Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies.

The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies

Abstract The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

Hipersensibilidade dentinária e satisfação com a saúde mediada pela presença de impacto físico e psicossocial das condições bucais: uma análise de caminhos / Dentin hypersensitivity and health satisfaction mediated by the presence of physical and psychosocial impacts of oral conditions: a pathway analysis

Objetivo: Objetivou-se investigar associação direta e mediada pela presença de impacto físico e psicossocial das condições bucais entre HD e satisfação com a saúde entre adultos. Métodos: Estudo transversal foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos residentes em Rio Acima (MG). Entrevista e exame bucal foram realizados por examinadoras calibradas. Satisfação com a saúde foi avaliada por meio da pergunta doWHOQoL-bref "Quão satisfeito (a) você está com a sua saúde?" e suas respostas categorizadas entre "satisfeito" e "insatisfeito". HD foi avaliada por estímulo tátil na região cervical dos dentes. Presença de impactos físicos e psicossociais das condições bucais foi definida pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do OHIP-14. Covariáveis foram dados sociodemográficos e econômicos, comportamentos em saúde, condições de saúde bucal e uso de serviços odontológicos. Associações foram investigadas por modelos de Regressão de Poisson e Modelagem de Equações Estruturais (MEE) para estimar associações diretas e indiretas (Stata 16). Resultados: Dos 197 adultos, 132 (66,18%) declararam estar satisfeitos com sua saúde e 73 indivíduos (38,75%) apresentavam HD. Houve associação significativa entre presença de HD e presença de impacto físico e psicossocial das condições bucais (RP: 1.34; IC 95%: 1.08­1.67), enquanto para satisfação a associação com HD não foi significativa (RP: 1.08; IC 95%: 0.75-1.54) após a inclusão da variável presença de impacto físico e psicossocial das condições bucais. MEE demonstrou associação direta não significativa entre HD e satisfação, enquanto a associação indireta mediada pela presença de impacto físico e psicossocial das condições bucais foi significativa. Conclusão: Indivíduos com HD podem relatar maior insatisfação com a vida quando esta experiência dolorosa está associada com impactos físicos ou psicossociais.

Aim: Dentin Hypersensitivity (DH) is a painful condition that affects the Oral Health-related Quality of Life and can affect the satisfaction with health of individuals who have it. This study aimed to investigate the direct association mediated by the presence of physical and psychosocial impacts of oral conditions between DH and satisfaction with health among adults. Methods: A cross-sectional study was carried out between 2018-2019 with a probabilistic sample consisting of a cluster of adults living in Rio Acima (MG). Interviews and epidemiological examinations were performed using calibrated tests. The dependent variable of satisfaction with health was assessed using the WHOQoL-bref question "How satisfied are you with your health?" Participants' answers were categorized between "satisfied" and "dissatisfied". The independent DH variable was assessed by tactile stimulation in the cervical region of the teeth. The presence of physical and psychosocial impacts of oral conditions was defined by the answers "farly often" or "very often" to at least one of the OHIP-14 items. Covariates were sociodemographic and psychological data, health behavior, oral health conditions, and use of dental services. Associations were investigated by Poisson Regression and Structural Equation Modeling (SEM) models to estimate direct and indirect associations (Stata 16). Results: Of the 197 adults, 132 (66.18%) reported being satisfied with their health, and 73 individuals (38.75%) had DH. There was a significant association between the presence of DH and the presence of physical and psychosocial impacts of oral health (PR:1.34; 95% CI: 1.08­1.67), while for receiving the association with DH, it was not significant (PR:1 .08; 95% CI: 0.75-1.54) after including the presence of impact variables. SEM showed a non-significant direct association between DH and satisfaction, while the indirect association mediated by the presence of impact was significant. Conclusion: Individuals with HD may report greater dissatisfaction with life when this painful experience is associated with physical or psychosocial effects.

