Patients from the Oral Oncology Center, UNESP, Araçatuba with an indication for prosthesis.

Head and neck tumors are a major health concern worldwide, due to their high incidence and mortality rates, particularly in developing countries. In Brazil, this type of cancer is commonly diagnosed and studies suggested that it may be the leading cause of mortality in the country. The increase in life expectancy worldwide, as well as environmental and behavioral factors, are related to carcinogenesis. Therefore, an understanding of basic epidemiology and statistical methods is critical, in order to promote early diagnosis and cancer prevention. Cancer patients with an indication for prosthesis were selected from the medical records of the Oral Oncology Center, School of Dentistry, São Paulo State University (UNESP), Araçatuba, between 1991 and 2010. The following variables were recorded: gender, age, type and location of the lesion, radiation dose and dental prosthesis. The majority of the patients were male (74.15%) and >60 years of age (53.37%). Tumors were most commonly located in the floor of the mouth (11.1%) and squamous cell carcinoma was the most prevalent type (72.8%). This study provides the profiles of patients who attended the Oral Oncology Center and the results may aid in the creation of cancer prevention programs.

Photoelastic analysis to compare implant-retained and conventional obturator dentures.

The use of photoelastic analysis contributes to the rehabilitation of patients with oral-sinus-nasal sequelae, which in turn affect important functions such as chewing, swallowing, and speech. The prosthetic rehabilitation with implant-retained dentures is a suitable treatment option. The purpose of this study was to verify, by using a photoelastic analysis, the stress distribution in implant-retained palatal obturator dentures (relined or not) associated with different attachment systems (O-ring, bar-clip, and bar-clip associated with distally placed O-rings). Two photoelastic models were obtained from an experimental maxillary cast presenting an oral-nasal communication. One model had two 13-mm length implants placed on the left region. A total of eight colorless maxillary obturators were fabricated and subsequently four of them were relined with soft silicone soft, and three had attachment systems associated. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a 100-N load was applied at 10 mm/s. The results showed that the denture relining influenced the distribution and amount of stress on the models. The O-ring group displayed the lowest stress levels, followed by bar-clip system associated with distally placed O-rings and bar-clip groups.

Effect of disinfection and accelerated aging on color stability of colorless and pigmented facial silicone.

PURPOSE: The aim of this study was to evaluate the color stability of a facial silicone with different pigmentations submitted to disinfection and accelerated aging. MATERIALS AND METHODS: Sixty replicas were fabricated with the silicone Silastic MDX 4-4210 and divided into three groups: no pigmentation, pigmentation with makeup powder, and pigmentation with ceramic powder. Half the replicas of each group were submitted to disinfection with Efferdent and the other with neutral soap for 60 days (n = 10). After this period, all replicas were inserted in a chamber for accelerated aging of nonmetallic specimens. The color measurements were carried out initially, after disinfection, and after accelerated aging (252, 504, 1008 hours). Color stability was evaluated through spectrophotometry. The values were submitted to ANOVA and the means to Tukey's test (p < 0.01). RESULTS: The specimens disinfected with neutral soap exhibited higher ΔE values regardless of the type of pigmentation. The colorless replicas and the specimens pigmented with ceramic exhibited a statistically significant difference between the methods of disinfection in all periods. The specimens pigmented with makeup powder did not demonstrate a statistically significant difference. CONCLUSIONS: The ceramic pigment presented greater color stability regardless of disinfection and period. On the other hand, the makeup pigment exhibited the highest values of chromatic alteration.

Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students.

