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1.
Medicine (Baltimore) ; 98(48): e18164, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770262

RESUMO

RATIONALE: Full-mouth rehabilitation of patients with bruxism and severely worn dentition poses a great challenge to clinicians. Several treatment planning methods and restorative materials are used to treat tooth wear in modern dentistry. Clinicians should be able to select the most suitable treatment planning methods and materials for individual patients depending on their specific situation. PATIENT CONCERNS: A 47-year-old male was referred for evaluation of a severely worn dentition. DIAGNOSES: Clinical and radiographic evaluation revealed tooth wear in the entire dentition. The interocclusal distance at rest was 4 mm, and the patient had a parafunctional habit of bruxism. INTERVENTIONS: A digital smile design was used to formulate a treatment plan. Full-mouth rehabilitation was performed using a combination of conventional and digital materials and methods. OUTCOMES: The full-mouth restoration showed satisfactory functions and esthetics. No complications were observed in the restorations, supporting tissues, and temporomandibular joints during 2-year follow-up. LESSONS: In clinical practice, it is important to determine the optimal combination of the available methods for treatment planning. This case report details the formulation of a unique treatment plan for the dental rehabilitation of a severely worn out dentition, which is considered challenging due to the limitations imposed by biological tissues and restorative materials. The use of conventional and digital tools for treatment planning, patient education, and treatment execution was demonstrated.


Assuntos
Bruxismo/complicações , Desenho Assistido por Computador , Materiais Dentários/uso terapêutico , Reabilitação Bucal , Desgaste dos Dentes , Dentição , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Bucal/instrumentação , Reabilitação Bucal/métodos , Planejamento de Assistência ao Paciente , Satisfação do Paciente , Radiografia Dentária Digital/métodos , Desgaste dos Dentes/diagnóstico , Desgaste dos Dentes/etiologia , Desgaste dos Dentes/cirurgia , Resultado do Tratamento
2.
Biomed Res Int ; 2019: 8078230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31058193

RESUMO

This in vitro study was designed to evaluate the effect of sol-gel derived TiO2 coating on blood coagulation, blood protein adsorption, and platelet response on zirconia surfaces. Square-shaped zirconia (n=96) (10x10x2 mm) was cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n=32) were fabricated: (a) zirconia coated with sol-gel derived TiO2, (b) zirconia coated with sol-gel derived TiO2 and treated with ultraviolet (UV) irradiation for 1 hour, and (c) non-coated zirconia as control. The coatings were prepared from tetraisopropyl orthotitanate solution by dip-coating. The thrombogenicity of the specimens was evaluated using a whole blood kinetic clotting time method where the extent of blood clotting was evaluated at 10, 20, 30, 40, 50, and 60 minutes (n=4/time point, total n=24/group). Scanning electron microscope images were taken to observe platelet morphologies after 1-hour incubation with platelet-rich plasma (PRP) (n=5/group). Surface characteristics were visualized using atomic force microscopy (n=1/group). Adsorption of plasma proteins and fibronectin on each surface was studied by gel electrophoresis (n=2/group). Significant differences were observed in blood coagulation between the test groups at 20-, 30-, 40-, and 50-minute time points (p<0.005). UV treated TiO2 coated specimens showed fastest blood coagulation followed by TiO2 coated and non-coated specimens. Furthermore, platelets appeared at a higher activation state on coated specimens. Gel electrophoresis revealed no difference in protein adsorption among the experimental groups. In summary, TiO2 coatings promoted blood coagulation, and it was further enhanced by UV treatment, which has the potential to hasten the wound healing process in vivo.


