada de maxilar edéntulo con carga inmediata. Relato del caso: Paciente, edéntulo total en ambos maxilares, expresó su deseo de cambiar la prótesis total superior removible por una prótesis total fija sobre implantes. Durante la evaluación clínica, se observaron condiciones biológicas favorables al tratamiento como, adecuada faja de tejido queratinizado y leve reabsorción ósea. Como tratamiento se le sugiere al paciente, una planificación inversa, asistida por cirugía virtual guiada, utilizando un prototipo de guía quirúrgica para la colocación de seis implantes dentales en el maxilar y la instalación de una prótesis protocolo de carga inmediata. Conclusiones: Los resultados nos permiten concluir que la cirugía virtual guiada por computadora para rehabilitación protésica implantosoportada de maxilar edéntulo, con carga inmediata, proporciona precisión en los procedimientos quirúrgicos, es fundamental para la confección de prótesis inmediatas, representa una alternativa mínimamente invasiva y el resultado complace a los pacientes.

Objective: present the report of a clinical case of a virtual guided surgery for implant-supported rehabilitation of the edentulous maxilla with immediate loading. Case report: Patient, bi-maxillary edentulous expressed the desire to replace the removable upper total prothesis for a total fixed prothesis on implants. During the clinical evaluation, favorable biological conditions for treatment were observed, such as adequate keratinized tissue band and mild bone resorption. As part of the treatment, the patient was recommended a reverse planning approach, assisted by virtual guided surgery. This involved a prototype surgical guide for the fixation of six dental implants in the maxilla and the installation of an immediate loading protocol prosthesis. Conclusions: The results lead us to conclude that computer-guided virtual surgery for implant-supported prosthetic rehabilitation of the edentulous maxilla with immediate loading, provides a high precision in surgical procedures. It is essential to fabrication of immediate prostheses, represents a minimally invasive alternative, and results in patient satisfaction.

Implante transitório de corpo único com ativação imediata para retenção de prótese total provisória - relato de caso / Single body transient implants immediate activated for provisional prosthesis retention ­ case report

A reabilitação protética ganhou um componente que veio solucionar problemas de pessoas edentadas que até então pareciam sem solução. Trata-se dos implantes osseointegráveis, introduzidos pelo professor Per Ingvar Branemark entre os anos 70 e 80, e que, nos dias de hoje, se tornou na maioria dos casos, a primeira opção para a reabilitação oral. No caso de edentados totais na mandíbula, a prótese total fixa sobre implantes instalados entre os forames mentuais é um tipo de tratamento reabilitador com elevado grau de sucesso. Nos casos onde não é possível a colocação da prótese fixa com carga imediata após a instalação dos implantes, o paciente pode usar uma prótese total provisória, diretamente sobre os implantes permanentes instalados ou retida por implantes transitórios de corpo único, com encaixe tipo bola/o'ring. O presente artigo relata um caso clinico com utilização de implantes transitórios de corpo único para reter prótese total provisória, durante o tempo da osseointegração dos implantes permanentes.

Prosthetic rehabilitation gained a component that solved problems of edentulous people. These are the Osseo integrative implants, introduced by Professor Per Ingvar Branemark between the 1970s and 1980s, and which has become in most cases the first option for oral rehabilitation. In the case of mandible total edentulous, the total fixed prosthesis on implants installed between the mental foramina is a type of rehabilitation treatment with a high degree of success. In cases where it is not possible to place the fixed prosthesis with immediate loading after implant installation, the patient may use a provisional total prosthesis, directly on the permanent implants installed or retained by transient implants of single body, ball-type fitting 'ring. The present article reports a clinical case with the use of single body transient implants to retain temporary total prosthesis during the time of osseointegration of permanent implants.

