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1.
BMC Med Res Methodol ; 20(1): 57, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32160871

RESUMO

BACKGROUND: The aims of this study were to assess whether the previous registration of a systematic review (SR) is associated with the improvement of the quality of the report of SRs and whether SR registration reduced outcome reporting bias. METHODS: We performed a search in PubMed for SRs in dentistry indexed in 2017. Data related to SR registration and reporting characteristics were extracted. We analyzed if the reporting of 21 characteristics of included SRs was associated with the prospective registration of protocols or reporting of a previously established protocol. The association between prospective registering of protocols, reporting of funding and number of included studies versus outcome reporting bias was tested via multivariable logistic regression. RESULTS: We included 495 SRs. One hundred and 62 (32.7%) SRs reported registering the SR protocol or working from a previously established protocol. Thirteen reporting characteristics were described statistically significant in SRs registered versus SRs that were not. Publication bias assessment and Report the number of participants showed the highest effects favoring the register (RR 1.59, CI 95% 1.19-2.12; RR 1.58, CI 95% 1.31-1.92 respectively). Moreover, Registration was not significantly linked with the articles' reporting statistical significance (OR 0.96, CI 95% 0.49-1.90). CONCLUSION: There is a positive influence of previously registering a protocol in the final report quality of SRs in dentistry. However, we did not observe an association between protocol registration and reduction in outcome reporting bias.

2.
PLoS One ; 15(3): e0229730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32119710

RESUMO

The tryptophan hydroxylase 2 (TPH2) enzyme catalyzes the first step of serotonin biosynthesis. Serotonin is known for its role in several homeostatic systems related to sleep, mood, and food intake. As the reaction catalyzed by TPH2 is the rate-limiting step of serotonin biosynthesis, mutations in TPH2 have been associated with several psychiatric disorders (PD). This work undertakes an in silico analysis of the effects of genetic mutations in the human TPH2 protein. Ten algorithms were used to predict the functional and stability effects of the TPH2 mutations. ConSurf was used to estimate the evolutionary conservation of TPH2 amino acids. GROMACS was used to perform molecular dynamics (MD) simulations of TPH2 WT and P260S, R303W, and R441H, which had already been associated with the development of PD. Forty-six TPH2 variants were compiled from the literature. Among the analyzed variants, those occurring at the catalytic domain were shown to be more damaging to protein structure and function. The ConSurf analysis indicated that the mutations affecting the catalytic domain were also more conserved throughout evolution. The variants S364K and S383F were predicted to be deleterious by all the functional algorithms used and occurred at conserved positions, suggesting that they might be deleterious. The MD analyses indicate that the mutations P206S, R303W, and R441H affect TPH2 flexibility and essential mobility at the catalytic and oligomerization domains. The variants P206S, R303W, and R441H also exhibited alterations in dimer binding affinity and stability throughout the simulations. Thus, these mutations may impair TPH2 functional interactions and, consequently, its function, leading to the development of PD. Furthermore, we developed a database, SNPMOL (http://www.snpmol.org/), containing the results presented in this paper. Understanding the effects of TPH2 mutations on protein structure and function may lead to improvements in existing treatments for PD and facilitate the design of further experiments.

3.
Nat Commun ; 11(1): 1539, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32210242

RESUMO

Idiopathic pulmonary fibrosis (IPF) is a chronic and fatal disease of unknown etiology; however, apoptosis of lung alveolar epithelial cells plays a role in disease progression. This intractable disease is associated with increased abundance of Staphylococcus and Streptococcus in the lungs, yet their roles in disease pathogenesis remain elusive. Here, we report that Staphylococcus nepalensis releases corisin, a peptide conserved in diverse staphylococci, to induce apoptosis of lung epithelial cells. The disease in mice exhibits acute exacerbation after intrapulmonary instillation of corisin or after lung infection with corisin-harboring S. nepalensis compared to untreated mice or mice infected with bacteria lacking corisin. Correspondingly, the lung corisin levels are significantly increased in human IPF patients with acute exacerbation compared to patients without disease exacerbation. Our results suggest that bacteria shedding corisin are involved in acute exacerbation of IPF, yielding insights to the molecular basis for the elevation of staphylococci in pulmonary fibrosis.