PURPOSE: This study evaluated the relationship between anxiety levels and severity degrees of chronic orofacial pain of temporomandibular disorder in brazilian university students. METHODS: 150 volunteers (117 men and 33 women), with age ranging from 17 to 30 years, were subjects to this study. Spielberger's trait-state anxiety inventory was used to evaluate trait and state anxiety of the students, while examination for chronic orofacial pain was performed in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Association between anxiety levels and severity degrees of chronic orofacial pain was tested using the Chi-square test. The significance level was set at p<.05. RESULTS: The results showed that 32.7% (n=49) of the subjects exhibited TMD, and the intensity of chronic orofacial pain was classified as degree 1 in 85.7% (n=42) and as degree 2 in 14.3% (n=7) of them. Based on the results of the Spielberger's trait-state anxiety inventory, the majority of the students had moderate anxiety (48.6% and 48.1%, respectively). The correlation between trait-anxiety levels and chronic orofacial pain degrees was significant and positive (p<.05). However, no significant correlation was found to state-anxiety levels and chronic orofacial pain degrees (p>.05). CONCLUSION: It was concluded that chronic orofacial pain of TMD could be present in university students and anxiety may be related.

Orbital implants insertion to improve ocular prostheses motility.

The objectives of this study were, through a literature review, to point the differences between orbital implants and their advantages and disadvantages, to evaluate prosthesis motility after orbital implants are inserted, and to point the implant wrapping current risks. Sixty-seven articles were reviewed. Enucleation implants can be autoplastics or alloplastics and porous (including natural and synthetic hydroxyapatite [HA]) or nonporous (silicone). Hydroxyapatite is the most related in the literature, but it has disadvantages, too, that is, all orbital implants must be wrapped. Exposure of the porous orbital implant can be repaired using different materials, which include homologous tissue, as well as autogenous graft, xenograft, and synthetic material mesh. The most used materials are HA and porous polyethylene orbital implant. The HA implant is expensive and possibly subject corals to damage, different from porous polyethylene orbital implants. Porous implants show the best prosthesis motility and a minimum rate of implants extrusion. Implant wraps can facilitate smoother entry of the implant into the orbit and allow reattachment of extraocular muscles. They also serve as a barrier between the overlying soft tissue and the rough surface of the implant, protecting implants from exposure or erosion.

Color stability of polymers for facial prosthesis.

Color stability of resin and silicone is an important factor for longevity of facial prostheses. The aim of this study was to evaluate the color stability of resins and silicone for facial prostheses. Three brands of acrylic resin and 1 of facial silicone were evaluated considering pigment incorporation for the colorless materials. Ten samples of each material were fabricated and submitted to measurements of chromatic alteration initially and after 252, 504, and 1008 hours of weathering through visual analysis and spectrophotometry. Data were evaluated by analysis of variance and Tukey test (P < 0.05). Results showed a statistically significant difference in color alteration among materials independent of aging. According to visual analysis, the color difference between pigmented and colorless Silastic MDX4-4210 and between pigmented and colorless Classico acrylic resin was statistically significant for the 3 weathering periods. Aging for 1008 hours represented a significant influence on color alteration of all resins. All materials presented chromatic alteration after accelerated artificial aging.

Relationship between psychological factors and symptoms of TMD in university undergraduate students.

Temporomandibular disorders is a collective term used to describe a number of related disorders involving the temporomandibular joints, masticatory muscles and occlusion with common symptoms such as pain, restricted movement, muscle tenderness and intermittent joint sounds. The multifactorial TMD etiology is related to emotional tension, occlusal interferences, tooth loss, postural deviation, masticatory muscular dysfunction, internal and external changes in TMJ structure and the various associations of these factors. The aim of this study was to evaluate the prevalence of the relationship between signs of psychological distress and temporomandibular disorder in university students. A total 150 volunteers participated in this study. They attended different courses in the field of human science at one public university and four private universities. TMD was assessed by the Research Diagnostic Criteria (RDC) questionnaire. Anxiety was measured by means of a self-evaluative questionnaire, Spielberger's Trait-State anxiety inventory, to evaluate students'state and trait anxiety. The results of the two questionnaires were compared to determine the relationship between anxiety levels and severity degrees of chronic TMD pain by means of the chi-square test. The significance level was set at 5%. The statistical analysis showed that the TMD degree has a positive association with state-anxiety (p = 0.008; p < 0.05) and negative with trait-anxiety (p = 0.619; p < 0.05). Moreover a high TMD rate was observed among the students (40%). This study concluded that there is a positive association between TMD and anxiety.

Photoelastic analysis of stress distribution in different retention systems for facial prosthesis.