Maxilectomia em paciente diabética tipo II, diagnosticada com Mucormicose rinomaxilar, com posterior reabilitação protética: relato de caso / Maxillectomy in a type II diabetic patient, diagnosed with rhinomaxillary mucormycosis, with subsequent prosthetic rehabilitation: case report / Maxilectomía en paciente diabética tipo II diagnosticada de mucormicosis rinomaxilar, con posterior rehabilitación protésica: reporte de caso

A mucormicose é uma infecção fúngica angioinvasiva que afeta uma ampla faixa etária, geralmente imunodeprimidos, sem predileção por gênero ou raça e com alta taxa de mortalidade. Essa infecção inicia se no nariz, devido à inalação dos esporos, podendo-se espalhar pelos seios paranasais, órbita e estruturas intracranianas. As características clínicas incluem parestesia perinasal, celulite periorbitária, rinorréia, obstrução nasal, epistaxe e diminuição de peso. O tratamento efetivo dessa comorbidade compoe uma combinação de manejo clínico e medicamentoso, conjuntamente com desbridamento cirúrgico radical do tecido infectado e/ou necrótico. O caso clínico descrito nesse trabalho refere-se a uma paciente diagnosticada com Mucormicose rino maxilar e diabetes do tipo II, a qual foi submetida a procedimento cirúrgico de hemimaxilectomia do lado esquerdo com posterior reabilitação protética para selamento de comunicação buco-naso-sino-etmoidal... (AU)

Mucormycosis is an angioinvasive fungal infection that affects a wide age group, usually immunocompromised, with no gender or race predilection, and with a high mortality rate. This infection starts in the nose, due to the inhalation of spores, and can spread through the paranasal sinuses, orbit and intracranial structures. Clinical features include perinasal paresthesia, periorbital cellulitis, rhinorrhea, nasal obstruction, epistaxis and weight loss. Effective treatment of this comorbidity comprises a combination of clinical and drug management, together with radical surgical debridement of infected and/or necrotic tissue. The clinical case described in this work refers to a patient diagnosed with Mucormycosis Rhinomaxilla and Type II diabetes, who underwent a surgical procedure of left hemimaxillectomy with subsequent prosthetic rehabilitation for sealing of the bucco nasal-sino-ethmoidal communication... (AU)

La mucormicosis es una micosis angioinvasiva que afecta a un amplio grupo de edad, habitualmente inmunodeprimidos, sin predilección de género ni raza, y con una alta tasa de mortalidad. Esta infección comienza en la nariz, debido a la inhalación de esporas, y puede extenderse a través de los senos paranasales, la órbita y las estructuras intracraneales. Las características clínicas incluyen parestesia perinasal, celulitis periorbitaria, rinorrea, obstrucción nasal, epistaxis y pérdida de peso. El tratamiento eficaz de esta comorbilidad comprende una combinación de manejo clínico y farmacológico, junto con un desbridamiento quirúrgico radical del tejido infectado y / o necrótico. El caso clínico descrito en este trabajo se refiere a una paciente diagnosticada de Mucormicosis Rinomaxilar y diabetes Tipo II, que fue sometida a un procedimiento quirúrgico de hemimaxilectomía izquierda con posterior rehabilitación protésica para sellar la comunicación buco-nasal-sino-etmoidal... (AU)

Autotransplante dentário como ferramenta de tratamento para perdas precoces de molares / Dental self transplantation as a treatment tool for early molar loss / Auto trasplante dental como herramienta de tratamiento para la pérdida molar temprana

O transplante dentário autógeno é um procedimento cirúrgico que consiste na transposição de um elemento dentário do seu alvéolo para um outro, em um mesmo indivíduo. Esta abordagem é indicada para substituir elementos com prognóstico desfavorável ou reabilitar áreas edêntulas. O objetivo deste trabalho é apresentar as vantagens do transplante dentário autógeno frente a perdas dentárias precoces e os critérios necessários para indicação do mesmo, por meio de um relato de caso clínico no qual, uma paciente do gênero feminino, 16 anos foi submetida ao transplante do elemento 48 para o alvéolo do 47 por motivos de lesão cariosa com extensa destruição coronária com impossibilidade de tratamento clínico restaurador. Em acompanhamento pós-operatório de 01 ano os resultados demostraram continuidade do desenvolvimento radicular do elemento transplantado em seu novo alvéolo, estando este, sem mobilidade, livre de lesões periodontais e/ou endodônticas. Desta forma, conclui-se que as vantagens do transplante dentário autógeno incluem a possibilidade de reabilitação dentária de forma natural, imediata e de baixo custo comparado a tratamentos como implantes e próteses. E este método quando indicado corretamente e realizado sob os devidos cuidados pode alcançar excelentes resultados funcionais e estéticos, sendo uma opção viável para reabilitação de perdas dentárias precoces... (AU)