4.
J Esthet Restor Dent ; 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32124517

RESUMO

OBJECTIVE: This study sought to describe the clinical and laboratory procedures and to discuss aspects involved in obtaining satisfactory esthetics on substrates presenting different colors. CLINICAL CONSIDERATIONS: This case report describes the clinical and laboratory procedures for obtaining an optimal esthetic result using different ceramic framework materials veneered with feldspathic ceramic over substrates of different colors. Zirconia frameworks were used for darkened substrates and were reinforced with lithium disilicate for substrates with minimal discoloration. The same feldspathic veneering ceramic was applied to provide similar translucency and color for favorable esthetics. CONCLUSIONS: The materials explored in the present case report presented favorable aesthetic results in masking darkened substrates. CLINICAL SIGNIFICANCE: Clinicians should consider the condition and color of the substrate when selecting the restorative material for masking such a condition.

5.
J Mech Behav Biomed Mater ; 104: 103686, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32174433

RESUMO

The aim of the study was to evaluate the effect of a ceramic primer and its increased passive application on the fatigue performance of adhesively cemented lithium disilicate simplified restorations. Ceramic discs (Ø = 10 mm; thickness = 1.0 mm) were submitted to an in-lab simulation of CAD/CAM milling and allocated into 8 groups (n = 15), considering 2 factors: "surface treatment"- PRIMER, only coupling agent application (Monobond N); HF5+PRIMER, 5% hydrofluoric acid and coupling agent; E&P 20s + 40s and E&P 20s+5min, ceramic etching/priming (Monobond Etch & Prime, E&P) for 20 s of active application followed by 40 s or 5 min of passive application, respectively; and "aging condition"- baseline, storage for 24 h to 5 days; aged, storage for 90 days +12,000 thermal cycles. Adhesive cementation (Multilink N) was performed onto epoxy discs (Ø = 10 mm; thickness = 2 mm) and the cemented assemblies were subjected to step-stress fatigue tests (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). The results showed that the groups had similar fatigue performance in the baseline condition (except for E&P 20s+5min: 940.0 N; 123,000 cycles > PRIMER: 786.7 N; 92,333 cycles). When aged, the PRIMER group presented the worst fatigue performance (480.8 N; 31,154 cycles) compared to the other groups (810.0-840.0 N; 97,000-103,000 cycles). In addition, only the PRIMER treatment showed unstable fatigue performance (baseline > aged). Therefore, ceramic surface treatment promoting micromechanical interlocking and chemical bonds is mandatory for stable fatigue performance of adhesively cemented lithium disilicate restorations. The one-step ceramic primer/conditioner promoted similar fatigue performance to the 5% hydrofluoric acid + coupling agent, but increased E&P etching time did not improve the fatigue behavior.

6.
Artigo em Inglês | MEDLINE | ID: mdl-32116034

RESUMO

The aim of this study was to assess the stress/strain in dental implant/abutments with alternative materials, in implants with different microgeometry, through finite element analysis (FEA). Three-dimensional models were created to simulate the clinical situation of replacement of a maxillary central incisor with implants, in a type III bone, with a provisional single crown, loaded with 100 N in a perpendicular direction. The FEA parameters studied were: implant materials-titanium, porous titanium, titanium-zirconia, zirconia, reinforced fiberglass composite (RFC), and polyetheretherketone (PEEK); and abutment materials-titanium, zirconia, RFC, and PEEK; implant macrogeometry-tapered of trapezoidal threads (TTT) and cylindrical of triangular threads (CTT) (ø4.3 mm × 11 mm). Microstrain, von Mises, shear, and maximum and minimum principal stresses in the structures and in peri-implant bone were compared. There was increased stress and strain in peri-implant bone tissue caused by implants of materials with lower elastic modulus (mainly for PEEK and RFC). They also presented higher concentration of stresses in the implant itself (especially RFC). Zirconia implants led to lower stress and strains in peri-implant bone tissue. Less rigid abutments (RFC and PEEK) associated with titanium implants led to higher stress in the implant and in peri-implant bone tissue. The TTT macrogeometry showed a higher stress concentration in the implant and peri-implant bone tissue. The stress/strain in peri-implant bone tissue and implant structures were affected by the material used, where reduced values were caused by stiffer materials. Lower stress/strain values were obtained with cylindrical implants of triangular treads.

