Feldspathic and Lithium Disilicate Onlays with a 2-Year Follow-Up: Split-Mouth Randomized Clinical Trial.

The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Feldspathic and Lithium Disilicate Onlays with a 2-Year Follow-Up: Split-Mouth Randomized Clinical Trial

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Resumo O presente estudo é um estudo clínico prospectivo, controlado, randomizado e de longo curto prazo, com o objetivo de avaliar o desempenho clínico de restauraç ões adesivas cerâmica vítrea reforçada com dissilicato de lítio e cerâmica feldspática por um período de até 2 anos. Um total de 11 pacientes (7 mulheres, 4 homens; faixa etária: 18-60 anos, idade média: 39 anos) foram inseridas para este estudo. Cada paciente recebeu duas restaurações por grupo em um delineamento de boca dividida. LD: Onze onlays, realizados com cerâmica à base de dissilicato de lítio (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein); e FP: Onze onlays, realizados com cerâmica feldspática (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Os retornos foram realizados em 2 semanas (linha de base = R1), 1 ano (R2) e 2 anos (R3) após a cimentação, por três investigadores independentes, cegos e calibrados, usando espelhos, óculos de aumento, sondas e radiografias interproximais. Foram avaliadas a sensibilidade pós-operatória, cárie secundária, integridade marginal, descoloração marginal, correspondência de cores, rugosidade da superfície, integridade dentária e integridade da restauração. O teste de Friedman (95%) foi utilizado para determinar se havia uma diferença estatisticamente significante na comparação periódica dos parâmetros nas restaurações cerâmicas. Um total de 95,4% das restaurações estava clinicamente aceitável no retorno de 2 anos, sem diferença para qualquer parâmetro de avaliação para ambos os materiais cerâmicos. Com base nos dados de 2 anos, as restaurações CAD-CAM fabricados com cerâmica feldspática e à base de dissilicato de lítio apresentaram desempenho clínico semelhante.

Efficacy of fluoride varnishes with different compositions on white spot lesions remineralization / Eficácia de vernizes fluoretados com diferentes composições na remineralização de manchas brancas

Objective: To evaluate the efficacy of different fluoride varnishes on white spot lesions (WSL) remineralization. Material and Methods: Polished bovine enamel specimens were obtained (n = 60) and had their initial surface Knoop microhardness (SMH) determined. WSL were created and the SMH was measured again. Then, specimens were allocated into six groups: C ­ Control (without varnish); BF ­ Bifluorid 12 (6% NaF + 6% CaF2); DP ­ Duraphat (5% NaF); PF ­ Profluorid (5% NaF); FP - Fluor Protector (0.2% NaF + 0.9% difluorsilane); CW - Clinpro White Varnish (5% NaF + 5% TCP). After varnishes application, specimens were immersed in artificial saliva for 24 h. Then, pH-cycling was performed for 8 days and SMH was measured. Data were analyzed by one-way ANOVA and Tukey's test. Results: Non-significant differences were observed among the groups at baseline (p = 0.187) and after WSL formation (p = 0.999). After treatments, significant differences were observed among the groups (p = 0.001). Mean % of alteration (SD) and results of Tukey test were: C- 92.40 (12.10)a; PF- 88.66 (10.66)a; FP- 85.90 (14.49)ab; BF- 67.85 (17.86)bc; CW- 66.60 (18.48)c; DP- 58.62 (8.69)c. Conclusion: Bifluorid 12, Clinpro White Varnish, and Duraphat showed higher efficacy than artificial saliva in promoting the remineralization of WSL, nevertheless, none of the treatments were able to recover sound enamel baseline microhardness (AU)

Objetivo: Avaliar a eficácia de diferentes vernizes fluoretados na remineralização de lesões de mancha branca (LMB). Material e métodos: Espécimes de esmalte bovino polido (n = 60) foram submetidos à análise de microdureza superficial Knoop (KMH) inicial. Foram então criadas LMB artificialmente e os espécimes foram alocados em seis grupos: C ­ Controle (sem aplicação de verniz); BF ­ Bifluorid 12 (6% NaF + 6% CaF2); DP ­ Duraphat (5% NaF); PF ­ Profluorid (5% NaF); FP - Fluor Protector (0.2% NaF + 0.9% difluorsilano); CW - Clinpro White Varnish (5% NaF + 5% TCP). Após a aplicação dos vernizes, os espécimes ficaram imersos em saliva artificial por 24h e uma ciclagem de pH foi realizada por 8 dias. Após a ciclagem, KMH final foi realizada. Os dados foram analisados por ANOVA e teste de Tukey (5%). Resultados: Não foi observada diferença significante para os grupos após a KHM inicial (p = 0.187) e após a formação de LMB (p = 0.999). Após os tratamentos, diferenças significativas foram observadas entre os grupos (p = 0.001). Valores de média de % de alteração superficial (desvio-padrão) e resultados do teste de Tukey foram: C- 92.40 (12.10)a; PF- 88.66 (10.66)a; FP- 85.90 (14.49)ab; BF- 67.85 (17.86)bc; CW- 66.60 (18.48)c; DP- 58.62 (8.69)c. Conclusão: Os vernizes Bifluorid 12, Clinpro White Varnish e Duraphat apresentaram maior eficácia na remineralização das LMB quando comparados à saliva artificial, entretanto, nenhum dos produtos testados foi capaz de recuperar os valores iniciais de microdureza. (AU)

Effect of framework type on survival probability of implant-supported temporary crowns: An in vitro study.