The aim of this study was to assess the behavior and stress distribution of 3 retention systems associated with implant for facial prosthesis by using the photoelasticity method. A photoelastic model was made from the replica of the orbital region on the left side of a dry skull with two 4-mm implants fixed in the superior orbital region. Three facial prosthetic retention systems were made for this study: O'ring, bar-clip, and magnets. The set (model/retention systems/prosthesis) was placed in a polariscope, and then traction began to be applied to the retention systems. The limit values for removal of the retention system were obtained by tests performed in an EMIC Universal test machine. The results were obtained by observation during the experiments and by photographic record of the stress behavior in the photoelastic model, resulting from the traction of the retention systems. In the magnet system, a lowest formation of fringes was verified both around and between the implants; in the O'ring system, the formation of photoelastic fringes was noted between the implants in the apical region; and in the bar-clip system, there was a greater concentration of colored fringes in the regions between the implants and cervical area. Based on the results obtained, it was concluded that the retention systems produced different stress distribution characteristics that, in general, were concentrated in the area around the implants, and the highest concentration of fringes, in increasing order, occurred in the retention systems of the magnets, O'ring, and bar-clip.

Methods used for assessing stresses in buccomaxillary prostheses: photoelasticity, finite element technique, and extensometry.

The authors describe a literature revision on assessing stresses in buccomaxillary prostheses photoelasticity, finite element technique, and extensometry. They describe the techniques and the importance for use of each method in buccomaxillary prostheses with implants and the need of accomplishing more studies in this scarce literary area.

Color stability comparison of silicone facial prostheses following disinfection.

PURPOSE: The purpose of this study was to evaluate the color stability of two silicones for use in facial prostheses, under the influence of chemical disinfection and storage time. MATERIALS AND METHODS: Twenty-eight specimens were obtained half made from Silastic MDX 4-4210 silicone and the other half from Silastic 732 RTV silicone. The specimens were divided into four groups: Silastic 732 RTV and MDX 4-4210 with disinfection three times a week with Efferdent and Sliastic 732 RTV and MDX 4-4210 disinfected with neutral soap. Color stability was analyzed by spectrophotometry, immediately and 2 months after making the specimens. After obtaining the results, ANOVA and Tukey test with 1% reliability were used for statistical analysis. RESULTS: Statistical differences between mean color values were observed. Disinfection with Efferdent did not statistically influence the mean color values. CONCLUSION: The factors of storage time and disinfection statistically influenced color stability; disinfection acts as a bleaching agent in silicone materials.

Análise fotoelástica da tensão entre diferentes tipos de sistemas de retenção em próteses obturadoras palatinas implanto-retidas ou não e com ou sem reembasamento “soft” / Photoelastic analysis of stress between different retention system in palatal obturator prostheses with or without implant retention or soft lining

O câncer da região de cabeça e pescoço é uma doença muito prevalente no Brasil, e as principais formas de tratamento são a cirurgia acompanhada ou não da radioterapia e quimioterapia. Perdas parciais ou totais de osso maxilar podem comprometer seriamente a fisiologia bucal causando sequelas como comunicações buconasosinosal. Neste caso, podese optar como forma de tratamento pela reabilitação protética com a aplicação de implantes osseointegrados. A literatura odontológica tem mostrado inúmeros trabalhos que avaliam a distribuição de forças com a finalidade de recolher melhores subsídios para o planejamento de próteses bucomaxilofaciais, que ainda é pouquíssimo explorada. Dentre os métodos utilizados, o da fotoelasticidade tem sido aceito, especialmente por permitir uma análise fiel da distribuição de forças. Assim, a proposta deste trabalho foi verificar a tendência de distribuição de forças e estresse, através do método fotoelástico, que incidem sobre diferentes tipos de sistemas de retenção em implantes (o’ring, barra clipe e o’ring/barra clipe) associado a próteses obturadoras palatinas implantoretidas e também em próteses obturadoras mucossuportadas (sem implante), utilizandose ou não de silicone com reembasamento direto (Sofreliner). O conjunto (prótese e modelo fotoelástico) foi posicionado em polariscópio circular e recebeu aplicação de carga de 100 N a velocidade de 10 mm/s no primeiro molar de cada prótese. Após as aplicações de carga houve a formação franjas correspondentes à tensão registrada. Então, as imagens foram transferidas para um computador e analisadas no programa ADOBE Photoshop. Ao se comparar os três sistemas de retenção das próteses obturadoras palatinas implantoretidas com a prótese mucossuportada (sem implantes), podese observar que as tensões foram distribuídas de forma mais homogênea e em menor quantidade nas próteses mucossuportadas, quando comparado às outras nos diferentes sistemas de retenção, o sistema barra clipe...

