Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth.

PURPOSE: The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. RESULTS: For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations (P>.05), but showed no discriminatory ability for amalgam restorations (P<.05). CONCLUSION: Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.

Accuracy of Digital Versus Conventional Periapical Radiographs to Detect Misfit at the Implant-Abutment Interface.

PURPOSE: Misfit is a risk factor for rehabilitation with implants, and its detection is of fundamental importance to the success of treatment with implants. The use of appropriate radiographic imaging is key for a good prognosis. The aim of this study was to compare the efficacy of film and digital radiographs for the detection of misfit at the implant-abutment interface. MATERIALS AND METHODS: Digital and conventional (manual and automatic processing) radiography was performed in seven test specimens, each one with a different vertical misfit between the abutment and the platform of the implant. Scanning electron microscopy was used to confirm the misfit and to measure it. Five dental radiologists independently and blindly evaluated the images. Cohen's kappa with linear weighting was calculated to determine interexaminer and intraexaminer concordance. Statistical analyses were performed using the Cochran's Q test and the receiver operating characteristic curve (ROC). RESULTS: Interexaminer analysis showed that the kappa value was equal to 0.74, whereas the average kappa value in the intraexaminer evaluation was 0.90. Digital imaging showed the largest area on the ROC graph, and conventional images with manual processing showed the smallest area. The images obtained through conventional radiography with both manual and automatic processing showed statistically significant differences from the measurement of the gold standard (P < .05). CONCLUSION: Digital imaging can be used to evaluate misfit at the implant-abutment interface. Conventional systems of radiographic imaging do not provide sufficient information to evaluate misfit at the implant-abutment interface.

Enamel loss and superficial aspect during bonding and debonding of metallic brackets / Perda de esmalte e aspecto superficial durante colagem e descolagem de bráquetes metálicos

To evaluate the cumulative enamel loss during bonding and debonding procedures of orthodontic metallic brackets and to analyze the enamel superficial roughness. Forty-seven maxillary first premolars were obtained for quantitative and qualitative analysis. For quantitative analysis, forty premolars were weighed at each stage of treatment and the equivalent thickness of enamel loss was measured. The amount of tooth mass loss in each stage was divided by the density value to obtain the corresponding enamel volume lost. Subsequently, these volumes were divided by a circular area with a diameter of 7 mm, thus obtaining the equivalent thickness of enamel loss. They were assessed under the following conditions: as sound enamel, after acid conditioning, following the removal of residual resin composite, after final polishing with high or low-speed, and with or without water refrigeration. A rugosimeter was used to obtain a graphic registration of the enamel superficial roughness before and after acid conditioning. The data were analyzed with the Quantikov software and the Shapiro Wilk's and Wilcoxon statistical tests were used to evaluate enamel superficial roughness. The one-way ANOVA followed by Bonferroni Post-Hoc tests were used to analyze the amount of enamel loss. For qualitative analysis, scanning electron microscopy (SEM) of the enamel surfaces was performed on seven premolars, one in each step. Acid conditioning significantly increased enamel surface roughness (p<0.01). Based on the dental mass weighed after each stage of evaluation, enamel loss was statistically significant in all stages (p<0.01). However, when the 4 different final polishing methods were compared, no statistically significant differences were registered regarding loss of mineralized structure (p=0.72). The SEM analysis revealed that the tungsten-carbide bur with water refrigeration and lowspeed rubber points caused less damage to the enamel. The greatest amount of enamel loss was due to acid conditioning. The losses relative to abrasion with composite removal or after the 4 polishing protocols were similar. Finally, none of the enamel surfaces was restored to their original aspects after bonding and debonding metallic brackets.