BACKGROUND: This in vitro study evaluated the effect of framework type on the survival probability of temporary implant-supported crowns and on the implant platform structure after dynamic fatigue. MATERIAL AND METHODS: Thirty (30) external hexagon implants (3.75 x 10 mm) were embedded in acrylic resin following the ISO-14801. Standardized temporary crowns (n=10, N=30) were manufactured in acrylic resin and divided according to the framework type: Total plastic, Plastic with CoCr base and Titanium. The crowns were installed onto the implants (20N.cm) and fatigued (100N, 2 Hz) to determine the crowns' survival probability for missions of 300.000 and 600.000 cycles. Fatigue data were submitted to the Kaplan-Meier test followed by Wilcoxon and Log Rank, all with α = 5%. The implant platforms were parametrically inspected based on the scanning before and after the fatigue to evaluate the damage. The strain values were analyzed using One-way ANOVA and Tukey test, all with α = 5%. RESULTS: ANOVA revealed that the Total plastic showed less implant damage (-0.07 ± -0.03 mm) than the Plastic with CoCr base (-0.08 ± -0.04 mm) and the Titanium (-0.10 ± -0.01 mm) frameworks. Therefore, the framework type to manufacture implant-supported temporary crowns influences the fatigue survival of the restoration and the implant platform damage. The Plastic with CoCr base and Titanium frameworks showed superior reliability than the Total plastic framework which could not survive 600,000 cycles. CONCLUSIONS: The Plastic with CoCr base and the Titanium framework are suitable for restorations over 3 months in use, without a difference in the implant platform damage. Key words:Implant dentistry, axial loading, occlusion, methodo-logical study.

Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers.

PURPOSE: This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. MATERIALS AND METHODS: Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. RESULTS: The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. CONCLUSION: Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

Effect of Framework Type on the Biomechanical Behavior of Provisional Crowns: Strain Gauge and Finite Element Analyses.

The aim of this study was to evaluate the effects of different frameworks on the biomechanical behavior of implant-supported provisional single crowns to indicate or not the use of plastic framework as infrastructure. For finite element analysis, a hemi-jaw stone model was scanned and modeled with an external hexagon implant. A framework was screwed onto the implant and a crown was constructed over it. The set was made in triplicate according to framework type: plastic, cobalt-chromium (CoCr), and titanium. Models were exported in volumetric format to analysis software where structures were considered isotropic, linear, elastic, and homogeneous. Axial loads (100, 200, and 300 N) were applied to the fossa bottom, and the system's fixation occurred on the bone base. For strain-gauge analysis, the same hemi-jaw model was built in polyurethane and an implant was placed on it. Three crowns were made, each one with a different framework. Four strain gauges were glued around the implant to obtain microstrain values. The data were analyzed by three-way analysis of variance (ANOVA) and Tukey tests (P < .05). Finite element analysis exhibited microstrain results for bone, von Mises stress values for the implant and screw, and maximum principal stress values for the crown. For computational method, as the applied load increased, so did the stress generated. Titanium frameworks concentrated more stress in the crown and bone, while plastic ones concentrated more in the implant and screw. ANOVA showed that the higher the load value and the framework elastic modulus, the higher the generated microstrain in bone. It can be concluded that all evaluated framework types can be used in the manufacturing of provisional crowns.

Influence of different alcohol intake frequencies on alveolar bone loss in adult rats: A sem study.

BACKGROUND: Alcohol intake is associated with oral diseases and bone changes including alveolar bone loss in humans and in experimental animals. The main aim of the present study is to assess the effect of long-term alcohol intake, at different frequencies, on periodontal bone loss (PBL) in adult rats. MATERIAL AND METHODS: Thirty-six (36) rats were divided into 3 groups: Control (daily water intake, n=12), daily alcohol intake (20% ethanol, n=12), and social alcohol intake (20% ethanol twice a week, n=12). The rats were sacrificed after 90 days and their right maxillae were removed. Initially, a random portion from each group was analyzed through SEM (scanning electron microscope) to assess surface topography. Next, all pieces were dissected and stained with methylene blue 1% and photographed in stereomicroscope at 10x magnification. The PBL was assessed by measuring the distance between cement-enamel junction and alveolar bone crest. RESULTS: Results showed higher (p=0.0368) alcohol solution amount in the daily intake group than in the twice week intake one. The SEM showed qualitatively flat bone surface in the control group, the social intake group presented surface with few minor hollows, and the daily intake group evidenced increased number and diameter of wells. The comparison between groups showed higher bone loss (p<0.05) in both frequencies than in the control, but the bone loss was lower (p<0.05) in the social alcohol intake group than in the daily intake one. CONCLUSIONS: Alcohol intake may cause alveolar bone loss in periodontitis-free rats depending on the frequency. Key words:Alcohol intake, alveolar bone loss, alcohol-induced periodontitis, alcoholic rats.

