ABSTRACT
The objective of this study was to analyze the influence of insertion torque, bone type, and peri-implant bone loss on implant stability quotient (ISQ) of cylindrical external hexagon (EH) and Morse Taper (MT) implants. Forty-four single implants were placed in the edentulous areas of 20 patients who met the inclusion and exclusion criteria. Immediately after implant placement (t1) and after osseointegration (four and six months for mandible and maxilla, respectively) (t2), insertion torque, resonance frequency, and peri-implant bone loss were measured using probing depths and digital periapical radiography. A significant difference was noted in the ISQ values between t1 and t2 in type III bone for EH and MT implants. No significant difference in bone loss values was observed when comparing bone types for EH or MT in all evaluated sites. Based on marginal bone loss assessed using radiography, there was no significant difference between the MT and EH groups. A positive correlation between torque and ISQ t1 value was observed for MT (correlation: 0.439; p = 0.041) and EH (correlation: 0.461; p = 0.031) implants. For EH and MT implants, the greater the insertion torque, the greater was the ISQ value (moderately positive correlation). A weak negative correlation was found between bone type and ISQ t1 for MT implants. Contrarily, no correlation was observed between bone type and ISQ t1 for EH implants. In all cases, bone loss around the implants was clinically normal.
Subject(s)
Alveolar Bone Loss , Dental Implantation, Endosseous , Osseointegration , Torque , Humans , Male , Female , Alveolar Bone Loss/diagnostic imaging , Osseointegration/physiology , Dental Implantation, Endosseous/methods , Middle Aged , Reference Values , Time Factors , Treatment Outcome , Statistics, Nonparametric , Dental Prosthesis Design , Adult , Mandible/surgery , Mandible/diagnostic imaging , Dental Prosthesis Retention/methods , Aged , Resonance Frequency Analysis , Dental Implants , Maxilla/surgery , Maxilla/diagnostic imaging , Dental Implants, Single-Tooth , Reproducibility of ResultsABSTRACT
Abstract The objective of this study was to analyze the influence of insertion torque, bone type, and peri-implant bone loss on implant stability quotient (ISQ) of cylindrical external hexagon (EH) and Morse Taper (MT) implants. Forty-four single implants were placed in the edentulous areas of 20 patients who met the inclusion and exclusion criteria. Immediately after implant placement (t1) and after osseointegration (four and six months for mandible and maxilla, respectively) (t2), insertion torque, resonance frequency, and peri-implant bone loss were measured using probing depths and digital periapical radiography. A significant difference was noted in the ISQ values between t1 and t2 in type III bone for EH and MT implants. No significant difference in bone loss values was observed when comparing bone types for EH or MT in all evaluated sites. Based on marginal bone loss assessed using radiography, there was no significant difference between the MT and EH groups. A positive correlation between torque and ISQ t1 value was observed for MT (correlation: 0.439; p = 0.041) and EH (correlation: 0.461; p = 0.031) implants. For EH and MT implants, the greater the insertion torque, the greater was the ISQ value (moderately positive correlation). A weak negative correlation was found between bone type and ISQ t1 for MT implants. Contrarily, no correlation was observed between bone type and ISQ t1 for EH implants. In all cases, bone loss around the implants was clinically normal.
ABSTRACT
Introduction: with the technological advance in dentistry, light-polymerized three-dimensional (3D) printing resins had become an alternative for the manufacture of occlusal splint splints. Objective: the present study aimed to analyze the flexural strength of a resin for 3D printing compared to conventional acrylic resins (chemically activated and thermally activated), under the influence of thermocycling. Material and method: 60 specimens were made, which were distributed in six experimental groups (n = 10), according to the resin employed (chemically activated acrylic resin, thermally activated acrylic resin and 3D printing resin) and the treatment received (control and thermocycling). The specimens were submitted to flexural strength by the three-point flexural test. Result: data analysis showed that the material factor (<0.0001) and the thermocycling factor (p = 0.0096) influenced flexural strength, however, the interaction between the two factors did not (p = 0.9728). Conclusion: it was concluded that 3D printing resins presented the lowest flexural resistance to acrylic resins, especially when submitted to thermocycling.
Introdução: com o avanço tecnológico dentro da odontologia, as resinas fotopolimerizáveis para impressão tridimensional (3D) se tornaram uma alternativa para a fabricação de dispositivos interoclusais. Objetivo: o presente trabalho teve como objetivo analisar a resistência flexural de uma resina para impressão tridimensional comparada com resinas acrílicas convencionais (quimicamente ativada e termicamente ativada), sob a influência da termociclagem. Material e método: foram confeccionados 60 corpos de prova, que foram distribuídos aleatoriamente em seis grupos experimentais (n=10), de acordo com a resina utilizada (resina acrílica ativada quimicamente, resina acrílica ativada termicamente e resina para impressão 3D) e com o tratamento recebido (controle e termociclagem). Os corpos de prova foram submetidos ao ensaio de flexão de três pontos para determinação da resistência flexural. Resultado: a análise dos dados demonstrou que o fator material (<0.0001) e o fator termociclagem (p=0.0096) influenciaram a resistência flexural, entretanto, a interação entre os dois fatores não (p=0.9728). Conclusão: deste modo podemos concluir que a resina para impressão 3D apresentou desempenho inferior às resinas acrílicas, especialmente quando submetida a termociclagem.
