Tongue prosthesis after total glossectomy: a case report.

Squamous cell carcinoma (SCC) is the type of cancer that most frequently affects the oral cavity, mainly in men older than 50 years of age. Treatment for oral SCC often involves surgical excision of the affected margins, resulting in mutilation that affects the patient's quality of life. The objective of this case report is to describe the prosthetic treatment of a 56-year-old man who underwent total glossectomy, resulting in speech and swallowing difficulties. The proposed treatment was a tongue prosthesis retained by orthodontic clasps on the mandibular first molars. After maxillary and mandibular complete-arch impressions were performed and casts were prepared for prosthetic planning, an acrylic resin plate and 3 tongue prototypes were fabricated. Esthetic and functional tests were carried out, and 2 tongue models (1 for speech and 1 for eating) were selected for acrylization, finishing, and polishing. After placement of the prostheses, the patient was referred for follow-up with a speech therapist to improve his adaptation with the prostheses. The patient was satisfied with the prostheses and able to perform the functions of chewing, swallowing, and speech production, which helped in his social reintegration and improved his quality of life.

Correlation between the event of the COVID-19 pandemic and symptoms of anxiety, depression and temporomandibular disorder in university students: cross-sectional study / Correlação entre o evento da pandemia de COVID-19 e sintomas de ansiedade, depressão e de disfunção temporomandibular em estudantes universitários: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has been shown to be a probable aggravator of psychological responses such as anxiety and depression. This study aimed to assess the correlation between symptoms of anxiety and depression during the COVID-19 pandemic and the existence of symptoms associated with temporomandibular dysfunction (TMD) in a Brazilian university population. METHODS: This epidemiological, cross-sectional clinical study evaluated its variables of interest using the COVID-19 Fear Scale, Hospital Anxiety and Depression Scale (HADS-A and HADS-D), Diagnostic Criteria for Temporomandibular Dysfunction (DC/TMD) and Oral Behavior Checklist (OBC) questionnaires. RESULTS: A total of 373 participants (females = 273) with a mean age of 23.8±5.45 years were included in this study. In addition, 78.2% of participants with anxiety symptoms and 54.5% of participants with depression symptoms reported a high level of TMD-related parafunction (p<0.01). The presence of anxiety symptoms increased the odds of developing intense fear of COVID-19 by 14.9 times (p<0.001) and the odds of developing moderate fear of COVID-19 by 3.5 times (p<0.001). The presence of an intense fear of COVID-19 increased the chances of developing anxiety symptoms by 17.15 times (p<0.001), while the presence of a moderate fear increased these chances by 3.12 times (p<0.001). In addition, the presence of intense (p=0.01) or moderate (p=0.018) COVID-19 fears increased the odds of developing TMD-related pain symptoms by 2.47 and 1.84 times, respectively, in this population. CONCLUSION: The presence of painful TMD symptoms was possibly influenced by fear of COVID-19. This, in turn, was related to the presence of anxiety and depression symptoms reported by the target population of this study.

RESUMO JUSTIFICATIVA E OBJETIVOS: A pandemia de COVID-19 mostrou-se um provável agravante de respostas psicológicas como ansiedade e depressão. Este estudo teve como objetivo avaliar a correlação entre sintomas de ansiedade e depressão durante o período da pandemia de COVID-19 e a existência de sintomas associados à disfunção temporomandibular (DTM) em uma população universitária brasileira. MÉTODOS: Este estudo clínico epidemiológico e transversal avaliou as suas variáveis de interesse por meio dos questionários Escala de Medo do COVID-19, Escala Hospitalar de Ansiedade e Depressão (HADS-A e HADS-D), Critérios Diagnósticos para Disfunção Temporomandibular (DC/DTM) e Checklist de Comportamentos Orais (OBC). RESULTADOS: Ao todo, 373 participantes (sexo feminino = 273), com média de idade de 23,8±5,45 anos foram incluídos neste estudo. Ademais, 78,2% dos participantes com sintomas de ansiedade e 54,5% dos participantes com sintomas de depressão reportaram alto nível de parafunção relacionada à DTM (p<0,01). A presença de sintomas de ansiedade aumentou em 14,9 vezes as chances de desenvolvimento de um quadro de medo intenso do COVID-19 (p<0,001) e de um quadro de 3,5 vezes nas chances de desenvolvimento de medo moderado do COVID-19 (p<0,001). A presença de um medo intenso do COVID-19 aumentou em 17,15 vezes as chances de desenvolvimento de sintomas de ansiedade (p<0,001), enquanto a presença de um medo moderado aumentou essas chances em 3,12 vezes (p<0,001). Ademais, a presença de medos intensos (p=0,01) ou moderados (p=0,018) do COVID-19 aumentou 2,47 e 1,84 vezes, respectivamente, as chances de desenvolvimento de sintomatologias dolorosas relacionadas à DTM nessa população. CONCLUSÃO: A presença dos sintomas dolorosos da DTM foi possivelmente influenciada pelo medo do COVID-19. Isso, por sua vez, esteve relacionado à presença de sintomas de ansiedade e de depressão, reportados pela população-alvo deste estudo.