Biomechanical effect of inclined implants in fixed prosthesis: strain and stress analysis / Efeito biomecânico de implantes inclinados em prótese fixa: analise das tensões e deformações

Introduction: Implant inclinations can be corrected using mini abutments at different angulations. Objective: To analyze the influence of external hexagon implants in different inclinations (3 levels) on the microstrain distribution generated around three implants. Method: A geometric bone model was created through Rhinoceros CAD software (version 5.0 SR8, Mcneel North America, Seattle, WA, USA). Three implants (4.1 × 13 mm) were modeled and inserted inside the substrate at three different inclinations: 0º, 17º and 30º. Next, all groups received mini conical abutments, fixation screws and a simplified prosthesis. The final geometry was exported in STEP format to analysis software and all materials were considered homogeneous, isotropic and linearly elastic. An axial load (300N) was applied on the center of the prosthesis. An in vitro study was conducted with same conditions and groups for validating the tridimentional model. Result: Stress was concentrated on the external area of the implants, in contact with the cortical bone and external hexagon. For the bone simulator, the strain increased in the peri-implant region according to the increase in the implant's inclination. The difference between groups was significant (p = 0.000). The 30º group presented higher stress and strain concentration. Conclusion: The microstrain and stress increase around implants directly proportional to the increase of the installation angle.

Introdução: A inclinação dos implantes pode ser corrigida através de mini-pilares de diferentes angulações. Objetivo: Analisar a influência de implantes com hexágono externo em diferentes inclinações (3 níveis) na distribuição de microdeformações geradas em torno de três implantes. Método: Um modelo geométrico de osso foi criado através do software CAD Rhinoceros (versão 5.0 SR8, Mcneel North America, Seattle, WA, EUA). Três implantes (4,1 × 13 mm) foram modelados e inseridos no interior do substrato em três diferentes inclinações: 0º, 17º e 30º. Em seguida, todos os grupos receberam mini-pilares cônicos, parafusos de fixação e prótese simplificada. A geometria final foi exportada em formato STEP para software de análise e todos os materiais foram considerados homogêneos, isotrópicos e linearmente elásticos. Uma carga axial (300N) foi aplicada no centro da prótese. Um estudo in vitro foi conduzido com as mesmas condições e grupos para validar o modelo tridimensional. Resultado: A concentração de tensão ocorreu na área externa dos implantes, em contato com o osso cortical e o hexágono externo. Para o simulador ósseo, a deformação aumentou na região peri-implantar de acordo com o aumento da inclinação do implante. A diferença entre os grupos foi significativa (p = 0.000). O grupo de 30º apresentou maior concentração de tensão e deformação. Conclusão: O aumento da microdeformação e das tensões ao redor dos implantes aumenta diretamente proporcional ao aumento do ângulo de instalação.

The importance of correct implants positioning and masticatory load direction on a fixed prosthesis.

BACKGROUND: Through the biomechanical study of dental implants, it is possible to understand the dissipation effects of masticatory loads in different situations and prevent the longevity of osseointegration. Aims: To evaluate the microstrains generated around external hexagon implants, using axial and non-axial loads in a fixed four-element prosthesis with straight implants and implants inclined at 17°. MATERIAL AND METHODS: Three implants were modeled using CAD software following the manufacturer's measurements. Then, implants were duplicated and divided into two groups: one with straight implants and respective abutments, and the other with angled implants at 17° and respective abutments. Both groups were arranged inside a block simulating bone tissue. A simplified fixed prosthesis was installed on both groups and the geometries were exported to CAE software. Five loads of 300N were performed at axial and non-axial points on the fixed prosthesis. Stress on the implants and strain on the block were both analyzed. An in vitro experiment was performed following all structures made in FEA in order to validate the model. In each experimental block, 4 strain gauges were linearly placed between the implants and the same loads were repeated with a loading applicator device. RESULTS: The deformations computed by the gauges were correlated with the FEA results, showing that the group with inclined implants had more damaging biomechanical behavior and was significantly different from the group with straight implants (P<0.005). CONCLUSIONS: The mathematical model used is valid and inclined implants can induce unwanted bone remodeling. Key words:Finite Element Analysis, Dental Implants, Fixed Prosthesis.

Validation of a Simplified Implant-Retained Cantilever Fixed Prosthesis.

PURPOSE: To evaluate the stress and strain generated in a fixed four-element prosthesis under the application of axial and nonaxial loads using a simplified implant-supported fixed prosthesis model. MATERIALS AND METHODS: A 3-dimensional model was constructed containing 3 implants with a conventional anatomical prosthesis (G1). The second model with the same implant system received the simplified prosthesis (G2). A load of 300 N was applied at an axial point and a nonaxial point through finite element analysis software. RESULTS: The G2 group showed different values of stress concentration in the prosthesis, fixation screw, retention screw, and abutments when compared with G1. Within a limit of 10% degrees of acceptability, the stress on the implants and the bone strain were enclosed for both models of prostheses. CONCLUSION: The simplified fixed prosthesis evaluated presents biomechanical behavior similar to an anatomical prosthesis in the implants and in the surrounding bone structure.