Subject(s)
Acrylic Resins , Occlusal Splints , Resins , Printing, Three-Dimensional , Flexural StrengthABSTRACT
This study evaluated the effect of fiber post customization and laser application on the results of pull-out tests in endodontically treated teeth. Forty-eight bovine incisors were stored in aqueous 2% formaldehyde (pH 7.0) for 30 days. At the end of the storage period, the incisors were scraped with No. 11/12 periodontal curettes, rinsed with water and sodium bicarbonate, and stored in 0.9% saline solution for 7 days. Roots with similar shape and dimensions were selected and sectioned to a standard 17-mm length. Root canals were prepared and filled to a depth of 12 mm. The roots were divided into 4 groups (n = 12): 1, conventional fiber post and no laser application; 2, customized fiber post and no laser application; 3, conventional fiber post and laser application; and 4, customized fiber post and laser application. After removal of the obturation material for post space preparation, the canals were enlarged, and a laser beam was applied to the roots of teeth in groups 3 and 4 as an auxiliary disinfection procedure. After cementation of the posts, a pull-out test was performed using an axial tensile load at 0.5 mm/min in a universal testing machine. Analysis of variance and the Tukey test were used for statistical analysis of the results. The mean (SD) maximum tensile force was 10.18 (4.73) kgf in group 1, 38.89 (6.49) kgf in group 2, 27.74 (10.07) kgf in group 3, and 38.92 (6.89) kgf in group 4. These values were significantly higher in groups 2 and 4 than in group 1 (P < 0.05). The customization of fiber posts used for the restoration of pulpless teeth resulted in significantly (P < 0.05) greater pull-out test values, a thinner cement layer, and improved retention.
Subject(s)
Dental Bonding , Post and Core Technique , Tooth, Nonvital , Animals , Cattle , Dental Pulp Cavity , Dental Stress Analysis , Glass , Humans , Lasers , Materials Testing , Resin CementsABSTRACT
O tratamento endodôntico frequentemente leva à perda de parte coronária de um elemento dentário, seja pelo enfraquecimento de sua estrutura, por lesões traumáticas ou por cárie. Desde que em condições favoráveis, esses dentes podem ser restaurados por meio de retenção adequada provida por meio de retentores intrarradiculares. Os pinos de quartzo utilizados como retentor intrarradicular surgiram com os avanços da odontologia adesiva, sendo uma opção relevante com inúmeras vantagens. A literatura odontológica aponta que a adaptação do pino às paredes do conduto radicular, somada a técnica de cimentação adesiva, são fatores essenciais para a longevidade do tratamento, sendo necessário em alguns casos sua personalização, para garantir melhor assentamento e promover prognóstico favorável. Objetivou-se neste artigo apresentar a técnica de preparo, personalização e cimentação do pino de quartzo na reconstrução de um dente tratado endodonticamente ilustrado por meio de caso clínico. Através de um protocolo ordenado e meticuloso da técnica de aplicação, foi possível alcançar o resultado desejado(AU)
Endodontic treatment often leads to loss of the coronary part of a tooth, either by weakening its structure, by traumatic lesions or by caries. Since under faborable conditions, these teetn can be restored by means of the biomechanical reinforcement promoted by the intraradicular retainers. The quartz posts have appeared with the advances of restorative dentistry, being a relevant option with numerous advantages. The dental literature indicates that the adaptation of the post to the root canal walls, together with the adhesive cementation technique, are essential factors for the longevity of the treatmet, being necessary in some cases its personalization, which guarantees its better settlement, avoiding the impression of undesirable forces to the tooth anf promoting better prognosis. The objective was to present the technique of preparation, personalization and cementation of the quartz post in the reconstruction of an endodontically treated tooth. Through an orderly and meticulous protocol of the application technique, it was possible to achieve the desired result(AU)
Subject(s)
Humans , Female , Adult , Quartz , Root Canal Filling Materials , Dental Cements , Dental Pins , Tooth, NonvitalABSTRACT
A reabilitação funcional e estética com cerâmicas adesivas é uma área da Odontologia em destaque tanto pelos resultados excepcionais que podem ser alcançados como pela demanda da sociedade contemporânea. Várias ferramentas de diagnóstico, planejamento e execução estão disponíveis com o objetivo de alcançar a excelência no tratamento reabilitador estético. O desenho digital do sorriso (DSD) é um dos recursos utilizados, possibilitando além da previsibilidade, comunicação e orientação eficiente da fase laboratorial, também a motivação do paciente. O objetivo desse trabalho foi apresentar um caso clínico de reabilitação oral estética guiado pelo DSD tanto para a abordagem periodontal como para o enceramento estético. Foram planejados e executados 10 laminados cerâmicos em dissilicato de lítio tendo como ponto de partida após exames clínicos, o enceramento e a plástica periodontal virtualmente desenhados. O resultado foi alcançado como almejado pelo paciente e previsto pelo profissional, sendo a presente reabilitação apoiada em criterioso protocolo de execução(AU)
