Flexural Strength of Four Adhesive Fixed Dental Prostheses of Composite Resin Reinforced with Glass Fiber

Purpose: To evaluate the flexural strength of two fixed dental prosthesis (FDP) designs simulating frameworks of adhesive fixed partial prostheses, reinforced or not by glass fiber.Materials and Methods: Forty specimens, made with composite resin, were divided into 4 groups according to the framework design and the presence of fiber reinforcement: A1 - occlusal support; A2: occlusal support + glass fiber; B1: occlusal and proximal supports; B2: occlusal and proximal supports + glass fiber. The specimens were subjected to the three-point bending test, and the data were submitted to two-way ANOVA and Tukey's test (5%).Results: Group A2 (97.9 +/- 38 N) was statistically significantly different from all other experimental groups, presenting a significantly lower mean flexural strength.Conclusion: The use of glass fibers did not improve the flexural strength of composite resin, and designs with occlusal and proximal supports presented better results than designs simulating only occlusal support.

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 Analysis of Biomechanical Behavior of Single and Multiple Fixed Partial Prostheses With Different Prosthetic Connections

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

Evaluation of mechanical properties of dental feldsphatic porcelains for metal and zirconia core

Studies has been reported a significant incidence of chipping of the feldspathic porcelain veneer in zirconia-based restorations. The purpose of this study was to compare the three-point flexural strength (MPa), Weibull parameters, Vickers hardness (VHN) and Vickers indentation fracture toughness (MPa/mm(1/2)) in feldspatic porcelains for metal and for zirconia frameworks. Bar specimens were made with the porcelains e.MaxCeram (EM) and VitaVM9 (V9) for zirconia core, and Duceragold (DG) and VitaVMK95 (VK) for metal core (n = 15). Kruskal-Wallis and Dun test were used for statistical analysis. There was no significant difference (p=0.31) among the porcelains in the flexural strength (Median = 73.2; 74.6; 74.5; 74.4). Weibull calculation presented highest reliability for VK (10.8) followed by em (7.1), V9 (5.7) and DG (5.6). Vickers hardness test showed that em (536.3), V9 (579.9) and VK (522.1) had no difference and DG (489.6) had the lowest value (p<.001). The highest fracture toughness was to VK (1.77), DG (1.58) had an intermediate value while V9 (1.33) and em (1.18) had the lowest values (p<.001). Despite of the suitable flexural strength, reliability and high hardness, the porcelains used to zirconia-based fixed dental prostheses showed lower fracture toughness values.

Characterization of ceramic powders used in the inCeram systems to fixed dental Prosthesis

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

An infection control protocol: effectiveness of immersion solutions to reduce the microbial growth on dental prostheses

This investigation evaluated the effectiveness of an infection control protocol for cleansing and disinfecting removable dental prostheses. Sixty-four dentures were rubbed with sterile cotton swab immediately after they had been taken from patients' mouths. Samples were individually placed in the culture medium and immediately incubated at 37 +/- 2 degreesC. The dentures were scrubbed for 1 min with 4% chlorhexidine, rinsed for 1 min in sterile water and placed for 10 min in one of the following immersion solutions: 4% chlorhexidine gluconate, 1% sodium hypochlorite, Biocide (iodophors) and Amosan (alkaline peroxide). After the disinfection procedures, the dentures were immersed in sterile water for 3 min, reswabbed and the samples were incubated. All samples obtained in the initial culture were contaminated with micro-organisms. All the lower dentures immersed in Biocide showed positive growth, and the upper dentures were positive for growth in six of eight dentures. The 4% chlorhexidine gluconate, 1% sodium hypochlorite and Amosan solutions have been proved effective to reduce the growth of the micro-organisms in the 10 min immersion period. The protocol evaluated in this study seems to be a viable method to prevent cross-contamination between dental personnel and patients.

A new intraoral device to facilitate preparation of the guide plane for removable dental prostheses

The design of the ParalAB device facilitates transfer of the path of insertion from the diagnostic cast to the mouth quickly and efficiently.