The influence of prophylaxis with amino acid glycine powder and sodium bicarbonate jet on the bond strength of dental enamel / A influência da profilaxia com aminoácido glicina em pó e jato de bicarbonato de sódio na resistência de união do esmalte dentário

Aim: To compare the influence of prophylaxis with sodium bicarbonate and amino acid glycine powder on the bond strength of bovine teeth enamel and on the properties of two adhesive systems. Methods:Thirty-six extracted bovine incisors were randomly divided into six groups (n = 6) according to the prophylactic treatment received: no prophylactic treatment (NT), sodium bicarbonate powder (SB), and glycine powder (GL). Each group was subdivided into 2 groups based on what adhesive systems were used: conventional system (A) and universal system (B). Composite resin was applied on the buccal surface of the teeth in a block measurement 8x8x6 mm. The specimens were cut to obtain beams measuring 1.0 x 1.0 mm and were subjected to microtensile bond strength tests. Results were compared using two-way ANOVA (p ≤ 0.05). Results: The GLA group obtained the highest bond strength value for the conventional adhesive (18.97 MPa), but the GLB group obtained a lower strength value than the SBB group (GLB: 21.05 MPa and SBB: 22.29 MPa) (p < 0.05). Conclusions: Cleaning of the enamel surface increases the adhesive properties of restorative materials, and the bond strength was more effective in the group that received glycine prophylaxis and the conventional adhesive system.

Objetivo:Comparar a influência da profilaxia com bicarbonato de sódio e ClinproProphy ™ na resistência de união do esmalte de dentes bovinos e nas propriedades de dois sistemas adesivos.Métodos: Trinta e seis incisivos bovinos extraídos foram divididos aleatoriamente em 6 grupos (n = 6), cada um de acordo com o tratamento profilático recebido: nenhum tratamento profilático (NT), bicarbonato de sódio em pó (SB), glicina em pó (GL). Cada grupo foi subdividido em 2 grupos com base nos sistemas adesivos utilizados: sistema convencional (A) e sistema universal (B). A resina composta foi aplicada na superfície bucal dos dentes em um bloco de 8x8x6 mm. As amostras foram cortadas para obter blocos medindo 1,0 x 1,0 mm e submetidas a testes de resistência de união por microtração. Os resultados foram comparados usando o teste two-way ANOVA (p ≤ 0,05). Resultados: O grupo GLA obteve o maior valor de resistência de união para o adesivo convencional (18,97 MPa), mas o grupo GLB obteve um valor de resistência menor que o grupo SBB (GLB: 21,05 MPa e SBB: 22,29 MPa) (p < 0,05). Conclusão: A limpeza da superfície do esmalte aumenta as propriedades adesivas dos materiais restauradores, e a resistência adesiva foi mais eficaz no grupo que recebeu profilaxia com glicina e sistema adesivo convencional.

Influência de tensoativo na liberação de própolis de cimentos ionoméricos modificados em diferentes períodos de tempo / Influence of surfactant on the release of propolis from ionomeric cements modified in different time periods

Objetivo: O objetivo deste estudo foi avaliar in vitro a influência de um tensoativo na liberação de própolis de um cimento ionomérico modificado, em diferentes períodos de tempo. Métodos: Vinte corpos de prova foram confeccionados com pó de ionômero de vidro modificado por própolis. Para a obtenção do pó modificado, foi incorporado 20% de própolis verde (Propolis Pharmanéctar- Belo Horizonte - MG) ao pó do ionômero de vidro, sendo em seguida homogeinizado. Corpos de prova foram confeccionadoss, sendo que no grupo A foi utilizado o pó modificado e o líquido do ionômero e no grupo B além do pó modificado e o líquido foi adicionado um tensoativo (álcool 50%). Como controle negativo foram confeccionados corpos de prova sem a presença da própolis, e como controle positivo foi empragada a própolis pura. A liberação foi mensurada nos tempos de 1h, 2h,4h, 24h, 7 dias, 15 dias e 30 dias através de um espectrofotômetro. As mensurações foram realizadas no comprimento de 300nm, e os resultados submetidos à análise de variância e teste de Tukey (p=0,05). Resultados: Os resultados apontaram que a liberação foi significativamente maior nos tempos de 24 horas (média de 166,6µg para o grupo A e 118,9µg para grupo B) e 7 dias (Grupo A: 134,4µg; Grupo B: 168µg), quando comparado aos demais períodos estudados. Conclusão: A liberação de própolis variou de forma significativa em função do tempo de liberação, sendo os picos de liberação da própolis nos períodos de 24 horas e 7 dias. O emprego de uma solução tensoativa alterou o padrão de liberação, sem alterar quantidade final de própolis liberada(AU)