Functional and aesthetic rehabilitation with adhesive ceramics is an area of dentistry that stands out both for the exceptional results that can be achieved and for the demands of contemporary society. Various diagnostic, planning and execution tools are available with the goal of achieving excellence in aesthetic rehabilitation treatment. The digital smile design (DSD) is one of the resources used, enabling not only the predictability, communication and efficient orientation of the laboratory phase, but also the motivation of the patient. The objective of this work was to present a clinical case of oral aesthetic rehabilitation guided by DSD for both the periodontal approach and aesthetic waxing. Ten ceramic laminates in lithium disilicate were designed and executed with virtually new clinical waxing and periodontal plastic as a starting point after clinical examination. The result was achieved as intended by the patient and predicted by the professional, and the present rehabilitation is supported by a judicious implementation protocol(AU)
Subject(s)
Humans , Female , Adult , Photography, Dental , Esthetics, Dental , Mouth Rehabilitation , CeramicsABSTRACT
ABSTRACT Objective: The aim of this study was to evaluate the satisfaction of patients rehabilitated with fixed partial denture and the incidence of failures/clinical complications of prostheses after one year. Methods: The patients answered a questionnaire about the satisfaction degree with dental treatment performed and care maintenance for prosthesis conservation. Clinical and radiographic evaluations of the prosthesis were performed. Data were tabulated for descriptive analysis of the factors assessed, with calculation of absolute frequencies and percentages, and chi-square and Fisher's exact test.. Results: A total of 9.67% failures were found. The most common was the prosthesis loosening (57.14%), followed by ceramic fracture (28.57%), and abutment tooth fracture (14.29%). Biological failures were observed in 30.65%. The most common failure was gingival recession (52.00%), periodontal pocket (24.00%), support periodontal involvement (16.00%), and recurrent caries (4.00%). Radiographic examination showed that 70.97% of the total number evaluated had some kind of failure. There was statistically significant association between satisfaction degree and technical failure (p=0.04). Conclusion: Patients were satisfied after observation period of 1 year. The main failures detected were: crown cementation failure and ceramic fracture; gingival recession, periodontal pocket; manufacture and cementation of short intraradicular post with increased diameter and crown cervical misfit.
RESUMO Objetivo: O objetivo deste estudo foi avaliar a satisfação dos pacientes reabilitados com prótese parcial fixa e a incidência de falhas/complicações clínicas das próteses instaladas após um ano. Métodos: Os pacientes responderam um questionário abrangendo o grau de satisfação pelo tratamento odontológico efetuado e os cuidados de manutenção realizados para a conservação da prótese. Na sequência foi realizada avaliação clínica e radiográfica das próteses. Os dados obtidos foram tabulados para análise descritiva dos fatores avaliados com cálculo de frequência absoluta e percentual, e teste de Qui-quadrado e Fischer. Resultados: Foram encontradas 9,67% de falhas, sendo a mais comum a descimentação (soltura da prótese) (57,14%), seguida da fratura da cerâmica (28,57%), e um caso de fratura no dente pilar (14,29%). As falhas biológicas foram observadas em 30,65%. A falha mais comum foi a recessão gengival (52,00%), seguida por bolsa periodontal (24,00%), envolvimento periodonto de suporte (16,00%), e recidiva de cárie (4,00%). No exame radiográfico 70,97% do número total avaliado apresentaram algum tipo de falha. Houve associação estatisticamente significante entre grau de satisfação e falhas mecânicas (p=0,04). Conclusão: Os pacientes ficaram satisfeitos após um período de acompanhamento de 1 ano. As principais falhas detectadas foram: falha de cimentação da coroa e fratura da cerâmica; Recessão gengival, bolsa periodontal; confecção e cimentação de pino intraradicular curto, pino com diâmetro aumentado e desajuste cervical da coroa.
ABSTRACT
ABSTRACT Objective The aim of this study was to investigate the subjective aspects related to the perception of dental appearance and expectations of patients who receive dental treatment in graduation clinics of the Araçatuba Dental School. Methods It was evaluated 362 patients of both gender aged over 18. The questionnaire included questions of demographic data, questions to assess facial and dental aesthetics, dental satisfaction and treatments considering patients notion to improve dental esthetics. The data collected was analyzed using descriptive statistics and the chi-square test. Results The factor teeth for facial analysis and factor positioning in the arch for smile analysis were considered the most important subjects regarding the esthetic according to the respondents. 67.5% of patients were dissatisfied with the appearance of their teeth, and dissatisfaction with the color was the most important factor (66.8%). The treatment most desired was tooth whitening and 85.0% of patients said yes to it. Conclusion Respondents place great value on the teeth on the face appearance, and it can be seen that aesthetic treatments are highly valued in all age groups. There is a need for treatments to restore the function, but treatments to improve dental appearance were the most requested.