Microscopic evaluation of implant platform adaptation with UCLA-type abutments: in vitro study / Avaliação microscópica da adaptação da plataforma do implante com pilares protéticos do padrão UCLA: estudo in vitro

Introduction: The fit between abutment and implant is crucial to determine the longevity of implant-supported prostheses and the maintenance of peri-implant bones. Objective: To evaluate the vertical misfit between different abutments in order to provide information to assist abutment selection. Material and method: UCLA components (N=40) with anti-rotational system were divided as follows: components usinated in titanium (n=10) and plastic components cast proportionally in titanium (n=10), nickel-chromium-titanium-molybdenum (n=10) and nickel-chromium (n=10) alloys. All components were submitted to stereomicroscope analysis and were randomly selected for characterization by SEM. Result: Data were analyzed using mean and standard deviation and subjected to ANOVA-one way, where the groups proved to statistically different (p=<0.05), followed by Tukey’s test. Conclusion: The selection of material influences the value of vertical misfit. The group machined in Ti showed the lowest value while the group cast in Ni Cr showed the highest value of vertical misfit.

Introdução: O ajuste entre a prótese e o implante é fundamental para determinar a longevidade do tratamento e manutenção do osso periimplantar. Objetivo: Avaliar o desajuste vertical entre diferentes infraestruturas metálicas e plataforma dos implantes, a fim de fornecer informação, para auxiliar na escolha do metal a ser utilizado. Material e método: O estudo utilizou componentes do tipo UCLA (N=40), com antirrotacional, foram divididos da seguinte forma: componentes usinados em titânio (n=10), componentes fundidos em titânio (n=10), níquel-cromo-titânio-molibdênio (n=10) e em níquel-cromo (n=10). Após o torque, as amostras foram analisados em estereomicroscópio. Para caracterização em MEV, foram utilizadas as amostras mais representativas, com maior e menor desajuste vertical. Resultado: Os dados foram analisados por média e desvio padrão e submetidos ao teste ANOVA ONE way, onde os grupos foram estatisticamente diferentes (p=<0,05), seguido do teste TUKEY. Conclusão: A escolha do infraestrutura influencia no valor do desajuste vertical, sendo que o grupo usinado em Ti apresentou o menor valor de desajuste, e o grupo fundido em Ni Cr o grupo com maior valor de desajuste vertical.

Avaliação das microdeformações ao redor de implantes, na utilização de pilares protéticos retos e angulados 17° e 30°, sob a influência de aplicação de cargas / Evaluation micro strain around implants in the use of straight and angled abutments 17° and 30°, under the influence of loads

O objetivo deste estudo in vitro foi analisar a distribuição das microdeformações geradas ao redor de implantes de hexágono externo, sob a influência da utilização de intermediários do tipo mini pilares cônicos retos e angulados 17° e 30°, sob cargas axiais e não axiais, por meio da análise de elementos finitos e extensometria. Os modelos tridimensionais foram criados simulando três blocos de poliuretano, os quais receberam três implantes cada, um grupo perpendicular e outros dois com fixações inclinadas em 17° e 30°. Para o estudo também foram modelados os intermediários do tipo mini pilar cônico reto e angulados e uma supraestrutura metálica padronizada para ambos os grupos, os materiais foram considerados homogêneos, isotrópicos e lineares. Após a confecção, as geometrias foram exportadas em malhas para o software de análises (ANSYS 15.0, ANSYS Inc., Houston, USA), um carregamento axial de 30 kgf foi aplicado e os valores de tensão e as microdeformações foram analisados. Para análise in vitro, foram confeccionados blocos idênticos aos desenhados anteriormente. Foram colados sete extensômetros na superfície dos blocos, quatro tangenciando cada um dos implantes e três na transversal dos implantes. Coifas plásticas foram adaptadas a um enceramento padronizado e depois fundidas. A supraestrutura metálica foi parafusada com torque de 10 N.cm. Para aplicação de cargas foi utilizado um dispositivo de aplicação de cargas (DAC) com uma carga de 30 kgf. durante 10 segundos. Os dados obtidos foram submetidos aos testes ANOVA e Tukey (p< 0,05). Observou-se diferença estatística para os fatores "Angulação do implante" (P=0,000) e o fator "Ponto de aplicação de carga" (P=0,000). Os dados obtidos pela análise de elementos finitos foram apresentados como: resultados qualitativos de tensão que foram analisados seguindo o esquema de cores da escala e resultados de valores de deformação, apresentados em gráficos, onde se observou maior concentração de tensão nos implantes inclinados em 30° localizados nos pontos não axiais 3 e 5 mm, o mesmo ocorreu com os valores de deformação encontrados na superfície ao redor dos implantes. O estudo concluiu que os implantes inclinados apresentaram maiores valores de microdeformações ao redor dos implantes, sendo as aplicações de cargas não axiais nos pontos 3 e 5 mm responsáveis por produzirem aumento na magnitude. Apenas o grupo reto 0° apresentou resultados dentro do limite fisiológico em todas as configurações de aplicação de carga(AU)

