Laypersons' Esthetic Perception of Different Dentogingival Characteristics Based on Smile Dynamics: Cross-Sectional Study.

This study aimed to evaluate laypersons' esthetic perception of different dentogingival characteristics based on smile dynamics. Six voluntary models were selected, with only one presenting dentogingival characteristics within esthetic standards: white teeth, good alignment, and adequate gingival contour. Two videos were then produced. One video focused on the mouth, whereas the other focused on the entire face of the model, to ensure that the dynamics of the smile could be evaluated. For the evaluation, 200 laypeople were asked to rank the models from first to sixth place in their order of preference. Laypeople were required to justify their reasons for choosing the first and last places. The obtained data were subjected to descriptive and inferential statistical analyses. The results showed that smile and face dynamics influenced the perception of dentogingival characteristics and facial esthetics. No significant changes were observed. However, a gummy smile accompanied by dental alterations was observed in the video of the mouth and was masked by the facial set exposed in the video of the face. A diastema between the central incisors was decisive for negative evaluation of both the mouth and face. The standard model was rated as the most pleasing. Smiles and facial dynamics influence the perception of dentogingival characteristics. Smile and facial dynamics influence the perception of dentogingival alterations among Brazilian laypeople. Diastema is an alteration that interferes with the isolated evaluation of the lower third of the face and the facial set.

Influence of the geometry of the screwdriver-screw connection on the reverse torque of UCLA screws.

The aim of this study was to evaluate the influence of the geometry of the screwdriver-screw connection on the reverse torque of UCLA screws after repeated cycles of tightening and loosening in an implant-supported prosthesis. Thirty sets of external hex titanium implants, UCLA abutments, and UCLA abutment screws were divided into 3 experimental groups (n = 10). In the square group, the implant and UCLA abutment system were mounted in an upright position using a screw with a square screwdriver-screw connection. In the hexagonal group, the implant and UCLA abutment system were mounted in an upright position using a screw with a hexagonal screwdriver-screw connection. In the hexalobular group, the implant and UCLA abutment system were mounted at 70° using a dynamic UCLA abutment and screw with a hexalobular screwdriver-screw connection. Ten alternating torque-reverse torque cycles were applied to each screw using a screwdriver fixed at the end of a digital torque meter. The screws with a square connection resulted in less loss of reverse torque than the other types. Screws with a hexagonal connection showed a statistically significant loss of torque initially but remained constant for the remaining cycles. For the screws with a hexalobular connection, the loss of torque was greater, and substantial deformation of the plastic in the microstructure was noted. The screwdriver-screw connection geometry had a direct influence on the reverse torque of UCLA screws, and the initial reverse torque of the abutment screws with a square connection was greater than that of the hexagonal and hexalobular designs.

Assessment of the aesthetic impact and quality of life of home dental bleaching in adult patients.

BACKGROUND: This study aimed to evaluate the impact of home bleaching with 10% carbamide peroxide on the quality of life and aesthetic perception of patients. MATERIAL AND METHODS: A total of 107 patients between 18 and 38 years of age with good oral and general health and at least one anterior tooth in color A2 or darker were selected. Patients who previously underwent any type of bleaching procedures were excluded. All patients received a home bleaching treatment with 10% carbamide peroxide. Before beginning the bleaching treatment, the selected patients responded a form with the Oral Health Impact Profile short form (OHIP-14) and Oral Aesthetic Subjective Impact Scale (OASIS) questionnaire. One month after the bleaching treatment, the patients answered the same questionnaires again. The mean ΔE after bleaching was obtained for the canines and lateral and central incisors. The OHIP-14 and OASIS data were measured for the total sample before and after bleaching using the Wilcoxon signed-rank test with a 5% significance level. RESULTS: The effectiveness of whitening by significant color variation was observed in all groups of teeth with less variation in ΔE for central incisors. Comparing before and after bleaching, there was no significant difference in impact for any of the seven domains and total OHIP-14 scores, although a decrease was observed in the discomfort and psychological disability domains. As for the self-perception of dental aesthetics, measured by the OASIS, there was also no significant difference for all the items evaluated; however, it was possible to observe an increase in "concern with dental appearance" after bleaching. CONCLUSIONS: Home bleaching with 10% carbamide peroxide did not have a significant impact on patients' quality of life and aesthetic perception, although there was a decrease in the domain of psychological discomfort and an increase in concerns about dental appearance. Key words:Tooth Bleaching, quality of life, self-perception, dental aesthetics.

Retention of cemented zirconia copings on TiBase abutments.

