Prevalência de arcadas totalmente dentadas, totalmente edêntulas e parcialmente dentadas segundo classificação de Kennedy / Prevalence of edentulous and partially edentulous jaws according to Kennedy's classification

Poucos estudos estão disponíveis na literatura a respeito da prevalência de diferentes tipos de arcadas dentárias. Portanto, o objetivo deste estudo foi avaliar a prevalência dos tipos de arcadas dentárias em relação à presença de dentes através de radiografias panorâmicas. Foram avaliados 1.017 prontuários clínicos da Faculdade de Odontologia da Universidade do Sul de Santa Catarina, sendo 385 pacientes do gênero masculino e 632 do gênero feminino, totalizando 2.034 arcadas. Os resultados evidenciaram uma maior prevalência por arcadas parcialmente desdentadas (1.023 arcadas), das quais 743 (36,52%) eram do tipo Classe III de Kennedy, seguidas por 224 (11,99%) Classe I, 197 (9,68%) Classe II e 19 (0,93%) Classe IV. Observou-se ainda que destas 2.034 arcadas, 663 (32,59%) eram totalmente dentados e 168 (8,25%) eram totalmente desdentadas. Conclui-se que as arcadas parcialmente desdentadas são mais prevalentes, seguidas pelas totalmente dentadas e, com menor prevalência, pelas totalmente desdentadas. Foi observada uma maior prevalência de espaços protéticos na mandíbula em relação à maxila (AU).

Few studies about the prevalence of different types of dental arches are available in the literature. So the objective of this study was to evaluate the prevalence of dental arches types in relation to the presence of teeth through panoramic radiographic examination. Clinical records of 1017 patients of the Dental School of the Universidade do Sul de Santa Catarina were evluated (385 male and 632 female), totalizing 2034 dental arches. Results showed a greater prevalence of partially edentulous jaws (1.023), of which 743 (36,52%) were Kennedy Class III, followed by 224 (11.99%) Class I, 197 (9,68%) Class II and 19 (0,93%) Class IV. It was also observed that of 2034 dental arches, 663 (32.59%) had all the teeth remaining and 168 (8.25%) were totally edentulous. It was concluded that the partially edentulous dental arches are more prevalent, followed by those which had all teeth, and with less prevalence the totally edentulous dental arches. It was also observed a higher prevalence of prosthetic spaces in the mandible compared to the maxilla (AU).

Push-out bond strength of fiber posts to root dentin using glass ionomer and resin modified glass ionomer cements

OBJECTIVE: The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resinmodified glass ionomer cements (RMGICs). MATERIAL AND METHODS: Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%. RESULTS: Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs. CONCLUSIONS: Except for Ionoseal, all cements provided satisfactory bond strength values. .

Push-out bond strength of fiber posts to root dentin using glass ionomer and resin modified glass ionomer cements.

OBJECTIVE: The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resinmodified glass ionomer cements (RMGICs). MATERIAL AND METHODS: Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%. RESULTS: Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs. CONCLUSIONS: Except for Ionoseal, all cements provided satisfactory bond strength values.

Influence of technique and manipulation on self-adhesive resin cements used to cement intraradicular posts.

STATEMENT OF PROBLEM: Resin cements are widely used to cement intraradicular posts, but bond strength is significantly influenced by the technique and material used for cementation. PURPOSE: The purpose of this study was to evaluate the bond strength of 3 self-adhesive cements used to cement intraradicular glass fiber posts. The cements all required different application and handling techniques. MATERIAL AND METHODS: Forty-five human maxillary canines were selected and randomly divided into 3 groups n= 15 by drawing lots: Group BIS - Biscem, Group BRE - Breeze, and Group MAX - Maxcem. Each group was divided into 3 subgroups according to application and handling techniques: Sub-group A - Automix/Point tip applicator, Sub-group L - Handmix/Lentulo, and Sub-group C - Handmix/Centrix. Cementation of the posts was performed according to the manufacturers' instructions. The push-out test was performed with a crosshead speed of 0.5 mm/min, and bond strength was expressed in megapascals. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05). RESULTS: Breeze cement showed the highest average for the subgroups A, L, and C when compared to the Biscem cement and Maxcem Elite (P<.05). Statistically significant differences among the subgroups were only observed for Biscem. CONCLUSIONS: This study shows that application and handling techniques may influence the bond strength of different self-adhesive cements when used for intraradicular post cementation.