Assuntos
Coagulação Sanguínea/efeitos dos fármacos , Materiais Dentários/química , Titânio/química , Zircônio/química , Plaquetas/efeitos dos fármacos , Plaquetas/ultraestrutura , Materiais Dentários/uso terapêutico , Humanos , Teste de Materiais , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Resistência ao Cisalhamento/efeitos dos fármacos , Titânio/uso terapêutico , Raios Ultravioleta , Zircônio/uso terapêutico
3.
Niger J Clin Pract ; 22(3): 328-334, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30837419

RESUMO

Aims: The aim of this study was to compare the effect of different restoration techniques on fracture resistance of endodontically treated teeth with different wall thicknesses. Materials and Methods: Extracted and endodontically treated 210 premolars were randomly divided into three thickness groups [2 mm (A), 1.5 mm (B), and 1 mm (C)] and, each group was further divided into seven restoration subgroups (n = 10): direct composite (control) (K), composite with fiber on cavity floor (KT), composite with fiber on occlusal level (KO), fiber post and composite (FP), inlay (L), fiber on cavity floor and inlay (LT), and inlay and fiber on occlusal level (LO). Fracture test was performed, and data were compared with Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Results: There were no differences between the subgroups in A and C statistically (P > 0.05). However, in B, KO subgroup showed statistically higher values (P = 0.039). Conclusion: Wall support of 2 mm was adequate, and support of 1 mm was completely insufficient. When the wall thickness was 1.5 mm, direct restoration with fiber at the occlusal level significantly improved resistance.


Assuntos
Resinas Compostas/uso terapêutico , Cárie Dentária , Preparo da Cavidade Dentária , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Fraturas dos Dentes/prevenção & controle , Dente não Vital/terapia , Dente Pré-Molar , Resinas Compostas/química , Materiais Dentários/uso terapêutico , Análise do Estresse Dentário , Humanos , Fraturas dos Dentes/etiologia , Dente não Vital/complicações
4.
Biomed Res Int ; 2019: 3126931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30805363

RESUMO

Objective: The aim of this study is to evaluate the effects of different fiber insertion techniques and thermomechanical aging on the fracture resistance of endodontically treated mandibular premolar teeth restored using bulk-fill composites. Materials and Methods: Eighty human mandibular premolar teeth were randomly divided into eight groups: Group IN, Group BF, Group PRF1, Group PRF2, Group IN-TMA, Group BF-TMA, Group PRF1-TMA ,and Group PRF2-TMA. Group IN (intact) and Group IN-TMA (intact but subjected to thermomechanical aging) served as control groups. In the other six groups, endodontic treatment was performed and standardized mesio-occluso-distal (MOD) cavities were prepared. In BF, PRF1, and PRF2, the cavities were restored with bulk-fill composite only, bulk-fill/Ribbond, and bulk-fill/additional Ribbond, respectively. In BF-TMA, PRF1-TMA, and PRF2-TMA, the teeth were subjected to thermomechanical aging after the restorations. All of the teeth were fractured on the universal testing machine. Fracture surfaces were analyzed with a stereomicroscope. Results: Control groups showed significantly higher fracture strengths than tested groups (P<0.05). No statistically significant difference was observed among the tested groups (P>0.05). Most of the favorable fractures were seen in PRF1, PRF2, and PRF2-TMA. Most of the unfavorable fractures were seen in BF-TMA. Conclusions: Although fiber insertion with different techniques did not increase the fracture strength of teeth restored with bulk-fill composites, it increased the favorable fracture modes. Thermomechanical aging did not change the fracture strength of the groups.


Assuntos
Resinas Compostas/uso terapêutico , Materiais Dentários/uso terapêutico , Resistência à Flexão/efeitos dos fármacos , Fraturas dos Dentes/terapia , Viscosidade/efeitos dos fármacos , Preparo da Cavidade Dentária/métodos , Restauração Dentária Permanente/métodos , Análise do Estresse Dentário/métodos , Humanos , Teste de Materiais/métodos , Polietilenos/uso terapêutico , Dente não Vital/terapia
5.
J Dent Res ; 98(1): 91-97, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30189149