7.
J Endod ; 2020 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32147184

RESUMO

INTRODUCTION: The aim of this study was to identify through a scoping review whether root canal irrigants influence the mechanical properties of endodontically treated teeth, and which properties could be affected. The protocol of this study, available online (https://osf.io/yc9nb/), followed the Joana Briggs Institute guidelines. Reporting was based on PRISMA Extension for Scoping Reviews. METHODS: We selected studies written in English that evaluated the effect of at least one irrigant on the mechanical properties of endodontically treated teeth. The search and study screening were performed in PubMed and Scopus databases by 2 independent researchers. A descriptive analysis was performed to consider the study design, the characteristics of the irrigants, and the properties tested. RESULTS: The initial search yielded 608 citations, of which 66 were included. On the basis of the collected data, the most commonly used solutions were 17% EDTA, 2.5% or 5% sodium hypochlorite, and 2% chlorhexidine, and the most common tested properties were hardness and strength. Alterations in the modulus of elasticity, stress and strain concentration during preparation, and roughness were also assessed. CONCLUSIONS: The majority of studies corroborated a negative effect of all solutions on the mechanical properties of endodontically treated teeth. Furthermore, increases in the concentration of the solution and in the time of exposure were found to intensify deleterious effects. However, disinfection of the canal is also a crucial factor in endodontic success. Thus, clinicians should consider these factors to mitigate the effects without interfering with antibacterial properties, customizing the choice of the solution to the case in hand.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32072443

RESUMO

Optical coherence tomography (OCT) provides excellent image resolution, however OCT optimal acquisition is essential but could be challenging owing to several factors. We sought to assess the quality of OCT pullbacks and identify the causes of suboptimal image acquisition. We evaluated 784 (404 pre-PCI; 380 post-PCI) coronary pullbacks from an anonymized OCT database from our Cardiovascular Imaging Core Laboratory. Imaging of the region-of-interest (ROI-lesion or stented segment plus references) was incomplete in 16.1% pullbacks, caused by pullback starting too proximal (63.7%), inappropriate pullback length (17.1%) and pullback starting too distal (11.4%). The quality of image acquisition was excellent in 36.3% pullbacks; whereas 4% pullbacks were unanalyzable. Pullback quality was most commonly affected by poor blood displacement from inadequate contrast volume (27.4%) or flow (25.6%), followed by artifacts (24.1%). Acquisition mode was 'High-Resolution' (54 mm) in 74.4% and 'Survey' (75 mm) in 25.6% of cases. The 54 mm mode was associated with incomplete ROI imaging (p = 0.020) and inadequate contrast volume (p = 0.035). We observed a substantial frequency of suboptimal image acquisition and identified its causes, most of which can be addressed with minor modifications during the procedure, ultimately improving patient outcomes.

9.
Theriogenology ; 144: 194-203, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31978855

RESUMO

Seminal plasma (SP) contributes to sperm physiology and metabolism, prevents premature capacitation, and protects sperm against oxidative stress. In order to evaluate the impact of heat stress in the semen of tropically adapted Brangus breed and in their seminal plasma proteome, we studied the effects of scrotal insulation for 72 h. Semen samples from six bulls, between 7 and 8 years of age, were collected prior to scrotal insulation (pre-insulation), and at 4 and 11 wk after insulation. Seminal plasma samples were analyzed by 2D SDS-PAGE and liquid chromatography coupled with mass spectrometry (LC-MS/MS). Insulation caused decrease in vigour, gross and total motility after 4 wk of scrotal insult (P < 0.001). Total defects in sperm were higher after 4 wk compared to pre-insulation and 11 wk after scrotal insulation (P < 0.001). The analysis of the 2D protein profile of the SP resulted in the identification 183 unique protein spots in all gels evaluated. There was no difference in mean number of protein spots amongst time points. Eight protein spots were more abundant in SP after scrotal insulation, returning to the same expression level at 11 wk post-insulation. One spot had higher abundance at 11 wk post-insulation, and one spot had decreased abundance 4 wk after insulation. The ten protein spots with differential abundance amongst time points were identified as Seminal plasma protein PDC-109, Seminal plasma protein A3, Seminal plasma protein BSP-30 kDa, Spermadhesin-1 and Metalloproteinase inhibitor 2. The validation of these five proteins as biomarkers for thermal testicular stress in Brangus breed would allow the development of new biotechnologies that could improve bovine semen analysis in breeding systems in tropical and subtropical conditions. A close association between the identified BSP and Spermadhesin-1 was evidenced in protein-protein interaction analysis. Based on gene ontology analysis, variation in sperm function after insulation could be explained by variation in the expressed proteins in the SP. Further studies are required to verify if these proteins could be used as biomarkers for the identification of bulls with increased seminal resistance to heat stress in Brangus breed.