RESUMO Objetivo Avaliar os aspectos subjetivos relacionados à percepção da aparência dental e expectativas de pacientes que recebem tratamento odontológico nas clínicas de graduação da Faculdade de Odontologia de Araçatuba. Métodos Foram avaliados 362 pacientes de ambos os sexos com idade superior a 18. O questionário incluiu perguntas sobre dados demográficos, perguntas para avaliar a estética facial e dentária, a satisfação dental e tratamentos considerando a noção dos pacientes de melhorar a estética dental. Os dados coletados foram analisados por meio de estatística descritiva e o teste do qui-quadrado. Resultados O fator dentes para análise facial e o fator posicionamento no arco para análise sorriso foram considerados os temas mais importantes a respeito da estética, de acordo com os entrevistados. 67,5% dos pacientes estavam insatisfeitos com a aparência de seus dentes, a insatisfação com a cor foi o fator mais importante (66,8%). O tratamento mais desejado foi o clareamento dental e 85,0% dos pacientes disse sim a ele. Conclusão Os pacientes dão grande valor aos dentes sobre a aparência rosto, e ele pode ser visto que os tratamentos estéticos são altamente valorizados em todos os grupos etários. Há uma necessidade de tratamentos para restabelecer a função, mas os tratamentos para melhorar a aparência dentária foram os mais solicitados.
ABSTRACT
O contorno gengival é um aspecto de extrema importância para a harmonia do sorriso. Nos sorrisos classificados como altos e com margens cervicais irregulares, para otimizar os resultados de um tratamento estético-reabilitador, é necessária a remodelação do tecido gengival com o uso de técnicas de cirurgia plástica periodontal, como a gengivectomia e/ou gengivoplastia em associação aos procedimentos restauradores. Atualmente, faz parte do protocolo reabilitador o ensaio estético ou mock-up, cujo objetivo é demonstrar ao paciente o tratamento a ser executado, prever a finalização estética e auxiliar na cirurgia periodontal. O uso do mock-up é uma excelente ferramenta para diagnóstico, planejamento e execução de procedimentos cirúrgicos-reabilitadores, dando previsibilidade ao resultado estético e funcional. Dessa forma, o objetivo deste trabalho foi revisar a literatura acerca da utilização do mock-up em procedimentos cirúrgico-reabilitadores, bem como relatar o caso clínico de uma paciente na qual se aplicou o ensaio estético para guiar a cirurgia plástica periodontal e prever o resultado a ser alcançado nos procedimentos restauradores. Assim, os profissionais podem ter previsibilidade de seus tratamentos estéticos associando o enceramento de diagnóstico ao ensaio estético, e este guiando o recontorno das margens gengivais que trará harmonia entre os tecidos da estética branca e estética rosa com excelentes resultados, principalmente nos casos de sorriso gengival alto.
The gingival contour is an aspect of extreme importance for the harmony of the smile. For smiles classified as high and with irregular cervical margins, in order to optimize the results of an aesthetic-rehabilitation treatment, it is necessary to remodel the gingival tissue with periodontal plastic surgery techniques, such as gingivectomy and/or gingivoplasty associated to restorative procedures. Currently, part of the rehabilitation protocol is the aesthetic or mock-up test, whose objective is to demonstrate to the patient the treatment to be performed, to predict aesthetic completion, and to assist in periodontal surgery. The mock-up is an excellent tool for diagnosis, planning and execution of surgical-rehabilitation procedures, giving predictability to the aesthetic and functional result. Thus, the objective of this work was to review the literature on the use of mock-up in surgical-rehabilitation procedures, as well as to report the clinical case of a patient in whom the esthetic test was applied to guide the periodontal plastic surgery and predict the result to be achieved in restorative procedures. Thus, professionals can have predictability of their aesthetic treatments by associating diagnostic waxing with the aesthetic test and this guiding the contouring of the gingival margins that will bring harmony between the tissues of pink and white esthetics with excellent results, especially in cases of high gingival smile.
Subject(s)
Humans , Female , Adult , Dental Veneers , Esthetics, Dental , Gingivoplasty , Minimally Invasive Surgical Procedures , Periodontics , SmilingABSTRACT
Os procedimentos de enxertia óssea para ganho vertical ainda são temerários na Implantodontia. Não há um consenso na literatura sobre as técnicas para aumento em altura da crista óssea alveolar para futura colocação de implantes. Além disso, o tempo de tratamento é demasiadamente prolongado quando são realizadas as técnicas de enxerto ósseo com implantação tardia. Sendo assim, o objetivo deste trabalho foi descrever uma técnica para aumento ósseo vertical simultâneo à instalação de implante denominado bone ring. Paciente apresentando severo defeito ósseo em altura e largura na região do dente 14 foi reabilitada a partir da reconstrução óssea tridimensional com anel ósseo removido da área mentual e implantação imediata à fixação do enxerto. Após seis meses, foram realizados a reabertura e procedimentos protéticos de personalização de perfil de emergência, com posterior instalação de coroa metalocerâmica. Decorridos dois anos de acompanhamento, notou-se estabilidade tecidual peri-implantar sem remodelações severas do tecido ósseo peri-implantar. Pôde-se concluir que a técnica de reconstrução óssea tridimensional simultânea à instalação de implante bone ring é uma alternativa viável, mediante rigoroso planejamento e curva de aprendizado indicada para defeitos ósseos severos.