RESUMO

The breakdown of the polymeric component of contemporary composite dental restorative materials compromises their longevity, while leachable compounds from these materials have cellular consequences. Thus, a new generation of composite materials needed to be designed to have a longer service life and ensure that any leachable compounds are not harmful to appropriate cell lines. To accomplish this, we have developed concurrent thiol-ene-based polymerization and allyl sulfide-based addition-fragmentation chain transfer chemistries to afford cross-linked polymeric resins that demonstrate low shrinkage and low shrinkage stress. In the past, the filler used in dental composites mainly consisted of glass, which is biologically inert. In several of our prototype composites, we introduced fluorapatite (FA) crystals, which resemble enamel crystals and are bioactive. These novel prototype composites were benchmarked against similarly filled methacrylate-based bisphenol A diglycidyl ether dimethacrylate / triethylene glycol dimethacrylate (bisGMA/TEGDMA) composite for their cytotoxicity, mechanical properties, biofilm formation, and fluoride release. The leachables at pH 7 from all the composites were nontoxic to dental pulp stem cells. There was a trend toward an increase in total toughness of the glass-only-filled prototype composites as compared with the similarly filled bisGMA/TEGDMA composite. Other mechanical properties of the glass-only-filled prototype composites were comparable to the similarly filled bisGMA/TEGDMA composite. Incorporation of the FA reduced the mechanical properties of the prototype and bisGMA/TEGDMA composite. Biofilm mass and colony-forming units per milliliter were reduced on the glass-only-filled prototype composites as compared with the glass-only-filled bisGMA/TEGDMA composite and were significantly reduced by the addition of FA to all composites. Fluoride release at pH 7 was greatest after 24 h for the bisGMA/TEGDMA glass + FA composite as compared with the similarly filled prototypes, but overall the F- release was marginal and not at a concentration to affect bacterial metabolism.


Assuntos
Resinas Compostas , Materiais Dentários , Teste de Materiais/métodos , Ácidos Polimetacrílicos , Estresse Mecânico , Bis-Fenol A-Glicidil Metacrilato , Resinas Compostas/uso terapêutico , Materiais Dentários/uso terapêutico , Humanos , Metacrilatos , Polietilenoglicóis , Polimerização , Ácidos Polimetacrílicos/uso terapêutico
6.
J Prosthodont ; 28(1): e342-e349, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29654646

RESUMO

PURPOSE: To investigate the effect of various surface pretreatments and adhesive systems on bond strength of resin cement to polyetheretherketone (PEEK). MATERIALS AND METHODS: 360 PEEK specimens were divided into 4 groups to receive the following pretreatments (n = 90): no pretreatment, sandblasting, silica coating and Er:YAG laser. Surface roughness (SR) and scanning electron microscopy (SEM) evaluations were conducted after mechanical pretreatments for topographical surface evaluations. After the pretreatments, each group was divided into 3 subgroups (n = 30) according to the adhesive system used: no adhesive system, Visio.link, and Signum PEEK Bond. Resin cement was applied, and specimens underwent 5000 thermocycles (5-55°C) before shear bond strength (SBS) test. One-way ANOVA and Tukey test were used to analyze the SR data; 2-way ANOVA and Fisher's LSD test were used to analyze the SBS data at the confidence interval of 95% (α = 0.05). RESULTS: The sandblasting group demonstrated the highest SR values (p < 0.05). No significant differences in SR values were identified among silica coating, laser, and control groups (p ˃ 0.05). Conditioning with Visio.link after sandblasting group exhibited the highest SBS values (p < 0.05). No significant differences in SBS values were found between laser and control group (p ˃ 0.05). Conditioned groups presented higher SBS values than unconditioned groups (p < 0.05). Between the two adhesive systems, Visio.link demonstrated statistically significant higher SBS values than Signum PEEK Bond (p < 0.05). CONCLUSION: Silica coating and sandblasting were shown to provide superior pretreatment of PEEK surface. Laser pretreatments showed no effectiveness on bond strength of resin cement to PEEK. Adhesive systems improved the resin bonding to PEEK.