This study evaluated the influence of resin cements and glass ionomers on tensile strength and types of failure of zirconia copings cemented on titanium base abutments. Forty-two samples were prepared, which were formed by a Cone Morse implant, a titanium abutment with the fixing screw, and a zirconia structure made using a CAD/CAM system. The samples (n = 42) were randomly distributed according to the cementing agent: resin-modified glass ionomer cement (RelyX Luting 2), self-adhesive resin cement (RelyX U200), and self-curing resin cement (Multilink N). After cementation of the copings, half of the samples from each group (n = 7) were randomly selected and subjected to thermocycling (5000 cycles). A tensile load test was performed on a universal testing machine until failure occurred (1 mm). In addition, the type of failure was analyzed using the two-way analysis of variance test and Tukey's post-hoc test (α = 0.05). Lower tensile load was observed for the glass ionomer cement (p < 0.001) regardless of the evaluation period. After thermocycling, a significant reduction in tensile load values was verified for both evaluated cements (p = 0.047). For the resin cements, failures were predominantly of the screw fracture type (82.1%) already with the use of glass ionomer cement, and 28.5% of the failures were of an adhesive type between the zirconia coping and the cement. Resin cements have better stability under tensile load compared to resin glass ionomers when cementing zirconia copings on titanium base abutments.

Este estudo avaliou influência dos cimentos resinosos e a base de ionômero de vidro na resistência à tração e os tipos de falhas de copings de zircônia cimentados sobre pilares TiBase. Foram confeccionadas 42 amostras, sendo estas formadas por implante cone morse, pilar de titânio (TiBase) com o parafuso de fixação e uma estrutura de zircônia (coping de Zr) confeccionado através do sistema CAD/CAM. As amostras (n =42) foram aleatoriamente distribuídas de acordo com o agente de cimentação: (cimento de ionômero de vidro modificado por resina [RelyXTMLuting2]; cimento resinoso autoadesivo [RelyXTM U200] e cimento resinoso autopolimerizavel (Multilink® N). Após cimentação dos copings, metade das amostras de cada grupo (n = 7) foram aleatoriamente selecionadas e submetidas a termociclagem (5000 ciclos). O Teste de resistência a tração foi realizado em uma máquina de ensaio universal, até que ocorresse a falha (1 mm/min). Adicionalmente, o tipo de falha foi analizado. Os dados foram analisados pelo teste ANOVA two-way e post teste de Tukey's (α = 0.05). Menor média de resistência a tração foi observada para o cimento de ionômero de vidro (p < 0,001) independente do período de avaliação. Após a termociclagem, foi verificada uma redução significativa nos valores de resistênca a tração, para os cimentos avaliados (p=0,047). Para os cimentos resinosos, as falhas foram predominantemente do tipo fratura do parafuso (82,1%) já com o uso do cimento de ionômero de vidro, 28,5% das falhas foram de tipo adesiva entre o coping de Zr e o cimento. Cimentos resinosos apresentam melhor estabilidade na resistência a tração em comparação a ionmeros de vidro resinosos na cimentação de copings de zircônia sobre pilares TiBase.

Retention of cemented zirconia copings on TiBase abutments / Retenção de copings de zirconia cimentados sobre pilares tibase

ABSTRACT This study evaluated the influence of resin cements and glass ionomers on tensile strength and types of failure of zirconia copings cemented on titanium base abutments. Forty-two samples were prepared, which were formed by a Cone Morse implant, a titanium abutment with the fixing screw, and a zirconia structure made using a CAD/CAM system. The samples (n = 42) were randomly distributed according to the cementing agent: resin-modified glass ionomer cement (RelyX Luting 2), self-adhesive resin cement (RelyX U200), and self-curing resin cement (Multilink N). After cementation of the copings, half of the samples from each group (n = 7) were randomly selected and subjected to thermocycling (5000 cycles). A tensile load test was performed on a universal testing machine until failure occurred (1 mm). In addition, the type of failure was analyzed using the two-way analysis of variance test and Tukey's post-hoc test (α = 0.05). Lower tensile load was observed for the glass ionomer cement (p < 0.001) regardless of the evaluation period. After thermocycling, a significant reduction in tensile load values was verified for both evaluated cements (p = 0.047). For the resin cements, failures were predominantly of the screw fracture type (82.1%) already with the use of glass ionomer cement, and 28.5% of the failures were of an adhesive type between the zirconia coping and the cement. Resin cements have better stability under tensile load compared to resin glass ionomers when cementing zirconia copings on titanium base abutments.