Determinar a perda de esmalte durante os procedimentos de colagem e descolagem de bráquetes ortodônticos e analisar a rugosidade superficial do esmalte. Quarenta e sete primeiros pré-molares superiores foram obtidos para análise quantitativa e qualitativa. Para a análise quantitativa, quarenta pré-molares foram pesados em cada uma das etapas do tratamento e a espessura equivalente do esmalte foi medida. A perda de massa em cada fase foi dividida pelo valor de densidade do esmalte para obter o volume correspondente. Em seguida, o volume foi dividido pela área circular de 7 mm de diâmetro, obtendo-se assim a espessura equivalente da perda de esmalte. Os dentes foram avaliados nas seguintes condições: esmalte íntegro, após condicionamento ácido, depois da remoção da resina remanescente e após o polimento final em alta e baixa rotação, com e sem refrigeração. Ainda foi utilizado um rugosímetro para obtenção dos registros gráficos de perfis da rugosidade superficial do esmalte antes e após o condicionamento ácido. Os dados foram analisados utilizando-se o software Quantikov, para determinação e comparação dos comprimentos dos registros obtidos antes e após o condicionamento ácido, o teste Shapiro Wilk e o Wilcoxon para rugosidade superificial do esmalte e, por fim, o ANOVA um fator seguido pelo Bonferroni Post-Hoc para perda de esmalte. Para a análise qualitativa, foi empregada a microscopia eletrônica de varredura nas superfícies de esmalte de sete pré-molares, um dente para cada etapa. O condicionamento ácido promoveu o aumento do comprimento do perfil de superfície do esmalte, ou seja, o aumento da rugosidade (p<0,01). Na avaliação da massa dos elementos dentários, percebeu-se que a perda de esmalte foi estatisticamente significante em todas as etapas do experimento (p<0,01). Entretanto, ao comparar os diferentes métodos de polimentos, verificou-se que não há diferença estatisticamente significante na perda de estrutura mineralizada (p=0,72). Na análise da microscopia eletrônica de varredura, a remoção da resina com broca carbide de tungstênio multilaminada com refrigeração e o polimento em baixa rotação sob refrigeração apresentaram menos dano ao esmalte. A maior perda de esmalte foi devida ao condicionamento ácido. As perdas referentes ao desgaste com a broca e o polimento são semelhantes e os 4 protocolos de polimento testados resultaram em diminuições similares na espessura do esmalte. Nenhuma das superfícies de esmalte foi restaurada ao seu aspecto original após a colagem e descolagem de bráquetes metálicos.

Morse taper internal connection implants: would abutment reseating influence retention?

Abstract Aim: To investigate whether the removal and reseating of the abutment influences the retention of Morse taper implant system. Methods: Two Morse taper implant systems were selected: Bicon Dental ImplantTM system (Bicon, LLC, Boston, MA, USA) and Kopp Implant(r) system (Kopp(r), Curitiba, PR, Brazil). In both systems, the abutment is connected to the implant with a locking taper. To seat the abutment, the same vertical force was applied in both systems. It was measured the compressive force necessary to engage effectively the locking taper connection and the tensile force to displace it. Results: The compressive force was determined by four activations in each abutment-implant set, and the sum of these forces was 21 N and 17 N in the BiconTM and Kopp(r) systems, respectively. Next, a tensile test was performed, revealing that the BiconTM system presented a 208 N resistance, whereas it was 194 N in the Kopp(r) system. Other three rounds of compression and tensile loads were applied, removing and reseating the abutment. We obtained the following tensile values: 367 N, 500 N and 756 N in the BiconTM System and 336 N, 360 N and 420 N in the Kopp(r) system. Conclusions: When the sets were subjected to repeated rounds of compressive and tensile forces, displacing and reseating the abutment, the tensile value increased.

Reabilitação oral de paciente portador de displasia ectodérmica anidrótica / Oral rehabilitation of a patient with anhidrotic ectodermal dysplasia

O presente trabalho teve como objetivo relatar um caso de reabilitação bucal de um paciente portador de displasia ectodérmica, através de próteses totais fixas aparafusadas sustentadas por implantes zigomáticos e convencionais. Os aspectos clínicos e radiográficos serão descritos juntamente com a sequência de tratamento realizada até a finalização do caso. Esse tipo de tratamento tem apresentado resultados satisfatórios.