10.
Appl Environ Microbiol ; 86(7)2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-31980431

RESUMO

Renewable fuels have gained importance as the world moves toward diversifying its energy portfolio. A critical step in the biomass-to-bioenergy initiative is deconstruction of plant cell wall polysaccharides to their unit sugars for subsequent fermentation to fuels. To acquire carbon and energy for their metabolic processes, diverse microorganisms have evolved genes encoding enzymes that depolymerize polysaccharides to their carbon/energy-rich building blocks. The microbial enzymes mostly target the energy present in cellulose, hemicellulose, and pectin, three major forms of energy storage in plants. In the effort to develop bioenergy as an alternative to fossil fuel, a common strategy is to harness microbial enzymes to hydrolyze cellulose to glucose for fermentation to fuels. However, the conversion of plant biomass to renewable fuels will require both cellulose and hemicellulose, the two largest components of the plant cell wall, as feedstock to improve economic feasibility. Here, we explore the enzymes and strategies evolved by two well-studied bacteria to depolymerize the hemicelluloses xylan/arabinoxylan and mannan. The sets of enzymes, in addition to their applications in biofuels and value-added chemical production, have utility in animal feed enzymes, a rapidly developing industry with potential to minimize adverse impacts of animal agriculture on the environment.

11.
J Prosthodont Res ; 64(1): 12-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31213364

RESUMO

PURPOSE: To characterize the effect of two processing techniques (pressing and CAD/CAM - Computer Aided Design/Computer Aided Machining) of lithium-disilicate (LD) based crowns on the microstructure, topography, roughness, fractal dimension, internal and marginal adaptation. METHODS: One-hundred identical preparations for monolithic crowns were made with dentin analogue material (G10 epoxy resin). One of the preparations was scanned and a monolithic crown in lithium-disilicate was planned in the CAD system. Fifty crowns were milled in a wax pattern and subjected to pressing (IPS e.max Press), while 50 crowns were machined at CAD/CAM (IPS e.max CAD) and posteriorly crystallized. Internal and marginal adaptation were assessed via replica technique at four manufacturing moments (Milled wax pattern; LDPRESS; Milled LDCAD; Crystallized LDCAD) and considering 5 regions (margin, cervico-axial angle, axial wall, axial-occlusal angle and occlusal wall). Complementary analysis considering microstructure and topography, roughness and fractal dimension were performed in Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: The processing technique resulted in different ceramic microstructure, topography, roughness and fractal dimension, whereas CAD/CAM lead to smoother, more homogeneous but more complex topography features (higher fractal dimension) in comparison to the pressing technique (P<0.05). Regarding marginal and internal fit, LDPRESS crowns showed to be more adapted at the margin, while LDCAD were more adapted at the occluso-axial angle; other regions were not statistically different (α=0.05). CONCLUSIONS: CAD/CAM and the pressing techniques for manufacturing LD crowns lead to completely different ceramic surface characteristics and affect crown adaptation at the margin and at occluso-axial angle.


Assuntos
Adaptação Marginal Dentária , Lítio , Cerâmica , Projeto Auxiliado por Computador , Coroas , Técnica de Fundição Odontológica , Técnica de Moldagem Odontológica , Porcelana Dentária , Planejamento de Prótese Dentária , Fractais , Propriedades de Superfície
12.
J Mech Behav Biomed Mater ; 103: 103528, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31743822

