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J Prosthet Dent ; 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32684353


STATEMENT OF PROBLEM: Evidence provided by implant-supported mandibular overdenture research on different loading protocols is important. However, methodological inconsistency, as well as inadequate reporting of results, hampers a consistent decision in terms of clinical applicability. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate whether immediate or early loading protocols can achieve comparable clinical outcomes when compared with a conventional loading protocol in edentulous patients rehabilitated with mandibular overdentures. MATERIAL AND METHODS: In accordance with the Participant, Intervention, Comparison, Outcome strategy, prospective clinical studies without restrictions as to language or follow-up period were included. The Cochrane collaboration and ROBINS-I tools were used for quality assessment and risk-of-bias evaluation. The follow-up for the different outcomes ranged from 3 to 168 months, with the focus on implant success and survival rates, marginal bone loss, bleeding on probing, probing depth, plaque index, and the implant stability quotient. Statistical analyses in which standard mean differences were applied with a 95% confidence interval when continuous data were included were performed. For dichotomous data, risk difference was adopted. RESULTS: The search strategy resulted in 14 234 references. Twenty-three studies fulfilled the inclusion criteria. Meta-analysis showed statistically significant differences for plaque index at 12 months (standard mean difference = 0.284 [0.022, 0.545], P=.033, I2=35%), probing depth at 36 months (standard mean difference = 0.460 [0.098, 0.823], P=.013, I2=0%), and on pooled results for plaque index (standard mean difference = 0.157 [0.031, 0.284], P=.015, I2=18%) in which the conventional loading protocol presented lower indices than those of immediate loading protocol or early loading protocol. Implant stability quotient presented a statistically significant difference only at 3 months (standard mean difference = 0.602 [0.309, 0.895], P<.001, I2=0%) with higher values for the conventional loading protocol. For the other parameters, statistically significant differences (P>.05) were not found. CONCLUSIONS: Immediate loading protocol or early loading protocolfor mandibular overdentures has been determined to be a well-established treatment and worthy of consideration in clinical practice.

Arch Oral Biol ; 117: 104822, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32592931


OBJECTIVE: Overcoming substantial shortcomings of soft liners as physico-chemical changes and liner-biofilm-related infections remains a challenge in the rehabilitation treatment. In this study, protective non-thermal plasma (NTP) treatments were developed on the soft liner surface to improve its surface and physico-chemical properties and to reduce fungal colonization after biofilm inhibition challenge. METHODS: Resinous liner specimens (Coe-Soft) were prepared and distributed in 3 groups according to the surface treatments: (1) untreated (control); (2) treated with sulfur hexafluoride-based NTP (SF6); and (3) treated with hexamethyldisiloxane-based NTP (HMDSO). To test the NTP stability and their protective and antimicrobial effect on the liner surface over time, the morphology, chemical composition, roughness, water contact angle, shore A hardness, sorption and solubility were evaluated before and after the specimens were exposed to dual-species biofilm of Candida albicans and Streptococcus oralis for 14 days. Colony forming units and biofilm structure were assessed. Data were submitted to ANOVA and Tukey tests (α = 0.05). RESULTS: Both treatments modified the surface morphology, increased hydrophobicity and roughness of the liner, and were effective to reduce C. albicans adhesion without affecting the commensal health-associated S. oralis. HMDSO presented chemical stability and lower hardness in both periods, whereas SF6 exhibited higher initial hardness than control and the highest sorption; contrarily, similar solubility was noted for all groups. CONCLUSION: HMDSO-based film showed improved physico-chemical properties and inhibited C. albicans biofilm. Thus, it has potential for use to control candida-related stomatitis and improve liner's stability even after being exposed to biofilm inhibition challenge.

Antiinfecciosos , Biopelículas , Alineadores Dentales , Gases em Plasma , Antiinfecciosos/farmacología , Candida albicans , Ensayo de Materiales , Gases em Plasma/farmacología , Streptococcus oralis , Propiedades de Superficie
Clin Oral Implants Res ; 31(9): 785-802, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32564392