This case reports on the use of total fixed implant-supported screwed prostheses with zygomatic and conventional implants in the treatment of a completely edentulous patient with anihidrotic ectodermal dysplasia. Clinical and radiographic aspects are demonstrated during treatment sequence. This kind of rehabilitation has presented satisfactory results.

Evaluation of Apical Contamination in Teeth with Prefabricated Posts Fixed with Different Dental Cements

To assess the sealing capacity of different dental cements regarding apical microleakage on teeth with prefabricated posts. Material and Methods:Forty-eight single-rooted teeth were selectedand, after having their coronal part removed at 10mm standard, underwent endodontic cleaning and preparation. The space for the post was prepared with # 3 Largo bur at 7 mm standard value. The study included the following groups: Group I, post prefabricated with # 1 intracanal glass fiber cemented with zinc phosphate cement (n = 12); Group II, post prefabricated with # 1 intracanal glass fiber cemented with conventional glass ionomer cement, Vidrion C (n = 12); Group III, post prefabricated with # 1 intracanal glass fiber cemented with chemical action resin cement, Multilink (n = 12). Two groups of six teeth each were also included, one as negative control group and the other as positive control. After cementing, teeth were tested through a dual-chamber experimental model, using Enterococcus Faecalis for apical contamination. Results:The control groups behaved as expected: positive control group with total contamination in 11 days and negative control group without any contaminated specimen within observation time of 60 days. Group I showed microleakage in all specimens for up to 29 days (100%)...

Group II and Group III showed microleakage in 50 and 49 specimens (83.33% and 75%) respectively along the research time of 60 days. Group 1 showed microleakage in all specimens for up to 29 days (100%). Group 2 and Group 3 showed microleakage in 50 and 49 specimens (83.33% and 75%) respectively along the research time of 60 days. The Log-Rank test showed differences between Groups 1 and 2 (p<0.05) and between Groups 1and 3 (p<0.05). However, there was no difference between Groups 2 and 3 (p> 0.05). The results showed higher delay in bacterial infiltration in Groups 2 and 3 when compared to Group 1.Conclusion:No cement completely prevented infiltration during the experimental period. Zinc phosphate cement had the lowest apical sealing capacity while glass ionomer cement and resin cement showed similar results...

Effects of enamel deproteinization on bracket bonding with conventional and resin-modified glass ionomer cements.

The objective of this study was to test the effects of enamel deproteinization on bracket bonding with conventional and resin-modified glass ionomer cement (RMGIC). One hundred premolars, extracted for orthodontic reasons, were divided into five groups (n = 20). Group 1 (control): enamel was etched with 35 per cent phosphoric acid, a thin layer of adhesive was applied, and the brackets were bonded with Transbond XT. Group 2: enamel was etched with 10 per cent polyacrylic acid and the brackets were bonded with conventional glass ionomer cement (GIC). Group 3: enamel was treated with 5.25 per cent NaOCl, etched with 10 per cent polyacrylic acid, and the brackets were bonded with conventional GIC. Group 4: enamel was etched with 10 per cent polyacrylic acid and the brackets were bonded with RMGIC. Group 5: enamel was treated with 5.25 per cent NaOCl, etched with 10 per cent polyacrylic acid, and the brackets were bonded with RMGIC. The teeth were stored in distilled water for 24 hours before they were submitted to shear testing. The results demonstrated that bond strength values of group 1 (17.08 ± 6.39 MPa) were significantly higher in comparison with the other groups. Groups 2 (3.43 ± 1.94 MPa) and 3 (3.92 ± 1.57 MPa) presented values below the average recommended in the literature. With regard to adhesive remnant index, the groups in which the enamel was treated with NaOCl showed a behaviour similar to that of the resin composite. It is conclude with enamel treatment with NaOCl increased bonding strength of brackets bonded with GIC and RMGIC, but increased bond strength was not statistically significant when compared to the untreated groups.