Assuntos
Colagem Dentária , Cimentos Dentários/uso terapêutico , Materiais Dentários/uso terapêutico , Cetonas/uso terapêutico , Polietilenoglicóis/uso terapêutico , Cimentos de Resina/uso terapêutico , Colagem Dentária/métodos , Polimento Dentário , Análise do Estresse Dentário , Técnicas In Vitro , Lasers de Estado Sólido , Microscopia Eletrônica de Varredura , Resistência ao Cisalhamento , Propriedades de Superfície
7.
J Prosthodont ; 28(1): e383-e394, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29855127

RESUMO

PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic and apoptotic effects of seven new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], Cerasmart [CS], IPS Empress CAD [EC]) and six provisional materials (Protemp 4 [PT], Telio CAD [TC], CAD-Temp [CT], Telio Lab [TL], Temdent Classic [TD], Telio CS C&B [TS]) on L929 mouse fibroblast cells. MATERIALS AND METHODS: 24 disc-shaped specimens (∅ = 5 mm, h = 2 mm) were prepared from each test material. Medium extracts were collected at the 1st, 3rd, and 7th days for each group and tested using the L929 cell line. Cytotoxicity was evaluated using XTT assay, and apoptosis was determined by Annexin-V/PI staining. Data were analyzed using one-way ANOVA, Tukey's multiple comparison tests at a significance level of p < 0.05. RESULTS: The cell viability results among all-ceramic material groups after the 1st and 7th days of incubation periods showed statistically significant differences (p < 0.05). There were significant differences within the ceramic groups in different incubation periods regarding apoptosis rate (p < 0.05). Throughout the entire test period, LU and VM from the CAD/CAM all-ceramic materials and PT and TC from the provisional restoration materials showed cell viability higher than 90%. EC and TD showed the lowest cell viability and highest apoptosis rates in their own groups. For the provisional materials, there were significant differences in cell viability and apoptosis rate in all the incubation periods for each material (p < 0.05). CONCLUSIONS: Although some new-generation CAD/CAM and provisional restoration materials display slight cytotoxicity values, the results are still within the reliable range, and they can safely be used in clinical conditions.


Assuntos
Cerâmica/uso terapêutico , Fibroblastos/efeitos dos fármacos , Resinas Acrílicas/efeitos adversos , Resinas Acrílicas/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Cerâmica/efeitos adversos , Resinas Compostas/efeitos adversos , Resinas Compostas/uso terapêutico , Materiais Dentários/efeitos adversos , Materiais Dentários/uso terapêutico , Porcelana Dentária/efeitos adversos , Porcelana Dentária/uso terapêutico , Técnicas In Vitro , Camundongos
8.
J Prosthodont ; 28(1): e395-e403, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29882387

RESUMO

PURPOSE: The purpose of this meta-analysis was to evaluate how the thickness variations in ceramic restorations of lithium disilicate and the use of different photopolymerizers influence the degree of conversion of the resin cements. METHODS: This study was performed according to the PRISMA checklist. The bibliographic research was performed to identify in vitro studies until December 2017 in the databases MEDLINE via PubMed, Web of Science, and Scopus. The selected studies were submitted to bias risk assessment. In the meta-analysis the data were evaluated using Review Manager Software v.5.3, with random-effect model at a 5% significance level. RESULTS: The meta-analysis in this study showed that despite the translucency of lithium disilicate, significant reduction of light was observed when activated through the ceramic. The degree of conversion was higher in the control groups in which the resin cement was photopolymerized without the interposition of the ceramic material. CONCLUSIONS: The thinner the ceramic material, the higher the degree of conversion. A thickness greater than 1.0 mm drastically reduces the degree of conversion of dual-curing or light-curing resins. The curing unit with irradiance of 3200 to 3505 mW/cm2 showed improvements in conversion values.


Assuntos
Cerâmica/uso terapêutico , Materiais Dentários/uso terapêutico , Porcelana Dentária/uso terapêutico , Restauração Dentária Permanente , Cimentos de Resina/efeitos adversos , Restauração Dentária Permanente/métodos , Humanos , Polímeros
9.
J Prosthodont ; 28(1): e431-e433, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28387982

RESUMO

Precise orientation and transfer of the selected path of insertion and removal is a critical step in cast removable partial denture prosthesis design. An easy technique for registering the same is described using addition silicon putty and a used diamond disk.


