Descrição de protocolo fotográfico para utilização na rotina pericial odontológica em âmbito civil / Photographic protocol for expert witness in dental malpractice litigance

A fotografia é uma ferramenta de suma importância na Odontologia e exerce um papel de fundamental valia para diagnóstico, planejamento, acompanhamento e prova pericial. A Lei nº 5.081/1966, que regula o exercício da Odontologia no Brasil, traz no artigo 6º, inciso IV, que compete ao cirurgião-dentista proceder à perícia odontolegal em foro civil, criminal, trabalhista e em sede administrativa. Nesse sentido, o constante aumento de situações que necessitam da atuação do cirurgião-dentista na função pericial, em casos de lides envolvendo o exercício profissional e a necessidade de avaliação do dano em lesões bucomaxilofaciais, tornam clara a importância do Perito Odontolegista para elucidar os fatos e auxiliar a Justiça. Observa-se, no entanto, certa dificuldade por parte dos profissionais de organizar e categorizar as fotografias capturadas para posterior utilização no laudo pericial. O objetivo desse trabalho foi apresentar um protocolo fotográfico para utilização na rotina pericial em âmbito civil. O referido protocolo baseia-se na indicação de equipamentos fotográficos (características a serem avaliadas), equipamentos auxiliares e sequência de tomadas fotográficas. Concluiu-se que a utilização de protocolo fotográfico para perícias odontológicas em foro civil possibilita que os profissionais registrem aspectos fundamentais para a elaboração de laudos, tornando-se crucial para esclarecer dúvidas e auxiliar os peritos a serviço da Justiça.

Photography is a very important tool in Dentistry and performs a fundamental role for diagnosis, planning, monitoring and expert evidence. The Brazilian Law no. 5,081/1966, which regulates Dentistry as a profession in Brazil, includes in Article 6th, IV, that it is a dentist's duty to carry out the Forensic Odontology expertise in civil, criminal, labor and administrative courts. In this sense, the constant increase of situations that require a dentist performing expert acts, in cases of lawsuits involving the professional practice and the need to evaluate the damage, makes clear the importance of the forensic dentist in order to clarify the facts to the Court. However, there is a certain difficulty to dentists to organize and categorize the photographs captured for later use in the expert witness report. The objective of this paper was to present a photographic protocol for use in expert witness routine in dental malpractice litigance and other issues related to Civil Law. The protocol is based on the indication of photographic equipment (characteristics to be evaluated), auxiliary equipment and sequence of picture. It was concluded that the use of photographic protocol as an expert witness for dentistry allows professionals to record key aspects for this reports, making it crucial to clarify doubts and assist experts in the service of Justice.

Effects of ethanol on the surface and bulk properties of a microwave-processed PMMA denture base resin.

PURPOSE: This study evaluated the effect of different concentrations of ethanol on hardness, roughness, flexural strength, and color stability of a denture base material using a microwave-processed acrylic resin as a model system. MATERIALS AND METHODS: Sixty circular (14 x 4 mm) and 60 rectangular microwave-polymerized acrylic resin specimens (65 x 10 x 3 mm(3)) were employed in this study. The sample was divided into six groups according to the ethanol concentrations used in the immersion solution, as follows: 0% (water), 4.5%, 10%, 19%, 42%, and 100%. The specimens remained immersed for 30 days at 37 degrees C. The hardness test was performed by a hardness tester equipped with a Vickers diamond penetrator, and a surface roughness tester was used to measure the surface roughness of the specimens. Flexural strength testing was carried out on a universal testing machine. Color alterations (DeltaE) were measured by a portable spectrophotometer after 12 and 30 days. Variables were analyzed by ANOVA/Tukey's test (alpha= 0.05). RESULTS: For the range of ethanol-water solutions for immersion (water only, 4.5%, 10%, 19.5%, 42%, and 100%), the following results were obtained for hardness (13.9 +/- 2.0, 12.1 +/- 0.7, 12.9 +/- 0.9, 11.2 +/- 1.5, 5.7 +/- 0.3, 2.7 +/- 0.5 VHN), roughness (0.13 +/- 0.01, 0.15 +/- 0.07, 0.13 +/- 0.05, 0.13 +/- 0.02, 0.23 +/- 0.05, 0.41 +/- 0.19 mum), flexural strength (90 +/- 12, 103 +/- 18, 107 +/- 16, 90 +/- 25, 86 +/- 22, 8 +/- 2 MPa), and color (0.8 +/- 0.6, 0.8 +/- 0.3, 0.7 +/- 0.4, 0.9 +/- 0.3, 1.3 +/- 0.3, 3.9 +/- 1.5 DeltaE) after 30 days. CONCLUSIONS: The findings of this study showed that the ethanol concentrations of tested drinks affect the physical properties of the investigated acrylic resin. An obvious plasticizing effect was found, which could lead to a lower in vivo durability associated with alcohol consumption.