Análise de tensões em prótese fixa dentoimplantossuportada com pilar intermediário / Stress analysis in tooth-implant-supported fixed prosthesis with pier abutment

Em algumas situações clínicas em que pacientes parcialmente edêntulos apresentam a indicação para prótese fixa de cinco elementos dentoimplantossuportada, o implante pode se tornar algumas vezes o pilar intermediário dessa prótese. Esse tipo de prótese deve ser feito com cautela, tendo em vista possíveis complicações biomecânicas, pelas diferenças de mobilidade entre dente e implante e pela diferença na absorção e na distribuição das cargas funcionais. O objetivo desse trabalho foi analisar, por meio do método dos elementos finitos (MEF), as tensões geradas em uma prótese fixa dentoimplantossuportada de cinco elementos, modelada pelo programa computacional Ansys Revisão 5.7, sendo composta por dois dentes como pilares terminais, dois pônticos e um implante como pilar intermediário unidos de forma rígida. Foi aplicada uma carga vertical com valor nominal de 100 Newtons (N), distribuída uniformemente nas superfícies oclusais dos dentes posteriores. Pôde-se observar em uma análise qualitativa que o maior deslocamento da prótese no sentido oclusogengival foi na região dos pônticos, com valor máximo de deslocamento de 6,4 micrometros (µm). A tensão equivalente de Von Mises SEQV foi de 77,4 Megapascal (MPa) notando uma distribuição de tensões semelhante por toda infraestrutura metálica, na região entre as coroas protéticas. Concluiu-se que a infraestrutura metálica rígida exerce papel fundamental na distribuição e absorção das tensões e no deslocamento do conjunto protético e o implante intermediário não atua como fulcro de uma alavanca Classe I.

In some clinical situations, partially edentulous patients can have indication for a five-element implant-supported prosthesis, with one of those implants being the pier abutment. This type of prosthesis should be constructed with caution, because of possible biomechanical uncertainties, due to different displacement behaviors and the distribution of the functional loads involved in the process. The aim of this work was to analyze by Finite Element Method (FEM) the global behavior of stresses and displacements involved in a tooth-implant-supported fixed prosthesis with five elements, having two teeth as terminal abutments, two bridges and an implant working as an intermediate abutment. The Ansys 5.7 program has been used as a computational tool. A nominal vertical load of 100 N has been applied, uniformly distributed, on the occlusive surfaces in the posterior teeth. It is possible to conclude, in a qualitative analysis, that the prosthesis showed a higher displacement in the occlusion-gingival direction of the bridges, with a value around 6,4 µm. The equivalent Von Misses stresses (SEQV) showed a maximum value of 77,4 MPa in the metallic bar among the prosthetic crowns. It can be concluded that the infra-structure has an important function in the distribution and absorption of stresses and displacements of the whole prosthetic set and the implant did not work as pier abutment.

The role of friction in orthodontics

INTRODUCTION: Sliding mechanics is widely used during orthodontic treatment. One of the disadvantages of this mechanics is the friction generated at the bracket/archwire interface, which may reduce the amount of desired orthodontic movement obtained. Due to the application and great acceptance of this type of mechanics, the role of friction in Orthodontics has been of interest for both clinicians and scientists. OBJECTIVE: Therefore, this article discussed how friction affects orthodontic tooth movement, with an approach to its clinical implications as well as the evolution of dental materials and its properties regarding resistance to sliding.

Stress analysis of a fixed implant-supported denture by the finite element method (FEM) when varying the number of teeth used as abutments

OBJECTIVES: In some clinical situations, dentists come across partially edentulous patients, and it might be necessary to connect teeth to implants. The aim of this study was to evaluate a metal-ceramic fixed tooth/implant-supported denture with a straight segment, located in the posterior region of the maxilla, when varying the number of teeth used as abutments. MATERIAL AND METHODS: A three-element fixed denture composed of one tooth and one implant (Model 1), and a four-element fixed denture composed of two teeth and one implant (Model 2) were modeled. A 100 N load was applied, distributed uniformly on the entire set, simulating functional mastication, for further analysis of the SEQV (Von Mises) principal stresses, which were compared with the flow limit of the materials. RESULTS: In a quantitative analysis, it may be observed that in the denture with one tooth, the maximum SEQV stress was 47.84 MPa, whereas for the denture with two teeth the maximum SEQV stress was 35.82 MPa, both located in the region between the pontic and the tooth. CONCLUSION: Lower stresses were observed in the denture with an additional tooth. Based on the flow limit of the materials, porcelain showed values below the limit of functional mastication.