The head and neck cancer is a very prevalent disease in Brazil and the main treatment is the surgery with or without radiation therapy and chemotherapy. Partial or total bone maxillary defects could involve seriously oral physiology causing consequences as buconasosinosal communications. In this case could be applied other option of treatment as prosthetic rehabilitation associated with osseointegrated implants. Scientific literature demonstrated countless studies that evaluate the force distribution with the aim to provide better subsidies for the planning of bucomaxillofacial prostheses, which still have few researches. Between the methodologies, the photoelastic method has been accepted; especially by allow an accurate analysis of the force distribution. Thus, the aim of this study was to verify the tendency of force distribution and the stress on different types of retention system (o’ring, clip bar and o’ring/clip bar) associated with palatal obturator prostheses with implant retention and conventional obturator prostheses (without implants), with or without silicone soft lining(Sofreliner), by means of photoelastic method. The set (prosthesis and photoelastic model) was located in circular polariscope and was applied a load of 100 load N at 10 mm/s on the first molar of each prostheses. After the load applications was registered the tension fringes. The images was transferred to a computer and analyzed at ADOBE Photoshop software. When compared the three retention systems of the palatal obturator prostheses and mucosupported prostheses (without implants), it can be observed that the stress was distributed more homogeneous and in lesser amount that the conventional prostheses, when compared to the other prostheses that presented implants and retention systems. With relation to stress distribution in the different retention systems, the bar clip showed highest stress values, followed by the the distal bar clip system associated to attachments distal...

Evaluation of dimensional change and detail reproduction in silicones for facial prostheses.

The aim of this study was to evaluate the dimensional stability and detail reproduction of two silicones used for facial prosthesis, under the influence of chemical disinfection and storage time. Twenty-eight test specimens were obtained, half made of Silastic MDX 4-4210 silicone, and the other half of Silastic 732 RTV silicone. The test specimens were divided into 4 groups: Silastic 732 RTV and Silastic MDX 4-4210, with disinfection 3 times a week with Efferdent and without disinfection. Dimensional change was analyzed using an electronic comparison microscope and detail reproduction was observed under a stereo microscope, immediately and 2 months after the test specimens were made. Once the results were obtained, an analisis of variance (ANOVA) was applied, followed by the Tukey's Test with 1% confidence. The storage time factor had a statistical influence on dimensional stability: Silastic MDX 4-4210 had less contraction than Silastic 732 RTV. Chemical disinfection did not significantly alter the dimensional stability of the materials used. Regarding detail reproduction, no alteration of values was observed in any of the materials analyzed, regardless of storage period or disinfection.

Complete denture masticatory efficiency: a literature review.

The restoration of masticatory function and esthetics is an important aim in dentistry mainly when patients present with extensive tooth loss. The aim of mastication is to reduce food size to produce a homogeneous bolus appropriate to be swallowed. For edentulous patients, chewing efficiency is reduced because dental arches are replaced by artificial teeth. The aim of this study is to present factors related to chewing efficiency for the edentulous patient.