Enxerto ósseo onlay autógeno de área doadora intraoral: relato de caso / Autogenous onlay bone grafts from an intraoral donor site: case report

A reconstrução óssea com blocos de enxertos tem sido utilizada na Implantodontia com o propósito de possibilitar a instalação de implantes quando o tecido de suporte é insuficiente ou não possibilitaria o posicionamento do implante na sua forma ideal. A técnica de enxertia realizada com o uso de osso autógeno é considerada a primeira opção de tratamento por esse material possuir características mais próximas do ideal como osteogenicidade e biocompatibilidade. Áreas doadoras intrabucais demonstram fornecer tecido suficiente, com menor morbidade e custo comparadas as áreas extrabucais. O presente relato de caso, associado à revisão de literatura, tem como objetivo analisar e discutir os diferentes aspectos de um tratamento com utilização de enxerto autógeno como: definição dos parâmetros que levam a opção pelo tratamento com enxerto ósseo, limitações do tratamento, escolha da área doadora, descrição da técnica e escolha pela colocação dos implantes simultaneamente ou não ao enxerto

Reconstruction with bone block grafts has been used in Implantology in order to permit the installation of implants when the alveolar ridge support is insufficient or can’t provide the positioning of the implant in its ideal form. The grafting technique accomplished with the use of autogenous bone is considered the first choice of treatment because this material has characteristics closer to ideal such as osteogenic potential and biocompatibility. Intraoral donor sites have proved to provide enough quantity of bone, with lower morbidity and cost compared to extraoral areas. The present case report, associated with a literature review, aims to analyze and discuss the different aspects of treatment using autograft such as: defining the parameters that lead to choosing treatment with bone graft, limitations of treatment, choice of donor area, description of technique and choice for placing implants simultaneously or not to graft

Utilização de implante estreito de TiZr em região de alta incidência de carga: relato de caso / The use of TiZr narrow implant in high impact load region: case report

Implantes estreitos de titânio surgiram na Implantodontia com a indicação clássica de serem utilizados para substituição de incisivos laterais superiores, incisivos inferiores, espaços edêntulos pequenos e com baixa incidência de carga mastigatória. Porém, na literatura encontra-se relatos de falhas mecânicas e biológica desses implantes, quando utilizados em situações de maior incidência de carga mastigatória, como em caninos e molares. Para permitir uma ampliação das indicações dos implantes de diâmetro reduzido, uma nova liga foi desenvolvida com objetivo de compensar as deficiências relatada. Os novos implantes estreitos são confeccionados a partir de uma liga de titânio e zircônia (TiZr), com 13-17% de zircônia em sua composição e possuem 3,3 mm de diâmetro. A nova liga apresenta maior resistência do que os implantes de titânio grau IV e melhor biocompatibilidade que as ligas de Ti-6Al-4V. Assim, vem sendo uma alternativa viável para ampliar as indicações clássicas dos implantes estreitos convencionais. No caso apresentado, o implante estreito de TiZr foi utilizado em região de segundo molar inferior como pilar de uma prótese fixa de 4 elementos, a fim de permitir a reabilitação de uma paciente que possuía perda óssea vertical severa, necessitando o implante tangenciar do nervo alveolar inferior. O controle foi feito durante 15 meses sem apresentar qualquer complicação, sendo assim, concluiu-se que os implantes estreitos de TiZr podem ser utilizados em espaços edêntulos reduzidos e táboa óssea fina, independente do dente a ser substituído

Narrow titanium implants came with the classic indication for use for replacement of maxillary lateral incisors, lower incisors and small edentulous spaces with low incidence of masticatory load. However, the literature reports biological and mechanical failures of these implants when used in situations of higher incidence of masticatory load, such as canines and molars. To amplify the indication of small diameter implants, a new alloy was developed in order to compensate for the deficiencies reported. The new narrow implants are made from an alloy of titanium and zirconium (TiZr) with 13-17% of zirconia in their composition and have 3.3 mm diameter. The new alloy has higher resistance than the titanium implants grade IV and better biocompatibility than the alloy Ti-V-6Al4, therefore it has being a viable alternative to broaden the classical indications of narrow conventional implants. In the case reported, the Strait of TiZr implant was used in the region of the second molar as an abutment for a fixed prosthesis in the four elements in order to allow the rehabilitation of a patient with severe vertical bone loss requiring that the implant was tangent to lower alveolar nerve. The control was carried out for 15 months without any complications, and therefore, it was concluded that the narrow TiZr implants can be used in reduced edentulous spaces and thin bone, independent of the tooth to be replaced