The Autogenous dental transplantation is a surgical procedure that consists of the transposition of a dental element from its socket to another, in the same individual. This approach is indicated to replace elements with an unfavorable prognosis or to rehabilitate edentulous areas. The objective of this paper is to present the advantages of autogenous dental transplantation against early tooth loss and the necessary criteria for its indication, through a clinical case report in which a 16-year-old female patient underwent transplantation element 48 for the alveolus of the 47 due to carious lesions with extensive coronary destruction with impossibility of restorative clinical treatment. In a 01-year postoperative follow-up, the results showed continuity of root development of the transplanted element in its new alveolus, which is without mobility, free from periodontal and/or endodontic lesions. Thus, it is concluded that the advantages of autogenous dental transplantation include the possibility of natural, immediate and low-cost dental rehabilitation compared to treatments such as implants and prostheses. And this method, when correctly indicated and performed with due care, can achieve excellent functional and esthetic results, being a viable option for the rehabilitation of early tooth loss... (AU)

El trasplante dentario autógeno es un procedimiento quirúrgico que consiste en la transposición de un elemento dentario de su alvéolo a otro, en el mismo individuo. Este abordaje está indicado para reemplazar elementos con pronóstico desfavorable o para rehabilitar áreas edéntulas. El objetivo de este trabajo es presentar las ventajas del trasplante dentario autógeno frente a la pérdida dentaria precoz y los criterios necesarios para su indicación, mediante el reporte de un caso clínico en el que se trasplantó a una paciente de sexo femenino de 16 años. 47 por lesiones cariosas con extensa destrucción coronaria con imposibilidad de tratamiento clínico restaurador. En un seguimiento postoperatorio de 01 año, los resultados mostraron continuidad del desarrollo radicular del elemento trasplantado en su nuevo alvéolo, que se encuentra sin movilidad, libre de lesiones periodontales y/o endodónticas. Así, se concluye que las ventajas del trasplante dental autógeno incluyen la posibilidad de una rehabilitación dental natural, inmediata y de bajo costo frente a tratamientos como implantes y prótesis. Y este método, correctamente indicado y realizado con el debido cuidado, puede lograr excelentes resultados funcionales y estéticos, siendo una opción viable para la rehabilitación de la pérdida dentaria temprana... (AU)

Sinus lift technique and dental implants for rehabilitation for a Down syndrome patient with tomographic 3-years follow-up.

Down Syndrome or trisomy 21 (T21) is a genetic condition caused by the presence of an extra chromosome in pair 21 and is related to a high prevalence of agenesis of permanent teeth and periodontal alterations that may be associated to the loss of permanent teeth at early ages. With the increase in life expectancy of people with T21 in the last decades, it is necessary to expand the knowledge to offer possibilities of treatment with dental implants, aiming to serve this aging population. AIMS: The aim of this article is to report a surgical procedure of sinus lift to enable the installation of dental implants in the posterior region of the maxilla. METHODS AND RESULTS: A 50 year-old patient with T21 was rehabilitated with implants, simultaneously with sinus lift surgery, by the lateral window technique, using xenogenous bone graft and fibrin-rich plasma. After 1 year, the patient was rehabilitated with prosthetics on implants. CONCLUSION: The feasibility of this technique in patients with Down syndrome could be observed, after 3 years of follow up, with favorable clinical results.

Percepção e conhecimento de odontopediatras sobre o uso de coroas pré-fabricadas de aço e zircônia na reabilitação de dentes decíduos / Perception and knowledge of pediatric dentists about the use of prefabricated steel and zirconia crowns in the rehabilitation of deciduous teeth

Objetivo: O presente trabalho tem como objetivo avaliar o conhecimento dos odontopediatras e suas percepções, conhecendo as dificuldades que estes encontram frente ao desafio da reabilitação de dentes decíduos. Métodos: A pesquisa foi realizada por meio da aplicação de questionários on-line e a análise estatística foi descritiva e comparativa, com tabelas de frequência para as variáveis quantitativas. O teste não paramétrico de Qui-quadrado foi utilizado para estimar a associação entre as diferentes categorias dos dados e em todo o estudo, estipulou-se o nível de significância em 5%. Resultados: Os resultados da pesquisa mostraram que a maioria dos entrevistados conhecem as coroas pré-fabricadas de aço, porém sua aplicação em atendimentos de crianças com extensas destruições coronárias limita-se a 34,1% destes profissionais, sendo que a baixa utilização se deve à dificuldade de aquisição do material e falta de habilidade técnica. Já com relação às coroas pré-fabricadas de zircônia, 82,4% das odontopediatras as conhecem, mas a grande maioria não as utiliza devido à dificuldade de aquisição, falta de habilidade técnica e o seu alto custo. Não foi encontrada associação entre a dificuldade de planejamento dos casos e a consideração estética e o âmbito de trabalho do entrevistado, bem como o fato de conhecer as coroas pré-fabricadas e utilizá-las. Conclusão: Conclui-se que os materiais reabilitadores, como coroas pré-fabricadas de aço e de zircônia, são de certa forma bem conhecidos pelos odontopediatras, mas sua utilização em reabilitação de dentes decíduos ainda é limitada.