Objective: The objective of this study was to evaluate in vitro the influence of a surfactant on the release of propolis from a modified ionomeric cement at different periods. Methods: Twenty test specimens were made with propolis modified glass ionomer powder. To obtain the modified powder, 20% of green propolis (Propolis Pharmanectar - Belo Horizonte - MG) was incorporated into the powder of the glass ionomer, and then homogenized. The modified powder and the liquid of the ionomer were used in group A, and in group B, in addition to the modified powder, the liquid was added a surfactant (50% alcohol). As a negative control, specimens were prepared without the presence of propolis, and as a positive control the pure propolis. The release was measured at 1h, 2h, 4h, 24h, 7 days, 15 days and 30 days using a spectrophotometer. Measurements were performed at 300nm length, and the results were submitted to analysis of variance and Tukey's test (p = 0.05). Results: The results indicated that the release was significantly higher at 24 hours (mean of 166.6µg for group A and 118.9µg for group B) and 7 days (Group A: 134.4µg; Group B: 168µg); when compared to the other periods studied. Conclusion: The release of propolis varied significantly as a function of the release time, with propolis release peaks in the periods of 24 hours and 7 days. The use of a surfactant solution altered the release pattern without altering the final amount of propolis released(AU)

Avaliação topográfica e in vitro de superfícies de titânio revestidas com vidro bioativo / Topographic and in vitro evaluation of titanium surfaces coated with bioative glass

Objetivo: Avaliar e comparar a rugosidade superficial e a atividade dos osteoblastos em contato com uma nova superfície bioativa e nanoestruturada de titânio grau 4 revestida com vidro bioativo contendo fosfato de cálcio, sintetizada pelo método sol-gel. Material e método: Sessenta e três discos de titânio, medindo 4 mm de diâmetro por 2 mm de altura, foram preparados e divididos em três grupos: microtexturizado (Ticp - controle); revestido com vidro bioativo e seco a vácuo a 37 °C por 10 dias (BGTi37), e revestido com vidro bioativo e aquecido a 600 °C por cinco horas (BGTi600). Três espécimes de cada grupo foram utilizados para avaliação da topografia superficial e 18 espécimes, para cultura celular. Resultado: O revestimento de vidro bioativo diminuiu a rugosidade média quando comparado ao titânio microtexturizado. A proporção de células viáveis, a produção de fosfatase alcalina e o grau de mineralização da matriz óssea em contato com os espécimes de titânio do grupo BGTi600 foram significativamente menores em relação aos grupos controle e do titânio microtexturizado. Conclusão: Apesar de sua marcante menor rugosidade, a superfície BGTi37 apresentou comportamento biológico semelhante a uma superfície de titânio microtexturizada e moderadamente rugosa. A outra superfície experimental (BGTi600), a de menor rugosidade entre todas as testadas, apresentou os piores resultados de ativação dos osteoblastos.