Effect of Static and Cyclic Loading on Ceramic Laminate Veneers Adhered to Teeth with and Without Aged Composite Restorations

Purpose: Existing composite restorations on teeth are often remade prior to the cementation of fixed dental prostheses. The aim of this study was to evaluate the effect of static and cyclic loading on ceramic laminate veneers adhered to aged resin composite restorations.Materials and Methods: Eighty sound maxillary incisors were collected and randomly divided into four groups: group 1: control group, no restorations; group 2: two Class III restorations; group 3: two Class IV restorations; group 4: complete composite substrate. Standard composite restorations were made using a microhybrid resin composite (Anterior Shine). Restored teeth were subjected to thermocycling (6000 cycles). Window preparations were made on the labial surface of the teeth for ceramic laminate fabrication (Empress II). Teeth were conditioned using an etch-and-rinse system. Existing composite restorations representing the aged composites were silica coated (CoJet) and silanized (ESPE-Sil). Ceramic laminates were cemented using a bis-GMA-based cement (Variolink Veneer). The specimens were randomly divided into two groups and were subjected to either static (groups 1a, 2a, 3a, 4a) or cyclic loading (groups 1b, 2b, 3b, 4b). Failure type and location after loading were classified. Data were analyzed using one-way ANOVA and Tukey's test.Results: Significantly higher fracture strength was obtained in group 4 (330 +/- 81 N) compared to the controls in group 1 (179 +/- 120 N) (one-way ANOVA, p < 0.05). Group lb survived a lower mean number of cyclic loads (672,820 cycles) than teeth of groups 2b to 4b (846x10(3) to 873x10(3) cycles). Failure type evaluation after the fracture test showed predominantly adhesive failures between dentin and cement, but after cyclic loading, more cohesive fractures in the ceramic were seen.Conclusion: Ceramic laminate veneers bonded to conditioned aged composite restorations provided favorable results. Surface conditioning of existing restorations may eliminate the necessity of removing aged composite restorations.

Caracterização microestrutural e resistência à corrosão de ligas Ni-Cr-Mo refundidas utilizadas em próteses dentárias

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência da angulação do implante e tipo de intermediário na distribuição das tensões

The aim of this study was to evaluate the influence of implant angulation and abutment type (UCLA and Estheticone) on stress distribution in screw-retained implant-supported prostheses through photoelasticity. Three models were fabricated with photoelastic resin PL-2 (Vishay, Micro-Measurements Group, Inc Raleigh, N.C., USA) containing one external hexagon implant with 3.75x10mm (Master screw, Conexão Sistemas de Prótese Ltda., Arujá, São Paulo) with 0°, 17° and 30° degrees and a screw-retained prostheses with UCLA and Estheticone abutments. The assembly was positioned in a circular polariscope; axial and oblique (45° degrees) loads of 100N were applied in fixed points on the occlusal crown surfaces by a universal testing machine. The stress generated was photographed and analyzed qualitatively with appropriate software (Adobe Photoshop®). The results demonstrated the same number of fringes for both abutment types for each angulation, with fringes increasing in the same way. A higher number of fringes were closer in the oblique loading mode. It was concluded that there was no significant difference in stress distribution in prostheses with UCLA and Estheticone abutments. Higher stress concentrations were observed with increased implant angulation. Stress concentration and intensity were higher in the oblique load than in axial load application.

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.