Avaliação do atrito em braquetes autoligáveis submetidos à mecânica de deslizamento: um estudo in vitro / Evaluation of friction in self-ligating brackets subjected to sliding mechanics: an in vitro study

INTRODUÇÃO: o atrito gerado na interface braquete/fio durante a mecânica de deslizamento pode reduzir a eficiência da movimentação ortodôntica. O método de ligação do fio ao braquete exerce importante papel na determinação desse atrito. MÉTODOS: o presente estudo comparou a força de atrito gerada por quatro tipos de braquetes autoligáveis (Time®; Damon 2®; In-Ovation R® e Smart Clip®) com um grupo de braquetes ortodônticos convencionais (Dynalock®) associados a ligaduras elásticas tradicionais (Dispens-A-Stix®), que serviu como grupo controle. A força de atrito estático foi mensurada através da máquina universal de ensaios EMIC® DL 500 com dois fios de aço inoxidável com secção transversal 0,018" e 0,017" x 0,025". RESULTADOS: a análise de variância ANOVA e o teste de Tukey mostraram baixos níveis de atrito nos quatro braquetes autoligáveis associados ao fio 0,018" (P<0,05). Entretanto, os resultados observados quando os braquetes autoligáveis foram testados com fios 0,017" x 0,025" mostraram alta resistência ao deslizamento nos grupos de braquetes autoligáveis ativos.

INTRODUCTION: Friction generated at the bracket/archwire interface during sliding mechanics can reduce the efficiency of orthodontic movement. The ligation method employed to tie the archwire to the bracket plays an important role in determining this friction. METHODS: This study compared the frictional force generated by four different types of self-ligating brackets (Time™, Damon 2™, In-Ovation R™ and Smart Clip™) with a group of conventional orthodontic brackets (Dynalock™) that require the use of traditional elastomeric ligatures (ExDispens-A-Stix™), which served as the control group. Static friction force was measured using an EMIC DL™ 500 universal testing machine using stainless steel round 0.018-in and rectangular 0.017x0.025-in archwires. RESULTS: ANOVA and Tukey's test showed low levels of friction in the four self-ligating brackets in tests with the 0.018-in wire (P <0.05). However, the results noted when the self-ligating brackets were tested using 0.017x 0.025-in archwires showed high resistance to sliding in the self-ligating groups.

Stress analysis of a fixed implant-supported denture by the finite element method (FEM) when varying the number of teeth used as abutments.

OBJECTIVES: In some clinical situations, dentists come across partially edentulous patients, and it might be necessary to connect teeth to implants. The aim of this study was to evaluate a metal-ceramic fixed tooth/implant-supported denture with a straight segment, located in the posterior region of the maxilla, when varying the number of teeth used as abutments. MATERIAL AND METHODS: A three-element fixed denture composed of one tooth and one implant (Model 1), and a four-element fixed denture composed of two teeth and one implant (Model 2) were modeled. A 100 N load was applied, distributed uniformly on the entire set, simulating functional mastication, for further analysis of the SEQV (Von Mises) principal stresses, which were compared with the flow limit of the materials. RESULTS: In a quantitative analysis, it may be observed that in the denture with one tooth, the maximum SEQV stress was 47.84 MPa, whereas for the denture with two teeth the maximum SEQV stress was 35.82 MPa, both located in the region between the pontic and the tooth. CONCLUSION: Lower stresses were observed in the denture with an additional tooth. Based on the flow limit of the materials, porcelain showed values below the limit of functional mastication.