Análise de resistência à tração de pinos de fibra de vidro cimentados com diferentes cimentos de ionômero de vidro através do teste pull-out / Evaluation of tensile strength of fiberglass posts cemented with different glass ionomer cements through pull-out-test

Para que se consiga resistência e retenção de pinos intrarradiculares é essencial a adequada seleção do agente cimentante. Objetivo: analisar diferentes tipos de cimento de ionômero de vidro utilizados na cimentação de pinos intrarradiculares de fibra de vidro, o método através do teste de resistência à tração pull-out. Métodos: Foram cimentados pinos de fibra de vidro em 50 caninos humanos, divididos nos seguintes grupos (n = 10): Grupo I ? Ionoseal (Voco), Grupo II ? Lining and Cement (GC), Grupo III ? Fuji II Improved (GC), Grupo IV ? Rely X Luting 2 (3M Espe), Grupo V ? Ketac Cem (3M Espe). Resultados: o teste Anova mostrou diferença significativa entre os grupos. O teste de Tukey mostrou que o Lining and Cement foi estatisticamente mais resistente que o Ionoseal (p < 0,05). Conclusão: assim, analisando-se os resultados, pode-se concluir que avaliando a resistência à tração dos pinos de fibra de vidro cimentados com diferentes cimentos de ionômero de vidro através do teste pull-out o cimento de ionômero de vidro convencional Lining and Cement se mostrou superior aos outros cimentos.

Avaliação da resistência ao cisalhamento por extrusão (push-out) de pinos de fibra de vidro cimentados com diferentes cimentos resinosos em um ambiente úmido: Estudo Piloto / Evaluation of shear bond strength (push-out) of glass fiber posts cemented with different resin cements in humid ambient. Pilot study

Objetivo: O objetivo deste trabalho foi analisar a resistência ao cisalhamento por extrusão de diferentes cimentos empregados na cimentação de pinos de fibra de vidro em ambiente úmido. Material e métodos: Para tanto, 21 caninos humanos tiveram suas coroas removidas, de modo que se obtiveram 15 mm de remanescente radicular. Depois de tratados endodonticamente, os dentes foram preparados para receber pinos de fibra de vidro. Os dentes selecionados foram divididos aleatoriamente em sete grupos: Grupo I - RelyX ARC, Grupo II - Enforce, Grupo III - BISCEM, Grupo IV - DUO-LINK, Grupo V - Cemente Post, Grupo VI - Variolink II e Grupo VII - RelyX U100. Cada dente foi seccionado perpendicularmente ao longo do eixo do pino com disco diamantado de alta concentração, obtendo-se uma fatia de cada profundidade com espessura de, aproximadamente, 1 mm, retiradas a partir de 1 mm, 5 mm e 9 mm do limite cervical de cada raiz, totalizando-se 63 espécimes. A análise microscópica foi realizada nesses três níveis: superficial, médio e profundo. Após análise, os espécimes foram avaliados pelo teste de push-out. Resultados: O teste Anova a dois critérios mostrou diferenças estatisticamente significativas entre os terços, cimentos e interação entre eles (p < 0,05). O teste de Tukey mostrou que os cimentos resinosos autoadesivos (Biscem e U100) e o terço cervical radicular apresentaram resultados significativamente superiores no teste de push-out (p < 0,05). As fotomicrografias mostraram que houve fendas maiores nas regiões médias e apicais do que nas regiões cervicais. Conclusão: Os resultados deste estudo mostraram que os cimentos autoadesivos apresentaram resultados superiores quando comparados aos cimentos adesivos. A região radicular cervical apresentou os melhores resultados no teste de cisalhamento.