Objective: To evaluate and compare the surface roughness and the activity of the osteoblasts in contact with a new bioactive and nanostructured surface of grade 4 titanium coated with bioactive glass containing calcium phosphate synthesized by the sol-gel method. Material and method: Sixty-three titanium disks, measuring 4 × 2 mm, were prepared and divided into three groups: rough surface, obtained by sandblasted, large-grit, acid-etched (SLA) treatment (Ticp); SLA surface coated with bioglass and dried in a vacuum at 37 °C for 10 days (BGTi37) and SLA surface coated with bioglass and dried in air at 600 °C for 5 hours (BGTi600). Three specimens of each group were used for evaluation of surface topography and 18 for cell cultures. Result: The bioactive glass coating decreased the average roughness when compared to rough titanium surface. The proportion of viable cells, the production of alkaline phosphatase and the degree of mineralization of the bone matrix in contact with the titanium specimens of the BGTi600 group was significantly lower in relation to the control and rough titanium surface groups. Conclusion: Despite its marked lower roughness, BGTi37 surface presented a similar biological behavior to a titanium rough surface obtained by SLA treatment. The other experimental surface (BGTi600), the one with the least roughness among all tested, presented the worst results of osteoblast activation.

Influence of Different Photoinitiators on Polymerization Kinetics and Marginal Microleakage in Restorations using Photopolymerizable Dental Composites

Objective: To evaluate the influence of four different photoinitiators on the polymerization kinetics and marginal microleakage in class V restorations using photopolymerizable dental composites. Material and Methods: Four photopolymerizable dental composites based on Bis-GMA (14.5 wt %), UDMA (6.5 wt %) and silanized filler particles (79 wt %) containing different photoinitiators were formulated. Camphorquinone (CQ)/amine, phenyl-propanedione (PPD), monoacylphosphine oxide (Lucirin® TPO) and bisacylphosphine oxide (Irgacure® 819) were used as photoinitiators. Sixteen intact human third molars were selected and divided into four groups. All teeth received class V cavity preparations in their buccal and lingual surfaces and were submitted to a dye leakage test. Data were independently analyzed for both enamel and dentin, and the results were assessed by a Kruskal-Walis test. The polymerization reactions of the four composites were evaluated by differential scanning calorimeter coupled with photocalorimeter accessory. Results: Lucirin® TPO presented the highest scores for microleakage in enamel, whereas the other photoinitiators have not demonstrated statistical differences. The lowest scores were obtained for PPD in dentin while the highest scores have been achieved by Irgacure® 819 and Lucirin® TPO. Photocalorimetric measurements demonstrated a correlation between polymerization reaction rate and marginal leakage, showing that faster reactions cause greater marginal leakage. Conclusion: Marginal microleakage scores in photopolymerizable dental composites can be greatly influenced by different types of photoinitiators through their distinct reaction rates.

Uso da tecnologia CAD/CAM na Odontologia: do enceramento diagnóstico ao desenho digital integrado. A mudança de um paradigma / The use of CAD/CAM technology in dentistry: from the diagnostic wax-up to the integrated digital design. A paradigm shift

O objetivo deste trabalho foi descrever a técnica de DDI (desenho digital integral) em substituição ao ED (enceramento diagnóstico), mudando um paradigma na Odontologia. Com o uso do DDI, não é necessário realizar o enceramento diagnóstico para estabelecer a meta protética. Esta é obtida digitalmente em um ambiente 3D, com mais requinte de informações e maior precisão. O DDI é então materializado (prototipado) utilizando uma impressora 3D, dentro do ambiente do consultório. Atualmente, os recursos CAD/CAM de baixo custo estão disponíveis para uso odontológico, e os resultados obtidos com esta tecnologia justificam a incorporação do tratamento 3D. Desta forma, a técnica do enceramento dental estaria próxima do fim, sendo que, em um futuro próximo, dentistas/técnicos de prótese serão dental digital designers e todo o conhecimento se voltará para o domínio dos programas de informática, e não para aquisição de equipamentos complexos e de alto custo.