OBJECTIVES: To determine whether photofunctionalization influences dental implant osseointegration. MATERIAL AND METHODS: Data on osseointegration rates were extracted from 8 databases, based on bone-to-implant contact (BIC) and pushout tests. Internal validity was accessed through the SYRCLE risk of bias tool for animal experimental studies. Meta-analyses were performed for investigation of the influence of photofunctionalization on implant osseointegration, with a random effect and a confidence interval of 95%. The certainty of evidence was accessed through the GRADE approach. RESULTS: Thirty-four records were identified, and 10 were included in the meta-analysis. Photofunctionalized implants showed higher mean values for BIC in rabbits (MD 6.92 [1.01, 12.82], p = .02), dogs (MD 23.70 [10.23, 37.16], p = .001), rats (MD 20.93 [12.91, 28.95], p < .0001), and in the pooled BIC analyses (MD 14.23 [7.80, 20.66], p < .0001) compared to those in control implants in the overall assay. Conversely, at late healing periods, the pooled BIC meta-analyses showed no statistically significant differences (p > .05) for photofunctionalized and control implants at 12 weeks of follow-up. For pushout analysis, photofunctionalized implants presented greater bone strength integration (MD 19.92 [13.88, 25.96], p < .0001) compared to that of control implants. The heterogeneity between studies ranged from "not important" to "moderate" for rabbits I2  = 24%, dogs I2  = 0%, rats I2  = 0%, and pooled BIC (I2  = 49%), while considerable heterogeneity was observed for pushouts (I2  = 90%). CONCLUSION: Photofunctionalization improves osseointegration in the initial healing period of implants, as summarized from available data from rabbit, dog, and rat in vivo models.

J Prosthodont ; 28(6): 692-700, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31125155


PURPOSE: To investigate the influence of nonthermal plasma (NTP) treatment on the tensile bond strength between heat-polymerized acrylic resin for ocular prostheses and silicone reliner, with and without the use of an adhesive primer. MATERIALS AND METHODS: One-hundred and sixty-four acrylic resin specimens were fabricated and randomly distributed into four groups according to the type of surface treatment: Sofreliner Primer, NTP, Sofreliner Primer + NTP, and NTP + Sofreliner Primer. Two specimens interposed with relining material (Sofreliner) formed one test sample to perform the tensile bond strength tests, before (initial) and after storage (final) in saline solution (37°C, 90 days, n = 10). Surface characterization was performed by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The failure type was classified as cohesive, adhesive, or mixed. The data were analyzed statistically using the two-way ANOVA and Tukey test, as well as the chi-squared test (α = 0.05), Bonferroni correction (α = 0.005), and Spearman correlation coefficient (α = 0.05). RESULTS: The SEM and EDS analyses showed the presence of a thin, homogenous organic film in the groups treated with NTP. The NTP + Sofreliner Primer group presented the largest bond strength mean values in the initial period (p < 0.05). Sofreliner Primer and NTP + Sofreliner Primer groups presented the first and second largest tensile bond strength mean values in the final period (p < 0.05), respectively. NTP + Sofreliner Primer group also had the largest number of cohesive (70%, initial) and mixed (90%, final) failures. CONCLUSIONS: The NTP treatment performed before the primer application enhanced the bond between the acrylic resin ocular prosthesis and the Sofreliner silicone-based reliner, even after 90 days of immersion in saline solution.

Recubrimiento Dental Adhesivo , Siliconas , Resinas Acrílicas , Cementos Dentales , Análisis del Estrés Dental , Ojo Artificial , Ensayo de Materiales , Propiedades de Superficie , Resistencia a la Tracción
Rev. Odontol. Araçatuba (Impr.) ; 38(1): 46-51, Jan.-Abr. 2017. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-876044


A fratura de côndilo mandibular é um dos tipos de traumas faciais mais comuns, podendo ser diagnosticado por diversos meios, sendo que uma variedade de planos de tratamentos podem ser instaurados. Este tipo de fratura configura também uma das etiologias da disfunção temporomandibular (DTM), portanto, é indispensável que o profissional realize exames minuciosos, inclusive por meio de exames complementares de imagem para o correto diagnóstico e conduta curativa, tanto da fratura, quanto da disfunção. Sendo assim, o objetivo deste estudo foi descrever um caso de fratura de côndilo mandibular não tratada seguida de DTM. Paciente de 36 anos do gênero masculino com histórico de acidente automobilístico há cinco anos, resultando em fratura de côndilo, com diagnóstico tardio e consolidação em posição inadequada buscou tratamento na Faculdade de Odontologia de Araçatuba - UNESP. A conduta por meio do uso de placa interoclusal levou à eliminação da sintomatologia dolorosa(AU)