Bone grafting procedures for vertical bone augmentation are still an issue on implant dentistry. There is no literature consensus regarding techniques for alveolar ridge height increase for further implant placement. Besides, treatment times are extended in case of delayed implant placement. The aim of this paper was to describe a technique for vertical bone augmentation at the same time of implant installation (bone ring). A patient having a several bone defect in height and width at the region of tooth 14 received a 3D reconstruction with a bone ring removed from the chin area. Six months later, implant exposure was performed with procedures for soft tissue conditioning and delivery of a metalloceramic restoration. Tissue stability and no significant bone remodeling were observed after two years. The proposed technique for three-dimensional reconstruction bone ring is a viable alternative provided that judicious treatment planning and considerable learning curve are observed to manage severe bone defects.
Subject(s)
Humans , Female , Middle Aged , Alveolar Ridge Augmentation/methods , Biocompatible Materials , Bone Transplantation , Connective Tissue/transplantation , Dental Implants , Tissue TransplantationABSTRACT
Introduction: The biomechanical behavior of endodontically treated teeth depending on the selected restorative material and tooth situation to be restored. Objective: To analyze by the two-dimensional finite element method the biomechanical behavior of different diameters in intraradicular posts and teeth with coronal remaining of 2mm. Material and method: Six models were made with three types of posts, as follows: Glass fiber post, carbon fiber post, and cast metal post, both with diameter # 1 (1.1 mm in diameter) and # 2 (1.3 mm of diameter). The modeling was performed using the Rhinoceros 4.0 program. The FEMAP 10.2 and NEiNastran 9.2 programs were used to develop finite element models. The loading used was 100N for axial and oblique forces. The results were visualized using the von Mises stress map. The statistical analysis was made using analysis of variance (ANOVA) and Tukey post-test, with a significance level of 5%. Result: The oblique loading stress values were higher than the axial loading (p< 0.001) for both situations. The glass fiber post showed the lowest concentrations of stress on both loads (p< 0.001). The carbon fiber post presented significant difference compared to the cast metal post, only in the oblique load (p=0.007). The diameter did not increase the stress of the evaluated posts (p=0.302). Conclusion: The fiber posts were more favorable for restoration of endodontically treated teeth; the increase of diameter did not influence the increase of tension; the oblique load was more harmful for both posts and tooth structure.
Introdução: O comportamento biomecânico de dentes tratados endodonticamente é variável conforme o material restaurador selecionado e situação do dente a ser restaurado. Objetivo: Analisar por meio do método dos elementos finitos bidimensional o comportamento biomecânico de diferentes retentores intrarradiculares e diâmetros em dentes com 2mm de remanescente coronário. Material e método: Foram confeccionados seis modelos com três tipo de retentores: pino de fibra de vidro, pino de fibra de carbono e núcleo metálico fundido, ambos com diâmetro #1 (1,1mm de diâmetro) e #2 (1,3mm de diâmetro). A modelagem foi realizada através do programa Rhinoceros 4.0, e em seguida nos programas FEMAP 10.2 e NeiNastran 9.2 para desenvolvimento d os modelos de elementos finitos. Nos carregamentos foram utilizadas forças de 100N axial e oblíquo. Os resultados foram visualizados pelo mapa de tensão von Mises, e pela análise de variância (ANOVA) e pós-teste Tukey, com nível de significância à 5%. Resultado: O carregamento oblíquo apresentou maiores valores de tensões (p< 0,001). O pino de fibra de vidro apresentou menores concentrações de tensões em ambos os carregamentos (p< 0,001). O pino de fibra de carbono apresentou diferença significativa em relação ao núcleo metálico somente no carregamento oblíquo (p=0,007). O diâmetro não influenciou para o aumento de tensões dos retentores avaliados (p=0,302). Conclusão: Os pinos de fibras são mais favoráveis para restaurações de dentes tratados endodonticamente; O aumento do diâmetro não influenciou no aumento de tensões; A carga oblíqua é mais prejudicial à tanto para o retentor quanto para a estrutura dentária.
Subject(s)
Root Canal Filling Materials , Post and Core Technique , Dental Prosthesis , Finite Element Analysis , Dental Pins , Denture, Partial, Fixed , Tensile Strength , Analysis of VarianceABSTRACT
The aim of this study was to evaluate the stress distribution on full-arch prostheses, considering axial implants and tilted implants with or without abutments. Two photoelastic models were made, being that in 1 model the implants were inserted perpendicular, whereas in the other model 2 implants were inserted perpendicular and 2 implants were inserted with tilting 30° to the distal area. The prosthetic situations were evaluated: A-axial implants and nonsegmented full-arch prosthesis; B-axial implants and segmented full-arch prosthesis; C-tilted distal implants and nonsegmented full-arch prosthesis; D-tilted distal implants and segmented full-arch prosthesis, and was applied an axial load of 100âN at 5 points. The results showed greater stress concentration for axial implants than tilted implants in anterior and posterior loading. There was no difference in stress distribution to the use of abutment in the tilted implants. Shorter cantilever with tilted implants improved the stress distribution; the use of abutment did not influence the stress distribution.