Assuntos
Planejamento de Dentadura/métodos , Prótese Parcial Removível , Técnica de Fundição Odontológica , Materiais Dentários/uso terapêutico , Planejamento de Dentadura/instrumentação , Humanos , Silício/uso terapêutico
10.
J Prosthodont ; 28(1): e350-e356, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29756670

RESUMO

PURPOSE: To evaluate the influence of different post systems on the biomechanical behavior of teeth with a severe loss of remaining coronal structure. MATERIALS AND METHODS: Fifty standardized bovine teeth (n = 10 per group) were restored with: cast post-and-core (CPC), prefabricated metallic post (PFM), parallel glass-fiber post (P-FP), conical glass-fiber post (C-FP), or composite core (no post, CC). The survival rate during thermomechanical challenging (TC), the fracture strength (FS), and failure patterns (FP) were evaluated. Finite element models evaluated the stress distribution after the application of 100 N. RESULTS: All specimens survived TC. Similar FS was observed among post-containing groups. Groups P-FP and CC presented 100% repairable fractures. The von Mises analysis showed the maximum stresses into the root canal in groups restored with metallic posts. Glass-fiber posts and CC presented the maximum stresses at the load contact point. Glass-fiber groups showed lower stresses in the analysis of maximal contact pressure; CPC led to the highest values of contact pressure. The modified von Mises (mvM) stress in dentin did not show differences among groups. Moreover, mvM values did not reach the dentin fracture limit for any group. CONCLUSIONS: The type of intracanal post had a relevant influence on the biomechanical behavior of teeth with little remaining coronal structure.


Assuntos
Técnica para Retentor Intrarradicular , Dente não Vital/cirurgia , Animais , Bovinos , Materiais Dentários/efeitos adversos , Materiais Dentários/uso terapêutico , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Análise do Estresse Dentário , Vidro , Técnica para Retentor Intrarradicular/efeitos adversos , Técnica para Retentor Intrarradicular/instrumentação
11.
Clin Implant Dent Relat Res ; 21(1): 208-222, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30589497

RESUMO

PURPOSE: Evaluation of the available research on PEEK materials to find that whether PEEK material has favorable properties and can enhance osseointegration, so that they can be utilize as implants material. MATERIALS AND METHODS: An electronic and structured systematic search was undertaken in May 2018, without any restrictions of time in the Medline/Pubmed, Sci-hub, Ebscohost, Cochrane, and Web of Science databases. To identify other related references further hand search was done. Articles related to PEEK and their applications in implants were only included. Articles not available in abstract form and article other than English language were excluded. RESULTS: Initially, the search resulted in 153 papers. Independent screenings of the abstracts were done by the reviewers to identify the articles related to the question in focus. Sixty-two studies were selected out of which 10 were further excluded due to not in English language. Two additional papers were obtained after hand searching, and finally 54 articles were included in the review. CONCLUSIONS: Surface modification of PEEK seems to enhance the cell adhesion, proliferation, biocompability, and osteogenic properties of PEEK implant materials. PEEK had also influence the biofilm structure and reduces the chances of periimplant inflammations. Further research and more number of controlled clinical trials on PEEK implant is required in near future so that it can replace titanium in future.


Assuntos
Implantes Dentários , Materiais Dentários/uso terapêutico , Cetonas/uso terapêutico , Polietilenoglicóis/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Planejamento de Prótese Dentária , Humanos , Titânio/uso terapêutico
13.
Oral Health Prev Dent ; 16(5): 417-424, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30460354