The objective of this in vitro study was to analyze microstrains distribuition generated around external hexagon implants, under the influence of intermediary prosthetic componentes as straight, 17° and 30° angled miniconical abutments, under axial and non-axial loads, by finite elements and strain-gauge analysis. The three-dimensional models were created simulating three polyurethane blocks, being installed three implants each, one perpendicular group and another two with inclined fixations at 17° and 30°. For the study were also created straight and angled miniconical abutments and a standardized metallic superstructure for both groups. The materials were considered symmetrical, isotropic and solid. After the preparation, the geometries were exported in mesh to the analysis software (ANSYS 15.0, ANSYS Inc., Houston, USA). An axial load of 30 kgf was applied and the values of main maximum stress and microstrains were analyzed. For in vitro analysis, blocks identical to those created previously were made, seven strain-gauges were placed on the surface of the block, four tangential to each of the implants and three transverse to the implants. Plastic copings were adapted to a wax pattern and then cast. The metallic superstructure was screwed with a torque of 10 N.cm. For load application, a load application device (DAC) with a load of 30 kgf was used, for 10 seconds. Data were submitted to ANOVA and Tukey tests (p <0.05). Statistical difference was observed for "Implant angulation" factors (P = 0.000) and "Load application point" factor (P = 0.000). The data obtained by the finite element analysis were presented as: qualitative results of stress that were analyzed following the color scheme of the scale and results of deformation values, presented in graphs, where it observed a higher concentration of tension in the inclined implants in 30° at the non-axial points 3 and 5 mm, the same occurred with the deformation values found on the surface around the implants. The study can conclude that the inclined implants had higher values of microdeformations around the implants, and the applications of non-axial loads at points 3 and 5 mm are responsible for producing an increase in magnitude. Only the 0° straight group presented results within the physiological limit in all load application configurations(AU)

Alveolar bone loss induced by alcohol consumption in rats / Perda ossea alveolar induzida por consumo de álcool em ratos

Objectives: The aim of the present study was to assess the effect of regular and constant longterm alcohol consumption on the percentage of the remaining periodontal bone support (PBS) and periodontal bone loss (PBL) in adult rats. Material and Methods: Fifty-four (54) rats were divided into 3 groups: Control (daily water intake, n=18) daily alcohol intake (20% ethanol, n=18) and social alcohol intake (20% ethanol 2x a week, n=18). The rats were treated with free-choice access to both ethanol consumption frequencies. They were euthanized after 90 days and their left mandibles were radiographed for PBS measuring. The same left mandibles were defleshed and stained. The PBL was morphometrically assessed by measuring the distance between cement-enamel junction and alveolar bone crest. Results: Did not show difference (p > 0.05) in the amount of consumed alcohol between the social and daily intake groups. Rats also evidenced lower PBS percentage and higher PBL (p<0.05) in both alcohol consumption groups in comparison to the control. Conclusion: The long-term constant and regular same amount alcohol consumption may cause alveolar bone loss and reduce the remaining periodontal bone support in adult rats. Thus, the alveolar bone loss was associated with the amount of consumed alcohol, rather than with periodicity in periodontitis-free rats (AU)

Objetivo: O objetivo do presente estudo foi avaliar o efeito do consumo regular e constante de álcool em longo prazo na porcentagem do suporte ósseo periodontal remanescente (SOP) e perda óssea periodontal (PO) em ratos adultos. Material e Métodos: Cinquenta e quatro (54) ratos foram divididos em 3 grupos: Controle (ingestão diária de água, n = 18), consumo diário de álcool (20% etanol, n = 18) e consumo social de álcool (20% etanol 2x por semana, n = 18). Os ratos foram tratados com acesso de livre escolha a ambas as frequências de consumo de etanol. Eles foram sacrificados após 90 dias e suas mandíbulas esquerdas foram radiografadas para medição do SOP. As mesmas mandíbulas esquerdas foram dissecadas e coradas. A PO foi avaliada morfometricamente medindo a distância entre a junção cimento-esmalte e a crista óssea alveolar. Resultados: Não houve diferença (p> 0,05) na quantidade de álcool consumido entre os grupos de ingestão diária e social. Os ratos também evidenciaram menor porcentagem de SOP e maior PO (p<0,05) em ambos os grupos de consumo de álcool em comparação com o controle. Conclusão: A mesma quantidade consumida constante e regular de álcool em longo prazo pode causar perda óssea alveolar e reduzir o suporte ósseo periodontal remanescente em ratos adultos. Assim, a perda óssea alveolar foi associada com a quantidade de álcool consumido, ao invés da periodicidade em ratos sem periodontite. (AU)

Influência da angulação e desajuste vertical na avaliação de microdeformações ao redor de implantes / Influence of angulation and vertical misfit in the evaluation of micro-deformations around implants

Objetivo: Este estudo in vitro avaliou as microdeformações em torno de implantes, sob a influência da angulação e do desajuste vertical em próteses parciais fixas implanto-suportada de três elementos, durante uma carga axial por análise de extensometria. Material e Métodos: Três implantes de hexágono externo com a configuração linear e três implantes de hexágono externo angulado em 17 °, foram inseridos em dois blocos de poliuretano. Para medir a microdeformação, quatro extensômetros foram colados sobre a superfície de cada bloco. Coifas plásticas foram adaptadas a um padrão de resina e fundidas posteriormente. Uma carga axial de 30 kgf foi aplicada sobre o centro de cada implante durante 10 segundos, usando um dispositivo de aplicação de carga. O desajuste vertical foi medido em seis pontos diferentes, utilizando um microscópio estéreo com 100 X amplificação. Resultados: Os resultados mostraram que os valores para diferentes angulações de implantes foram significativos (P = 0,0086). O teste de correlação de Pearson entre deformação e desajuste vertical revelou não haver correlação tanto para o grupo angulado (P = 0,891) quanto para o grupo linear (P = 0,568). Conclusão: As microdeformações foram maiores para os implantes angulados; nenhuma correlação foi encontrada entre o desajuste vertical e os valores de microdeformação (AU)