RESUMO

This study aims to evaluate the effect of distinct surface treatments (grinding, polishing and glaze) of the occlusal surface of fully-stabilized zirconia (FSZ) simplified restorations bonded onto epoxy resin on the fatigue behavior of the restorations. Disc shaped specimens of FSZ (IPS e.max Zircad MT Multi) were produced (Ø = 10 mm and 0.8 mm in thickness) and randomly allocated into 5 groups, considering the factor 'surface treatment' of the occlusal surface: Ctrl - as-sintered; Gr - ground with coarse diamond bur; Gr + Pol- grinding + polishing with two-step polishing system; Gr + Gl - grinding + glaze application; Gr + Pol + Gl - grinding + polishing + glaze application. Next, the FSZ intaglio surface was air-abraded with 45 µm aluminum oxide powder for 10 s at 15 mm of distance under 2 bar pressure and the discs were adhesively cemented (Multilink Automix) onto its dentin analogue pair (Ø = 10 mm; thickness = 2.7 mm). Finally, the step-stress fatigue test was executed (load ranging from 200 to 1300 N; step-size of 100N; 10,000 cycles per step, 20 Hz). In addition, surface topography, roughness, phase transformation and fractography analyses were performed. Grinding altered the topographical pattern introducing defects into the material surface and increasing roughness. Polishing and glaze application led to a smoothening effect, reducing surface defects and statistically decreasing roughness. However, the effect on roughness of polishing and glaze was statistically similar. No phase transformation was observed, thus only cubic and tetragonal phases were detected. No surface treatment had a deleterious effect regarding the fatigue failure load, number of cycles for failure and survival rates. All failures (cracks) started on the bonding surface. Thus, polishing and glaze are indicated to reduce surface roughness, despite not leading to differences in terms of fatigue performance.

13.
Int J Cardiol ; 301: 45-49, 2020 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-31757646

RESUMO

BACKGROUND: Vessel Fractional Flow Reserve (vFFR), a new angiography-derived method for the functional assessment of coronaries, was recently shown to have good correlation with invasive wire-derived FFR, when vFFR-specific image acquisition requirements were followed. We sought to investigate the feasibility of vFFR analysis and its correlation with FFR in the situation where angiography is completed in routine fashion, without intention for virtual analysis. METHODS: Utilizing an anonymized database maintained at our Cardiovascular Imaging Core Laboratory, we included angiographic images from patients that underwent pre- and post-PCI FFR. CAAS Workstation 8.1 software (Pie Medical Imaging) was used for vFFR evaluation. RESULTS: Out of 624 angiograms (312 pre-PCI and 312 post-PCI), vFFR was successfully analyzed in 219 (35.1%) (115 pre-PCI and 104 post-PCI). Reasons for vFFR analysis failure were: <2 angiographic projections (42.5%), table movement while acquisition (25.7%) and resolution incompatibility (15%). From 115 patients with analyzable pre-PCI vFFR, 74 (64.3%) showed agreement with the respective FFR results in terms of positive (≤0.80) vs negative (>0.80) FFR. Pearson's correlation coefficient between them was 0.449 (p < 0.0001). From 104 lesions with analyzable post-PCI vFFR, 94 had availability of FFR, 74 (78.7%) of which showed agreement between the vFFR and FFR. Pearson's correlation between the values was 0.115 (p = 0.2703). CONCLUSION: vFFR could be analyzed in about one-third of previously completed angiographies and a weak correlation was seen between vFFR and FFR. Our results show the importance of following the pre-specified requirements for vFFR analysis. Further studies are needed to validate the software in different settings.

14.
J Prosthodont Res ; 2019 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-31718959

RESUMO

PURPOSE: To compare the effect of different surface treatments (pre-treatments and bonding agents) on the bond strength between glass-fiber post and composite resin, and the topographic alterations of the treated post surface. METHODS: Thirty-six glass-fiber blocks (12mm×10mm×8mm) were specifically manufactured for this study and randomly assigned into 12 groups considering two factors: 'pre-treatments' (-cleaning with 70% alcohol; air-abrasion with silica-coated aluminum oxide particles; 35% hydrogen peroxide) and type of 'bonding agent' (no bonding agent; application of Monobond Plus; RelyX Ceramic Primer; Single Bond Universal). After that, 6 cylindrical templates (1mm high×1mm Ø) were fixed on each block, filled with composite resin (n=18) and light-cured. Specimens were stored under 37°C for 24h and microshear tests (wire loop Ø=0.2mm) were performed. Topographic, roughness and failure analyses were also performed. RESULTS: Different surface pre-treatments led to different topographic and roughness alterations; a higher surface alteration was noted after silica particles air-abrasion, while a slight surface alteration in the hydrogen peroxide group and a smooth pattern were observed in the cleaning group. The factors 'pre-treatments' (p<0.05), 'bonding agent' (p<0.05) and their interaction (p<0.05) influenced the bond strength. Silica coating, apart from bonding agent application, or Single Bond Universal application without pre-treatment promoted the highest bond values. The main failure type was adhesive at the resin-post interface. CONCLUSIONS: In terms of pre-treatments, silica coating promotes the best bonding performance, but pre-treatments can be dispensable when applying Single Bond Universal.