Subject(s)
Dental Implantation, Endosseous/methods , Dental Implants , Dental Prosthesis, Implant-Supported , Dental Stress Analysis/methods , Denture, Complete , Dental Prosthesis Design , Humans , ToothABSTRACT
OBJECTIVE: The purpose of this systematic review was to compare the survival and complication rates of all-ceramic restorations after a minimum follow-up time of 5 years. DATA SOURCES: A comprehensive search of studies published from 2005 to November 2015 and listed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the PRISMA statement. Two reviewers independently analyzed the abstracts. Relevant studies were selected according to predetermined inclusion criteria. RESULTS: Twenty-nine studies were selected for the final analysis from an initial yield of 514. Only four studies fulfilled the requirement of having a randomized design, and 25 studies were prospective with a mean follow-up period of 5 to 16 years. Overall, the 5-year complication rates were low. The most frequent complications were secondary caries, endodontic problems, ceramic fractures, ceramic chipping, and loss of retention. CONCLUSION: This systematic review showed that all-ceramic restorations fabricated using the correct clinical protocol have an adequate clinical survival for at least 5 years of clinical service with very low complication rates. Minor ceramic chipping and debonding did not affect the longevity of the restorations. CLINICAL RELEVANCE: Long-term clinical performance of all-ceramic restorations manufactured using various ceramic systems provides clinical evidence of complications and long-term management of these restorations. Available evidence indicates the effectiveness of many ceramic systems for numerous clinical applications. Correct planning and a rigorous technical execution protocol increase clinical success. Studies of ceramic prostheses indicate more problems with ceramic failure and debonding.
Subject(s)
Dental Porcelain/chemistry , Dental Prosthesis Design , Dental Restoration Failure , Follow-Up Studies , HumansABSTRACT
O objetivo deste trabalho foi apresentar três casos clínicos de implantação imediata com provisionalização imediata, empregando a filosofia one abutment at one time. Nos três casos clínicos, após a realização das imagens tomográficas e prescrição medicamentosa, os implantes foram posicionados nas raízes mesiais (molares inferiores) e distovestibulares (molares superiores), sendo o espaço remanescente preenchido com biomaterial para preservação alveolar. Após a colocação dos pilares defi nitivos, coroas provisórias permaneceram por 90 dias até a cimentação das coroas metalocerâmicas definitivas. Os implantes são colocados abaixo do nível da crista óssea e o pilar utilizado constitui um exemplo de platform switching, que cria um espaço biológico e uma zona de selamento. Os controles destes casos vão de um a quatro anos demonstrando excelente estabilidade dimensional. Os resultados clínicos sugerem que a osseointegração de implantes unitários imediatamente carregados na região posterior pode ser alcançada. O uso de uma restauração provisória com a anatomia ideal de um dente molar pode facilitar a formação de contornos naturais da mucosa peri-implantar. É importante que o paciente não apresente bruxismo, possua osso suficiente para o posicionamento do implante e que pratique uma boa higiene oral.
The aim of this paper was to present three clinical cases with immediate implant insertion and provisionalization using the one abutment one time philosophy. On these, after CBCT and medicament prescription, the implants were positioned at the mesial (mandibular molars) and at the alveolar center (maxillary molars) aspects, being the gaps and the alveoli filled with a biomaterial for alveolar preservation. After the definitive abutments being placed, the provisional crowns remained in position for 90 days until cementation of the definitive metalloceramic crowns. The implants are placed below the bone crest level and the prosthetic abutment forms a platform-switching which creates a biologic space and a sealing zone. The follow-ups range from 1 to 4 years demonstrating excellent dimensional stability. The clinical results suggest that the osseointegration of immediate, single-tooth implants at the posterior region can be achieved. The use of a provisional restoration with ideal characteristics of a molar tooth facilitates the peri-implant mucosa contouring. It is important to select symptom-free bruxism patient, with sufficient bone for implant placement, and having good oral hygiene levels.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dental Implantation , Dental Implants, Single-Tooth , Immediate Dental Implant Loading , OsseointegrationABSTRACT
O objetivo deste artigo é apresentar um protocolo de tratamento de implantes imediatos de excelente previsibilidade estética e biológica. O caso clínico em questão apresenta comprometimento do elemento 21, que após o exame clínico e complementar constatou a fratura radicular irreparável. O planejamento foi a exodontia da raiz fraturada e instalação de implante imediato com provisionalização imediata, associando biomaterial para preenchimento do gap e enxerto conjunto na vestibular. Para restauração final foram confeccionadas uma coroa zircocerâmica como restauração definitiva do elemento 21 e uma microlâmina em dissilicato de lítio (IPS e.max) no dente 11 para harmonizar contorno e proporção entre os incisivos. O resultado final obtido mostrou-se favorável no follow-up de 1 ano, tanto nos aspectos biológicos dos tecidos peri-implantares e quanto à estética final. Com isso, concluímos que o protocolo adotado mostrou excelente previsibilidade.