Impact of chronic orofacial pain of temporomandibular disorder and anxiety on the academic performance of dental students / Impacto da dor orofacial crônica da disfunção temporomandibular e ansiedade no desempenho acadêmico de estudantes de odontologia

Introduction: The presence of chronic pain and mood disorders can be related to the performance of intellectual and technical tasks. Objective: This study evaluated the correlation between anxiety level, chronic orofacial pain of temporomandibular disorders (TMD), and academic performance in dental students. Methods: One hundred ninety-five students (74 men and 121 women) answered the Spielberger's trait­state anxiety inventory to evaluate the level of anxiety; the Research Diagnostic Criteria for TMD (RDC/TMD) was used to analyze chronic orofacial pain of TMD, and the academic performance was evaluated through the average grade of all college subjects concluded by the students. Correlations between the presence of chronic orofacial pain of TMD, trait, and state anxiety levels, chronic pain grade (CPG), chronic pain intensity (CPI), and academic performance were tested using Pearson's correlation test. Results: The mean age of the students was 21.8 years (SD=2.3). Chronic TMD was observed in 37.5% of the students. The majority of students had moderate trait and state anxiety. A significant correlation was observed between traitanxiety level and CPG (r=0.148, p=0.044), and CPI (r=0.187, p=0.009). No significant correlation was found between academic grade and presence of chronic pain of TMD (r=0.041, p=0.571), trait (r=0.079, p=0.273) and state-anxiety (r=0.107, p=0.136). Conclusion: The CPG and CPI increase in participants with higher trait-anxiety levels, however, no significant correlation was found between academic performance and trait/state anxiety or chronic orofacial pain of TMD.

Use of silicone finger prostheses in amputee patients: An integrative review.

This study aimed to perform an integrative review of the literature on the use of silicone finger prostheses in amputee patients. Searches were performed in the PubMed, EMBASE, Web of Science, Scielo, and Cochrane Library databases until July 2021. Descriptors used in this article were: Silicone, finger, rehabilitation, and prosthesis. Clinical research and clinical reports on silicone finger prostheses, available in full and in English were included. Initially, 152 articles were identified. After establishing the inclusion/exclusion criteria, 23 studies were identified and constituted the final sample. Regarding the publication date of the included studies, 17.2% of them were published between 2012 and 2016. Most of the rehabilitations occurred in India (69.9%; n = 16), and the mean age of patients who used prostheses was 38.1 years. The level of scientific evidence of the included studies was IV and VI. Therefore, patients rehabilitated with silicone finger prostheses highlighted significant improvements in functional range of motion, restoration of self-esteem, advantages in psychological therapy, more pleasant social interaction, and changes in their quality of life.

Tratamento reabilitador de deformidade ocular: relato de caso / Treatment of eye deformity: a case report

O olho, responsável por um dos nossos cinco sentidos, é considerado a janela das nossas vidas, por onde observamos as paisagens, vivenciamos experiências e registramos as imagens. A ausência parcial ou total desse orgão pode acarretar problemas funcionais, estéticos, pessoais e sociais ao seu portador. Por se encontar na região da face, aréa considerada nobre para a identidade do indivíduo, a deformidade ocular acaba sendo muito constrangedora ao mesmo, dificultando sua interação com o próximo e afetando diretamente seus aspectos psicológicos. O objetivo deste trabalho é apresentar um relato de caso clínico de reabilitação com prótese ocular. Dessa forma foi realizado a seguinte sequência clínica: Moldagem da cavidade ocular, prova e ajustes da esclera artificial, pintura da íris artificial e instalação da prótese finalizada. O tratamento reabilitador possibilitou a restauração da harmonia facial e, com isso, devolveu a autoestima perdida do indivíduo, reinserindo-o à sociedade(AU)

The eye, responsible for one of our five senses, is considered the window of our lives, through which we observe the landscapes, experience and record the images. The partial or total absence of this organ can cause functional, aesthetic, personal and social problems to its bearer. Because it is found in the region of the face, which is considered noble for the identity of the individual, the eye deformity ends up being very embarrassing to it, making it difficult to interact with others and directly affecting their psychological aspects. The aim of this paper is to present a case report of rehabilitation with ocular prosthesis. Thus, the following clinical sequence was performed: Ocular cavity molding, testing and adjustments of the artificial sclera, painting of the artificial iris and installation of the finished prosthesis. The rehabilitative treatment enabled the restoration of facial harmony and, thus, returned the lost selfesteem of the individual, reinserting him to society(AU)

Anxiety and depression associated with pain and discomfort of temporomandibular disorders / Ansiedade e depressão associados à dor e desconforto das desordens temporomandibulares