15.
J Mech Behav Biomed Mater ; 102: 103457, 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31605929

RESUMO

This study aimed to evaluate the effect of shading procedures on the fatigue performance and optical properties of an yttria-stabilized tetragonal zirconia polycrystal ceramic (4Y-TZP - stabilized by 4 mol% Y2O3). Disc-shaped specimens were produced at pre-sintered stage and randomly allocated into 5 groups (n=15) considering the shading technique: Ctrl (no pigmentation); Brush 1× and Brush 3× (brushing on 1 or 3 applications, respectively); Immer 2min and Immer 4min (immersion for 2 or 4 min, respectively). Following each pigment application, the specimens were dried in accordance with the manufacturers' guidelines (15 min in a stove at 70 °C) and sintered in a specific furnace. Biaxial flexural fatigue test followed a step-stress approach (initial strength: 200 MPa; step-size: 25 MPa; 10.000 cycles/step; frequency: 20 Hz). Optical measurements were conducted in a spectrophotometer following the CIEDE2000 parameters. Roughness, topography, crystalline grain size, crystalline phase content and fractography analysis were also performed. The flexural fatigue strength (FFS) and the number of cycles to fracture (CFF) were statistically affected by pigmentation techniques (mean FFS in MPa/mean CFF): Ctrl (446.7/105,619) > Brush 1 × (436.7/102,854) ≥ Brush 3 × (405.0/89,962) ≥ Immer 2 min (395.0/85,103) ≥ Immer 4 min (383.3/81,382), although the exposure intensity (increase in number of applications or in application time) to the pigment had no effect (Brush 1 × = Brush 3 × ; Immer 2 min = Immer 4 min). Regarding optical properties, shading techniques similarly affected translucency and opalescence parameters, regardless of the exposure intensity to the pigment (Brush 1 × = Brush 3 × = Immer 2 min = Immer 4 min > Ctrl), whereas the exposure intensity to the pigment only promoted relevant alterations in the color change parameter (ΔE00) for the brushing technique (Brush 3 × > Brush 1 × ). No difference was observed in crystalline phase content, topographic pattern or roughness, although an increase in the zirconia grain size could be detected. Thus, the shading technique might affect the fatigue behavior and promote optical changes in a 4Y-TZP ceramic.

16.
Braz Dent J ; 30(5): 446-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596328

RESUMO

Two clinical cases are presented to explore technical differences and discusses the advantages and disadvantages of using veneered or monolithic zirconia to manufacture posterior single crowns. The first case describes the clinical steps in manufacturing a monolithic crown on a mandibular left second premolar using high translucency zirconia. It shows the use of a conservative tooth preparation based on the superior mechanical properties that this material presents as well as the final optical characteristics achieved by shading and staining. In the second case, a conventional bilayer restorative treatment was made using zirconia framework followed by veneering with feldspar ceramic on a mandibular left first molar. Recent literature indicates that each of these restorative alternatives presents specific advantages and disadvantages. Factors such as mechanical performance, fracture, esthetic characteristics, clinical success, complication rates, adhesion and antagonist wear performance are discussed comparing the two restorative assemblies. The data highlight that monolithic crowns prevent a major problem reported on bilayer restorations: the chipping of veneering ceramic. Monolithic crowns also allow minimally invasive tooth preparations, thus increasing tooth remnant preservation. However, data that support esthetic performance similarity between monolithic and bilayer assemblies are lacking, thus the predictability of use is restricted for the posterior region, as cases demanding high esthetic appeal continue to fundamentally use bilayer restorations. Failures were not found, and patient satisfaction was reported in both techniques after the 12-month follow up.