The objective of this study was to describe the IDD technique (integrated digital design) to replace the DW (diagnostic waxing) as a paradigm shift in Dentistry. In this way, it is not necessary to perform the diagnostic waxing to establish the prosthetic outcomes. This is achieved in a 3D environment, with more information refi nement and greater accuracy. The IDD is then materialized (prototyped) using a 3D printer within the dental offi ce. Currently, the CAD/CAM resources are low-cost and available for dental use, with the obtained results justifying the incorporation of the 3D dental treatment. Thus, the diagnostic waxing would be close to an end; in the near future, clinicians/laboratory technicians will be dental digital designers and all knowledge will be managed to computer software domain and not to the acquisition of complex and expensive production equipment.

Definitive Presurgical CAD/CAM-Guided Implant-Supported Crown in an Esthetic Area

This paper describes the digital workflow from cone beam computer tomography (CBCT) to the installation of a definitive presurgical zirconium individual crown in a 19-year-old woman requiring implant replacement of a maxillary right lateral incisor. The patient had agenesis of this tooth and had completed the orthodontic treatment. CBCT was conducted and diagnostic casts were digitized. Virtual planning was completed by defining a prosthetically driven implant and a stereolithographic surgical template was produced. Good adaptation of a stereolithographic surgical template was verified in the working cast. Implant and abutment were installed in this cast using a stereolithographic surgical template, and a CAD/CAM definitive zirconium crown was produced. Flapless computer-guided implant surgery was performed. The abutment was connected, and a definitive zirconium crown was cemented using resin cement. The digital workflow presented herein shows high accuracy for a virtually planned implant with flapless guided placement, allowing the successful delivery of a definitive presurgical zirconium single crown in an esthetic area in a single visit. The patient was revaluated after 1 year of function with an excellent outcome of the treatment.

Resumo Este relato descreve o fluxo de trabalho digital desde tomografia de feixes cônicos até a instalação de uma coroa unitária pré cirúrgica definitiva em zircônia em uma mulher de 19 anos que necessitava de reabilitação com implante do incisivo lateral superior direito. A paciente apresentava agenesia deste dente e tinha finalizado o tratamento ortodôntico. Foi realizada a tomografia e os modelos diagnósticos foram digitalizados. O planejamento virtual do implante foi definido pelo planejamento protético virtual e em seguida um guia cirúrgico foi produzido pelo método da esteriolitografia. Foi verificada a boa adaptação deste guia cirúrgico sobre o modelo de trabalho. O implante e o pilar foram instalados neste modelo de trabalho usando o guia cirúrgico e confeccionada coroa pré cirúrgica definitiva em zircônia pela técnica de CAD / CAM. A cirurgia guiada de instalação do implante foi realizada sem deslocamento de retalho. O pilar selecionado foi instalado e coroa pré cirúrgica definitiva em zircônia foi cimentada com cimento resinoso. O fluxo de trabalho digital apresentado mostrou grande precisão para instalação guiada do implante em uma área estética, permitindo a instalação de uma coroa pré cirúrgica definitiva em zircônia em uma única sessão clínica. A paciente foi reavaliada e apresentou excelentes resultados do tratamento após um ano em função.

Effects of immediate and delayed intraradicular preparation on bond strength of fiber posts.

BACKGROUND: To assist the retention of restorations prepared in endodontically treated teeth, fiber posts are widely used in dental practice. The ideal time to prepare space for the post is still controversial. AIM: The purpose of this study was to evaluate the effects of immediate and delayed postspace preparation on the retention of the self-adhesive resin cement. MATERIALS AND METHODS: Twelve bovine teeth were used with sectioned roots standardized to 19 mm. The teeth were properly instrumented and filled with gutta-percha and eugenol-free cement AH Plus. Two experimental groups (n = 6) were created based on the different times of post preparation (immediate and delayed). Using cemented cylindrical fiber posts, the teeth were put in acrylic resin and polyvinyl chloride tubes, where the cuts were made. Two slices were obtained from the cervical third, two from the medium third and two from the apical third. Subsequently, the samples were subjected into push-out tests. Statistical analysis were performed using ANOVA and Tukey's test (P = 5%). RESULTS: The results indicated that, for all of the evaluated thirds, delayed preparation showed greater bond strength than immediate preparation. CONCLUSION: A delayed post preparation of the root space, following the root canal filling, is recommended.

