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.

Low intensity sonosynthesis of iron carbide@iron oxide core-shell nanoparticles.

Here we demonstrate a simple method for the organic sonosynthesis of stable Iron Carbide@Iron Oxide core-shell nanoparticles (ICIONPs) stabilized by oleic acid surface modification. This robust synthesis route is based on the sonochemistry reaction of organometallic precursor like Fe(CO)5 in octanol using low intensity ultrasonic bath. As obtained, nanoparticles diameter sizes were measured around 6.38 nm ±â€¯1.34 with a hydrodynamic diameter around 25 nm and an estimated polydispersity of 0.27. Core-Shell structure of nanoparticles was confirmed using HR-TEM and XPS characterization tools in which a core made up of iron carbide (Fe3C) and a shell of magnetite (γ-Fe2O3) was found. The overall nanoparticle presented ferromagnetic behavior at 4 K by SQUID. With these characteristics, the ICIONPs can be potentially used in various applications such as theranostic agent due to their properties obtained from the iron oxides and iron carbide phases.

Oral rehabilitation of patients after maxillectomy. A systematic review.

Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients' characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient.

Psychosocial impact on anophthalmic patients wearing ocular prosthesis.

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.

Influence of natural weathering on colour stability of materials used for facial prosthesis.

Colour stability of resin and silicone is an important factor for longevity of facial prostheses. The aim of this study was to evaluate the colour stability of resins and silicone for facial prostheses. Three brands of acrylic resin and one of facial silicone were evaluated considering pigment incorporation for the colourless materials. Ten samples of each material were fabricated and submitted to measurements of chromatic alteration initially and after 90 and 180 days of weathering natural through visual analysis and spectrophotometry. Data were evaluated by ANOVA and Tukey test (p < 0.05). Statistically significant colour alteration was observed among some materials regardless of the period. The materials did not present a statistical difference between 90 and 180 days except for the pigmented heat-polymerized resin. The colour difference between pigmented Silastic MDX4-4210 and colourless Silastic was statistically significant (p < 0.01) in both periods as well as between pigmented and colourless heat-polymerized resin, and between the resins Rapidaflex and Lentaflex. The visual method demonstrated colour alteration in all materials evaluated during the first 90 days of ageing. All materials exhibited colour alteration due to exposure to environment.

Effect of disinfection and accelerated ageing on dimensional stability and detail reproduction of a facial silicone with nanoparticles.

The aim of the present study was to evaluate the effect of disinfection and accelerated ageing on the dimensional stability and detail reproduction of a facial silicone with different types of nanoparticle. A total of 60 specimens were fabricated with Silastic MDX 4-4210 silicone and they were divided into three groups: colourless and pigmented with nanoparticles (make-up powder and ceramic powder). Half of the specimens of each group were disinfected with Efferdent tablets and half with neutral soap for 60 days. Afterwards, all specimens were subjected to accelerated ageing. Both dimensional stability and detail reproduction tests were performed after specimen fabrication (initial period), after chemical disinfection, and after accelerated ageing periods (252, 504 and 1008 hours). The dimensional stability test was conducted using AutoCAD software, while detail reproduction was analysed using a stereoscope magnifying glass. Dimensional stability values were statistically evaluated by analysis of variance (ANOVA) followed by Tukey's test (p < 0.01). Detail reproduction results were compared using a score. Chemical disinfection and also accelerated ageing affected the dimensional stability of the facial silicone with statistically significant results. The silicone's detail reproduction was not affected by these two factors regardless of nanoparticle type, disinfection and accelerated ageing.