Effect of post length on endodontically treated teeth: analyses of tensile strength

Aim: This study compared the tensile strength of endodontically treated teeth restored withdifferent posts and cores with different post lengths. Methods: Sixty extracted intact canines wererandomly divided into 6 groups. Groups CP1, CP2 and CP3 were restored with custom cast postand-core and groups PF1, PF2 and PF3 were restored with prefabricated post and compositeresin core, with different combinations of post length of 5,0 mm, 7.5 mm and 10 mm, respectively(n = 10). All teeth were restored with a total metal crown. A tensile loading was applied at a 180-degree angle to the long axis until failure. Results: The 2-way analysis of variance (á=0.05)showed statistically significant difference (p<0.001) among the groups. However, when the meanfracture forces for the groups were compared (Groups 1, 2, 3, 4, 5 and 6: 134.5 N (34.2), 178.9N(40.1), 271,5 N (55.9), 161.7 N (22.0), 216.1 N (42.0) and 257.9 N (41.0), respectively), nosignificant differences could be detected among the groups restored with prefabricated post andcast post-and-core. It was found significant differences when it was compared the different lengthsfor each type of post (p<.05). Conclusions: This study showed that increasing post lengthsignificantly increased the tensile strength of prefabricated posts and cast post-and-core used inendodontically treated teeth. On the other hand, significant differences were not found whencomparing endodontically treated teeth restored with custom cast post-and-cores or pre-fabricatedposts and composite resin cores with the same post length.

A multidisciplinary approach for the management of hypodontia: case report.

Hypodontia is the congenital absence of one or more teeth and may affect permanent teeth. Several options are indicated to treat hypodontia, including the maintenance of primary teeth or space redistribution for restorative treatment with partial adhesive bridges, tooth transplantation, and implants. However, a multidisciplinary approach is the most important requirement for the ideal treatment of hypodontia. This paper describes a multidisciplinary treatment plan for congenitally missing permanent mandibular second premolars involving orthodontics, implantology and prosthodontic specialties.

A multidisciplinary approach for the management of hypodontia: case report

Hypodontia is the congenital absence of one or more teeth and may affect permanent teeth. Several options are indicated to treat hypodontia, including the maintenance of primary teeth or space redistribution for restorative treatment with partial adhesive bridges, tooth transplantation, and implants. However, a multidisciplinary approach is the most important requirement for the ideal treatment of hypodontia. This paper describes a multidisciplinary treatment plan for congenitally missing permanent mandibular second premolars involving orthodontics, implantology and prosthodontic specialties.

Efeito de diferentes elastômeros na adaptação cervical de coroas totais metálicas / Effect of different elastomers on cervical fit of full metal crowns

Objective: The aim of this study was to evaluate the cervical fit of full metal crowns using four different elastomers. Methods: A stainless steel metallic die similar to a prepared first upper molar was obtained. Four di-fferent elastomeric impression materials were utilized: polysulfide (A), polyether (B), condensation silicone (C) and addition silicone (D). Forty molds were created, 10 for each group. It was obtained 40 gypsum abutments. After the end of this stage, it was performed complete metal crowns on all specimens. Crown displacement was measured through a comparative microscope, obtaining diametrically opposite points. Results: The re-sults were the following: Group D (31.97 um), Group B (49.57 um), Group A (51.12 um), Group C (61.12 um). The analysis of variance (ANOVA) test and a Tukey test for multiple comparisons were used to analyze the results. Conclusions: There were significant differences among all groups, except for Groups A and B. The major result of displacement was Group C. The best results were shown by Group D (p < 0.05).

Linear dimensional changes in plaster die models using different elastomeric materials.

