Evaluation of dimensional change and detail reproduction in silicones for facial prostheses.

The aim of this study was to evaluate the dimensional stability and detail reproduction of two silicones used for facial prosthesis, under the influence of chemical disinfection and storage time. Twenty-eight test specimens were obtained, half made of Silastic MDX 4-4210 silicone, and the other half of Silastic 732 RTV silicone. The test specimens were divided into 4 groups: Silastic 732 RTV and Silastic MDX 4-4210, with disinfection 3 times a week with Efferdent and without disinfection. Dimensional change was analyzed using an electronic comparison microscope and detail reproduction was observed under a stereo microscope, immediately and 2 months after the test specimens were made. Once the results were obtained, an analisis of variance (ANOVA) was applied, followed by the Tukey's Test with 1% confidence. The storage time factor had a statistical influence on dimensional stability: Silastic MDX 4-4210 had less contraction than Silastic 732 RTV. Chemical disinfection did not significantly alter the dimensional stability of the materials used. Regarding detail reproduction, no alteration of values was observed in any of the materials analyzed, regardless of storage period or disinfection.

Effects of mandibular fixed implant-supported prostheses on masticatory and swallowing functions in completely edentulous elderly individuals

Purpose: To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and rive men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals.

Airway space changes after maxillomandibular counterclockwise rotation and mandibular advancement with TMJ Concepts® total joint prostheses: Three-dimensional assessment

This study focused on three-dimensional (3D) airway space changes and stability following simultaneous maxillomandibular counterclockwise rotation, mandibular advancement, and temporomandibular joint (TMJ) reconstruction with custom-made total joint prostheses (TMJ Concepts®). Cone beam computed tomography (CBCT) scans of 30 consecutive female patients with irreversibly compromised TMJs were obtained at the following intervals: T1, presurgery; T2, immediately after surgery; and T3, at least 6 months after surgery. The CBCT volumetric datasets were analysed with Dolphin Imaging ® software to evaluate surgical and postsurgical changes to oropharyngeal airway parameters. The average changes in airway surface area (SA), volume (VOL), and minimum axial area (MAA) were, 179.50 mm2, 6302.60 mm3, and 92.23 mm2, respectively, at the longest follow-up (T3 - T1) (P ≤ 0.001). Significant correlations between the amount of mandibular advancement and counterclockwise rotation of the occlusal plane and 3D airway changes were also found (P ≤ 0.01). The results of this investigation showed a significant immediate 3D airway space increase after maxillomandibular counterclockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses, which remained stable over the follow-up period. © 2013 International Association of Oral and Maxillofacial Surgeons.

Stress analysis in oral obturator prostheses over parallel and tilted implants: photoelastic imaging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Microstrain Around Dental Implants Supporting Fixed Partial Prostheses Under Axial and Non-Axial Loading Conditions, In Vitro Strain Gauge Analysis

The current study used strain gauge analysis to perform an in vitro evaluation of the effect of axial and non-axial loading on implant-supported fixed partial prostheses, varying the implant placement configurations and the loading points. Three internal hexagon implants were embedded in the center of each polyurethane block with in-line and offset placements. Microunit abutments were connected to the implants using a torque of 20 N.cm, and plastic prosthetic cylinders were screwed onto the abutments, which received standard patterns cast in Co-Cr alloy (n = 10). Four strain gauges (SGs) were bonded onto the surfaces of the blocks, tangentially to the implants: SG 01 mesially to implant 1, SG 02 and SG 03 mesially and distally to implant 2, respectively, and SG 04 distally to implant 3. Each metallic structure was screwed onto the abutments using a 10-N.cm torque, and axial and non-axial loads of 30 kg were applied at 5 predetermined points. The data obtained from the strain gauge analyses were analyzed statistically through the repeated measures analysis of variance and the Tukey test, with a conventional level of significance of P < 0.05. The results showed a statistically significant difference for the loading point (P = 0.0001), with point E (nonaxial) generating the highest microstrain (327.67 mu epsilon) and point A (axial) generating the smallest microstrain (208.93 mu epsilon). No statistically significant difference was found for implant placement configuration (P = 0.856). It was concluded that the offset implant placement did not reduce the magnitude of microstrain around the implants under axial and non-axial loading conditions, although loading location did influence this magnitude.

Photoelastic stress analysis of splinted and unitary implant-supported prostheses

The aim of this study was to evaluate the effects that splinting and different lengths of implants have on the stress distribution in implant-supported prostheses by photoelastic analysis. A total of five photoelastic resin models were made with different proposed situations, and 400 load applications were performed for the analysis. Compared with the unitary prosthesis, the splinted implant-supported prosthesis acted favorably in the distribution of stresses and strains to the implant (p < 0.001). The increase in length was a significant factor in the stress distribution (p < 0.05) and, ultimately, the overall reduction in stress. It was concluded that the splinted implant-supported prosthesis behaved better biomechanically compared with the unitary prosthesis.