RESUMO Este estudo avaliou influência dos cimentos resinosos e a base de ionômero de vidro na resistência à tração e os tipos de falhas de copings de zircônia cimentados sobre pilares TiBase. Foram confeccionadas 42 amostras, sendo estas formadas por implante cone morse, pilar de titânio (TiBase) com o parafuso de fixação e uma estrutura de zircônia (coping de Zr) confeccionado através do sistema CAD/CAM. As amostras (n =42) foram aleatoriamente distribuídas de acordo com o agente de cimentação: (cimento de ionômero de vidro modificado por resina [RelyXTMLuting2]; cimento resinoso autoadesivo [RelyXTM U200] e cimento resinoso autopolimerizavel (Multilink® N). Após cimentação dos copings, metade das amostras de cada grupo (n = 7) foram aleatoriamente selecionadas e submetidas a termociclagem (5000 ciclos). O Teste de resistência a tração foi realizado em uma máquina de ensaio universal, até que ocorresse a falha (1 mm/min). Adicionalmente, o tipo de falha foi analizado. Os dados foram analisados pelo teste ANOVA two-way e post teste de Tukey's (α = 0.05). Menor média de resistência a tração foi observada para o cimento de ionômero de vidro (p < 0,001) independente do período de avaliação. Após a termociclagem, foi verificada uma redução significativa nos valores de resistênca a tração, para os cimentos avaliados (p=0,047). Para os cimentos resinosos, as falhas foram predominantemente do tipo fratura do parafuso (82,1%) já com o uso do cimento de ionômero de vidro, 28,5% das falhas foram de tipo adesiva entre o coping de Zr e o cimento. Cimentos resinosos apresentam melhor estabilidade na resistência a tração em comparação a ionmeros de vidro resinosos na cimentação de copings de zircônia sobre pilares TiBase.

Cytokine signatures of Plasmodium vivax infection during pregnancy and delivery outcomes.

Plasmodium vivax malaria is a neglected disease, particularly during pregnancy. Severe vivax malaria is associated with inflammatory responses but in pregnancy immune alterations make it uncertain as to what cytokine signatures predominate, and how the type and quantity of blood immune mediators influence delivery outcomes. We measured the plasma concentrations of a set of thirty-one biomarkers, comprising cytokines, chemokines and growth factors, in 987 plasma samples from a cohort of 572 pregnant women from five malaria-endemic tropical countries and related these concentrations to delivery outcomes (birth weight and hemoglobin levels) and malaria infection. Samples were collected at recruitment (first antenatal visit) and at delivery (periphery, cord and placenta). At recruitment, we found that P. vivax-infected pregnant women had higher plasma concentrations of proinflammatory (IL-6, IL-1ß, CCL4, CCL2, CXCL10) and TH1-related cytokines (mainly IL-12) than uninfected women. This biomarker signature was essentially lost at delivery and was not associated with birth weight nor hemoglobin levels. Antiinflammatory cytokines (IL-10) were positively associated with infection and poor delivery outcomes. CCL11 was the only biomarker to show a negative association with P. vivax infection and its concentration at recruitment was positively associated with hemoglobin levels at delivery. Birth weight was negatively associated with peripheral IL-4 levels at delivery. Our multi-biomarker multicenter study is the first comprehensive one to characterize the immunological signature of P. vivax infection in pregnancy thus far. In conclusion, data show that while TH1 and pro-inflammatory responses are dominant during P. vivax infection in pregnancy, antiinflammatory cytokines may compensate excessive inflammation avoiding poor delivery outcomes, and skewness toward a TH2 response may trigger worse delivery outcomes. CCL11, a chemokine largely neglected in the field of malaria, emerges as an important marker of exposure or mediator in this condition.

Blood cytokine, chemokine and growth factor profiling in a cohort of pregnant women from tropical countries.

The immune status of women changes during and after pregnancy, differs between blood compartments at delivery and is affected by environmental factors particularly in tropical areas endemic for multiple infections. We quantified the plasma concentration of a set of thirty-one TH1, TH2, TH17 and regulatory cytokines, pro-inflammatory and anti-inflammatory cytokines and chemokines, and growth factors (altogether biomarkers), in a cohort of 540 pregnant women from five malaria-endemic tropical countries. Samples were collected at recruitment (first antenatal visit), delivery (periphery, cord and placenta) and postpartum, allowing a longitudinal analysis. We found the lowest concentration of biomarkers at recruitment and the highest at postpartum, with few exceptions. Among them, IL-6, HGF and TGF-ß had the highest levels at delivery, and even higher concentrations in the placenta compared to peripheral blood. Placental concentrations were generally higher than peripheral, except for eotaxin that was lower. We also compared plasma biomarker concentrations between the tropical cohort and a control group from Spain at delivery, presenting overall higher biomarker levels the tropical cohort, particularly pro-inflammatory cytokines and growth factors. Only IL-6 presented lower levels in the tropical group. Moreover, a principal component analysis of biomarker concentrations at delivery showed that women from Spain grouped more homogenously, and that IL-6 and IL-8 clustered together in the tropical cohort but not in the Spanish one. Plasma cytokine concentrations correlated with Plasmodium antibody levels at postpartum but not during pregnancy. This basal profiling of immune mediators over gestation and in different compartments at delivery is important to subsequently understand response to infections and clinical outcomes in mothers and infants in tropical areas.