Objective: This in vitro study was to evaluate micro strains around of implant, under the influence of angulations and vertical misfit in three-element implant-supported fixed partial dentures during axial loading by using strain gauge analysis. Material and Methods: Three external hexagon implants with straight configuration and three external hexagon implants with angled (17°) configuration were inserted into two polyurethane blocks. To measure micro strain, four strain gauges were bonded onto the surface of each block. Plastic copings were adapted to a standard wax pattern and cast. An axial load of 30 kgf was applied on the center of each implant for 10 seconds, using a load application device. The vertical misfit was measured at six different points by using a stereo microscope with 100-X magnification. Results: The results showed that the values for different implant angulations were significant (P = 0.0086). The Pearson's correlation test between micro-strain and vertical misfit revealed no correlation between angled configuration (P = 0.891) and straight configuration (P = 0.568). Conclusion: The micro strain was higher for angled implants; no correlation was found between the vertical misfit and the strain values (AU)

Stress and strain distributions on short implants with two different prosthetic connections ­ an in vitro and in silico analysis / Distribuições de tensão e microdeformação em implantes curtos com duas conexões protéticas diferentes - uma análise in vitro e in silico

Objetivo: Uma biomecânica ideal que minimiza a tensão entre implante e osso pode proporcionar sucesso para implantes osseointegrados. Este estudo avaliou a concentração de deformação no tecido circundante e a tensão nos componentes de dois implantes com diferentes conexões protéticas através de métodos in vitro e in silico. Material e Métodos: Vinte blocos de poliuretano foram divididos em dois grupos (n = 10), seguido da instalação de hexágono interno (IH) (AS Tecnologia - Titanium Fix, São José dos Campos, Brasil) ou de implantes cone morse (LT) (Bicon Dental Implants). Para o método da extensometria (SG), foram colocados quatro sensores ao redor dos implantes. Para a análise por elementos finitos (FEA), o mesmo bloco foi modelado e analisado. Foi aplicada uma carga axial (30 kgf) para ambas as metodologias. Os valores de tensão e deformação foram analisados quanto à correlação com o SG. Resultados: Para SG, LT apresentou uma média de deformação mais agressiva (-932) que IH (-632). Para FEA, a LT mostrou menor tensão (-547) que IH (-1169). Conclusão: Para os dois sistemas implantes, os valores de microdeformação capazes de induzir remodelação óssea indesejada não foram medidos. No entanto, para o implante IH, a presença de um parafuso de retenção tem a desvantagem de concentrar a tensão, enquanto um pilar sólido dissipa a carga axial através do implante, o que sugere um melhor desempenho para o grupo LT. (AU)

Objective: An ideal biomechanics minimizes the stress between implant and bone that can provide success for osseointegrated implants. This study evaluated the strain concentration in surrounding tissue and stress in the components of two implants with different prosthetic connections through an in vitro and in silico methods. Methods: Twenty polyurethane blocks were divided into two groups (n=10) followed by the installation of internal hexagon (IH) (AS Technology ­ Titanium Fix, São José dos Campos, Brazil) or locking taper implants (LT) (Bicon Dental Implants). For strain gauge (SG) method, four sensors were placed around the implants. For finite element analysis (FEA), the same block was modeled and analyzed. An axial load (30 kgf) was applied for both methodologies. The values of stress and strain were analyzed for correlation to SG. Results: For SG, LT presented a mean of strain most aggressive (-932) than IH (-632). For FEA, LT showed less stress (-547) then IH (-1169). Conclusion: For two implant's system, microstrain values capable to induce unwanted bone remodeling were not measured. However, for IH implant, the presence of a retention screw has the disadvantage to concentrate stress while a solid abutment dissipates the axial load through the implant that suggests a better performance for LT group(AU)

Low-Fusing Porcelain Glaze Application on 3Y-TZP Surfaces can Enhance Zirconia-Porcelain Adhesion.

The aim of this study was to assess whether surface treatment improves zirconia-porcelain adhesion. The 3Y-TZP blocks were cut into squares, then polished and sintered. The zirconia surface treatments were performed as follows: no treatment (C); tribochemical silica coating (TBS); glaze application + hydrofluoric acid etching (GA); glaze application + hydrofluoric acid etching + silanization (GAS); deposition of silica nanofilm (NF). After treatments, veneering porcelain cylinders (3.3 x 3.3 mm) were built up on all specimens and fired. Then the specimens were subjected to thermal cycling (6000 cycles), and subjected to shear test. Fractures were analyzed by stereomicroscopy and SEM. Data were statistically analyzed by 1-way ANOVA and Tukey's test (5%). Zirconia-porcelain bond strength was affected by the ceramic surface treatments (p=0.0001). GA (19.5±3 MPa) and GAS (16.2±4 MPa) recorded the highest bond strength values, while control group had the lowest bond value (10.1±4 MPa). Adhesive failure of the samples predominated. Therefore, glaze application as 3Y-TZP treatment before veneering porcelain stratification may enhance zirconia-porcelain adhesion.