Assuntos
Coroas , Porcelana Dentária , Cerâmica , Humanos , Teste de Materiais , Zircônio
17.
Braz. dent. j ; 30(5): 446-452, Sept.-Oct. 2019. graf
Artigo em Inglês | LILACS-Express | ID: biblio-1039140

RESUMO

Abstract Two clinical cases are presented to explore technical differences and discusses the advantages and disadvantages of using veneered or monolithic zirconia to manufacture posterior single crowns. The first case describes the clinical steps in manufacturing a monolithic crown on a mandibular left second premolar using high translucency zirconia. It shows the use of a conservative tooth preparation based on the superior mechanical properties that this material presents as well as the final optical characteristics achieved by shading and staining. In the second case, a conventional bilayer restorative treatment was made using zirconia framework followed by veneering with feldspar ceramic on a mandibular left first molar. Recent literature indicates that each of these restorative alternatives presents specific advantages and disadvantages. Factors such as mechanical performance, fracture, esthetic characteristics, clinical success, complication rates, adhesion and antagonist wear performance are discussed comparing the two restorative assemblies. The data highlight that monolithic crowns prevent a major problem reported on bilayer restorations: the chipping of veneering ceramic. Monolithic crowns also allow minimally invasive tooth preparations, thus increasing tooth remnant preservation. However, data that support esthetic performance similarity between monolithic and bilayer assemblies are lacking, thus the predictability of use is restricted for the posterior region, as cases demanding high esthetic appeal continue to fundamentally use bilayer restorations. Failures were not found, and patient satisfaction was reported in both techniques after the 12-month follow up.


Resumo Dois casos clínicos são apresentados para explorar as diferenças técnicas e discutir as vantagens e desvantagens de se utilizar zircônia com cerâmica estratificada ou monolítica para confeccionar coroas unitárias. O primeiro caso descreve os passos clínicos na confecção de uma coroa monolítica no segundo pré-molar esquerdo utilizando uma zircônia altamente translúcida. Neste caso é apresentado a confecção de um preparo conservador devido as propriedades mecânicas deste material bem como suas características ópticas encontradas com a pigmentação e maquiagem. No segundo caso, um tratamento restaurador convencional de estratificação foi realizado utilizando uma infraestrutura de zircônia seguido pelo recobrimento com cerâmica feldspática em um primeiro molar inferior esquerdo. A literatura recente indica que cada uma dessas alternativas restauradoras apresenta vantagens e desvantagens específicas. Fatores como desempenho mecânico, fratura, características estéticas, sucesso clínico, taxas de complicações, adesão e desgaste do antagonista são discutidos comparando as duas possibilidades restauradoras. Os achados da literatura destacam que coroas monolíticas impedem um grande problema relatado em restaurações estratificadas: o lascamento da cerâmica de recobrimento. Coroas monolíticas também permitem preparos dentários minimamente invasivos, aumentando assim a preservação do remanescente dentário. No entanto, dados suportando um desempenho estético similar entre coroas monolíticas e estratificadas são inexistentes, assim a previsibilidade de uso é restrita para a região posterior, pois casos exigindo alta demanda estética restaurações estratificadas continuam ser principalmente utilizadas. Falhas não foram encontradas e a satisfação do paciente foi relatada em ambas as técnicas após o acompanhamento de 12 meses.

18.
J Mech Behav Biomed Mater ; 99: 198-205, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31374515

RESUMO

This study evaluated and compared the effects of two glaze application methods (brush and spray) on the fatigue strength and surface characteristics (topography and roughness) of a translucent yttrium stabilized partially tetragonal zirconia polycrystal ceramic (Y-TZP) prior to and after grinding. Disc-shaped specimens of translucent Y-TZP (Vita YZ-HT; Vita-Zahnfabrik) were processed (ISO 6872-2015) and randomly allocated into 6 groups, according to the surface treatments performed on the tensile surface: Ctrl - as-sintered (no treatment); Gr - grinding with a diamond bur (181 µm-grit; #3101G); Br - glaze obtained from a powder-liquid mix and applied by brush (Vita Akzent; Vita Zahnfabrik); Sp - glaze application via spray (Vita Akzent Plus; Vita Zahnfabrik); Gr + Br and Gr + Sp - association of grinding + respective glaze method. Analyses of surface roughness (Ra and Rz), fatigue strength (staircase method), surface topography and fractography were carried out. The as-sintered condition had the smoothest surface, while grinding led to the rougher and more heterogeneous topography. Both glaze application methods showed a potential for topography evenness (smoothening effect), while the glaze spray method led to thinner layers of material, showing a limitation in reducing the roughness compared to the brush method. No deleterious effect on fatigue strength of the Y-TZP could be observed, as the glaze-spray application on the as-sintered surface showed the highest values. Fractography depicted two distinct fracture origin regions: from defects in the surface/sub-surface region for the Ctrl and Gr groups; and at the zirconia-glaze layer interface for Br, Sp, Gr + Br and Gr + Sp. The clinical relevance of this work is that the tested glaze application methods did not damage the fatigue strength of the tested Y-TZP.