Avaliação do impacto do clareamento dental na qualidade de vida de pacientes adultos / Evaluation of the impact of dental bleaching on the quality of life of adult patients / Evaluación del impacto del blanqueamiento dental en la calidad de vida de pacientes adultos

Objetivo: este trabalho teve como objetivo avaliar o impacto do clareamento dental profissional na qualidade de vida de pacientes. Método: foram selecionados 40 pacientes em tratamento de clareamento dental de consultório com peróxido de hidrogênio a 35%, e que atenderam a critérios específicos de inclusão e exclusão. Para determinar o impacto do clareamento dental na qualidade de vida dos pacientes, foi aplicado o questionário OHIP-14, contendo 14 perguntas divididas em 7 domínios avaliando os aspectos: limitação funcional, dor física, desconforto psicológico, incapacidade física, incapacidade psicológica, incapacidade social e desvantagem social, antes do inicio e 30 dias após finalizado o clareamento dental. Resultados: os escore total do Ohip-14 e dos domínios foram comparados nos dois momentos (antes e após o clareamento), por meio do teste de Wilcoxon, que não mostrou diferencia significante (p<0.05%), para todos os domínios, com exceção do domínio desconforto psicológico no qual foi observado uma diminuição de impacto após o procedimento clareador. Conclusão: o OHIP 14 mostrou que o procedimento clareador favorece a estética dos indivíduos, melhorando sua qualidade de vida e, diminuindo assim, o estresse frente aos impactos psicológicos em sociedade.(AU)

Objective: this study aimed to evaluate the impact of professional tooth bleaching on patients' quality of life. Methods: a total of 40 patients were selected in the treatment of office tooth bleaching with 35% hydrogen peroxide, which met specific inclusion and exclusion criteria. To determine the impact of dental bleaching on patients' quality of life, the OHIP-14 questionnaire was used, containing 14 questions divided into 7 domains assessing aspects: functional limitation, physical pain, psychological discomfort, physical incapacity, psychological incapacity, social incapacity and social disadvantage, before the beginning and 30 days after dental bleaching was completed. Results: the total Ohip-14 score and domains were compared at both time points (before and after bleaching) using the Wilcoxon test, which showed no significant difference (p <0.05%) for all domains, except for the psychological discomfort domain in which a reduction in impact was observed after the bleaching procedure. Conclusion: OHIP-14 showed that the bleaching procedure favors the aesthetics of individuals, improving their quality of life, thus reducing the stress on the psychological impacts on society.(AU)

Objetivo: este trabajo tuvo como objetivo evaluar el impacto del blanqueamiento dental profesional en la calidad de vida de pacientes. Métodos: se seleccionaron 40 pacientes en tratamiento de blanqueamiento dental de consultorio con peróxido de hidrógeno al 35%, y que atendieron a criterios específicos de inclusión y exclusión. Para determinar el impacto del blanqueamiento dental en la calidad de vida de los pacientes, se aplicó el cuestionario OHIP-14, conteniendo 14 preguntas divididas en 7 áreas evaluando los aspectos: limitación funcional, dolor físico, incomodidad psicológica, incapacidad física, incapacidad psicológica, incapacidad social y desventaja social, antes del inicio y 30 días después de finalizado el blanqueamiento dental. Resultados: los puntajes totales del Ohip-14 y de los dominios fueron comparados en los dos momentos (antes y después del blanqueamiento), por medio de la prueba de Wilcoxon, que no mostró diferencia significante (p <0.05%), para todos los dominios, excepción del dominio de incomodidad psicológica donde se observó una disminución de impacto después del procedimiento blanqueador. Conclusión: el OHIP-14 mostró que el procedimiento blanqueador, favorece la estética de los individuos mejorando, su calidad de vida disminuyendo así el estrés frente a los impactos psicológicos en sociedad.(AU)

Dentogingival Alterations and Their Influence on Facial and Smile Attractiveness.

AIM: This study aimed to evaluate the influence of labial and dentogingival characteristics on facial and smile attractiveness. MATERIALS AND METHODS: Four different close-up photographs each of six women models with different labial and dentogin-gival characteristics were obtained. One of the models was considered standard. Photographs were arranged in an album were evaluated by 100 laypersons, and 30 dentists who ranked each close-up of the models from according to the degree of attractiveness from first to sixth place, with first being the model considered most attractive and justified the reasons for choosing. RESULTS: The standard model received the best scores for both lips (7.75) and face (5.18). Medium-sized lips were preferred (p < 0.05), and the smile positively or negatively interfered with esthetic perception depending on the dentogingival alteration present. Diastema was the alteration that had the greatest negative influence. CONCLUSION: Not all dentogingival alterations interfere with esthetic evaluation. The lips are not decisive in facial attractiveness. Attraction is assessed significantly differently by laypeople than by dentists. The smile directly influences the analysis of facial beauty. CLINICAL SIGNIFICANCE: Dentogingival alterations may be imperceptible, especially when evaluating the facial joint, so its correction will not always be necessary.