Effect of Beverages and Mouthwashes on the Hardness of Polymers Used in Intraoral Prostheses

PurposeThe mechanical properties of acrylic resins used in intraoral prostheses may be altered by frequent exposure to liquids such as beverages and mouthwashes. This study aimed to evaluate the effect of thermocycling and liquid immersion on the hardness of four brands of acrylic resins commonly used in removable prostheses (Onda Cryl, QC-20, Classico, Lucitone).Materials and MethodsFor each brand of resin, seven specimens were immersed in each of six solutions (coffee, cola, red wine, Plax-Colgate, Listerine [LI], Oral B), and seven more were placed in artificial saliva (control). The hardness was tested using a microhardness tester before and after 5000 thermocycles and after 1, 3, 24, 48, and 96 hours of immersion. The results were analyzed using three-way repeated-measures ANOVA and Tukey's test (p < 0.05).ResultsThe hardness of the resins decreased following thermocycling and immersion in the solutions. Specimens immersed in cola and wine exhibited significant decreases in hardness after immersion for 96 hours, although the greatest significant decrease in hardness occurred in specimens immersed in LI. However, according to American Dental Association specification 12, the Knoop hardness of acrylic resins for intraoral prostheses should not be below 15. Thus, the median values of superficial hardness observed in most of the acrylic resins in this study are considered clinically acceptable.ConclusionsThe microhardness of polymers used for intraoral prostheses decreases following thermocycling. Among specimens immersed in beverages, those immersed in cola or wine experienced the greatest decrease in microhardness. Immersion of acrylic resins in LI significantly decreased the microhardness in relation to the initial value. Among the resins assessed, QC-20 exhibited the lowest initial hardness.

Axial loads on implant-supported partial fixed prostheses for external and internal hex connections and machined and plastic copings: strain gauge analysis

The aim of this in vitro study was to use strain gauge (SG) analysis to compare the effects of the implant-abutment joint, the coping, and the location of load on strain distribution in the bone around implants supporting 3-unit fixed partial prostheses. Three external hexagon (EH) implants and 3 internal hexagon (IH) implants were inserted into 2 polyurethane blocks. Microunit abutments were screwed onto their respective implant groups. Machined cobalt-chromium copings and plastic copings were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in a cobalt-chromium alloy (n = 5): group 1 = EH/machined. group 2 = EH/plastic, group 3 = IH/machined, and group 4 = IH/plastic. Four SGs were bonded onto the surface of the block tangentially to the implants. Each metallic structure was screwed onto the abutments and an axial load of 30 kg was applied at 5 predetermined points. The magnitude of microstrain on each SG was recorded in units of microstrain (mu epsilon). The data were analyzed using 3-factor repeated measures analysis of variance and a Tukey test (alpha = 0.05). The results showed statistically significant differences for the type of implant-abutment joint, loading point, and interaction at the implant-abutment joint/loading point. The IH connection showed higher microstrain values than the EH connection. It was concluded that the type of coping did not interfere in the magnitude of microstrain, but the implant/abutment joint and axial loading location influenced this magnitude.

Electrical activity of the orbicularis muscles before and after installation of ocular prostheses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part I - Skeletal and dental stability

The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total join, prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9 +/- 8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9 +/- 3.5 mm at the lower incisor tips, 12.4 +/- 5.4 mm at Point B, 17.3 +/- 7.0 mm at menton, 18.4 +/- 8.5 mm at pogonion, and 11.0 +/- 5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9 +/- 4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the rnaxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.

Evaluation of Torque Maintenance of Abutment and Cylinder Screws With Morse Taper Implants

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of Cusp Inclination on Stress Distribution in Implant-Supported Prostheses. A Three-Dimensional Finite Element Analysis

Purpose: The aim of this study was to assess the influence of cusp inclination on stress distribution in implant-supported prostheses by 3D finite element method.Materials and Methods: Three-dimensional models were created to simulate a mandibular bone section with an implant (3.75 mm diameter x 10 mm length) and crown by means of a 3D scanner and 3D CAD software. A screw-retained single crown was simulated using three cusp inclinations (10 degrees, 20 degrees, 30 degrees). The 3D models (model 10d, model 20d, and model 30d) were transferred to the finite element program NeiNastran 9.0 to generate a mesh and perform the stress analysis. An oblique load of 200 N was applied on the internal vestibular face of the metal ceramic crown.Results: The results were visualized by means of von Mises stress maps. Maximum stress concentration was located at the point of application. The implant showed higher stress values in model 30d (160.68 MPa). Cortical bone showed higher stress values in model 10d (28.23 MPa).Conclusion: Stresses on the implant and implant/abutment interface increased with increasing cusp inclination, and stresses on the cortical bone decreased with increasing cusp inclination.