Aim: The present study aims to evaluate the knowledge of pediatric dentists and their perceptions, knowing the difficulties they face in the challenge to rehabilitate deciduous teeth. Methods: This study was carried out through the application of online questionnaires. The statistical analysis was descriptive and comparative, with frequency tables for the quantitative variables. The non-parametric chi-square test was used to estimate the association between the different categories of data, and the significance level was set at 5%. Results:The survey results showed that most respondents know about prefabricated steel crowns, but their application in the care of children with extensive coronary destruction is limited to 34.1% of these professionals. The low use is due to the difficulty of acquiring the material and the lack of technical skills. It was found that 82.4% of the pediatric dentists have knowledge about prefabricated zirconia crowns, but the vast majority do not use them due to the difficulty of acquisition, their lack of technical skills, and the product's high cost. No association was found between the difficulty of planning the cases and the esthetic consideration and sphere of work of the interviewee, nor regarding the fact of their having knowledge about the prefabricated crowns and using them. Conclusion: It can therefore be concluded that rehabilitation materials, such as prefabricated steel and zirconia crowns, are well-known by pediatric dentists, but their use in the rehabilitation of deciduous teeth is still limited.

Transplante dental autógeno triplo: relato de caso clínico / Triple autogenous dental transplantation: clinical case report / Triple trasplante dental autógeno: informe de caso clínico

A importância da permanência dos dentes naturais na cavidade bucal vem sendo cada dia mais reconhecida e almejada, seja pelo fator estético ou pelo funcional. Uma alternativa para a reabilitação de indivíduos com perdas dentárias ou exodontias indicadas é o transplante dental. Esta modalidade de tratamento corresponde à transferência de um órgão dental, para um alvéolo receptor. O presente trabalho relata e discute um caso de triplo transplante autógeno, utilizando terceiros molares, enfatizando as etapas cirúrgicas e demonstrando que após dois anos de preservação os resultados confirmam o sucesso deste tratamento. Anamnese, exames clínicos e radiográficos foram analisados de forma criteriosa, antes e após a cirurgia, sendo a radiografia panorâmica utilizada antes e após o ato cirúrgico e radiografias periapicais após, para acompanhamento individual das unidades transplantadas. Houve sucesso na realização dos transplantes dentários, obtendo regeneração pulpar e adaptação ao alvéolo receptor, mantendo o espaço dental com vitalidade e oclusão dentaria satisfatória. O procedimento apresentou sucesso significativo, obtendo êxito nas três unidades transplantadas, devolvendo o equilíbrio ao desenvolvimento crânio facial, comprovando sua eficácia na reabilitação oral em jovens com perdas prematuras de unidades dentárias... (AU)

The importance of the maintenance of natural teeth in the oral cavity has been increasingly recognized and desired, for the aesthetic and also the functional factor. An alternative for the rehabilitation of individuals with indicated tooth loss or extractions is dental transplantation. This type of treatment corresponds to the transfer of a dental organ to a recipient alveolar socket. The present work reports and discusses a case of triple autogenous transplantation, using third molars, emphasizing the surgical stages and demonstrating that after two years of preservation the results confirm the success of this treatment. Anamnesis, clinical and radiographic examinations were carefully analyzed, before and after surgery, with panoramic radiography used before and after surgery and periapical radiographs afterwards, for individual monitoring of transplanted units. Dental transplants were successful in achieving pulp regeneration and adaptation to the recipient alveolus, maintaining the dental space with vitality and satisfactory dental occlusion. The procedure was significantly successful, achieving success in the three transplanted units, restoring balance to the facial skull development, proving its effectiveness in oral rehabilitation in young people with premature loss of dental units... (AU)