Regeneração óssea na região posterior da maxila para instalação de implantes dentários / Regeneración del hueso en la región posterior del maxilar para la instalación de implantes dentales / Bone regeneration in the posterior maxillary region for installation of dental implants

Introdução: regeneração óssea da região posterior da maxila, é um recurso importante para possibilitar a localização correta dos implantes e assim permitir uma adequada reabilitação protética. Várias técnicas cirúrgicas são relatadas, desde a forma de acesso ao seio, elevação da membrana de Schneider e preenchimento da cavidade. Objetivo: abordar os recursos que vem sendo utilizados na cirurgia de regeneração óssea da região posterior da maxila bem como a efetividade dos métodos aplicados. Métodos: foi realizada uma busca eletrônica da literatura, nas bases de dados LILACS, MEDLINE e BBO de estudos publicados na língua inglesa e portuguesa. Como critérios de inclusão foram considerados artigos entre o ano 2000 e 2014, sendo que as palavras chaves que orientaram a busca foram: maxillary bone regeneration, Schneiderian membrane, maxillary sinus lift. Foram obtidos 1 529 artigos, dos quais selecionados 27 artigos relevantes para o estudo em questão. Como critérios de exclusão foram eliminados artigos no qual se encontravam no ano abaixo de 2008 e que fugiam do assunto em questão. Análises e integração da informação : encontrou-se que a técnica tradicional de acesso ao seio maxilar com uso de brocas, elevação da membrana, por meio de curetas, e a regeneração propriamente dita com enxerto ósseo autógeno e/ou heterógeno continuam como as mais utilizadas, no entanto alternativas menos invasivas como tecnologia ultrassônica para fazer acesso, hidrodissecção para elevar a membrana Schneider e biomateriais para preencher a cavidade surgem como opções viáveis e com resultados favoráveis. Conclusões: existe um direcionamento na busca por métodos e materiais que diminuam a morbidade da técnica tradicional e que ofereçam resultados satisfatórios a curto e a longo prazo. A utilização de técnicas cirúrgicas menos invasivas e uso de biomateriais estão entre os avanços para a regeneração da região posterior da maxila(AU)

Introducción: la regeneración ósea de la región posterior del maxilar es un procedimiento importante que permite la correcta colocación de los implantes dentales y una adecuada rehabilitación protésica. Se describen varias técnicas quirúrgicas que van desde la forma de acceder al seno maxilar, el levantamiento de la membrana de Schneider hasta el relleno de la cavidad. Objetivo: abordar los recursos utilizados en la cirugía de regeneración ósea de la zona posterior del maxilar y la efectividad de los métodos aplicados. Métodos: se realizó una revisión bibliográfica en las bases de datos LILACS, MEDLINE y BBO en busca de estudios publicados en inglés y portugués. El criterio de inclusion abarcó los artículos publicados entre los años 2000 y 2014 y las palabras claves que orientaron la búsqueda fueron: regeneración del hueso maxilar, membrana de Schnneider y elevación del seno maxilar. Se encontraron 1 529 artículos de los cuales se seleccionaron 27 con contenido relevante para el estudio en cuestión. En cuanto a los criterios de exclusion, se eliminaron los artículos publicados antes del 2008 y que no se asociaban mucho con el tema referido. Análisis e integración de la información: se halló que la técnica tradicional de acceso al seno maxilar con el uso de brocas, el levantamaiento de la membrana de Schnneider por medio de curetas y la regeneración como tal mediante injertos óseos autógenos y/o heterógenos siguen siendo los procedimientos más utilizados. Por otra parte, alternativas menos invasivas como la tecnología del ultrasonido para lograr acceso, la hidrodisección para levantar la membrana de Schneider y el empleo de biomaterials para rellenar la cavidad emergen como opciones viables con resultados alentadores. Conclusiones: existe una orientación hacia la búsqueda de métodos y materials que disminuyan la morbilidad de las técnicas tradicionales y ofrezcan resultados satisfactorios a corto y a largo plazos. Las técnicas quirúrgicas menos invasivas y el uso de los biomateriales se encuentran entre los avances de hoy día para la regeneración de la zona posterior del maxilar(AU)

Introduction: bone regeneration of the posterior maxilla is an important feature to enable correct placement of implants and thus allow an adequate prosthetic rehabilitation. Several surgical techniques are reported, since the form of access to the sinus, elevation of Schneider membrane and fill the cavity. Objective: to address the resources used in bone regeneration surgery of the posterior maxilla and the effectiveness of the methods applied. Methods: an electronic search of the literature was performed in the databases LILACS, MEDLINE and BBO studies published in English and Portuguese. The inclusion criteria were considered articles between 2000 and 2014, with the key words that guided the search were: maxillary bone regeneration, Schneiderian membrane, maxillary sinus lift. 1 529 articles were obtained, of which 27 selected articles relevant to the study. Exclusion criteria were eliminated in the articles which were in the year below 2008 and fleeing the matter at hand. Data analysis and integration: it was found that the traditional technique of access to the maxillary sinus with the use of drills, lifting the membrane through curettes, and the regeneration itself with autogenous bone graft and/or heterogeneous continue as the most commonly used, however alternative as less invasive ultrasonic technology to access, hydrodissection to raise the Schneider membrane and biomaterials to fill the cavity emerge as viable, with favorable results options. Conclusions: there is a direction in the search for methods and materials that reduce the morbidity of traditional techniques and which offer satisfactory results in the short and long term. The use of surgical techniques less invasive and use of biomaterials are among the advances for the regeneration of the posterior maxilla(AU)