ABSTRACT BACKGROUND AND OBJECTIVES: The etiology of temporomandibular disorders includes local and systemic factors, with an emphasis on the occlusal condition, trauma, parafunctional activities, and emotional stress, deriving signs of anxiety and depression. These, in turn, are more likely to develop in the university population, due to the changes required when entering university and the demand for good performance. This study aimed to evaluate the correlation between anxiety and depression symptoms and the existence of symptoms associated with temporomandibular disorders in university students. METHODS: An epidemiological, randomized, and cross-sectional clinical study conducted with 100 university students. The Research Diagnostic Criteria for Temporomandibular Disorders: Axis II and the Hospital Anxiety and Depression Scale questionnaires were applied. For the statistical analysis, the Chi-square tests and the Logistic regression model were used. RESULTS: The results of the present study consisted of responses from 79 women and 21 men, with a mean age of 19 years. The following associations were observed: general health status and depression; anxiety and pain in the face/ clicking; habit of grinding/clenching teeth when sleeping, and a "yes" answer to anxiety; discomfort with your teeth and depression; state of anguished/worried about all anxiety issues; depression and thoughts about death, difficulty in breathing and feeling discouraged about the future. CONCLUSION: From the data obtained, it was possible to conclude that the presence of symptoms related to anxiety and depression interfere with the painful symptoms of temporomandibular disorders in the addressed population.

RESUMO JUSTIFICATIVA E OBJETIVOS: A etiologia das disfunções temporomandibulares engloba fatores locais e sistêmicos, destacando-se a condição oclusal, trauma, atividades parafuncionais e estresse emocional, derivando-se os sinais de ansiedade e de depressão. Esses, por sua vez, apresentam maior propensão em se desenvolver na população universitária devido às mudanças exigidas ao ingressar na universidade e a cobrança por um bom desempenho. O objetivo deste estudo foi avaliar a correlação de sintomas de ansiedade e de depressão e a existência de sintomas associados às disfunções temporomandibulares em estudantes universitários. MÉTODOS: Realizou-se um estudo clínico epidemiológico, aleatório e transversal, cuja amostra foi constituída por 100 estudantes universitários, aos quais foram aplicados os questionários Research Diagnostic Criteria for Temporomandibular Disorders: Eixo II e o Hospital Anxiety and Depression Scale. Para a análise estatística foram utilizados os testes Qui-quadrado e o Modelo de regressão logística. RESULTADOS: Os resultados do presente estudo foram constituídos pelas respostas de 79 mulheres e 21 homens, com média de idade de 19 anos. Foram observadas as seguintes associações: estado de saúde geral e depressão, ansiedade e dor na face/estalos, hábito de ranger/apertar os dentes ao dormir, e resposta "sim" para ansiedade, desconforto com seus dentes e depressão; estado de angustiado/preocupado com todas as questões de ansiedade; depressão e pensamentos sobre morte, dificuldade em respirar e sentir-se desanimado sobre o futuro. CONCLUSÃO: A partir dos dados obtidos foi possível concluir que a presença de sintomas relativos à ansiedade e depressão interferem nos sintomas dolorosos das disfunções temporomandibulares da população abordada.

Reabilitação de paciente maxilectomizado por meio de prótese parcial removível obturadora palatina / Maxilectomized patient rehabilitation with removable partial palatal obturator prosthesis

Este trabalho tem como objetivo apresentar o protocolo de reabilitação por meio de prótese obturadora palatina, preconizado pela Universidade Federal de Alfenas (UNIFAL-MG), através do relato de um caso clínico de paciente maxilectomizada. A paciente apresentava comunicação buco-sinu-nasal e ausência parcial de dentes maxilares e mandibulares. Foi realizada moldagem de estudo, obtenção do modelo de trabalho, delineamento, planejamento das armações metálicas, preparos específicos, moldagem de trabalho e obtenção das armações; que foram provadas, os registros intermaxilares tomados, modelos montados em articulador e selecionados os dentes artificiais. Foi realizada prova estética e funcional com ênfase na pronúncia em função da existência de comunicação. Foi selecionada a cor da base e as próteses foram instaladas. Conclui-se que a prótese obturadora constitui um método satisfatório para a reabilitação de defeitos palatinos, pois proporcionou o vedamento da comunicação, proteção aos tecidos da área afetada, melhoras funcionais e estéticas, favorecendo a reintegração da paciente ao convívio social(AU)