La importancia de la permanencia de los dientes naturales en la cavidad bucal ha sido cada vez más reconocida y buscada, ya sea por motivos estéticos o funcionales. Una alternativa para la rehabilitación de personas con pérdida de dientes o extracciones recomendadas es el trasplante dental. Esta modalidad de tratamiento corresponde a la transferencia de un órgano dentario a un alvéolo receptor. Este trabajo reporta y discute un caso de triple trasplante autógeno, utilizando terceros molares, enfatizando los pasos quirúrgicos y demostrando que luego de dos años de preservación, los resultados confirman el éxito de este tratamiento. Se analizó cuidadosamente la anamnesis, los exámenes clínicos y radiográficos, antes y después de la cirugía, con radiografía panorámica antes y después de la cirugía y radiografías periapicales después, para el seguimiento individual de las unidades trasplantadas. Los trasplantes dentales fueron exitosos, logrando la regeneración pulpar y la adaptación al alvéolo receptor, manteniendo el espacio dentario con una oclusión y vitalidad dentarias satisfactorias. El procedimiento fue significativamente exitoso, teniendo éxito en las tres unidades trasplantadas, devolviendo el equilibrio al desarrollo craneofacial, demostrando su efectividad en la rehabilitación oral en jóvenes con pérdida prematura de unidades dentales... (AU)

Manejo Protésico y Multidisciplinario de Prótesis Maxilofacial: serie de Casos / Prosthodontic and Multidisciplinary Management of Maxillofacial Prosthesis. a series of Cases

Objetivo: determinar los principios de los tratamientos multidisciplinarios. Materiales y métodos: ejemplificar el trabajo multidisciplinario con 4 casos clínicos, tratamiento de pacientes complejos. Resultados: La evaluación multidisciplinar, delimita la dirección, planificación y tratamiento con opiniones discutidas y orientadas para el bien del paciente, definiendo los aspectos complementados para la rehabilitación. Discusión: El manejo multidisciplinario de los pacientes de Rehabilitación Maxilofacial presenta una compleja evaluación con relación a la planificación, pronóstico y tratamiento, donde diversos especialistas confluyen en una sinergia de criterios clínicos para un mejor resultado. Los recursos limitados en el servicio público incentivan el lograr los mejores resultados tanto con la disponibilidad económica del paciente como del servicio, esta limitación implica igualmente una gran oportunidad de trabajo conjunto. Se establecen finalmente, criterios generales y principios de tratamientos integrales. Conclusión: Para el trabajo en equipo multidisciplinar io es fundamental mantener el objetivo de analizar y manejar en conjunto las distintas alternativas involucradas en los tratamientos de los casos, sean estas consideraciones Médicas, Odontológicas, Fonoaudiológicas, Psicólogas, Kinesiológicas, entre otras, para lograr el resultado funcional y estético deseado, satisfaciendo y tratando de recuperar a los pacientes de manera integral.

The objective of this study was to determine the principles of multidisciplinary treatments, and to exemplify multidisciplinary work with 4 clinical cases, treatment of complex patients. The multidisciplinary evaluation, delimits the direction, planning and treatment with discussed and oriented opinions for the benefit of the patient, defining the complemented aspects for the rehabilitation. The multidisciplinary management of patients in Maxillofacial Rehabilitation presents a complex evaluation in relation to planning, prognosis and treatment, where different specialists converge in a synergy of clinical criteria, for a better outcome. The limited resources in the public service encourage the achievement of the best results both with the economic availability of the patient and the service; this limitation also implies a great opportunity to work together. Finally, general criteria and principles of integral treatments are established. For the multidisciplinary team work it is fundamental to maintain the objective of analyzing and managing together the different alternatives involved in the treatment of the cases, medical and dental considerations, phonoaudiology, psychology, kinesiology, among others, to achieve the desired functional and aesthetic result, satisfying and trying to recover the patients integrally.