Comportamento biomecânico das próteses fixas dentoimplantossuportada / Biomechanical aspect of combined tooth-implant supported fixed partial denture by finite elements analysis varying the number of tooth and implant abutments

Os implantes osseointegrados utilizados para reabilitação de edentulismo total mostram elevado grau de previsibilidade terapêutica. Entretanto, surgiu a necessidade de extrapolar as alternativas de tratamento com implantes para pacientes parcialmente edêntulos. Diante disto, vários estudos têm sido direcionados para a possibilidade ou não de unir tais implantes a dentes naturais, visto que o comportamento biomecânico destas duas estruturas apresentam peculiaridades distintas. Foram construídos dois modelos visando a simulação do comportamento mecânico de uma prótese fixa de união rígida entre dente natural e implante osseointegrado, variando a quantidade de implantes e dentes envolvidos a partir dos métodos de elementos finitos (MEF). A partir da modelagem geométrica dos modelos utilizando meio computacional, obteve-se a geração automática da malha de elementos finitos. Foi aplicada uma carga nominal de 100 N, distribuída uniformemente nas superfícies oclusais de todo o conjunto protético. Na análise dos resultados, observou-se maior deslocamento do conjunto da prótese no modelo contendo dois dentes e um implante e a tensão máxima SEQV gerada foi de 35,82 MPa. Para o modelo contendo um dente e dois implantes a tensão máxima SEQV foi de 27,11 MPa. A união entre dente e implante é previsível mecanicamente. A colocação de implantes adicionais promove maior ancoragem para o conjunto protético.

Osseointegrated implants used for rehabilitation of totally edentulous patients show a high degree of predictability. However, there is a need to extrapolate treatment options with implants for partially edentulous patients. Several studies have been focused on the possibility or not for joining such implants to natural teeth as the biomechanical behavior of these two structures have distinct features. Two computerized models were designed to simulate the mechanical behavior of a fixed union between natural tooth and osseointegrated implant, varying the number of implants and teeth involved for finite element analysis (FEA). From the geometric modeling environment using computational models, we obtained the automatic generation of finite element mesh. A 100N nominal load was uniformly distributed on the occlusal surfaces of the whole prosthesis. Results showed greater displacement of the prosthetic joint in the model with two teeth and one implant, and the maximum SEQV stress generated was 35.82 MPa. For the model containing one tooth and two implants, the maximum SEQV stress was 27.11 MPa. The union between tooth and implant is mechanically predictable. The use of additional implants promotes greater anchorage to the prosthetic joint.

Biomechanical analysis of the stresses generated by different disocclusion patterns in an implant-supported mandibular complete denture.

OBJECTIVES: This study evaluated by three-dimensional finite element analysis the tensions generated by different disocclusion patterns (canine guide and bilateral balanced occlusion) in an implant-supported mandibular complete denture. MATERIAL AND METHODS: A three-dimensional model of implant-supported mandibular complete denture was fabricated according to the Brånemark protocol. A 5-element 3.75 x 13-mm screw-shape dental implant system was modeled for this study. The implants were located in the inter-mental foramen region with 3-mm-high prosthetic components joined by a nickel-chromium framework with 12-mm bilateral cantilever covered by acrylic resin and 12 acrylic denture teeth. SolidWorks software was used before and after processing the simulations. The mechanical properties of the components were inserted in the model and a 15 N load was established in fixed points, in each one of the simulations. Data were collected in the entire nickel-chromium framework. The results were displayed three-dimensionally as color graphic scales. RESULTS: The canine guide generated greater tensions in the region of the first implant, while the bilateral balanced occlusion generated great tensions in the entire metallic framework. The maximum tension found in the simulation of the bilateral balanced occlusion was 3.22 fold higher than the one found in the simulation of the disocclusion in canine guide. CONCLUSION: The pattern of disocclusion in canine guide is the ideal for implant-supported mandibular complete denture.