Assessment of a Synthetic Type IV Cast and a Resin Polyol Used in the Fabrication of Dental Models.

OBJECTIVE: To evaluate the dimensional changes, reproduction of details, and surface roughness of a type IV cast and a resin used to fabricate dental models. MATERIALS AND METHODS: Two commercial brands of materials were evaluated: a type IV synthetic cast (Fuji Rock) and a polyol resin (Novox). Twenty samples were obtained from polyvinyl siloxane molds that reproduced the surface of a metal master model standardized according to the American National Standards Institute/American Dental Association specification no. 19. The materials were used according to the manufacturer's instructions and divided into two groups (n = 10). Each mold was photographed immediately after molding and 1 hour after molding. The obtained models were also photographed and measurements were obtained by using Image J software. The paired t-test was used to compare the molding materials and one-way analysis of variance (ANOVA) was used to compare the dimensional changes between the groups at a significance level of 5%. RESULTS: Statistically significant differences were observed between the models fabricated with the polyol resin and type IV synthetic cast with regard to reproduction of surface details, surface roughness, and dimensional stability (p < 0.05), with the resin providing superior surface detail reproduction and greater dimensional accuracy. CONCLUSION: The polyol resin exhibited superior behavior regarding detail reproduction, surface roughness, and dimensional change compared with the type IV synthetic cast.

Association between Tooth Loss and Degree of Temporomandibular Disorders: A Comparative Study.

OBJECTIVE: The aim of this study was to evaluate the association between tooth loss and the signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: One hundred fifty patients with an average age of 49.2 (±14.06) years were divided into three groups (n = 50/group) according to the degree of tooth loss: GI (dentate -control), GII (edentulous), GIII (partially dentate). After performing anamnesis and clinical examination, a questionnaire was used, so that the patients could fill in information on signs and symptoms of TMD. After analyzing this information, it was possible to classify the degree of severity of TMD. As age is a confounding variable to the level of TMD, an analysis of covariance (ANCOVA) was used to check for differences in the degree of TMD between groups (covariate = age). A post hoc test (Bonferroni) was performed to compare the groups two by two (5% significance level). RESULTS: The mean level of TMD according to the groups was GI - 1.95; GII - 2.15; GIII - 2.55. There were significant differences between the study groups (p > 0.05). A post hoc test (Bonferroni) confirmed the difference between edentulous patients and the other groups. CONCLUSION: The tooth loss is directly related to the signs and symptoms of TMD. The degree of TMD was significantly higher in edentulous patients.

Aspectos odontológicos a serem considerados para o tratamento de portadores da doença de Alzheimer / Dental issues to be considered on the treatment of patients with AlzheimerÆs disease

A doença de Alzheimer é uma doença neurodegenerativa que provoca o declínio das funções intelectuais, reduzindo as capacidades de trabalho e relação social, interferindo no comportamento e personalidade do indivíduo. O objetivo deste estudo foi analisar os aspectos relativos às necessidades odontológicas dos pacientes idosos portadores de Alzheimer. Para tanto, foi realizada uma revisão de literatura utilizando as bases de dados, em que os resultados foram divididos em dois tópicos: considerações relativas ao tratamento odontológico e alterações bucais frequentes em pacientes com doença de Alzheimer. Concluiu-se que o cirurgião dentista deve conhecer as características dos pacientes com doença de Alzheimer planejando o tratamento mais adequado, e orientando a equipe de saúde, cuidadores e familiares a fim de ser obter sucesso na implementação de medidas preventivas e curativas...

Alzheimer disease is a neurodegenerative disease that causes the decline of intellectual functions, reducing the capacity for work and social relationships, interfering with the behavior and personality of the individual. The aim of this study was to analyze factors related to dental needs of elderly patients with AlzheimerÆs. Therefore, it was conducted a literature review and the results were divided into two topics: considerations about dental treatment and frequent buccal alterations in patients with AlzheimerÆs. It was concluded that it is important that the dentist knows the characteristics of patients with degenerative diseases in order to develop proper treatment planning, and guide caregivers and family in order to achieve successful adoption of preventive and healing measures...

An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: a case report.