Low-Fusing Porcelain Glaze Application on 3Y-TZP Surfaces can Enhance Zirconia-Porcelain Adhesion

Abstract The aim of this study was to assess whether surface treatment improves zirconia-porcelain adhesion. The 3Y-TZP blocks were cut into squares, then polished and sintered. The zirconia surface treatments were performed as follows: no treatment (C); tribochemical silica coating (TBS); glaze application + hydrofluoric acid etching (GA); glaze application + hydrofluoric acid etching + silanization (GAS); deposition of silica nanofilm (NF). After treatments, veneering porcelain cylinders (3.3 x 3.3 mm) were built up on all specimens and fired. Then the specimens were subjected to thermal cycling (6000 cycles), and subjected to shear test. Fractures were analyzed by stereomicroscopy and SEM. Data were statistically analyzed by 1-way ANOVA and Tukey's test (5%). Zirconia-porcelain bond strength was affected by the ceramic surface treatments (p=0.0001). GA (19.5±3 MPa) and GAS (16.2±4 MPa) recorded the highest bond strength values, while control group had the lowest bond value (10.1±4 MPa). Adhesive failure of the samples predominated. Therefore, glaze application as 3Y-TZP treatment before veneering porcelain stratification may enhance zirconia-porcelain adhesion.

Resumo O objetivo do estudo foi avaliar o efeito de tratamentos de superfície para melhora a união entre zircônia-porcelana. Os materiais testados foram 3Y-TZP e VM9. Os blocos de 3Y-TZP foram cortados em quadrados, polidos e sinterizados. Os tratamentos de superfície foram: Rocatec soft e aplicação de silano (TBS), vitrificação e ácido fluorídrico (GA), vitrificação, ácido fluorídrico e aplicação de silano (GAS), deposição de nanofilme de sílica (NF) e ausência de tratamento (C). Após os tratamentos, cilindros de porcelana foram construídos sobre as amostras e sinterizados. Após a sinterização da porcelana, todas as amostras foram submetidas a ciclos térmicos (6000 ciclos). Em seguida, os espécimes foram acoplados em uma máquina de ensaio universal e foi realizado o teste de micro cisalhamento a uma velocidade de 1,0 mm/min. As fraturas foram analisadas por estereomicroscópio e MEV. Os dados foram submetidos à ANOVA 1fator e teste de Tukey (5%). A resistência de união zircônia-porcelana foi afetado pelos tratamentos de superfície de cerâmica (p=0,0001). GA e GAS registraram os maiores valores de resistência de união, os valores mais baixos de resistência de união foram observados no grupo C (ausência de tratamento) (19,5 ± 3a, 16,2 ± 4ab e 10,1 ± 4c respectivamente). Houve predominância de falhas adesivas. Portanto, a vitrificação pode ser considerada uma opção para aumentar a resistência de união entre zircônia-porcelana.

Comparative Microstrain Study of Internal Hexagon and Plateau Design of Short Implants Under Vertical Loading.

PURPOSE: To quantify microstrain development during axial loading using strain gauge analysis for short implants, varying the type of fixture-abutment joint and thread design. MATERIALS AND METHODS: An internal hexagon implant (4 × 8 mm) and a plateau design implant (4 × 8 mm) were embedded on the center of 10 polyurethane blocks with dimensions of 190 × 30 × 12 mm. The respective abutments were screwed onto the implants. Four strain gauges (SGs) were bonded onto the surface of each block, and 4 vertical SGs were bonded onto the side of each block. Axial load of 30 kgf was applied for 10 seconds in the center of each implant. RESULTS: The data were analyzed statistically by analysis of variance for repeated measures and Tukey test (P < 0.05). The interaction between implant and region factors have been statistically significant (P = 0.0259). Tukey test revealed a difference on plateau's horizontal region. The cervical region presented higher microstrain values, when compared with the medium and apical regions of the implants. CONCLUSION: Within the purpose of the study, the type of fixture-abutment joint is a relevant factor to affect the amount of stress/strain in bone simulation. The microstrain development was concentrated on the cervical region of the implant.

The effect of metal surface treatment on bond strength interface between metal/cement / O efeito do tratamento de superficies metálicas na interface de resistência de união entre metal / cimento

This study evaluated the hypothesis that different treatments of surface upon three metalalloys for metal ceramic dental prostheses (Gold; Nickel-Chromium; Titanium) do not Influence the values of bond strength with resin cement. Material and Methods: Twenty blocks, 5 x 5 x 5 mm, ofeach alloy were divided into two subgroups (n =10) according to surface treatments: 1 (Primer): sandblasting with aluminum oxide particles 110µm (Al2O3) + Alloy Primer (Kuraray); 2 (Cojet): sandblasting with silica oxide particles with Cojet-Sand + Silane ESPE-Sil. The conditioned blocks ofeach group were cemented, with Panavia F, to resinblocks under constant load of 750 g/10 min. Thesets were cut to obtain 4 samples with dimensions of 10x1x1 mm per block (n = 10) and the adhesive surface with approximately 1 mm2. The microtensile test was done in the universal testing machine at 1 mm/min crosshead speed. The values of bond strength and standard deviation (MPa) were: Au P:7.33 ± 1.93d; Au C: 13.35 ± 2.18c; NiCr P: 23.56± 6.5b; NiCr C: 42.6 ± 5.84a; Ti P: 26.17 ± 1.94b;Ti C: 44.30 ± 2.3a. Data were analyzed by varian cetest (ANOVA) and Tukey’s test, p < 0.05. Results: The results indicated that the conditioning withtreatment 2 increased the bond strength between theresin cement and alloys. The lowest bond strengths values were obtained with gold alloy, regardless the surface treatment. Conclusion: The results denied the hypothesis that the metallic alloys surface treatments do not alter the bond strengths values...