RESUMO

PURPOSE: In this study, the protective effects of restorative materials with fluoride content, resin-modified glass-ionomer cement (RMGIC), giomer, and glass carbomer against artificial initial caries lesions in a simulated highly cariogenic oral environment were evaluated. Considering the reported recharging abilities of these restorative materials, fluoridated toothpaste was applied to some groups, in which the anti-demineralising effect was also evaluated. MATERIALS AND METHODS: Two enamel blocks were produced from each of 60 sound permanent molars. Sixty specimens were used for microhardness analysis, and the rest were used for SEM-EDX analysis. Enamel specimens were randomly assigned to three groups according to the restorative material: A = resin-modified glass-ionomer cement; B = giomer; C = glass carbomer. Artificial initial caries lesions were created using demineralising solutions, after which specimens were exposed to in vitro pH cycling simulating a highly cariogenic oral environment. Microhardness and mineral analyses were performed on the enamel surrounding the restorative materials at three different times during the experiment: at the beginning of the experiment, then after the creation of the artificial early caries lesions, and finally after pH cycling. RESULTS: Microhardness and SEM-EDX results mostly confirmed each other. RMGIC and glass carbomer groups with added fluoride toothpaste showed statitsically significantly better anti-demineralising effects in comparison to other groups. Neither of the giomer groups performed as well as RMGIC or glass carbomer. CONCLUSION: Because of the similarity between the demineralisation inhibitory activity of glass carbomer and RMGIC, glass carbomer may be preferred as a restorative material in paediatric dentistry.


Assuntos
Apatitas/uso terapêutico , Cariostáticos/uso terapêutico , Cárie Dentária/terapia , Esmalte Dentário/ultraestrutura , Fluoretos/uso terapêutico , Cimentos de Ionômeros de Vidro/uso terapêutico , Dureza , Cimentos de Resina/uso terapêutico , Esmalte Dentário/diagnóstico por imagem , Materiais Dentários/uso terapêutico , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Cremes Dentais/uso terapêutico
14.
Oral Health Prev Dent ; 16(5): 431-438, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30460356

RESUMO

PURPOSE: To understand the effect of the addition of hydroxyapatite (HA) and bioactive glass (BAG) to compomer restorative materials on the remineralisation capacity of the material. MATERIALS AND METHODS: 1%, 2%, 3% and 4% w/w HA and BAG particles were added mechanically to the compomers. To examine the resistance to demineralisation, Class V cavities were prepared in extracted teeth and restored with experimental filling materials. Demineralised lesions were created in 72 enamel samples. Vickers microhardness measurements of samples were performed at three different areas including the margin of the restoration, the varnish-protected enamel and the exposed enamel areas. Measurements performed on protected enamel were used as reference enamel values for each group. SEM was used to evaluate the surface texture of the specimens. The statistical analyses were performed by one-way ANOVA, Tukey's HDS and paired-samples t-tests. RESULTS: BAG and HA groups revealed higher microhardness values at the exposed enamel and exposed marginal enamel than did the control group (p = 0.001). 3% and 4% HA and BAG groups produced higher microhardness values than did 1% modified groups on exposed enamel (p = 0.001). 4% HA group revealed the highest microhardness values on marginal exposed enamel (p = 0.001). 2%, 3%, 4% and HA, as well as 3% and 4% BAG groups showed higher microhardness values than did the control group on marginal exposed enamel at 20 µm depth (p = 0.001). SEM images revealed that HA and BAG particles were not distributed homogeneously and the particles seemed to be grouped in the matrix. CONCLUSIONS: Within the limits of this study, the addition of the BAG and HA into compomers improved the demineralisation resistance properties of enamel, depending on the amount of additive.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Compômeros/uso terapêutico , Cárie Dentária/terapia , Esmalte Dentário/ultraestrutura , Durapatita/uso terapêutico , Vidro , Remineralização Dentária/métodos , Materiais Dentários/uso terapêutico , Dureza , Testes de Dureza , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura
15.
Clin Oral Implants Res ; 29 Suppl 18: 196-223, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30306684

RESUMO

OBJECTIVE: This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). MATERIAL AND METHODS: Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. RESULTS: Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. CONCLUSIONS: All-ceramic implant-supported SCs showed-with the exception of a RNC material-high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs.