The aim of this paper is to present a treatment protocol for excellent aesthetic and biological predictability with immediate implant. In the reported clinical case, the element 21 was compromised with irreparable root fracture. The planning was the extraction of the fractured root and immediate implant placement with immediate temporization, associating biomaterial for gap filling and conjunctive tissue graft. for the final restoration were made a zirco-ceramic crown in the element 21, and a lithium disilicate veneer (IPS e.max) in tooth 11 to harmonize contour and ratio between the incisors. The final result was favorable along the 1 year follow-up for both biological aspects of peri-implant tissues and final aesthetic. Thus, it could be concluded that the adopted protocol showed great predictability.
Subject(s)
Humans , Female , Adult , Biocompatible Materials , Connective Tissue/transplantation , Dental Implants, Single-Tooth , Immediate Dental Implant Loading , Surgery, Oral , Transplantation, AutologousABSTRACT
Introduction: Temporary restorative materials are widely used, however, little is know about their color stability. Objective: to evaluate the color stability of the following temporary restorative materials: acrylic and bis-acrylic resins after immersion in pigmenting solutions for different periods of storage. Material and method: Four materials were tested (Dêncor/Clássico, Protemp 4/3M ESPE; Structur 2 SC/Voco; Luxatemp AM Plus/DMG) and 30 test specimens (15 mm in diameter and 2 mm thick) per material were fabricated. They were divided according to the storage medium (artificial saliva, saliva + cola type soda, and saliva + coffee) and storage time intervals (2, 5, 7 and 15 days). Color measurements were made before and after immersions, with use of a spectrophotometer, by means of the CIE L*a*b* system. The data were analyzed by the analysis of variance and the Tukey Test, at a level of significance of 5%. Result: Acrylic resin presented greater color stability in comparison with bis-acrylic resins (p<0.001). When bis-acrylic resins were compared no significant difference was observed between the resins Structur and Luxatemp (p=0.767). As regards solutions tested, coffee showed the highest color change values (p<0.001), and the longer the storage time interval, the greater was the color change in all the temporaryrestorative materials analyzed (p<0.001). Conclusion: Acrylic resin presented greater color stability in comparison with bis-acrylic resins (p<0.001). Coffee caused the greatest color change, and immersion time was determinant in color stability of the temporary materials analyzed.
Introdução: Os materiais restauradores provisórios são amplamente utilizados, porém pouco se sabe a respeito de sua estabilidade de cor. Objetivo: Avaliar a estabilidade de cor de materiais restauradores provisórios: resina acrílica e resinas bisacrílicas, após a imersão em soluções pigmentantes, durante diferentes períodos de armazenamento. Material e método: Quatro materiais foram testados (Dêncor/Clássico, Protemp 4/3M ESPE; Structur 2 SC/Voco; Luxatemp AM Plus/DMG) sendo confeccionadas 30 amostras (15 mm de diâmetro e 2 mm de espessura) por material. Estes foram divididos de acordo com o meio de imersão (saliva artificial, saliva + refrigerante tipo cola e saliva + café) e período de armazenamento (2, 5, 7 e 15 dias). As mensurações de cor foram realizadas antes e após as imersões, com auxílio de um espectrofotômetro, através do sistema CIE L*a*b*. Os dados foram analisados com análise de variância (ANOVA) e Tukey, com nível de significância à 5%. Resultado: A resina acrílica apresentou maior estabilidade de cor quando comparada às resinas bisacrílicas (p<0,001). Comparando as resinas bisacrílicas, não foi observado diferença significativa entre as resinas Structur e Luxatemp (p=0,767). Em relação as soluções testadas, o café apresentou os maiores valores de alteração de cor (p<0,001), sendo que quanto maior o período de armazenamento, maior foi a alteração de cor de todos os materiais provisórios analisados (p<0,001). Conclusão: A resina acrílica apresentou maior estabilidade de cor, quando comparada às bisacrílicas. O café causou a maior alteração de cor, e o tempo de imersão foi determinante na estabilidade de cor dos materiais provisórios analisados.
Subject(s)
Spectrophotometers , Analysis of Variance , Dental Prosthesis , Color , Dental Restoration, Temporary , Acrylic Resins , CoffeeABSTRACT
This in vitro study evaluated the effect of mechanical cycling on the torque of retaining screw in external hexagon implants with platform switching (PS), regular platform (RP) and wide platform (WP). A total of 30 specimens were equally divided into 3 groups: PS, PR and WP. Each specimen was prepared with implants: 3.75 x 10 mm for RP group and 5.0x10 mm for PS and WP groups and its respective abutment with 32 Ncm torque. All groups were subjected to 106 cycles with 100 N (corresponding to about 40 months of chewing). The results were obtained with the reverse torque of each specimen and data were evaluated using ANOVA and Tukey test (p<0.05). The PS group showed statistically significant difference in screw removal torque (30.06±5.42) compared with RP (23.75±2.76) and WP (21.32±3.53) (p<0.05) groups; the RP and WP groups showed no statistically significant difference between them. It was concluded that the PS group showed higher reverse torque value, suggesting lower susceptibility of the abutment screw loosening.