Biomechanical analysis of the stresses generated by different disocclusion patterns in an implant-supported mandibular complete denture

OBJECTIVES: This study evaluated by three-dimensional finite element analysis the tensions generated by different disocclusion patterns (canine guide and bilateral balanced occlusion) in an implant-supported mandibular complete denture. MATERIAL AND METHODS: A three-dimensional model of implant-supported mandibular complete denture was fabricated according to the Brånemark protocol. A 5-element 3.75 x 13-mm screw-shape dental implant system was modeled for this study. The implants were located in the inter-mental foramen region with 3-mm-high prosthetic components joined by a nickel-chromium framework with 12-mm bilateral cantilever covered by acrylic resin and 12 acrylic denture teeth. SolidWorks® software was used before and after processing the simulations. The mechanical properties of the components were inserted in the model and a 15 N load was established in fixed points, in each one of the simulations. Data were collected in the entire nickel-chromium framework. The results were displayed three-dimensionally as color graphic scales. RESULTS: The canine guide generated greater tensions in the region of the first implant, while the bilateral balanced occlusion generated great tensions in the entire metallic framework. The maximum tension found in the simulation of the bilateral balanced occlusion was 3.22 fold higher than the one found in the simulation of the disocclusion in canine guide. CONCLUSION: The pattern of disocclusion in canine guide is the ideal for implant-supported mandibular complete denture.

Stress analysis on the free-end distal extension of an implant-supported mandibular complete denture.

A comparative and qualitative analysis of the tensions generated in the cantilever region of an implant-supported mandibular complete denture was conducted using the three-dimensional finite element method. The mechanical properties of the components were input in the model and a load of 15 N was applied in pre-determined points. In the first simulation, the load was applied on the occlusal surface of the first premolar. In the second simulation, it was applied on the first and second premolars. In the third simulation, it was applied on the first and second premolars and on the first molar. The different occlusion patterns produced similar tension distributions in the cantilever region, which followed a similar pattern in the three simulations. In all of the cases, the highest levels of tension were located in the region of the first implant. However, as the loads were dislocated distally, the tensions increased considerably. The more extensive the cantilever, the more compromised will be the infrastructure, the prosthetic components and the implants. Regardless of the length of the cantilever, the highest tensions will always be located in the region of the implant next to the load application point.

Comportamento biomecânico de uma prótese fixa implantodentossuportada com variação na localização do carregamento / Biomechanical aspect of combined tooth-implant supported fixed partial denture varying the loading place

Em algumas situações clínicas, ocorrem casos de pacientes parcialmente edêntulos com indicação para prótese através da união de dentes com implantes. Entretanto, esse tipo de conexão ainda é controverso na literatura, tendo em vista possíveis complicações biomecânicas, pelas diferenças de mobilidade e forma de absorver e distribuir as cargas funcionais. O sucesso de tal procedimento está diretamente associado aos cuidados especiais no planejamento criterioso visando a minimização de possíveis incompatibilidades. O presente estudo objetiva simular o comportamento mecânico de uma prótese fixa de união rígida entre dente natural e implante osseointegrado, variando a localização do carregamento. A análise dos resultados permitiu concluir que a incidência de carga nesse tipo de prótese é fator limítrofe na longevidade do conjunto.

On a daily clinical basis, partially edentate patients seems to be indicated to a prosthesis treatment using the union of teeth and implants. However, this type of connection is still a controversial procedure, according to the literature, because of possible biomechanical damages due to different relative displacements and irregular absorption of functional loads. The final success of the treatment is directly related to special care associated with careful planning, in order to minimize possible incompatibilities. The aim of this study is to simulate the mechanical behavior of a rigid union between a natural tooth with an osseointegrated implant using different loading places. This behavior may be explained by better load distribution for prosthetic survival.

Stress analysis on the free-end distal extension of an implant-supported mandibular complete denture

A comparative and qualitative analysis of the tensions generated in the cantilever region of an implant-supported mandibular complete denture was conducted using the three-dimensional finite element method. The mechanical properties of the components were input in the model and a load of 15 N was applied in pre-determined points. In the first simulation, the load was applied on the occlusal surface of the first premolar. In the second simulation, it was applied on the first and second premolars. In the third simulation, it was applied on the first and second premolars and on the first molar. The different occlusion patterns produced similar tension distributions in the cantilever region, which followed a similar pattern in the three simulations. In all of the cases, the highest levels of tension were located in the region of the first implant. However, as the loads were dislocated distally, the tensions increased considerably. The more extensive the cantilever, the more compromised will be the infrastructure, the prosthetic components and the implants. Regardless of the length of the cantilever, the highest tensions will always be located in the region of the implant next to the load application point.