SAT: Sistematización Adhesiva Temporaria. Integración estético-oclusal predecible en rehabilitación conservadora. Informe de caso y revisión bibliográfica / TAS: Temporary Adhesive Systematization. Predictable aesthetic-occlusal integration in conservative rehabilitation. Case report and bibliographic review

Objetivos: Realizar una revisión de la literatura sobre métodos de rehabilitación mínimamente invasivos, y presentar un caso clínico acerca de un nuevo procedimiento denominado sistematización adhesiva temporaria (SAT), destinado a pacientes que presentan pérdida de sustancia dentaria y que se caracteriza como un abordaje terapéutico predecible para transferir el proyecto rehabilitador (encerado) a la boca del paciente mediante 3 pasos bien definidos y con objetivos específicos. Caso clínico: Un paciente adulto joven de sexo masculino con desgastes severos por bruxismo es rehabilitado temporalmente con resinas compuestas (SAT) para devolver la anatomía perdida en forma adhesiva y conservadora, siguiendo un protocolo de abordaje terapéutico predecible denominado EGOP (estéticamente guiado y oclusalmente protegido). Este procedimiento, que es considerado muchas veces de transición previo a las restauraciones finales, nos permite evaluar la estética, la oclusión y mejorar la comunicación entre el equipo de trabajo para poder realizar el cambio por restauraciones cerámicas en forma gradual. En aquellos pacientes que necesitan rehabilitaciones totales producto del desgaste dentario severo, la SAT puede ser una herramienta que facilite al odontólogo la posibilidad de restablecer los patrones oclusales y estéticos perdidos sin la necesidad de realizar desgastes dentarios y provisionales como se hacía clásicamente (AU)

Aims: To carry out a literature review on minimally-invasive rehabilitation methods and to present a clinical case on a new procedure called Temporary Adhesive Systemization (TAS), intended for patients that show a considerable loss of dental substance, characterized by a predictable therapeutic approach to transfer the rehabilitation diagnosis wax-up through 3 well defined steps and with specific objectives to the patient´s dentition. Clinical case: A young adult male patient with severe wear due to bruxism is temporarily rehabilitated with composite resins (TAS) to return the lost anatomy in a conservative way, following a predictable therapeutic approach protocol called EGOP (aesthetically guided and occlusally protected). This procedure, which is often considered transitional prior to final restorations, allows us to evaluate aesthetics, occlusion, improve communication between the working team and to be able to gradually change for ceramic restorations. In patients that need full rehabilitation due to severe dental erosion, TAS is a predictable procedure that helps the dentist to re-establish the loss of aesthetical and occlusal patterns, without the need of preparing the teeth for the classic provisional restorations (AU)

Is Sjogren's syndrome a risk factor/contraindication for dental implants? An umbrella review.

INTRODUCTION: There have been concerns that longstanding oral dryness secondary to Sjogren's syndrome may increase the risk of failure of dental implants. AIMS: The aim of the present study was to determine the level of methodological quality of systematic reviews that evaluated the effectiveness of dental implants in patients diagnosed with Sjogren's syndrome. METHODS AND RESULTS: Databases of PubMed/Medline, LILACS, Science Direct and Dare Cochrane to October 2020 were evaluated. A total of 833 articles were initially identified but following use of appropriate inclusion and exclusion criteria 4 papers were identified for detailed analysis. An eventual study sample comprised 722 implants placed in 189 patients with a 95.22% success rate, the minimum follow-up time was 45.2 ± 23.8 months and the maximum 125.5 months. The studies were assessed for their methodological quality by the AMSTAR 2 tool, in which 3 had critically low quality and one low quality. CONCLUSION: Oral rehabilitation with dental implants in patients with Sjogren's syndrome seems to have a high success rate; however, the low quality of relevant reports highlights the need for primary and secondary studies with better methodological design in order to reduce bias and provide reassurance for this treatment option.

Reabilitação implantossuportada pela técnica "All on four" após periimplantite mandibular: relato de caso / Implant rehabilitation supported by the "All on four" technique after mandibular periimplantitis: case report

Com o avanço da odontologia, os implantes dentários tornaram-se cada vez mais atrativos por oferecerem um melhor conforto, estética e função mastigatória. Todavia, com o aumento da sua utilização também surgiram os problemas, dentre eles a periimplantite. Vista como uma doença irreversível de caráter inflamatório, ela afeta os tecidos ao seu redor, levando à perda. No contexto da Implantodontia, os implantes dentários são afetados pela periimplantite - quando instalada - o que induz à destruição dos tecidos de suporte e proteção adjacentes, ocasionando também a perda destas reabilitações. Portanto, novas reabilitações devem ser planejadas para que possam corrigir os defeitos causados pela doença. Dentre as opções, a técnica "All on four" apresenta-se como vantajosa, po dendo ser escolhida para grandes reabilitações. Logo, o presente artigo tem o objetivo de descrever um caso clínico utilizando a técnica "all on four" que reabilitou um paciente edêntulo em mandíbula, na qual possuía implantes afetados pela periimplantite, optando-se pela remoção e nova instalação de 4 implantes pela técnica escolhida. Após 4 meses, foi realizada a instalação da prótese definitiva... (AU)