Subject(s)
Bone Screws , Dental Implants , Prosthesis Design , TorqueABSTRACT
This in vitro study evaluated the effect of mechanical cycling on the torque of retaining screw in external hexagon implants with platform switching (PS), regular platform (RP) and wide platform (WP). A total of 30 specimens were equally divided into 3 groups: PS, PR and WP. Each specimen was prepared with implants: 3.75 x 10 mm for RP group and 5.0x10 mm for PS and WP groups and its respective abutment with 32 Ncm torque. All groups were subjected to 106 cycles with 100 N (corresponding to about 40 months of chewing). The results were obtained with the reverse torque of each specimen and data were evaluated using ANOVA and Tukey test (p<0.05). The PS group showed statistically significant difference in screw removal torque (30.06±5.42) compared with RP (23.75±2.76) and WP (21.32±3.53) (p<0.05) groups; the RP and WP groups showed no statistically significant difference between them. It was concluded that the PS group showed higher reverse torque value, suggesting lower susceptibility of the abutment screw loosening.
Este estudo in vitro avaliou o efeito da ciclagem mecânica no torque dos parafusos de retenção em implantes de hexágono externo com plataforma switching (PS), plataforma regular (RP) e plataforma larga (WP). Foram utilizados 30 corpos de prova divididos em 3 grupos equitativamente: PS, RP e WP. Cada corpo de prova foi preparado com implantes: 3,75x10 mm para o grupo RP e 5,0x10 mm para os grupos PS e WP, e seu respectivo abutment com o torque de 32 Ncm. Todos os grupos foram submetidos a 106 ciclos com 100 N de força (o que corresponde a aproximadamente 40 meses de mastigação). Os resultados foram obtidos com o torque reverso de cada espécime e os dados foram avaliados com ANOVA comparado com o teste de Tukey (p<0,05). O grupo PS apresentou diferença estatisticamente significante no torque de remoção do parafuso (30,06±5,42) comparado com os grupos RP (23,75±2,76) e WP (21,32±3,53) (p<0,05); os grupos RP e WP não apresentaram diferença estatisticamente significante entre si. Concluiu-se que o grupo PS apresentou maior valor de torque reverso sugerindo menor susceptibilidade de afrouxamento do parafuso de fixação do abutment.
Subject(s)
Bone Screws , Dental Implants , Prosthesis Design , TorqueABSTRACT
To evaluate the adherence of Streptococcus mutans to the surface of the amalgam and copper/aluminum alloy samples and also evaluate the release of metallic ions. METHODS: The prepared medium was changed every 72 h and analyzed by atomic absorption spectrophotometer. Samples were removed from the prepared medium at 15, 30, 48 and 60 days. RESULTS: The result shows that ions released were statistically different among all groups, and so were both biofilm and pits formation and the corrosion induced by the S. mutans in both types of samples. SEM observation of the samples immersed in the prepared medium with S. mutans showed adherence of microorganisms on the whole surface, in all groups. CONCLUSIONS: The S. mutans adhere to both amalgam and copper/aluminum alloy causing corrosion of those restorations. S. mutans produced a greater ions release in Cu/Al alloy; in amalgam, the ions release was not influenced by exposure to S. mutans...
Subject(s)
Humans , Corrosion , Dental Alloys , Dental Amalgam , Ions , Streptococcus mutansABSTRACT
Algumas vezes nos deparamos no consult¢rio com situaães cl¡nicas, nas quais a falta de harmonia no sorriso encontra-se devido a uma grande exposiÆo de tecido gengival. Nestes casos o profissional deve ser capaz de realizar uma an lise detalhada dos componentes est ticos e dinmicos do sorriso, em busca de um planejamento e tratamento satisfat¢rios, que poder englobar diferentes especialidades odontol¢gicas. Para estas situaães, a associaÆo periodontia/pr¢tese uma alternativa vi vel a ser proposta ao paciente, que vem sendo utilizada de maneira positiva em busca de uma condiÆo esttica e funcional favor vel ao paciente, sem deixar de lado os princ¡pios de preservaÆo dos tecidos periodontais e da estrutura dent ria remanescente. Diante disso, o objetivo deste trabalho foi descrever um caso cl¡nico no qual a associaÆo periodontia/pr¢tese foi proposta para correÆo de sorriso gengival e vestibularizaÆo dent ria. Atravs do resultado cl¡nico obtido e a satisfaÆo do paciente, podemos entender que o tratamento multidisciplinar envolvendo a associaÆo de tcnicas periodontais e protticas em casos com comprometimento esttico gengival e dental, favor vel para alcanar um resultado positivo.
Sometimes we face clinical situations in which the lack of harmony in the smile is caused by a major exhibition of the gingival tissue. In these cases the professional should be able to perform a detailed analysis of the static and dynamic components of the smile, in search of a satisfactory planning and treatment which may include different dental specialties. For these situations, the association of periodontics/prosthesis is a viable alternative that has been used positively in search of an aesthetic and functional condition that benefits the patient, without leaving aside the preservation of periodontal tissues and of the remaining structure of the tooth. Thus, the aim of this study was to describe a case in which the association between these two areas was proposed to correct gummy smile and dental vestibularization. Clinical results and the satisfaction of the patient indicate that this multidisciplinary treatment combining periodontal and prosthetic techniques is favorable to positive results in cases of compromised smile aesthetics due to excessive gum tissue.