Restauração protética com facetas indiretas de In-Ceram alumina / Prosthetic restoration with laminate venners indirect of In-Ceram alumina

O nível de exigência e de expectativa em relação às restaurações protéticas por parte de nossos pacientes exige de nós profissionais, um conhecimento e um domínio muito maior acerca de todas as possibilidades restauradoras. O sistema In-Ceram é uma opção para casos onde a estética é indispensável sem, contudo, deixar de suprir necessidades de resistência exigida dependendo da extensão do tratamento reabilitador. Assim, o objetivo do trabalho é apresentar um caso clínico solucionado pela confecção de facetas indiretas de In-Ceram Alumina. Paciente, apresentou-se na Clínica de Prótese Dentária da FOA-UNESP queixando-se da aparência de seu sorriso. Após avaliação clínica e radiográfica, foi observada necessidade de substituição das facetas de resina composta insatisfatórias. Diante do quadro avaliado e considerando sua exigência estética, optou-se pela realização de facetas indiretas de In-Ceram Alumina nos elementos 11 e 21

The demand and expectation level related to prosthetic restorations by our patients, demands from us, professionals, knowledge and a very larger domain concerning all restoring possibilities. In-Ceram system is an option for cases where aesthetics is indispensable without, however, letting to supply the needs of demanded resistance depending on the extension of the rehabilitation treatment. Therefore, the objective of this study is to present a clinical case solved by the making of indirect veneers of In-Ceram Alumina. The patient came to the Dental Prosthesis Clinic of FOA-UNESP complaining about the appearance of her smile. After clinical and radiographic evaluation, it was observed a need of substitution of the unsatisfatory composite resin veneers. Analyzing these factors and considering her aesthetic demand, she opted for the accomplishment of indirect veneers of In-Ceram Alumina in the elements 11 and 21

Avaliação da microdureza superficial de quatro diferentes resinas acrílicas para base de dentaduras / Evaluation of superficial microhardness of four different acrylic resins for dentadure bases

O objetivo deste trabalho foi avaliar a microdureza superficial de quatro tipos de resinas acrílicas (Onda Cryl, Vipi Wave, Vipi Cril e QC-20 com polimerização convencional e com polimerização por energia de microondas) para base de dentaduras, em função do período de armazenagem, em água, de seis meses. Foram confeccionadas vinte e cinco amostras, as quais foram fixadas em discos acrílicos incolores, devidamente identificados, que foram então polidas em uma politriz e foram submetidas ao teste de microdureza superficial Knoop em um microdurômetro digital (modelo HMV-2T) e posteriormente armazenados em água destilada a 35 ± 2°C por seis meses, após o qual um segundo teste de microdureza superficial das amostras foi realizado. Os resultados obtidos foram submetidos à análise de variância e ao teste de Tukeyao nível de significância de 5%. Observou-se que o fator tempo de armazenagem promoveu um decréscimo dos valores médios de microdureza superficial Knoop para todos os grupos estudados, sendo que apenas para os grupos Vipi Cril e QC-20 polimerizado por energia de microondas esta diminuição dos valores foi estatisticamente significativa.

Materiais reembasadores: estudo da deformação inicial, permanente e porosidade / Soft liners: study of initial and permanent deformation and porosity

O objetivo desta pesquisa foi avaliar a influência da desinfecção química e da armazenagem por 3 meses sobre a deformaçãoinicial, deformação permanente e a porosidade de três materiais reembasadores resilientes. Os corpos-de-provaforam divididos em 2 grupos para cada material: sem e com desinfecção química. Foram analisados em relógio indicador,para a verificação da deformação inicial e permanente e visualmente para a porosidade. Essas leituras foram realizadas 3meses após a polimerização dos corpos-de-prova. Concluiu-se que todos os materiais reembasadores resilientes sofreramdeformação inicial e permanente, após o período analisado, independentemente da desinfecção química. O material queapresentou a menor deformação inicial e permanente foi o Dentuflex. Após 3 meses, apenas o material Dentuflex nãoapresentou porosidade.