The purpose of this study was the proposal of the clinical therapy and treatment of prosthetic patient under the Federal University of Alfenas (UNIFAL-MG), using a clinical report of a maxilectomized patient. The patient presented buco-sinu-nasal communication and partial absence of maxillary and mandibular teeth. It was made the study impression, obtaining the working model, designing, planning of metal frames, specific preparation, working impression and obtaining frames were carried out; which were tested, taken intermaxillary records, articulator mounted models and selected artificial teeth. Aesthetic and functional tests were performed with emphasis on pronunciation as a function of the existence of communication. The color of the base was selected and the prostheses were installed. It was concluded that the obturator prosthesis is a satisfactory method for the rehabilitation of palatal defects, since it provided the seal of communication, protection to the tissues of the affected area, functional and aesthetic improvements, favoring the reintegration of the patient to social interaction(AU)

Reabilitação de paciente anoftálmico bilateral por meio de prótese ocular: relato de caso / Rehabilitación de paciente anoftálmico bilateral por medio de prótesis ocular: relato de caso / Rehabilitation of bilateral anoftálmic patient by eye prosthesis: case report

Introdução: A prótese ocular visa à reparação aloplástica das perdas ou deformidades do bulbo ocular, tendo por objetivos recuperar a estética facial; prevenir o colapso e a deformidade palpebral; proteger a cavidade anoftálmica contra agressões por poeira, fumaça ou poluentes; restaurar a direção da secreção lacrimal e prevenir o acúmulo deste fluido na cavidade evitando as alterações assimétricas que progressivamente se instalam. Objetivo: relatar um caso clínico de reabilitação de paciente anoftálmico bilateral por meio de prótese ocular. Material e método: Para a realização do procedimento, a cavidade anoftálmica do paciente foi moldada com alginato. Esse molde foi incluído em mufla para obtenção da esclera artificial em Resina Acrílica Ocular Termicamente Ativada (RAOTA) cor N2. A esclera obtida foi provada no paciente e recebeu os ajustes necessários. Em seguida, foi realizada a centralização da pupila, feito o platô e pintada a íris artificial, que foi colada sobre o platô. Toda a superfície da esclera recebeu caracterização e o conjunto foi recoberto com RAOTA incolor. Por fim, a prótese recebeu acabamento, polimento, e foi instalada. O paciente foi instruído quanto ao uso e higienização. Resultado: Foi observado que após a instalação da prótese, a estética facial do indivíduo foi restaurada, o suporte palpebral restabelecido e o direcionamento lacrimal corrigido, além da reinserção do indivíduo ao convívio social. Conclusão: o tratamento reabilitador atingiu seu objetivo de restaurar a estética facial e foi de grande importância para o paciente, pois o mesmo resgatou a autoestima e pôde retornar ao convívio social sem constrangimentos(AU)

Introduction: The ocular prosthesis aims at the alloplastic repair of the losses or deformities of the ocular bulb, aiming to recover the facial esthetics; prevent collapse and eyelid deformity; protect the anophthalmic cavity against aggression from dust, smoke or pollutants; restore the direction of lacrimal secretion and prevent the accumulation of this fluid in the cavity avoiding the asymmetric changes that progressively install. Objective: to report a clinical case of rehabilitation of bilateral anophthalmic patient by ocular prosthesis. Material and method: To perform the procedure, the patient's anophthalmic cavity was cast with alginate. This template was included in muffle to obtain artificial sclera in thermally activated ocular acrylic resin (RAOTA) color N2. The obtained sclera was tested on the patient and received the necessary adjustments. Afterwards, the pupil was centralized, made the plateau and painted the artificial iris, which was glued on the plateau. The entire surface of the sclera was characterized and the whole was covered with colorless RAOTA. Finally, the prosthesis was finished, polished, and installed. The patient was instructed in the use and hygiene. Results: It was observed that after the installation of the prosthesis, the individual's facial aesthetics were restored, the eyelid support was restored and the corrected lacrimal targeting was performed, as well as the reinsertion of the individual into social interaction. Conclusion: the rehabilitation treatment reached its goal of restoring the facial aesthetics and was of great importance for the patient, since it rescued the self-esteem and was able to return to the social life without constraints(AU)

Introducción: La prótesis ocular se refiere a la reparación aloplástica de las pérdidas o deformidades del bulbo ocular, teniendo como objetivo recuperar la estética facial; prevenir el colapso y la deformidad palpebral; proteger la cavidad anoftálmica contra agresiones por polvo, humo o contaminantes; restaurar la dirección de la secreción lagrimal y prevenir la acumulación de este fluido en la cavidad evitando los cambios asimétricos que progresivamente se instalan. Objetivo: relatar un caso clínico de rehabilitación de paciente anoftálmico bilateral por medio de prótesis oculares. Material y método: Para la realización del procedimiento, la cavidad anoftálmica del paciente fue moldeada con alginato. Este molde fue incluido en mufla para la obtención de la esclera artificial en Resina Acrílica Ocular Termalmente Activada (RAOTA) color N2. La esclera obtenida fue probada en el paciente y recibió los ajustes necesarios. A continuación, se realizó la centralización de la pupila, hecha la meseta y pintada el iris artificial, que fue pegada sobre la meseta. Toda la superficie de la esclera recibió caracterización y el conjunto fue recubierto con RAOTA incoloro. Por último, la prótesis recibió el acabado, pulido, y se instaló. El paciente fue instruido en cuanto al uso e higienización. Resultado: Se observó que después de la instalación de la prótesis, la estética facial del individuo fue restaurada, el soporte palpebral restablecido y el direccionamiento lagrimal corregido, además de la reinserción del individuo a la convivencia social. Conclusión: el tratamiento rehabilitador alcanzó su objetivo de restaurar la estética facial y fue de gran importancia para el paciente, pues el mismo rescató la autoestima y pudo regresar a la convivencia social sin limitaciones(AU)