Dental impression is an important step in the preparation of prostheses since it provides the reproduction of anatomic and surface details of teeth and adjacent structures. The objective of this study was to evaluate the linear dimensional alterations in gypsum dies obtained with different elastomeric materials, using a resin coping impression technique with individual shells. A master cast made of stainless steel with fixed prosthesis characteristics with two prepared abutment teeth was used to obtain the impressions. References points (A, B, C, D, E and F) were recorded on the occlusal and buccal surfaces of abutments to register the distances. The impressions were obtained using the following materials: polyether, mercaptan-polysulfide, addition silicone, and condensation silicone. The transfer impressions were made with custom trays and an irreversible hydrocolloid material and were poured with type IV gypsum. The distances between identified points in gypsum dies were measured using an optical microscope and the results were statistically analyzed by ANOVA (p < 0.05) and Tukey's test. The mean of the distances were registered as follows: addition silicone (AB = 13.6 µm, CD=15.0 µm, EF = 14.6 µm, GH=15.2 µm), mercaptan-polysulfide (AB = 36.0 µm, CD = 36.0 µm, EF = 39.6 µm, GH = 40.6 µm), polyether (AB = 35.2 µm, CD = 35.6 µm, EF = 39.4 µm, GH = 41.4 µm) and condensation silicone (AB = 69.2 µm, CD = 71.0 µm, EF = 80.6 µm, GH = 81.2 µm). All of the measurements found in gypsum dies were compared to those of a master cast. The results demonstrated that the addition silicone provides the best stability of the compounds tested, followed by polyether, polysulfide and condensation silicone. No statistical differences were obtained between polyether and mercaptan-polysulfide materials.

Linear dimensional changes in plaster die models using different elastomeric materials

Dental impression is an important step in the preparation of prostheses since it provides the reproduction of anatomic and surface details of teeth and adjacent structures. The objective of this study was to evaluate the linear dimensional alterations in gypsum dies obtained with different elastomeric materials, using a resin coping impression technique with individual shells. A master cast made of stainless steel with fixed prosthesis characteristics with two prepared abutment teeth was used to obtain the impressions. References points (A, B, C, D, E and F) were recorded on the occlusal and buccal surfaces of abutments to register the distances. The impressions were obtained using the following materials: polyether, mercaptan-polysulfide, addition silicone, and condensation silicone. The transfer impressions were made with custom trays and an irreversible hydrocolloid material and were poured with type IV gypsum. The distances between identified points in gypsum dies were measured using an optical microscope and the results were statistically analyzed by ANOVA (p < 0.05) and Tukey's test. The mean of the distances were registered as follows: addition silicone (AB = 13.6 µm, CD=15.0 µm, EF = 14.6 µm, GH=15.2 µm), mercaptan-polysulfide (AB = 36.0 µm, CD = 36.0 µm, EF = 39.6 µm, GH = 40.6 µm), polyether (AB = 35.2 µm, CD = 35.6 µm, EF = 39.4 µm, GH = 41.4 µm) and condensation silicone (AB = 69.2 µm, CD = 71.0 µm, EF = 80.6 µm, GH = 81.2 µm). All of the measurements found in gypsum dies were compared to those of a master cast. The results demonstrated that the addition silicone provides the best stability of the compounds tested, followed by polyether, polysulfide and condensation silicone. No statistical differences were obtained between polyether and mercaptan-polysulfide materials.

Effect of post length on endodontically treated teeth: fracture resistance

Aim: This study compared the fracture resistance of endodontically treated teeth restored with posts and cores systems with different post lengths. Methods: Sixty extracted intact canines were randomly divided in 6 groups of 10 teeth each, as follows: groups 1, 2 and 3 were restored with custom cast post-and-core, and groups 4, 5 and 6 were restored with prefabricated post and composite resin core, with different post lengths (5.0, 7.5 and 10 mm, respectively). A compressive load was applied at a 45-degree angle to the long axis until failure occurred. Results: Two-way analysis of variance (á=0.05) showed statistically significant difference between the groups(p<0.001). However, when the mean fracture forces for the groups were compared (group 1:254.4 N; groups 2, 3, 4, 5, 6 – 331.7 N, 434.7 N, 405.4 N, 395.6 N and 393.8 N, respectively),no significant differences could be detected among the three groups restored with prefabricated post and group 3. Conclusions: This study showed that an increased post length in teeth restored with prefabricated posts does not significantly increase the fracture resistance of endodontically treated teeth. On the other hand, endodontically treated teeth restored with custom cast-post and core showed significant increase on fracture resistance when the post length is increased.

Sistemas cerâmicos atuais: revisão de literatura / Current ceramic systems: literature review

A fabricação de restaurações em cerâmica está se tornando cada vez mais popular, devido ao crescente avanço na qualidade desse material e na tecnologia empregada na confecção dessas restaurações. Essa evolução ocorreu graças, principalmente, à tecnologia CAD/CAM, que possibilitou o uso de cerâmicas de alta resistência na fabricação de próteses sem metal, com qualidade e uniformidade, padronizando os processos e reduzindo custos. O objetivo deste trabalho é realizar uma revisão da literatura dos sistemas cerâmicos existentes, bem como descrever os aspectos relacionados à estética, propriedades mecânicas, adaptação marginal, caracteristicas dos pônticos e conectores, e modo de cimentação, procurando mostrar as vantagens, desvantagens, indicações e contra-indicações da cada sistema.