Effect of the use of die spacer on the marginal fit of copings cast in NiCr, NiCrBe and commercially pure titanium.

The goal of this study was to evaluate the effect of using die spacers on the marginal fit of NiCr (M1) and NiCrBe (M2) alloys and commercially pure titanium (cpTi) (M3) copings cast by the lost wax technique. Using a metal matrix, 45 resin added extra hard type IV stone models were obtained for the fabrication of wax patterns under the following conditions: no die spacer (A), with one die spacer layer (B) and with two die spacer layers (C), with five repetitions for each condition (alloy x die). Each die was waxed and the wax patterns were invested as per manufacturer's instructions. Three wax patterns were embedded in each casting ring, each corresponding to one of the conditions. Each coping, seated to the metal matrix by a seating pressure standardizing device (SPSD), was taken to an optical microscope for measurement of marginal discrepancy. The obtained data (microm) were analyzed statistically by ANOVA and Tukey' test (a=5%). There was statistically significant difference (p<0.05) among the materials (M1=110.67; M2=130.33 and M3=148.33). Regarding the use of the die spacer, there was a statistically significant difference (p<0.05) among the three conditions (A=162.00; B=131.06 and C=96.67). It was concluded that there is less marginal discrepancy with two die spacer layers.

Effect of the use of die spacer on the marginal fit of copings cast in NiCr, NiCrBe and commercially pure titanium

The goal of this study was to evaluate the effect of using die spacers on the marginal fit of NiCr (M1) and NiCrBe (M2) alloys and commercially pure titanium (cpTi) (M3) copings cast by the lost wax technique. Using a metal matrix, 45 resin added extra hard type IV stone models were obtained for the fabrication of wax patterns under the following conditions: no die spacer (A), with one die spacer layer (B) and with two die spacer layers (C), with five repetitions for each condition (alloy x die). Each die was waxed and the wax patterns were invested as per manufacturer's instructions. Three wax patterns were embedded in each casting ring, each corresponding to one of the conditions. Each coping, seated to the metal matrix by a seating pressure standardizing device (SPSD), was taken to an optical microscope for measurement of marginal discrepancy. The obtained data (µm) were analyzed statistically by ANOVA and Tukey' test (a=5 percent). There was statistically significant difference (p<0.05) among the materials (M1=110.67; M2=130.33 and M3=148.33). Regarding the use of the die spacer, there was a statistically significant difference (p<0.05) among the three conditions (A=162.00; B=131.06 and C=96.67). It was concluded that there is less marginal discrepancy with two die spacer layers.

O objetivo deste trabalho foi avaliar o efeito do uso de espaçadores na adaptação marginal de "copings" de ligas de NiCr (M1) e NiCrBe (M2) e titânio (M3) fundidos pela técnica de cera perdida. A partir de uma matriz metálica, foram obtidos 45 troquéis de gesso resinado tipo IV para confecção dos padrões de cera nas seguintes condições: sem a presença de espaçador (A), com uma camada de espaçador (B) e com duas camadas de espaçador (C), com cinco repetições para cada condição (liga x espaçador). Foi realizado o enceramento de cada troquel e os padrões de cera foram incluídos no revestimento indicado pelo fabricante. Em cada anel de fundição foram incluídos 3 padrões de cera, sendo cada um correspondente a cada condição. Cada "coping", adaptado à matriz metálica por meio de um dispositivo padronizador da pressão de assentamento, foi levado ao microscópio óptico para aferição das medidas da desadaptação marginal. Os dados obtidos (µm) foram submetidos à análise estatística por ANOVA e teste de Tukey (a=5 por cento). Entre os materiais houve diferença estatisticamente significante (M1=110,67, M2=130,33 e M3=148,33). Em relação ao fator espaçador, houve diferença estatisticamente significante entre as três condições (A=162,00; B=131,06 e C=96,67). Conclui-se que a presença de duas camadas de espaçador propicia menor desadaptação marginal.