Reabilitação de paciente eviscerado por meio de prótese ocular: relato de caso / Rehabilitation of patient eviscerated with eye prosthesis: case report / Rehabilitación de paciente eviscerado por medio de prótesis ocular: reporte de caso

O objetivo do presente estudo é relatar um caso clínico de reabilitação de paciente eviscerado unilateral por meio de prótese ocular. Para tal, o paciente teve o remanescente de sua esclera moldado. Este molde foi incluído em mufla para a posterior obtenção da esclera artificial em Resina Acrílica Ocular Termicamente Ativada (RAOTA) incolor. A esclera obtida foi provada no paciente e recebeu os ajustes necessários. Em seguida, foi realizada a centralização da pupila, feito o platô e pintada a íris artificial, que foi colada sobre o platô. Toda a superfície da esclera recebeu caracterização e o conjunto foi recoberto com uma nova camada de RAOTA incolor. Por fim, a prótese recebeu acabamento, polimento, e foi instalada. O paciente foi instruído quanto ao uso e higienização. Foi observado que após a instalação da prótese, a estética facial do indivíduo foi restaurada, o suporte palpebral restabelecido e o indivíduo foi reinserido ao convívio social. A partir do exposto, conclui-se que o tratamento reabilitador atingiu seu objetivo de restaurar a estética facial e foi de grande importância para o paciente, pois o mesmo resgatou a autoestima perdida e pode retornar ao convívio social sem constrangimentos(AU)

The objective was to report a clinical case of rehabilitation of unilateral eviscerated patient through ocular prosthesis. To do this, the patient had his sclera molded with alginate. This mold was included in muffle for the posterior obtaining of the artificial sclera in Thermally Activated Ocular Acrylic Resin (TAOAR) colorless. The sclera obtained was proven in the patient and received the necessary adjustments. Then the pupil's centralization was conducted, made the plateau and painted the artificial iris, which was glued on the plateau. The entire surface of the sclera received characterization and the set was covered with colorless TAOAR. Finally, the prosthesis received finishing, polishing, and was installed. The patient was instructed as to use and sanitize. It was observed that after installing the prosthesis, the facial aesthetics of the individual was restored, the eyelid support restored and the obtaining of the reinsertion of the individual to social conviviality. From the foregoing, it is concluded that the rehabilitation treatment has reached its objective of restoring the facial aesthetic and was of great importance to the patient, as the same rescued the lost self-esteem and could return to social conviviality without constraints(AU)

El objetivo del presente estudio es relatar un caso clínico de rehabilitación de paciente eviscerado unilateral por medio de prótesis oculares. Para ello, el paciente tuvo el remanente de su esclera moldeada. Este molde fue incluido en mufla para la posterior obtención de la esclera artificial en Resina Acrílica Ocular Termalmente Activada (RAOTA) incolora. La esclera obtenida fue probada en el paciente y recibió los ajustes necesarios. A continuación, se realizó la centralización de la pupila, hecha la meseta y pintada el iris artificial, que fue pegada sobre la meseta. Toda la superficie de la esclera recibió caracterización y el conjunto fue recubierto con una nueva capa de RAOTA incoloro. Por último, la prótesis recibió el acabado, pulido, y se instaló. El paciente fue instruido en cuanto al uso e higienización. Se observó que después de la instalación de la prótesis, la estética facial del individuo fue restaurada, el soporte palpebral restablecido y el individuo fue reinsertado a la convivencia social. A partir de lo expuesto, se concluye que el tratamiento rehabilitador alcanzó su objetivo de restaurar la estética facial y fue de gran importancia para el paciente, pues el mismo rescató la autoestima perdida y puede retornar a la convivencia social sin limitaciones(AU)

Effect of different methods of hygiene on the color stability of extrinsically pigmented facial silicone