Resolução estética com laminado cerâmico unitário: relato de caso / Aesthetics resolution with single ceramic veneer: a case report

A Odontologia Restauradora atual funde conceitos estéticos e conservadores. Assim, são preconizados tratamentos que apresentam bom prognóstico em longo prazo, preservação de estrutura dentária e alta satisfação estética do paciente. Inseridos nesse contexto, destacam-se os laminados cerâmicos. O objetivo deste trabalho é descrever, por meio de um relato de caso, os desafios do planejamento e da execução de um laminado cerâmico na reconstrução de um incisivo central esteticamente comprometido.

Recuperação do relacionamento entre pôntico e rebordo alveolar utilizando técnica de enxerto conjuntivo em "rolo" e condicionamento tecidual: relato de caso / Recovery of the pontic-alveolar ridge relationship using the connective tissue roll graft technique and tissue conditioning: case report

Alterações anatômicas no rebordo alveolar – como a perda das papilas interproximais, do contorno do arco côncavo regular e a diminuição tanto da espessura quanto da altura do rebordo – dificultam o correto relacionamento entre o pôntico e o rebordo alveolar, e podem comprometer o resultado estético final. As depressões no rebordo alveolar podem ser resultado de extrações traumáticas ou de extrações de dentes com perda óssea avançada devido à doença periodontal ou relacionada com patologias apicais. Essas deformações desafiam a reabilitação protética, exigindo procedimentos corretivos tanto cirúrgicos quanto protéticos. Inúmeras técnicas têm sido utilizadas para reconstituir cirurgicamente os rebordos alveolares. Contudo, o enxerto de tecido conjuntivo subepitelial é a técnica que apresenta melhor resultado estético, pois permite semelhança de cor, de textura e de contorno do rebordo reconstituído com as áreas adjacentes. Abrams, em 1980, descreveu a técnica de enxerto de tecido conjuntivo subepitelial em “rolo”, aonde o enxerto é rodado para a área receptora. Scharf e Tarnow, em 1992, modificaram a técnica de Abrams mantendo o pedículo de tecido epitelial, o qual é utilizado para recobrir a área doadora. A região do segundo pré-molar superior apresentava-se com perda do contorno gengival fisiológico, interferindo no tratamento protético. A técnica cirúrgica de enxerto de tecido conjuntivo subepitelial em “rolo” e os passos clínicos do condicionamento tecidual são descritos. No caso apresentado, ambas as técnicas são previsíveis e contribuíram para proporcionar melhores características estéticas, assim como melhorar o relacionamento entre o pôntico e o rebordo.

Anatomical changes in the alveolar ridge, such as the loss of the interproximal papillae and of the contour of the regular concave arc, and the decrease of both the thickness and the height of the ridge, complicate the correct relationship between the pontic and the alveolar ridge and may affect the final aesthetic outcome. Depression in the alveolar ridge may be the result of traumatic extractions or teeth extractions with advanced bone loss due to periodontal disease or apical pathology. These alterations challenge the prosthetic rehabilitation demanding corrective procedures both surgical as well as prosthetic. Several techniques have been used to surgically reconstruct the alveolar ridges. However, the subepithelial connective tissue graft is the technique that shows better esthetic results, as it allows resemblance in color, texture and in the contour of the reshaped ridge to the adjacent areas. Abrams in 1980 described the subepithelial connective tissue roll graft technique, in which the graft is rolled to the receptive area. In 1992 Scharf and Tarnow changed Abram's technique keeping the pedicle of the epithelial tissue, which is used to cover the donor site. The site of the second superior maxillary premolar presented loss of physiologic gingival contour, interfering on the prosthetic treatment. Both the "roll" surgical technique of subepithelial connective tissue graft and the clinical steps of tissue conditioning are described. In the case presented both techniques are predictable and contributed to provide better esthetic characteristics as well as better pontic-ridge relationship characteristic.