19.
J Adhes Dent ; 21(4): 373-381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31432052

RESUMO

PURPOSE: To evaluate the influence of different ceramic surface conditioning methods on the fatigue failure load of adhesively cemented simplified lithium-disilicate glass-ceramic restorations. MATERIALS AND METHODS: Ceramic (IPS e.max CAD, Ivoclar Vivadent) (Ø = 10 mm; thickness = 1.2 mm) and epoxy resin (Ø = 10 mm; thickness = 2.3 mm) disks were produced. The ceramic bonding surfaces were treated as follows: no etching and MPS-silane primer application only (MN); etching with 10% hydrofluoric acid (HF) for 20 s followed by primer application (HF + MN); HF + universal multimode adhesive application (HF + SU); etching with a one-step etching primer (ME&P); HF + primer + conventional adhesive (HF + MN + PAB). The epoxy resin disks were etched with 10% HF for 20 s followed by a coat of bonding agent (Multilink Primer A+B). Pairs of ceramic/epoxy resin disks were cemented with composite cement (Multilink N, Ivoclar Vivadent). The mean fatigue failure load was determined by the staircase method (100,000 cycles at 20 Hz frequency; initial load = 1435 N; step size = 72 N). RESULTS: ME&P had the highest fatigue failure load, followed by HF etched groups, while the non-etched condition (MN group) had the lowest. All samples presented radial cracks originating from defects at the conditioned ceramic surface (interface). CONCLUSION: The simultaneous physicochemical conditioning with one-step self-etching ceramic primer promoted the best fatigue behavior results of the glass-ceramic restorations. It might indicate that this one-step conditioning reduces the number of flaws at the ceramic surface due to the slighter surface alterations than those produced by hydrofluoric acid etching, improving the fatigue behavior.


Assuntos
Ataque Ácido Dentário , Cerâmica , Porcelana Dentária , Teste de Materiais , Propriedades de Superfície
20.
J Mech Behav Biomed Mater ; 100: 103401, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31445400

RESUMO

This study compared the fatigue performance and the stress distribution of endodontically treated molars restored with endocrowns obtained with lithium disilicate glass-ceramic or a polymer-infiltrated ceramic network, both processed by CAD-CAM, and direct composite restorations. Forty-eight human mandibular molars were randomly assigned into 03 groups (n = 16) and restored with endocrowns (LD - lithium disilicate glass-ceramic or PICN - polymer-infiltrated ceramic network) or with direct composite restorations. Fatigue testing followed a step-stress approach (initial maximum load of 200 N and 5000 cycles, incremental step load of 200N and 10,000 cycles/step, being the specimens loaded until failure or to a maximum of 135,000 cycles at 2800 N). The fatigue failure load and number of cycles until failure were recorded and statistically analyzed. Fractographic and finite element (FEA) analyzes were conducted as well. There were no differences in fatigue failure load, number of cycles until fracture and mean survival probabilities among groups. However, indirect endocrowns had higher mechanical structural reliability, and LD restorations lasted more time before start to failing. FEA showed that the stress concentration in tooth tissues was higher for the resin composite, followed by PICN and LD in a decreasing order. Almost all fractures were restricted to the restorative material (without tooth involvement), and origins were identified at occlusal surface. The type of restoration did not influence the fatigue failure load, number of cycles until fracture and mean survival probabilities of the restorative strategies. Despite that, the mechanical structural reliability of endocrowns, especially those made of lithium disilicate, was higher and lasted more time before start to failing.

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