Assuntos
Cerâmica/uso terapêutico , Coroas , Materiais Dentários/uso terapêutico , Prótese Dentária Fixada por Implante , Coroas/efeitos adversos , Prótese Dentária Fixada por Implante/efeitos adversos , Prótese Dentária Fixada por Implante/microbiologia , Falha de Restauração Dentária , Humanos
16.
Clin Oral Implants Res ; 29 Suppl 18: 237-242, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30306691

RESUMO

OBJECTIVES: The tasks of this working group were to evaluate the existing evidence on the efficiency and efficacy of the digital and conventional workflows for the fabrication of fixed implant reconstructions, to assess the performance of all-ceramic fixed implant reconstructions and, finally, to evaluate the outcomes of internally and externally connected implant abutments and reconstructions. METHODS: Four reviews were available analyzing the current literature on the respective topics. One review dealt with the efficiency and efficacy of digital and conventional fabrication workflows. Two reviews analyzed the outcomes of all-ceramic fixed implant reconstructions, one focusing on single-implant reconstructions and the other evaluating multiple-unit implant fixed dental prostheses (FDPs). The fourth review evaluated the clinical outcome on external, respectively, internal implant-abutment connections. These reviews were the basis for the discussions within the group and at the plenary sessions. RESULTS: The present consensus report gives the consensus statements, the clinical recommendations, and the implications for future research as discussed and approved by the plenum of the consensus conference. The four manuscripts by Mühlemann et al., Rabel et al., Pieralli et al., and Pjetursson et al. are published as part of the journal supplement of the present EAO consensus conference.


Assuntos
Desenho Assistido por Computador , Planejamento de Prótese Dentária , Cerâmica/uso terapêutico , Coroas , Dente Suporte , Projeto do Implante Dentário-Pivô/métodos , Materiais Dentários/uso terapêutico , Planejamento de Prótese Dentária/métodos , Prótese Dentária Fixada por Implante/métodos , Planejamento de Dentadura/métodos , Humanos
17.
Clin Oral Implants Res ; 29 Suppl 18: 224-236, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30306694

RESUMO

OBJECTIVE: To assess the survival and technical complication rate of partial and full-arch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. MATERIALS AND METHODS: An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. RESULTS: A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P- and FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. CONCLUSIONS: All-ceramic implant-supported P- and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated.


Assuntos
Cerâmica/uso terapêutico , Materiais Dentários/uso terapêutico , Prótese Total , Prótese Parcial Fixa , Cerâmica/efeitos adversos , Materiais Dentários/efeitos adversos , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Prótese Total/efeitos adversos , Prótese Parcial Fixa/efeitos adversos , Humanos
18.
Clin Oral Implants Res ; 29 Suppl 16: 215-223, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30328196

RESUMO

OBJECTIVES: Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full-arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. MATERIALS AND METHODS: Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. RESULTS: A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. CONCLUSIONS: The literature supports the use of various implant numbers to support full-arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One-piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two-piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Odontologia , Prostodontia , Cerâmica/uso terapêutico , Consenso , Coroas/normas , Dente Suporte , Projeto do Implante Dentário-Pivô/métodos , Implantação Dentária Endo-Óssea/normas , Implantes Dentários/estatística & dados numéricos , Materiais Dentários/uso terapêutico , Planejamento de Prótese Dentária/métodos , Prótese Dentária Fixada por Implante/métodos , Prótese Dentária Fixada por Implante/normas , Falha de Restauração Dentária , Restauração Dentária Permanente/normas , Prótese Total/normas , Prótese Parcial Fixa/normas , Humanos , Metanálise como Assunto , Ligas Metalo-Cerâmicas/uso terapêutico , Revisões Sistemáticas como Assunto , Fatores de Tempo , Resultado do Tratamento , Zircônio/uso terapêutico
19.
J Prosthet Dent ; 120(4): 530-536, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30318049