The rehabilitation of patients requiring an esthetic smile demands a multidisciplinary approach. This clinical report describes a treatment plan for recovery aesthetics' smile of anterior teeth using ceramic prosthesis with zirconia structure. Initially, a review of aesthetic parameters, diagnostic waxing, mock-up and provisional restorations was performed. A contextual assessment of aesthetic, proportion and shape of teeth was done to recreate a natural looking for teeth in consonance with the smile line. Subsequently, based on these parameters, fixed prostheses of the upper anterior teeth using ceramic restorations with zirconia infrastructures were performed. The use of ceramic restorations with zirconia structures associated with a careful treatment plan allows the professional to integrate esthetic and function for satisfactory clinical results. How to cite the article: Tavarez RR, Gonçalves LM, Dias AP, Dias AC, Malheiros AS, Silva AC, Bandeca MC. An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: A case report. J Int Oral Health 2014;6(3):90-2.

Overlays or ceramic fragments for tooth restoration: an analysis of fracture resistance.

PURPOSE: The aim of this study was to evaluate the mode of fracture and resistance of partial ceramic restorations of posterior teeth. MATERIALS AND METHODS: Thirty healthy upper premolars were selected and divided into three groups (n = 10): Group 1- control, healthy unrestored teeth, group 2-teeth restored with ceramic fragments; and group 3-teeth restored with ceramic overlays. The restorations were manufactured with feldspathic ceramic and cemented with RelyX ARC resin cement. After being stored in distilled water for 7 days, the teeth were subjected to axial compression mechanical testing with a universal testing machine. Force was applied to the long axis of the tooth at a speed of 0.5 mm/min until fracture. The data were analyzed with one-way ANOVA and Tukey's test (5%). The mode of fracture was scored according to the degree of involvement of the tooth structure and the type of restoration. RESULTS: A significant difference (p < 0.05) was showed between groups 2 (1155 N) and 3 (846.6 N), but there was no significant difference between group 1 and the other groups (1046 N), More extensive fractures were prevalent in the healthy teeth group (Group 1), which had no occlusal coverage; less severe fractures were found in groups 2 and 3. CONCLUSION: We conclude that teeth restored with ceramic fragments may offer greater resistance to fractures compared to teeth that have overlay restorations.

Alinhamento dental por meio de faceta cerâmica - relato de caso / Dental alignment using ceramics veneers - case report

Dentes em uma correta posição e com um adequado contorno gengival são peças-chaves para a obtenção da harmonia e estética do sorriso. Em pacientes com mau posicionamento dentário e necessidade de recuperação estética, um planejamento multidisciplinar com a interrelação entre tratamento ortodôntico e reabilitador permite a recuperação da estética. Mas devido ao tempo de tratamento, idade e tipo de paciente, em muitas ocasiões nos vemos impossibilitados a planejar e executar o tratamento ortodôntico. Assim procuram-se alternativas que permitam a recuperação estética do paciente. Este trabalho apresenta a descrição de um caso clínico com abordagem estética, onde devido a impossibilidade de realização de tratamento ortodôntico optou-se pela recuperação do alinhamento dental utilizando-se facetas cerâmicas. Conclui-se que com um correto planejamento e a técnica utilizada ‚ possível recuperar a estética e harmonia do sorriso

Precisely positioned teeth and proper gingival contour are fundamental aspects to achieve an aesthetically harmonious smile. In patients with poor dental alignment orthodontic and rehabilitation treatments allow aesthetic improvement. However, sometimes it is not possible to plan and execute the orthodontic treatment due to the time of treatment, age of the patient and other particularities. Thus we search for alternatives that allow the recovery of the patient aesthetics. This paper presents the description of a clinical case with aesthetic approach in which the recovery of dental alignment was performed using ceramic veneers since an orthodontic treatment wasn’t possible. It was concluded that with proper planning and the utilized technique it is possible to recover aesthetics and harmony of the smile

Atraumatic extraction, implant placement and immediate provisionalization.

Front tooth extraction typically results in significant loss of hard and soft tissue volume, both in the vestibular-lingual and mesiodistal directions. As these changes can compromise the esthetic results of prosthetic rehabilitation, extraction techniques that cause minimal trauma to the remnant tissues are applied in combination with immediate implant placement to minimize such alterations. The case reported in the present article illustrates a therapeutic plan consisting of atraumatic extraction followed by immediate implant placement and provisionalization. When carefully indicated and planned, our results indicate that this technique may provide promising immediate results relative to the maintenance and stability of the peri-implanted tissues.

Preoperative gingival conditioning as a guide for implant installation and to achieve proper dentogingival contours.

A successful esthetic outcome for implant-supported dentures depends on the careful manipulation of peri-implant tissue as well as the precise placement of the implant. In addition, careful surgical and prosthetic planning is essential for esthetically important areas, especially in partially edentulous cases. This study describes a clinical case that presented absent maxillary central incisors in which prior prosthetic planning was used to perform provisional restorations, that was used to condition the gingival tissues and guide implant installation. These procedures made it possible to achieve a dentogingival contour, interdental papillae, and an emergence profile in the edentulous area. The techniques outlined here proved to be sufficient and support the peri-implant tissues to create a more esthetic final prosthesis.