Definitive Presurgical CAD/CAM-Guided Implant-Supported Crown in an Esthetic Area.

This paper describes the digital workflow from cone beam computer tomography (CBCT) to the installation of a definitive presurgical zirconium individual crown in a 19-year-old woman requiring implant replacement of a maxillary right lateral incisor. The patient had agenesis of this tooth and had completed the orthodontic treatment. CBCT was conducted and diagnostic casts were digitized. Virtual planning was completed by defining a prosthetically driven implant and a stereolithographic surgical template was produced. Good adaptation of a stereolithographic surgical template was verified in the working cast. Implant and abutment were installed in this cast using a stereolithographic surgical template, and a CAD/CAM definitive zirconium crown was produced. Flapless computer-guided implant surgery was performed. The abutment was connected, and a definitive zirconium crown was cemented using resin cement. The digital workflow presented herein shows high accuracy for a virtually planned implant with flapless guided placement, allowing the successful delivery of a definitive presurgical zirconium single crown in an esthetic area in a single visit. The patient was revaluated after 1 year of function with an excellent outcome of the treatment.

Enxerto alógeno em odontologia / Allogenic graft in dentistry

A reabilitação protética de pacientes com perda óssea nos maxilares é uma situação comum na clínica odontológica. Tais perdas podem estar presentes tanto na região anterior quanto na posterior, implicando na necessidade de reconstruções ósseas de tamanhos variados. Vários procedimentos clínicos são indicados para estas reconstruções, sendo os mais comuns o levantamento sinusal na região posterior da maxila e o enxerto em bloco na região anterior da maxila e na mandíbula. Vários materiais são utilizados para este fim, dentre os quais podemos citar o osso autógeno, osso alógeno, osso xenógeno (osso bovino), biomterias sintéticos (biovidros e hidroxipatitas) e as proteínas ósseas morfogenéticas. O osso autogeno é considerado o padrão ouro, visto suas propriedades osteogênicas, osteoindutoras e não antigênicas; porém tem como inconveniente a necessidade de um segundo sítio cirúrgico com grande morbidade para o paciente. O osso alógeno, proveniente de banco de ossos, representa uma alternativa aos enxertos autógenos, mostrando-se um material bastante útil para regenerar o tecido ósseo ausente...

Accidental ingestion of an inter-occlusal device used for the restoration of occlusion: a case report.

The accidental swallowing of prosthetic devices has been discussed in the relevant literature as an unusual, although ordinary, event in clinical practice. This article aims at reporting the ingestion of an inter-occlusal device used to restore the Vertical Dimension of Occlusion (VDO) which, during the ingestion of an analgesic pill, was accidentally swallowed. The patient was sent to the Clinics Hospital UFMG where, upon taking radiographs, the device was located in the upper third of the esophagus. The device was removed during an endoscopic exam with the help of forceps for removing foreign objects. Dealing with a relevant situation, one may conclude that patients who use removable intra-oral devices must take part in a reevaluation protocol in order to detect adaptation and retention of these devices, as well as proper instruction for the patient.

Uma técnica de distração alveolar horizontal minimamente invasiva, colocação dos implantes e restauração cerâmica definitiva CAD/CAM / A minimally invasive, horizontal alveolar distraction technique followed by implant placement and definitive CAD/CAM ceramic restorations: a case report

O emprego de implantes dentais para reabilitação oral pode se defrontar com as dificuldades anatômicas de qualidade e quantidade de osso alveolar. Este relato descreve uma situação clínica de pouca disponibilidade óssea na região dos dentes 44 e 45, com a proximidade de estruturas neurais importantes. Nestas condições, a técnica cirúrgica preferencial seria uma cirurgia de enxerto ósseo em bloco, que apresenta desvantagens, como alto risco de parestesia e grande morbidade para o paciente. Diante disto, o caso foi tratado com uma cirurgia minimamente invasiva, empregando um distrator alveolar para proporcionar um ganho de volume horizontal. Após 80 dias da distração, foi observado uma ganho ósseo significativo, possibilitando a colocação de dois implantes. A reabilitação protética foi executada no sistema CAD/CAM Cerec. Observou-se a importância do emprego de novas tecnologias para minimizar a morbidade e proporcionar o restabelecimento dos tecidos ósseos e dentais perdidos.