With the advancement of dentistry, dental implants have become increasingly attractive as they offer bet ter comfort, aesthetics and masticatory function. However, with the increase in its use, problems also arose, among them the peri-implantitis disease. Seen as an irreversible disease with an inflammatory character, it affects the tissues around it, leading to loss. In the context of Implantology, dental implants are affected by peri-implantitis - when installed - which induces the destruction of adjacent support and protective tissues, also causing the loss of these rehabilitations. Therefore, new rehabilitation must be planned so that they can correct the defects caused by the disease. Among the options, the "All on four" technique presents itself as an advantage and can be chosen for major rehabilitation. Therefore, the present article aims to describe a clinical case using the "all on four" technique that rehabilitated an edentulous patient in the mandible, in which he had implants affected by peri-implantitis, opting for the removal and new installation of 4 implants by the technique chosen. After 4 months, the definitive prosthesis was installed... (AU)

Rehabilitación estética y funcional en paciente con compromiso gastroesofágico y desorden temporomandibular: reporte de un caso / Rehabilitación estética y funcional en paciente con compromiso gastroesofágico y desorden temporomandibular: reporte de un caso

Paciente masculino, de 32 años, acudió a la Clínica de Prótesis Parcial Fija (PPF), de la Facultad de Odontología de Araçatuba-Universidad Estadual Paulista, manifestando como queja principal que sus dientes anteriores estaban "feos y rotos". Después del exa- men clínico, el paciente fue diagnosticado con desorden temporomandibular, bruxismo y presencia de erosiones dentarias (intrínsecas y extrínsecas). Se propuso el acompaña- miento de un médico gastroenterólogo y la rehabilitación con prótesis libres de metal (11, 12, 21 y 22) confeccionadas en silicato de litio reforzado con zirconio por el sistema CAD/CAM. Después de la endodoncia de los incisivos antero-superiores, fueron insta- lados los pernos de fibra de vidrio anatomizados con resina compuesta; la impresión fue realizada con hilo retractor y silicona de adición. Después de la prueba estética y ajustes oclusales, las PPFs de e-max Ceram, fueron preparadas para cementación resinosa con el sistema Variolink II color Light. Después de 1 semana, se tomó la impresión de la arcada superior y posteriormente se le instaló una placa miorrelajante. El paciente y los profesionales involucrados aprobaron el resultado final, comprobando la eficacia estética asociada al uso de prótesis libre de metal, a pesar de que el paciente presenta compromiso gastroesofágico y desorden temporomandibular.

A 32-year-old male patient attended in the Fixed Partial Prosthesis Clinic (PPF), of the Araçatuba Dental School-Paulista State University, stating as the main complaint that his anterior teeth were "ugly and broken". After clinical examination, the patient was diagnosed with temporomandibular disorder, bruxism and the presence of dental ero- sions (intrinsic and extrinsic). It was proposed to be followed up by a gastroenterologist and rehabilitation with metal-free prostheses (11, 12, 21 and 22) made of lithium silicate reinforced with zirconium by the CAD / CAM system were proposed. After endodontics of the anterior-superior incisors, the anatomized fiberglass posts with composite resin were installed; the impression was made with retractor wire and addition silicone. After aesthetic testing and occlusal adjustments, the e-max Ceram PPF ̈s were prepared for resin cementation with the Variolink II color Light system. After 1 week, the impression of the upper arch was taken and subsequently a muscle relaxant plate was installed. The patient and the professionals involved approved the final result, verifying the aesthetic efficacy associated with the use of a metal-free prosthesis, despite the fact that the patient has gastroesophageal involvement and temporomandibular disorder.

Microcomputed tomography evaluation of cement film thickness of veneers and crowns made with conventional and 3D printed provisional materials.