Prevalência e gravidade de disfunção temporomandibular em professores do ensino superior / Temporomandibular disorder and severity in university professors

BACKGROUND AND OBJECTIVES: University professors are part of a category of professionals constantly submitted to stress, which may trigger a temporomandibular disorder (TMD). By recognizing this relationship, this study aimed at evaluating the prevalence and severity of TMD in university professors. METHODS: A sample of 200 individuals of both genders, above 25 years of age, who were still not diagnosed with TMD, was divided in two groups: Group I, made up of university professors, and Group II made up of individuals of any other professional activity, different from teaching. Volunteers were asked to fill a historical questionnaire which allowed a classification of the presence and severity of TMD. RESULTS: Participated in this study 95 males and 105 females. With regard to TMD severity in Group I, it was observed that 62.7% of evaluated individuals were classified as having mild TMD; 25.3% as having moderate TMD; and 12% as having severe TMD. In Group II, 73.9% had mild TMD; 24.6% had moderate TMD; and 1.4% had severe TMD. CONCLUSION: The prevalence of TMD among professors was not different from the group of non professors. When professors had TMD, the level severity was higher as compared to non professors.

JUSTIFICATIVA E OBJETIVOS: O professor de ensino superior faz parte de uma categoria de profissionais que é submetida constantemente a estresse, podendo desencadear uma disfunção temporomandibular (DTM). Ao reconhecer essa relação, este trabalho teve como objetivo avaliar a prevalência e grau de gravidade de DTM em professores de ensino superior. MÉTODOS: Uma amostra de 200 indivíduos, de ambos os gêneros, maiores de 25 anos, que ainda não tinham diagnóstico de DTM, foi dividida em dois grupos: o Grupo I, formado por indivíduos que exerciam a profissão de professor de ensino superior e o Grupo II, formado por indivíduos que exerciam qualquer outra atividade profissional desvinculada da docência. Aos voluntários, foi solicitado o preenchimento de um questionário anamnésico que permitiu estabelecer uma classificação em relação à presença e ao grau de gravidade da DTM. RESULTADOS: Foram avaliados 95 homens e 105 mulheres. Em relação ao grau de gravidade de DTM no Grupo I, detectou-se que 62,7% dos avaliados foram classificados como portadores de DTM leve; 25,3% como portadores de DTM moderada; e 12% como portadores de DTM grave. No Grupo II, constatou-se que 73,9% como portadores de DTM leve; 24,6% DTM como portadores de DTM moderada; e 1,4% como portadores de DTM grave. CONCLUSÃO: A prevalência de DTM em professores não foi diferente da encontrada no grupo de não professores; quando professores foram acometidos por DTM, o grau de gravidade foi maior quando comparado com o grupo de não professores.

Torque aplicado de forma manual em diferentes tipos de parafusos utilizados em próteses implantossuportadas / Torque produced by hand in different types of screws used in implant prostheses

Este estudo teve por objetivo avaliar in vitro a quantidade de torque manual gerada por profissionais de diferentes gêneros em parafusos utilizados em próteses implantossuportadas. Um manequim odontológico foi usado para simular uma condição clínica. Quatro implantes osseointegrados foram instalados na área de primeiro e segundo molar inferior direito e esquerdo. Dez profissionais participaram do estudo sendo que aos mesmos foi solicitado aplicar o torque máximo a quatro tipos de parafusos diferentes (Parafusos UCLA de titânio, UCLA de ouro, de retenção de ouro e esteticone). Após o torque aplicado, foi medido o destorque que foi considerado como o torque gerado. Cada participante realizou este procedimento três vezes em cada parafuso, com intervalo de tempo de 1 minuto. Os resultados encontrados mostraram diferenças significativas entre os profissionais, mas não entre o gênero masculino e feminino. Concluiu-se que quando o torque é aplicado de forma manual espera-se uma variabilidade na quantidade de torque gerada, mas não existindo diferenças estatisticamente significantes entre profissionais de diferentes gêneros

This study aimed to evaluate in vitro the amount of torque generated manually by professionals from different genres in different types of screws used in implant prosthesis. A dental mannequin was used to simulate a clinical condition. Four dental implants were attached in the area of the first and second molar right and left. Ten professionals have participated, and were asked to apply the maximum torque to four different types of screw (titanium and gold screws UCLA, gold retention screw and esteticone). After applying the torque, detorque was measured and considered as generated torque. Each professional has performed this procedure three times with each screw with one minute interval. Results have shown significant differences among professionals, but not between males and females. Therefore it was concluded that when torque is applied manually a variability in the quantity of generated torque is expected, but with no significant differences between professionals from different genres