O estudo avaliou a influência de diferentes tratamentos de superfície em três ligas metálicas para próteses dentárias de metalocerâmicas (ouro;níquel-cromo; titanium), nos valores de resistência de união com cimento resinosos. Material e Métodos:Vinte blocos, 5 x 5 x 5 mm, de cada liga foram divididos em dois subgrupos (n = 10) de acordo com os tratamentos de superfície: 1: jateamento com partículas de óxido de alumínio (Al2O3) 110μm + Alloy Primer (Kuraray); 2 (Cojet): jateamento com partículas de óxido de sílica com Cojet-Sand +Silano ESPE-Sil. Os blocos foram cimentados, com Panavia F, a blocos de resina sob carga constante de 750 g / 10 min. Os conjuntos foram cortados para obter assim, 4 amostras com dimensões de 10 x 1x 1 mm por bloco (n = 10) e a superfície adesiva com cerca de 1 mm2. Foi realizado o teste de microtração na máquina de ensaio universal a 1 mm/ min. Os valores de resistência de união e desvios-padrão (MPa) foram: Au P: 7,33 ± 1.93d; Au C:13,35 ± 2.18c; NiCr P: 23,56 ± 6.5b; NICR C: 42,6± 5.84a; Ti P: 26,17 ± 1.94b; Ti C: 44,30 ± 2.3a, e analisados estatisticamente pelo teste de variância(ANOVA) e teste de Tukey, p < 0,05. Resultados: Os resultados indicaram que a resistência de união do condicionamento com o tratamento Cojet aumentou a resistência de união entre o cimento resinoso e ligas. Conclusão: Os valores mais baixos foram obtidos com liga de ouro, independente do tratamento de superfície...

Estudo comparativo das microdeformações resultantes de cargas estáticas axiais e não axiais em próteses de três elementos implantossuportadas / Comparative study of micro deformations resulting from axial and non-axial static loads under three prosthetic implant elements

Introdução: O controle das microdeformações ao redor dos implantes é um fator que pode levar a uma melhor osseointegração e manutenção das estruturas ósseas. Objetivo: Avaliar a distribuição de tensões ao redor dos implantes, utilizando-se a extensometria, sob a influência da aplicação de cargas estáticas axiais e não axiais em próteses parciais fixas de três elementos, em diferentes pontos de aplicação de carga. Material e Método: Em um bloco de poliuretano, foram instalados três implantes de hexágono interno e, sobre esses implantes, pilares protéticos microunit foram conectados com torque de 20 Ncm. Cilindros plásticos foram utilizados para realização dos enceramentos padronizados que, posteriormente, foram fundidos em liga de cobalto cromo. Extensômetros foram colados na superfície do bloco ao redor dos três implantes. As estruturas metálicas foram parafusadas com torque de 10 Ncm cada. Em seguida, foram realizados carregamentos verticais estáticos de 30 kgf, durante dez segundos, em cinco pontos pré-determinados (A, B, C, D e E), utilizando um dispositivo de aplicação de cargas (DAC). Resultado: Os dados foram analisados pelo teste RM ANOVA, que indicou que o efeito entre o ponto de aplicação de carga e os diferentes corpos de prova não foi estatisticamente significante, enquanto que, para o efeito entre os pontos de aplicação de carga, houve diferença (p=0,0001). Em seguida, aplicou-se o teste de comparação múltipla de Tukey. Conclusão: A aplicação de carga sobre os pontos não axiais D e E produziu um aumento da magnitude de microdeformação ao redor dos implantes. .

Introduction: The control of the micro strain surrounding implants is a factor that can lead to a better osseointegration and maintenance of bone structures. Objective: evaluate in vitro, using strain gauge analysis , the influence of the axial and non-axial static load in implant-supported fixed partial dentures, varying the point of load application. Material and Method: In a block of polyurethane three internal hexagonal implants were installed, on implants abutments microunit were connected with torque of 20 Ncm, and plastic prosthetic cylinders were screwed on to the abutments, which received standard patterns cast in Co-Cr alloy (n=10). Four strain gauges were bonded on the surface of the block tangentially to the three implants. Each metallic structure was screwed onto the microunit with a 10 Ncm torque. With a load application device (DAC) static vertical loads of 30kgf were applied for ten seconds at five predetermined points (A, B, C, D and E). Result: Result analyzed by RM ANOVA, in which the effect of the point of load application and differents specimens were not statistically significant, whereas regarding the points of load application presented statistical differenced (p=0.0001). Applying Tukey's multiple comparison tests. Conclusion: The application of load on the non-axial points D and E produced an increase in the magnitude of micro strain around implants. .