The condylar fracture is one of the most common types of facial trauma and can be diagnosed by different methods, and a variety of treatment plans can be used. This type of fracture also constitutes one of the etiologies of temporomandibular disorders (TMD). Therefore, it is essential that the professional conduct thorough examinations, including complementary imaging tests for the correct diagnosis and treatment of the fracture and the dysfunction. Thus, the aim of this study was to describe a case of untreated condylar fracture followed by the development of TMD. A 36-year-old male patient with a history of automobile accident five years ago, resulting in condylar fracture, sought treatment at the Aracatuba Dental School - UNESP. The fracture had late diagnosis and consolidation in a wrong position. The conduct treatment through the use of occlusal splint led to the elimination of the painful symptomatology(AU)

Humanos , Masculino , Adulto , Fracturas Mandibulares , Ferulas Oclusales , Articulación Temporomandibular
Mater Sci Eng C Mater Biol Appl ; 69: 995-1003, 2016 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-27612795


The effect of a photopolymerized glaze on different properties of acrylic resin (AR) for ocular prostheses submitted to accelerated aging was investigated. Forty discs were divided into 4 groups: N1 AR without glaze (G1); colorless AR without glaze (G2); N1 AR with glaze (G3); and colorless AR with glaze (G4). All samples were polished with sandpaper (240, 600 and 800-grit). In G1 and G2, a 1200-grit sandpaper was also used. In G3 and G4, samples were coated with MegaSeal glaze. Property analysis of color stability, microhardness, roughness, and surface energy, and assays of atomic force microscopy, scanning electron microscopy, and energy-dispersive spectroscopy were performed before and after the accelerated aging (1008h). Data were submitted to the ANOVA and Tukey Test (p<0.05). Groups with glaze exhibited statistically higher color change and roughness after aging. The surface microhardness significantly decreased in groups with glaze and increased in groups without glaze. The surface energy increased after the aging, independent of the polishing procedure. All groups showed an increase of surface irregularities. Photopolymerized glaze is an inadequate surface treatment for AR for ocular prostheses and it affected the color stability, roughness, and microhardness. The accelerated aging interfered negatively with the properties of resins.

Resinas Acrílicas/química , Ojo Artificial , Luz , Polimerizacion , Dureza , Microscopía de Fuerza Atómica , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Factores de Tiempo
Rev. Odontol. Araçatuba (Online) ; 36(1): 70-74, jan.-jun. 2015. tab
Artículo en Portugués | BBO - Odontología | ID: biblio-857011


A prótese obturadora é uma alternativa para a reabilitação funcional e estética de pacientes que se submeteram a ressecção cirúrgica total ou parcial da maxila. Para a obtenção de maior estabilidade e retenção desta prótese, faz-se necessário a associação de implantes osseointegrados para a maioria dos pacientes. Porém, quando se trata de pacientes com história de câncer de cabeça e pescoço, ainda não há consenso na literatura quanto a essa associação, devido ao envolvimento da radioterapia e/ou quimioterapia durante o tratamento, as quais possuem efeitos secundários como: xerostomia, diminuição do suprimento vascular, dificuldade na abertura de boca e deglutição, e a dificuldade em tolerar a prótese. Contudo, a oxigenoterapia hiperbárica tem sido utilizada como um recurso para melhorar a osseointegração dos implantes, aumentando a oxigenação dos tecidos irradiados. Pode-se verificar que a associação da prótese obturadora com implantes osseointegrados, conjuntamente com a radioterapia e/ou quimioterapia, resultaram em melhora na qualidade de vida da maioria dos pacientes estudados

The obturator prosthesis is an alternative for functional and esthetic rehabilitation of patients who have been submitted total or partial surgical resection of the jaw. To obtain increased stability and retention of this prosthesis, osseointegrated implants are due for most patients. However, when dealing with patients with head and neck cancer history, there is no consensus in the literature about this association due to the involvement of radiotherapy and / or chemotherapy during treatment, which have side effects such as: dry mouth, decreased vascular supply, difficulty of mouth opening and swallowing, and difficulty tolerating the prosthesis. Although, the hyperbaric oxygen therapy has been used as a resource to improve osseointegration of the implants, increasing the oxygenation of the irradiated tissues. It was shown that the combination of obturator prosthesis with osseointegrated implants in conjunction with radiotherapy and / or chemotherapy, resulted in improved quality of life for most patients

Implantes Dentales , Quimioterapia , Prótesis Maxilofacial , Rehabilitación Bucal , Oseointegración , Radioterapia