The practice of dental implants for oral rehabilitation procedures can face with anatomic impairments on bone quantiy and quality. This case report describes a clinical situation with minimal bone availability at teeth 44 and 45 and their proximity to important neural structures. In this condition, a block bone graft would be advised, but with drawbacks such as paresthesia and morbidity to the patient. Thus, this case received minimally invasive surgery through distraction osteogenics aiming to improve the horizontal bone volume. After 80 days, two dental implants were placed. The prosthetic restoration was performed with Cerec CAD/CAM technology. It was concluded that new techniques can minimize morbidity and at the same time to reestablish lost bone and dental structures

Increased vertical dimension of occlusion: signs, symptoms, diagnosis, treatment and options.

During the planning of oral rehabilitation, the vertical dimension of occlusion (VDO) is one of the first parameters to be measured since its improper restoration can lead to the failure of any prosthetic rehabilitation. A decreased VDO can lead to the appearance of lesions, such as angular cheilitis, facial disharmony, and temporomandibular disorders; meanwhile, an increased VDO may lead to the onset of joint and muscle pain, tension in functional speech, difficulty in swallowing, impaired chewing, tooth sensitivity due to traumatogenic forces, pathologic bone resorption, abnormal wearing of teeth, the appearance of an elongated face, and a facial expression of fatigue. Most scientific articles deal with methods and techniques for re-establishing VDO in edentulous patients or those who have lost their tooth reference due to prosthetic preparations. However, patients with increased VDO are also found in everyday practice. One treatment option for these patients is occlusal adjustment by selective tooth wear; it is still possible to perform orthodontic intrusion and/or orthognathic surgery in severe cases. The aim of this study was to discuss signs, symptoms, diagnosis, and treatment, and to report a clinical case of a patient with increased VDO.

Comparação do desajuste vertical de infraestruturas metálicas sobre implantes: fundida versus fresada / Comparison of vertical misfit between cast and CNC-milled frameworks for implant-supported prostheses

A adaptação passiva da infraestrutura da prótese sobreimplantes é um dos parâmetros mecânicos que podem interferir na longevidade das próteses. Várias complicações no tratamento com implantes osseointegrados podem ser causadas por deficiência na adaptação das infraestruturas protéticas, podendo ser agravadas pela ausência de ligamento periodontal. O objetivo deste trabalho foi comparar a desadaptação de infraestruturas metálicas em monobloco parafusadas sobreimplante, confeccionadas pelo sistema de fundição por cera perdida e fresadas por sistema CAD/CAM. Sobre um modelo mestre de alumínio foram instalados quatro análogos de minipilares. Sobre estes foram confeccionadas duas barras metálicas: uma fundida em Co-Cr e outra fresada. O desajuste vertical na interface barra/análogos foi mensurado utilizando-se um microscópio comparador. Foi calculada a média de desadaptação em cada um dos pilares (45, 43, 33 e 35) e a média final de desadaptação de cada uma das barras. Na barra metálica fresada observou-se redução nos valores da desadaptação vertical em todos os pilares. A barra metálica fundida mostrou uma desadaptação vertical média (108,6 µm) aproximadamente dez vezes maior do que a barra metálica fresada (9,6 µm).