Evaluate the color stability of facial silicone pigmented extrinsically under the influence of the hygiene process. Methods: 160 samples were prepared and divided into 8 groups (n = 20) according to the pigmentation technique used: Group 1: Colorless silicone; Group 2: Pigmented exclusively with oil ink; Group 3: Pigmented with oil ink + opacifier; Group 4: Colorless, applying Prime; Group 5: Pigmented with oil ink covered with Prime; Group 6: Pigmented with oil ink + opacifier and covered with Prime; Group 7: Pigmented with oil ink diluted in Prime; Group 8: Pigmented with oil ink + opacifier diluted in Prime. Then the samples were distributed into two subgropus (n=10): 1: neutral soap and 2: 1% hypochlorite solution. The color readings occurred in the initial period and 60 days after the hygiene procedures. For this, it was used a spectrophotometer reflection and CIE-Lab program. The data was tabulated and submitted to analysis of variance (ANOVA) followed by Tukey test (p <0.05). Results: The groups of samples disinfected with soap showed significantly lower color change values than those presented by the samples disinfected with hypochlorite. The best results were presented by the group of samples pigmented with oil ink diluted in prime and sanitized with neutral soap (ΔE=1.21, without opacifier and ΔE=0.82, with opacifier). Conclusions: The association of oil ink diluted in prime and hygiene technique with soap promotes the lower color change of facial silicone pigmented extrinsically

Biocompatibility of primers and an adhesive used for implant-retained maxillofacial prostheses: An in vitro analysis.

STATEMENT OF PROBLEM: Implant-retained maxillofacial prostheses should be biocompatible, regardless of the primers and adhesives used to bond the acrylic resin and facial silicone. The authors are unaware of any study evaluating the influence of these primers and adhesives on the biocompatibility of maxillofacial prostheses. PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic effect of primers and an adhesive used to bond acrylic resin and facial silicone during the fabrication of implant-retained maxillofacial prostheses. MATERIAL AND METHODS: Twenty-eight circular specimens made of resin and silicone were fabricated, either bonded or nonbonded with primer and adhesive. The specimens were divided into 7 groups: resin; silicone; resin+silastic medical adhesive type A+silicone; resin+DC 1205 primer silicone; resin+Sofreliner primer+silicone; resin+DC 1205 primer+silastic medical adhesive type A+silicone; and resin+Sofreliner primer+silastic medical adhesive type A+silicone. Eluates of the materials tested were prepared by setting 4 specimens of each experimental group in Falcon tubes with medium and incubating at 37°C for 24 hours. The eluate cytotoxicity was evaluated by an assay of survival/proliferation ((3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide [MTT] test) in cultures of human keratinocytes. The levels of IL1, IL6, TNFα, and the chemokine MIP-1α were evaluated by enzyme-linked immunosorbent assay. The mRNA expressions for MMP-9, TGF-ß, and collagen type IV were analyzed by the real time polymerase chain reaction. Data were submitted to analysis of variance with Bonferroni post hoc tests (α=.05). RESULTS: An increased cell proliferation was observed for the RAS group, with statistically significant differences (P<.001) compared with the unstimulated group. The RDCpS group showed the highest IL6 concentration values (P<.001). No significant statistical difference was found in the relative quantification of mRNA for collagen type IV, MMP9, or TGFß between the groups (P>.05). CONCLUSIONS: The RAS group showed the highest cell proliferation percentage, while the RDCpS group exhibited the highest IL6 concentration values. No detectable levels of IL1ß, TNF α, or CCL3/MIP1α were observed. The tested materials showed no toxic effects on the HaCaT cell line.

Epidemiological Data and Survival Rate of Removable Partial Dentures.

INTRODUCTION: The use of removable partial denture (RPD) is considered as low-cost and common treatment option to rehabilitate edentulous areas. AIM: This study aimed to investigate the epidemiological data of patients rehabilitated with removable partial denture (RPD) in order to assess treatment survival rate and failures. MATERIALS AND METHODS: Epidemiological data and medical records of patients treated with RPD between 2007 and 2012 at the RPD discipline of a Brazilian University (Aracatuba Dental School- UNESP) were evaluated as well as dental records of patients who underwent RPD treatments (fabrication or repairs) between 2000 and 2010. Factors such as gender, age, presence of systemic disease, main complaint, edentulous arch, period and cause of denture replacement and the prosthesis characteristics were recorded. The chi-square test was used to assess the differences between the variables and the Kaplan Meyer to assess the survival of the RPDs evaluated. RESULTS: A total of 324 maxillary RPD and 432 mandibular RPD were fabricated. Most of the patients were women aging 41 to 60-year-old. The number of mandibular RPD Kennedy class I (26%) was statistically higher for the maxillary arch (p<.05). There was no association between main complaint to gender or the presence of systemic disease. The lingual plate was the most common major connector used in the mandible (32%). The main reason for altering the design of replaced RPDs were changes during treatment plan. CONCLUSION: The number of patients who require RPD is large; most of RPDs are Kennedy Class I. A good treatment plan is very important for achieving a positive treatment outcome, and it is strictly related to the survival rate.