Residual monomer: effect on tensile bond strength of silicone resilient liners / Monômero residual: o efeito na resistência de união de reembasadores resilientes de silicone

Adhesion failure between silicone resilient liner materials and denture base resin is a common problem found in clinical practice. Bond failure results in localized unhygienic conditions at the debonded regions and causes functional failure of the prosthesis. The aim of this study was to evaluate the tensile bond strength of 2 resilient liners (auto-polymerized silicone - Permafix® and heat-polymerized silicone - Permaflex®) under the influence of a residual monomer methylmethacrylate ([MMA]R) concentration. Two polymethyl methacrylate (PMMA) specimens were prepared by implementing brass dies by means of a 3 mm thick spacer in a denture flask. Specimens (20 X 10 X 3 mm) were made by processing the resilient liners against the polymerized PMMA blocks. After polymerization, the brass spacer was removed from the mold, the PMMAblocks were trimmed, and the bonding surfaces were smoothed. The PMMA blocks were placed back into the molds and resilient liners were packed into the space provided by the brass spacer, followed by trial packing and polymerization according to manufacturer instructions. Twenty specimens...

Falha na união entre reembasadores resilientes de silicone e base acrílica da prótese é um problema encontrado na prática clínica. A falha na união resulta em condições anti-higiênicas localizadas em regiões que apresentam descolamento, além de causar perda de função das próteses. O objetivo deste trabalho foi avaliar a resistência de união de 2 reembasadores resilientes de silicone (autopolimerizável - Permafix® and termopolimerizável - Permaflex®) sob a influência da concentração do monômero residual metilmetacrilato ([MMA]R). Duas amostras de polimetilmetacrilato (PMMA) foram obtidas por meio da inclusão de matrizes metálicas separadas por um espaçador com 3mm de espessura em mufla. As amostras (20 X 10 X 3 mm) foram obtidas processando o material resiliente contra os blocos de PMMA polimerizados. Após a polimerização, removeu-se o espaçador, submeteram-se os blocos ao processo de acabamento, sendo as superfícies de união alisadas. Os blocos foram recolocados no molde e o material resiliente condensado no local...

Análise das tensões localizadas na interface resina acrílica/infra-estrutura metálica de uma prótese total inferior implantossuportada submetida a distintos padrões de oclusão / Analysis of functional stress on the acrylic resin interface/ metallic infrastructure of the mandibular complete denture supported by implants when submitted to distinct standards of occlusion

Este trabalho analisou, pelo método dos elementos finitos tridimensional (MEF 3D), as tensões geradas, na interface entre a resina acrílica e a infra-estrutura metálica, quando são aplicadas cargas funcionais na região de extremo distal livre, em uma prótese total inferior, implantossuportada. Foi desenvolvido um MEF 3D de uma prótese total implantossuportada, inferior, tipo protocolo de Branemark, com 12 mm de cantilever bilateral. O pacote do programa SolidWorks® foi utilizado no pré e pós processamento dos dados. Na primeira simulação, o carregamento foi aplicado na superfície oclusal do primeiro pré-molar, na segunda, no primeiro e no segundo pré-molares e, na terceira, no primeiro e segundo pré-molares e no primeiro molar. Os resultados obtidos puderam ser visualizados tridimensionalmente, por imagens, com escalas e gráficos, mostrando que o padrão de oclusão na região da extremidade distal livre gerou uma distribuição das tensões uniforme nas três simulações, com os maiores níveis de tensão localizados na região do primeiro implante, em todos os casos. Porém, conforme os carregamentos foram se deslocando para distal, as tensões aumentavam consideravelmente. Foi possível concluir que quanto mais extensa a extremidade distal livre, mais comprometida será a interface entre a resina acrílica e a infra-estrutura metálica, e independentemente do comprimento do extremo livre distal, as maiores tensões sempre se localizam na interface entre a resina acrílica e a infraestrutura metálica ao redor da região do implante localizado mais próximo à extremidade distal livre, do lado de trabalho.