Passive fit of an implant framework is one of the mechanical parameters that can affect treatment longevity. Several complications in dental implant treatment may be due to misfit of metallic frameworks and can be aggravated by the absence of periodontal ligament. The objective of this study is to compare the misfit of a metallic, one-piece cast and CNC-milled implant frameworks. Four implant analogues were placed in a aluminum master model to receive conical abutments. A Co-Cr alloy was used in both groups. Vertical misfits at implant-framework interface were measured with an optical microscope. Mean misft levels were registered at implant positions 45, 43, 33, and 35, as well as for the overall sample. Individual misfit levels were reduced in CNC-milled frameworks. Cast frameworks showed a mean vertical misfit level (108.6 micrometers) almost 10 times higher than in the milled frameworks (9.6 micrometers).

Invasive cervical resorption: etiology, diagnosis, classification and treatment.

BACKGROUND: Invasive cervical resorption (ICR) is not well understood by the professional, being misdiagnosed, leading to inappropriate treatment and unnecessary loss of tooth. INTRODUCTION: ICR is defined as a localized process of resorption, which begins in the cervical area of the tooth, just below the epithelial junction and above the ridge crest in the area of the connective tissue insertion. Possible predisposing factors include external trauma, orthodontic movement, surgical procedures, periodontal disease and its treatments, endogenous bleaching, pressure generated by wind instruments and herpes virus infection. Different approaches have been suggested for the treatment of ICR, depending on the extent of the lesion and its location. However, in some cases due to the severity of the injury, there is no alternative but to tooth extraction, followed by restoration of the edentulous area. AIM AND OBJECTIVE: Discuss etiology, diagnosis and classification of the ICR, as well as different treatment options. Also is presented a case in which extraction was carried out, installation of the implant and ceramic crown, subsequent to a treatment approach that resulted in failure in the short-term period. CONCLUSION: Early diagnosis of the ICR is critical to proper treatment and favorable prognosis. Interdisciplinary treatment should be instituted as soon as possible, avoiding the loss of the affected tooth. In advanced cases, treatment involving the installation of osseointegrated implants should be considered the first choice of treatment. CLINICAL SIGNIFICANCE: Early diagnosis of the ICR is critical do prevent unnecessary tooth loss, once the prognosis for advanced cases is doubtful.

Influence of surface area and geometry of specimens on bond strength in a microtensile test: an analysis by the three-dimensional finite element method.

PURPOSE: This study employed three-dimensional (3D) finite element analysis to investigate the stress distribution patterns in a microtensile test with the goal of evaluating the effects of the bond surface area and geometry on bond strength. MATERIALS AND METHODS: Finite element models of six specimens were generated: three stick models and three hourglass models. All models simulated the bond strength between dentin and ceramic. The mechanical properties of the materials-the modulus of elasticity and Poisson's coefficient-were defined according to a literature review. The base of each specimen was considered inserted (constrained area) and possessed nodes with displacements restricted in all directions. A traction load, which was calculated to generate a uniformly distributed stress of 20 N/mm(2) at the bond interface, was applied to the top of the specimen. The distribution pattern of the generated stress was qualitatively and quantitatively measured based on color scales ranging from blue to red, according to the von Mises equivalent stress. RESULTS: Specimens with similar shapes demonstrated similar stress distributions. Ceramic specimens had a higher stress value (30.35 MPa) compared to specimens consisting of resinous cement (23.59 MPa) and dentin (19.77 MPa). At the bond interface, the specimens with square sections demonstrated stress values ranging from 22.00 to 24.20 MPa. For the circular section, the stress values ranged from 23.40 to 27.00 MPa. CONCLUSION: The maximum stress values determined for the circular and square sections were similar among specimens with the same interface area. At the bond interface, the highest stress values were observed in hourglass-shaped specimens.

Combined technique with dentin post reinforcement and original fragment reattachment for the esthetic recovery of a fractured anterior tooth: a case report.

This case report describes the esthetic and functional recovery of a maxillary central incisor. The treatments used were dentin post (biological post) reinforcement and reattachment of the fragment. From the outcomes achieved, it can be concluded that this technique is promising and is yet another alternative method that can be used for the recovery of fractured anterior teeth.