Reabilitação com prótese total imediata: relato de caso / Rehabilitation with immediate dentures: case report

Quando extrações dentais múltiplas são indicadas, os pacientes costumam relatar receio quanto às alterações estéticas e fonéticas que sofrerão em decorrência do tratamento odontológico, o que leva muitos indivíduos a recusarem se a submeter a tal procedimento. Uma alternativa de tratamento para situações como esta é a instalação de próteses imediatamente após o ato cirúrgico, evitando o possível constrangimento por parte do paciente em se expor ao convívio social com ausência de elementos dentais. O presente estudo teve por objetivo revisar a literatura a respeito da conceituação, vantagens, desvantagens, indicações, contraindicações, etapas para confecção, cuidados pré e pós- instalação de Próteses Totais Imediatas, bem como relatar um caso clínico de instalação de Próteses Totais, sendo uma convencional (arco maxilar) e outra imediata (arco mandibular), mostrando aos cirurgiões-dentistas, a importância dessas peças protéticas quanto a estética e função ofertadas aos pacientes

When multiple teeth extractions are indicated, patients often report misgivings about the aesthetic and phonetic changes that they will suffer as a result of this dental treatment, leading many individuals to refuse to undergo such a procedure. An alternative treatment for similar situations is the installation of dental prosthesis immediately after surgery in order to avoid possible embarrassment from the patients in exposing themselves to the social life with the absence of dental elements. This study aimed to review the literature regarding the conceptualization, advantages, disadvantages, indications, contraindications, steps for preparation, before and after installation of Immediate Dentures. This study also reported a case of Dentures installation, a conventional (maxillary) and an immediate (mandibular arch), showing dentists the importance of these prosthetic pieces for both esthetic and function benefits offered to patients

Color stability of the artificial iris button in an ocular prosthesis before and after acrylic resin polymerization.

This study investigated the effects of the ocular prosthesis fabrication technique and the paint on the color stability of the artificial iris button before and after polymerization of the colorless resin. Sixty samples simulating artificial eyes were made, including 30 samples with blue- and 30 samples with sepia-colored artificial irises. Ten samples were made by each of three techniques (i.e., conventional, prefabricated cap, and inverted painting) for each color. The color of the artificial iris button was measured through reflection spectrophotometry by the CIE L*a* b* system before and after polymerization of the prosthesis (colorless resin). Data were evaluated by analysis of variance (ANOVA) and the Tukey honestly significant different (HSD) tests (α=0.05). All of the samples exhibited color changes. Samples made by the prefabricated cap technique exhibited the highest color change values for both colors (P<.05). The inverted painting technique exhibited the lowest color change values for the sepia-colored artificial irises (P<.05). Sepia-colored artificial irises exhibited lower color change values than blue-colored artificial irises for both techniques (P<.05). In conclusion, the technique used to obtain the ocular prosthesis significantly affected the stability of the artificial iris color for each color tone and the conventional technique and the painting technique inverted were considered clinically acceptable for sepia color.

The Effect of Disinfection Techniques on the Flexural Strength of Thermopolymerisable Acrylic Resins With or Without Pigment Addition.

OBJECTIVES: The aim of this study was to assess the flexural strength of two brands of thermopolymerisable acrylic resins (Onda Cryl, Artigos Odontológicos Clássico Ltda, São Paulo, SP, Brazil; and Lucitone 550, Dentsply, York, PA, USA) with varying concentrations of pigment (Poli-Côr, Artigos Odontológicos Clássico Ltda, São Paulo, SP, Brazil) under the influence of thermocycling, storage and disinfection. MATERIAL AND METHODS: A total of 210 samples were manufactured (105 for each acrylic resin brand), with dimensions of 64 x 10 x 3.3 mm. The samples were divided into 30 subgroups (n = 7) according to the proportion of pigment used (without pigment, 3% and 7%), the assessment period (initial or thermocycling for 2000 cycles) and disinfection method (immersion in 1% sodium hypochlorite, (Apothicário, Araçatuba, SP, Brazil), microwave energy or immersion in alkaline peroxide (Efferdent, Pfizer, Morris Plains, NJ, USA). The samples were submitted to the flexural strength test before and after thermocycling, and after storage with disinfection. The disinfection process was performed every 3 days, for 60 days. Data were submitted to analysis of variance (ANOVA) and Tukey test (p < 0.05). RESULTS: The factors that provided statistical alteration in flexural strength values were resin type and assessment period. The Onda Cryl resin and the period after disinfection (126 ± 25 MPa) exhibited the higher values of flexural strength. CONCLUSION: Following disinfection, Onda-Cryl resin exhibited the highest values of flexural strength. All the samples obtained are considered clinically acceptable.

Photoelastic stress analysis in prosthetic implants of different diameters: mini, narrow, standard or wide.