OBJECTIVE: To evaluate, through microcomputed tomography (µCT), the cement film thickness of veneers and crowns made with different provisional materials. MATERIAL AND METHODS: A veneer and a crown preparation were performed on a central incisor and a second molar of a dental model, respectively, scanned with an intraoral scanner, and the .stl files were exported to an LCD-based SLA three-dimensional (3D)-Printer. Twenty-four preparations were 3D-printed for each veneer and crown and divided into four groups (n = 6/group): (a) Acrylic resin (Acrílico Marche); (b) Bisacrylic resin (Protemp 4); (c) PMMA computer-aided design and computer-aided manufacturing (CAD-CAM) (Vipiblock); and (d) 3D-printed resin for provisional restorations (Raydent C&B for temporary crown and bridge). Veneers and crowns restorations were performed and cemented with a flowable composite. Each specimen was scanned with a µCT apparatus, files were imported for data analysis, and cement film thickness was quantitatively measured. Data were analyzed by 2-way ANOVA and Tukey post-hoc tests (α = .05). RESULTS: Crowns presented a thicker cementation film than veneers (P < .05).The bisacrylic resin showed the smallest veneer film thickness, similar to the acrylic resin (P = .151), which was not significantly different than the PMMA CAD/CAM material (P = .153). The 3D printed provisional material showed the thicker film, different than all other materials (P < .05). The bisacrylic resin showed a cement film thickness with a high number of voids in its surface. For crowns cementation, the 3D printed provisional material showed the thicker cementation film, different than all other materials (P < .05). CONCLUSIONS: Different provisional materials present different film thicknesses. The 3D printed provisional material showed the highest veneer and crown film thicknesses. Veneers film thicknesses were smaller than crowns for all provisional materials. CLINICAL SIGNIFICANCE: The 3D printed provisional material studied can be satisfactorily used, presenting appropriate adaptation with the tooth preparation, however, it shows the highest cement film thickness for both veneers and crowns cementations when compared with other provisional materials. A better internal fit, or smaller cement film thickness is obtained by CAD/CAM materials, acrylic and bisacrylic resins. Veneer cementation showed a smaller cement film thickness compared with crown cementation for all provisional materials.

Computer guided surgery in the maxillary esthetic zone / Cirurgia guiada por computador em área estética da maxila

ABSTRACT This clinical report describes the implant rehabilitation for the treatment of pathological roots resorption due to inadequate orthodontic movement in prosthetic space reduced by means of load and immediate implants, computer-guided surgery and use of the own tooth crown in a 21-year-old-patient. The atraumatic exodontics of the right and left upper lateral incisors was performed, and then immediate placement of osseointegrated implants using the computer guided surgery technique. The crown teeth itself was used in the immediate aesthetic and functional rehabilitation. Completion of the treatment resulted in a functional and aesthetic successful outcome and a 27 months follow-up presented uneventful. The procedures included in this complex rehabilitation treatment in the esthetic zone were appropriate and essential for the maintenance of the soft and hard tissues contour and thickness ensuring the excellence in rehabilitation.

RESUMO Este relato de caso clínico descreve a reabilitação com implantes para o tratamento da reabsorção radicular patológica devido à movimentação ortodôntica inadequada em espaço protético reduzido, por meio implante imediato e carga imediata, pela técnica da cirurgia guiada por computador e uso da própria coroa dentária, em paciente de 21 anos. A exodontia atraumática dos incisivos laterais superiores direito e esquerdo foi realizada, em seguida realizou-se a instalação imediata dos implantes osseointegráveis, utilizando a técnica de cirurgia guiada por computador. Os próprios dentes da coroa foram usados na reabilitação estética e funcional imediata. A conclusão do tratamento resultou em sucesso funcional e estético com acompanhamento de 27 meses sem intercorrências. Os procedimentos incluídos neste complexo tratamento de reabilitação na zona estética foram adequados e essenciais para a manutenção do contorno e espessura dos tecidos moles e duros garantindo a excelência na reabilitação.

La operatoria dental y su rol en la rehabilitación integral: caso clínico / Operative dentistry and its role in comprehensive rehabilitation: a clinical case

El objetivo del presente informe clínico es describir una manera de lograr resultados predecibles en las restauraciones estéticas, con una rehabilitación integral. Se emplearon distintos materiales, centrados en la nueva generación de materiales cerámicos para la confección de frentes estéticos. Se realizó un diagnóstico seguido de un plan de tratamiento que integró tanto la correcta función como la estética. Se tuvo en cuenta que la responsabilidad estética no se limita sólo a la forma, el tamaño y el color de los dientes, sino que, además, es importante preservar o recuperar la armonía dentogingival (AU)