RESUMO

STATEMENT OF PROBLEM: The use of resin patterns to produce partial coverage restorations is poorly documented. PURPOSE: The purpose of this in vitro study was to compare the marginal and internal fit accuracy of lithium disilicate glass-ceramic inlays obtained from wax or resin patterns and fabricated with digital and conventional techniques. MATERIAL AND METHODS: A dentoform mandibular first molar was prepared for a mesio-occlusal ceramic inlay. Six groups of 15 inlays were obtained by conventional impression and manual wax (group CICW) or resin patterns (group CICR); conventional impression, laboratory scanning of the stone die, CAD-CAM milled wax (group CIDW), or polymethylmethacrylate (PMMA) blocks (group CIDR); and scanning of the master preparation with an intraoral scanner, CAD-CAM milled wax (group DSDW), or PMMA blocks (DSDR). The same design was applied to produce the wax and PMMA patterns in the last 4 groups. The replica technique was used to measure marginal and internal fit under stereomicroscopy. Mixed-model ANOVA was applied to assess differences according to the techniques, materials, and discrepancy location (α=.05). RESULTS: The results demonstrated significant effects of the technique (P<.001), material (P=.009), and discrepancy location (P<.001) on fit measurements. Marginal discrepancy was only affected by the technique (P<.001), with the digital approaches yielding the smallest marginal discrepancy (23.5 ±3.6 µm), followed by the conventional digital techniques (31.1 ±5.6 µm) and finally by the conventional (42.8 ±7.2 µm) techniques. Internal fit was significantly influenced only by the material with lower discrepancy in wax (75.2 ±9.0 µm) than in resin patterns (84.7 ±15.1 µm). The internal discrepancy was significantly larger than the marginal discrepancy in all groups (P<.001). CONCLUSIONS: Inlays generated from conventional wax and resin patterns tend to show higher marginal discrepancies than conventional digital and full digital patterns. Wax and resin materials yield similar marginal fit accuracies irrespective of the impression/manufacturing technique. Better internal fit was shown in wax than in resin patterns, regardless of the technique.


Assuntos
Desenho Assistido por Computador , Materiais Dentários/uso terapêutico , Porcelana Dentária/uso terapêutico , Planejamento de Prótese Dentária , Restaurações Intracoronárias , Cerâmica/uso terapêutico , Materiais para Moldagem Odontológica/uso terapêutico , Técnica de Moldagem Odontológica , Adaptação Marginal Dentária , Planejamento de Prótese Dentária/métodos , Humanos , Técnicas In Vitro , Resinas Sintéticas/uso terapêutico , Ceras/uso terapêutico
20.
Eur J Oral Sci ; 126 Suppl 1: 95-101, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30178556

RESUMO

In dentistry, isotropic materials, such as metals, ceramics, and polymers, are used. Their properties are not related to any specific direction of the material microstructure. There is a trend toward non-metallic, adhesive, and minimally invasive dentistry. This is in line with the conceptual change seen in the automobile industry, in which the basis of car structures has changed from body-on-frame designs to unibody designs. In unibody designs, all structural parts of the body of the car mechanically form a single structural entity. In modern adhesive dentistry, remaining tooth substance and the dental material form unibody designs, enabling preservation of tooth substance. Biological structures are created to withstand loading and are light in weight. The structural designs of elements in these biological materials are, to a large extent, based on fibrous material. More attention has been paid to mimicking fibrous structures of dental hard tissues by synthetic fiber-reinforced composites. This overview reports key features of natural fibrous elements and how they are utilized in dentistry. Special emphasis is placed on the aspects of interfacial adhesion of restorative materials, especially ceramics to resin-based materials and their role in the unibody design of the tooth-restoration system.


Assuntos
Materiais Biomiméticos/uso terapêutico , Planejamento de Prótese Dentária , Prótese Dentária , Cerâmica/uso terapêutico , Resinas Compostas/uso terapêutico , Cimentos Dentários/uso terapêutico , Materiais Dentários/uso terapêutico , Planejamento de Prótese Dentária/métodos , Restauração Dentária Permanente/métodos , Humanos
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