ABSTRACT
The purpose of this study was to warn the dental community about a possible problem in function with partial implant-supported prostheses used for long periods. The misalignment between natural teeth and the implant-supported prosthesis on teeth 11 and 12, observed in a 14-year clinical follow-up, illustrates the fact. The metal-ceramic crowns were placed in 1995 after a rigorous occlusal adjustment. Evaluations were made at 4, 6, 9, and 14 years, when it was noticed that the restorations were positioned palatally and extruded in comparison with the natural teeth. After 9 years, a greater discrepancy was noticed, with anterior occlusion and esthetic changes. The possible causes have been discussed: occlusal problems, parafunctional habits, and natural movement. The first 2 options were discarded after clinical analysis and diagnosis. Therefore, the natural movement probably deriving from an interaction of mechanical and genetic factors might have been the cause. The implants do not have periodontal ligaments but rather ankylosis, so they do not suffer those movements. This case emphasizes the need to inform patients that implants can last more than 10 years in function, but this is not the case with restorations, which lose function and esthetics and must be replaced.
Subject(s)
Crowns , Dental Arch/pathology , Dental Prosthesis, Implant-Supported , Maxilla/pathology , Adult , Dental Implantation, Endosseous/methods , Dental Implants , Dental Occlusion , Dental Prosthesis Design , Esthetics, Dental , Follow-Up Studies , Humans , Incisor/injuries , Jaw, Edentulous, Partially/rehabilitation , Jaw, Edentulous, Partially/surgery , Male , Tooth Avulsion/therapy , Tooth Fractures/therapyABSTRACT
The continuous technological advance and increasing availability of new base metal alloys and ceramic systems in the market, coupled to the demands of daily clinical practice, have made the constant evaluation of the bond strength of metal/porcelain combinations necessary. This study evaluated the metal/porcelain shear bond strength of three ceramic systems (Duceram, Williams and Noritake) in combination with three nickel-chromium (Ni-Cr) alloys (Durabond, Verabond and Viron). Thirty cast cylinder specimens (15 mm high; 6 mm in diameter) were obtained for each alloy, in a way that 10 specimens of each alloy were tested with each porcelain. Bond strength was measured with an Emic screw-driven mechanical testing machine by applying parallel shear forces to the specimens until fracture. Shear strength was calculated using the ratio of the force applied to a demarcated area of the opaque layer. Mann-Whitney U test was used for statistical analysis of the alloy/ceramic combinations (p<0.05). Viron/Noritake had the highest shear bond sregnth means (32.93 MPa), while Verabond/Duceram (16.31 MPa) presented the lowest means. Viron/Noritake differed statistically from other combinations (p<0.05). Viron/Duceram had statistically significant higher bond strengths than Verabond/Duceram, Verabond/Williams and Durabond/Noritake (p<0.05). It was also found significant difference (p<0.05) between Verabond/Noritake, Verabond/Duceram and Durabond/Noritake. No statistically significant difference (p>0.05) were observed among the other combinations. In conclusion, the Noritake ceramic system used together with Viron alloy presented the highest resistance to shear forces, while Duceram bonded to Verabond presented the lowest bond strength. Viron/Duceram and Verabond/Noritake provided intermediate results. The combinations between the Williams ceramic system and Ni-Cr alloys had similar shear strengths among each other.