Influencia del tiempo de almacenamiento sobre la dureza y rugosidad de materiales para rebasados resilentes / Influence of storage time on the hardness and roughness of soft liners materials

Fundamento: Los materiales para rebasados resilentes de prótesis, presentan ciertas características clínicamente importantes que pueden alterarse con el tiempo de uso, entre ellas la dureza, y rugosidad. El objetivo de este estudio fue evaluar la influencia del almacenamiento sobre la dureza Shore A y rugosidad de cuatro materiales resilentes para rebasado. Materiales y método: Fueron utilizados 4 materiales resilentes: Dentuflex, Coe-Soft, Dentusoft y Dinabase, 3 temporales y un permanente; para cada material fueron confeccionadas 7 muestras. Se evaluó la dureza y rugosidad inicialmente, a los 30 y 90 días de almacenamiento en agua destilada a 35±2ºC. Los resultados fueron sometidos al análisis de varianza (ANOVA) y las medias comparadas por el Test de Tukey (p<0,05). Resultados: Dentuflex, Coe-Soft, Dentusoft y Dinabase presentaron los mayores valores medios iniciales de dureza, en este orden. Con respecto a la rugosidad, Dentuflex, Dentusoft, Coe-Soft y Dinabase presentaron los mayores valores medios iniciales. Después del periodo de almacenamiento se observó un aumento significativo de los valores de dureza en todos los materiales. El material Dentuflex presentó valores de rugosidad significativamente menores, mientras que los valores de los otros materiales aumentaron significativamente. Conclusión: El tiempo de almacenamiento influenció sobre la dureza y rugosidad todos los materiales

Statement of problem: Resilient soft liners materials have many important features that could be altered over time, like hardness and roughness. The aim of this study was to assess the influence of water storage on the hardness Shore A and roughness of four resilient soft liners materials. Materials and methods: Four materials were used: Dentuflex, Coe-Soft, Dentusoft and Dinabase, three temporary and one permanent material. For each material 7 specimens were made. The hardness and the roughness were evaluated in the initial period, after 30 and 90 days of distilled water storage at 35±2ºC. The results were submitted to analyses of variance (ANOVA) and the averages compared by Tukey's Test (p<0.05). Results: Dentuflex, Coe-Soft, Dentusoft and Dinabase displayed higher initial average of hardness values, whereas Dentuflex, Dentusoft, Coe-Soft and Dinabase higher initial average of roughness values. After water storage a significant increase in the hardness values in all materials was observed. Dentuflex material showed smaller roughness values, while the other materials increased significantly. Conclusion: Time storage influenced all the materials analyzed with respect to hardness and roughness

Avaliação da recuperação elástica e da resistência ao rasgamento de um silicone para uso em prótese facial sob a influência da pigmentação e da desinfecção química / Effect of pigmentation and chemical disinfection on the elastic recovery and tear strength of a silicone maxillofacial prosthetic material

A proposta deste estudo foi analisar o efeito da pigmentação e da desinfecçãoquímica sobre a recuperação elástica e a resistência ao rasgamento de um silicone (Silved Selante – Sil Trade) para uso em prótese facial. As amostras para os testes de rasgamento (75 mmx 25 mm x 0,5 mm) e recuperação elástica (20 mm x 12,5 mm) foram confeccionadas de acordo com as instruções do fabricante. Para cada propriedade (n = 30), dez amostras foram pigmentadas com pó de maquiagem, dez com óxido de ferro, e dez sem pigmentação. Cinco amostras de cada grupo foram submetidas à desinfecção química utilizando clorexidina a 2% por aspersão. Todasas amostras foram imersas em soro fisiológico e armazenadas em uma estufa a 35° + 1°C. Depois de 60 dias, as amostras foram submetidas ao teste de rasgamento utilizando-se uma máquina de ensaio universal (EMIC), e a recuperação elástica foi avaliada por um relógio indicador. Para ambas as propriedades, os dados foram analisados por dois métodos de análise, o de variância (ANOVA) seguido pelo teste de Tukey (α = 0,05). Os resultados mostraram que as amostras pigmentadas com pó de maquiagem, com e sem desinfecção, apresentaram médias mais altas de resistência ao rasgamento. A desinfecção química promoveu uma significância (p < 0,5) diminuindo os valores da recuperação elástica independente da pigmentação. O silicone (Silved Selante – Sil Trade) pigmentado com pó de maquiagem apresenta propriedades físicas satisfatórias para uso em prótese maxilofacial.