Avaliação da retenção de coroas totais metálicas cimentadas com diferentes cimentos provisórios / Evaluation of total metallic crowns retention cemented with different provisional cements

O objetivo deste trabalho foi avaliar a resistência à tração de coroas totais metálicas cimentadas com diferentes cimentos temporários. Para tanto, foram selecionados trinta molares superiores humanos, os quais foram preparados para receber coroas totais metálicase divididos aleatoriamente em três grupos de dez cada. As coroas do Grupo 1 foram cimentadas com hidróxidode cálcio (Dycal®); as do Grupo 2 (Temp-Bond®) e 3 (pasta Lysanda®), com cimento e pasta de óxido de zinco e eugenol, respectivamente. Decorridas 24h, submeteram-se os corpos-de prova à tração em máquina de ensaios universal. Terminados os testes, todas as coroas e dentes foram limpados e fez-se a recimentação, submetendo os espécimes novamente ao teste de tração após 21 dias. Os resultados foram avaliados por meio de análise de variância a um critério e a comparação entre as médias foi realizada pelo método de comparação de Student-Newman-Keuls. A análise estatística mostrou diferença significativa entre os grupos submetidos ao tracionamento um dia e 21 dias após a cimentação. A resistência à tração após um dia foi maior para o Grupo 1 (21,92 Kgf), seguido, respectivamente, pelos grupos 2 (12,95 Kgf) e 3 (3,64 Kgf). Após 21 dias, os resultados encontrados para o Grupo 1 (1,52 Kgf) e 2 (1,40 Kgf) foram inferiores aos anteriores, ao passo que o Grupo 3 (3,76 Kgf) se manteve semelhante, não havendo diferenças significativas entre si. Observando os resultados, pode-se concluir que o fator tempo pode ser determinante na diminuição da resistência à tração de diferentes cimentos temporários

Aplicação de carga imediata em prótese sobre implante: revisão de literatura / Implementation of immediate load on implant prosthesis: literature review

A reabilitação bucal com uso de implantes é uma realidade confirmada e embasada pela literatura. Desde meados da década de 60, quando Bränemark apresentou o conceito de osseointegração, os implantes têm sido usados e pesquisados. Na década de 80, a técnica de carga imediata foi implantada; essa técnica atinge vários anseios de pacientes e profissionais, pois se caracteriza como um tratamento que reabilita função e estética em curto período de tempo. Os sistemas utilizados nessa técnica são variados, como de infra-estrutura fundida ou pré-fabricada e de cirurgia guiada. Abrange desde mandíbula e maxila totalmente desdentadas até falhas parciais e unitárias. Com toda essa variabilidade, a técnica de carga imediata está sendo amplamente utilizada. A proposta deste artigo foi de confirmar a eficácia da carga imediata, através de uma revisão de literatura (base de dados Pubmed, seleção de 1969 a 2007). Após a análise de todos os artigos, a conclusão obtida foi que é um tratamento viável, visto que apresentou uma média alta de taxa de sobrevida (maior que 90%), similar à taxa do tratamento convencional, e que apenas 12 implantes dentre todos os estudos analisados excederam a taxa de perda óssea do tratamento convencional. Porém, seguir um protocolo adequado é de extrema importância para o sucesso do tratamento.

The oral rehabilitation with the use of implants is a fact confirmed by literature. Since the mid of 60’s, when Bränemark presented the concept of osseointegration, the implants have been used and searched. In the 80’s the immediate load technique was introduced, which affects several technical concerns of patients and professionals, as is characterized as a treatment to rehabilitate function and aesthetics in a short period of time. The systems used in this technique are varied, as the infrastructure merged or pre-manufactured and guided surgery. It covers since upper or lower jaw and totally edentulous by failures and partial unit. With all this variability the technique of immediate load is being widely used. The aim of this article was to confirm the effectiveness of the load through an immediate review of literature (Pubmed database, selection from 1969 to 2007). After examination of all the articles, it was concluded that it is a viable treatment, since presented a high average rate of survival (greater than 90%), similar to the rate of conventional treatment, and that only 12 implants among all studies analyzed exceeded the rate of bone loss of conventional treatment. However, to follow the appropriate protocol is extremely important to the success of treatment.