PURPOSE: This study investigated the biomechanical behavior of screwed partial fixed prosthesis supported by implants with different diameters (2.5 mm; 3.3 mm and 3.75 mm) by using a photoelastic analysis. MATERIALS AND METHODS: Six photoelastic models were fabricated in PL-2 resin as single crowns or splinted 3-unit piece. Models were positioned in a circular polariscope and 100-N axial and oblique (45 degrees) loads were applied in the occlusal surface of the crowns by using a universal testing machine (EMIC). The stresses were photographically recorded and qualitatively analyzed using a software (Adobe Photoshop). RESULTS: Under axial loading, the number of fringes was inversely proportional to the diameter of the implants in the single crown models. In the splinted 3-unit piece, the 3.75-mm implant promoted lower number of fringes regardless of loading area application. Under oblique loading, a slight increase of fringes number was observed for all groups. CONCLUSION: The standard implant diameter promoted better stress distribution than the narrow and mini diameter implants. Additionally, the splinted crowns showed a more uniform stress distribution.

Stress analysis in oral obturator prostheses, part II: photoelastic imaging.

In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC--splinted implants with a bar connected to two centrally placed O-rings, and BOD--splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.

Use of stress analysis methods to evaluate the biomechanics of oral rehabilitation with implants.

Because the biomechanical behavior of dental implants is different from that of natural tooth, clinical problems may occur. The mechanism of stress distribution and load transfer to the implant/bone interface is a critical issue affecting the success rate of implants. Therefore, the aim of this study was to conduct a brief literature review of the available stress analysis methods to study implant-supported prosthesis loading and to discuss their contributions in the biomechanical evaluation of oral rehabilitation with implants. Several studies have used experimental, analytical, and computational models by means of finite element models (FEM), photoelasticity, strain gauges and associations of these methods to evaluate the biomechanical behavior of dental implants. The FEM has been used to evaluate new components, configurations, materials, and shapes of implants. The greatest advantage of the photoelastic method is the ability to visualize the stresses in complex structures, such as oral structures, and to observe the stress patterns in the whole model, allowing the researcher to localize and quantify the stress magnitude. Strain gauges can be used to assess in vivo and in vitro stress in prostheses, implants, and teeth. Some authors use the strain gauge technique with photoelasticity or FEM techniques. These methodologies can be widely applied in dentistry, mainly in the research field. Therefore, they can guide further research and clinical studies by predicting some disadvantages and streamlining clinical time.

Effect of beverages and mouthwashes on the hardness of polymers used in intraoral prostheses.

PURPOSE: The mechanical properties of acrylic resins used in intraoral prostheses may be altered by frequent exposure to liquids such as beverages and mouthwashes. This study aimed to evaluate the effect of thermocycling and liquid immersion on the hardness of four brands of acrylic resins commonly used in removable prostheses (Onda Cryl, QC-20, Clássico, Lucitone). MATERIALS AND METHODS: For each brand of resin, seven specimens were immersed in each of six solutions (coffee, cola, red wine, Plax-Colgate, Listerine [LI], Oral B), and seven more were placed in artificial saliva (control). The hardness was tested using a microhardness tester before and after 5000 thermocycles and after 1, 3, 24, 48, and 96 hours of immersion. The results were analyzed using three-way repeated-measures ANOVA and Tukey's test (p < 0.05). RESULTS: The hardness of the resins decreased following thermocycling and immersion in the solutions. Specimens immersed in cola and wine exhibited significant decreases in hardness after immersion for 96 hours, although the greatest significant decrease in hardness occurred in specimens immersed in LI. However, according to American Dental Association specification 12, the Knoop hardness of acrylic resins for intraoral prostheses should not be below 15. Thus, the median values of superficial hardness observed in most of the acrylic resins in this study are considered clinically acceptable. CONCLUSIONS: The microhardness of polymers used for intraoral prostheses decreases following thermocycling. Among specimens immersed in beverages, those immersed in cola or wine experienced the greatest decrease in microhardness. Immersion of acrylic resins in LI significantly decreased the microhardness in relation to the initial value. Among the resins assessed, QC-20 exhibited the lowest initial hardness.

Fabrication techniques for ocular prostheses--an overview.

The goals of treatment with ocular prostheses are to restore facial aesthetics and self-esteem to anophthalmic patients. Fabricated in acrylic resin, artificial eyes should be aesthetically pleasing, scratch-resistant, and adequately polished. Use of a prosthesis without such characteristics can lead to psychological damage, as well as infection and inflammation due to the accumulation of microorganisms and other substances on an irregularly shaped prosthesis. The present literature review describes the different techniques for fabricating ocular prostheses. Reproduction of the iris color and color stability are important factors that promote adequate aesthetics. The fabrication of an individual ocular prosthesis in acrylic resin provides satisfactory aesthetic results because the impression process establishes the defect contour. Additionally, the iris and sclera can be individually characterized. As the techniques, materials, and manufacturing methods for ocular prostheses continue to evolve, the aesthetics and functionality of prostheses will also improve.