Clinical and radiographic changes around dental implants inserted in different levels in relation to the crestal bone, under different restoration protocols, in the dog model

Background: The aim of the present study was to evaluate clinical and radiographic changes that occur around dental implants inserted in different levels in relation to crestal bone under different restoration protocols.Methods: Thirty-six implants were inserted in the edentulous mandible of six mongrel dogs. Each implant was assigned to an experimental group according to the distance from the top of the implant to the crestal bone: Bone Level (at crestal bone level), Minus 1 (1 mm below crestal bone), or Minus 2 (2 mm below crestal bone). Each hemimandible was submitted to a restoration protocol: conventional (prosthesis was installed 120 days after implant placement, including 30 days with healing cap) or immediate (prosthesis was installed 24 hours after implant placement). Fixed partial prostheses were installed bilaterally in the same day. After 90 days, clinical and radiographic parameters were evaluated.Results: As long as the implants were inserted in more apical positions, the first bone-to-implant contact (fBIC) was positioned more apically (P<0.05). However, the apical positioning of the implants did not influence the ridge loss or the position of the soft tissue margin (PSTM) (P>0.05). In addition, in immediately restored sites, the PSTM was located significantly more coronally than that in conventionally restored sites (P=0.02).Conclusions: Despite the more apical positioning of the fBIC, the height of the peri-implant soft tissues and ridge was not jeopardized. Moreover, the immediate restoration protocol was beneficial to the maintenance of the PSTM. Further studies are suggested to evaluate the significance of these results in longer healing periods.

Comparison of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible - A computed tomography-based three-dimensional finite element analysis

A finite element analysis was used to compare the effect of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible. Four models of an human mandible were constructed. In the OR (O'ring) group, the mandible was restored with an overdenture retained by four unsplinted implants with O'ring attachment; in the BC (bar-clip) -C and BC groups, the mandibles were restored with overdentures retained by four splinted implants with bar-clip anchor associated or not with two distally placed cantilevers, respectively; in the FD (fixed denture) group, the mandible was restored with a fixed full-arch four-implant-supported prosthesis. Models were supported by the masticatory muscles and temporomandibular joints. A 100-N oblique load was applied on the left first molar. Von Mises (σvM), maximum (σmax) and minimum (σmin) principal stresses (in MPa) analyses were obtained. BC-C group exhibited the highest stress values (σvM=398.8, σmax=580.5 and σmin=-455.2) while FD group showed the lowest one (σvM=128.9, σmax=185.9 and σmin=-172.1). Within overdenture groups, the use of unsplinted implants reduced the stress level in the implant/prosthetic components (59.4% for σvM, 66.2% for σmax and 57.7% for σmin versus BC-C group) and supporting tissues (maximum stress reduction of 72% and 79.5% for σmax, and 15.7% and 85.7% for σmin on the cortical and trabecular bones, respectively). Cortical bone exhibited greater stress concentration than the trabecular bone for all groups. The use of fixed implant dentures and removable dentures retained by unsplinted implants to rehabilitate edentulous mandible reduced the stresses in the periimplant bone tissue, mucosa and implant/prosthetic components. © 2013 Elsevier Ltd.

Genetic relatedness of commensal strains of Candida albicans carried in the oral cavity of patients' dental prosthesis users in Brazil

The aim of this study is to describe the degree of yeast-colonization in diabetic and hemodialysed-users of dental prostheses. Individuals (306) were examined using an oral rinse technique in order to evaluate the incidence of yeast-carriage, and genotype of C. albicans. Yeasts were isolated from 68.4% (91/133) individual's dental prostheses users. Dental prostheses were found to be a significant factor for the yeast colonization (P < 0.05). Overall, the intensity of carriage was higher in diabetic patients as compared with health and hemodialysed individuals (P < 0.05). The isolation rates were: C. albicans (51.7%), C. parapsilosis (20.9%), C. tropicalis (14.3%), C. glabrata (6.6%), C. krusei (3.3%), C. rugosa (1.1%), and Pichia (Pichia ohmeri, 2.2%). Ready-To-Go RAPD Analysis Beads were used and primer OPJ 6 distinguished the C. albicans isolates found in prostheses users. All the isolates were grouped into 11 RAPD profiles in four main clusters and, the average S (AB) for the entire collection of 47 C. albicans isolates were 0.779 +/- 0.178. Over 85% of isolates had a similarity level higher than or equal to 0.8 reinforcing the idea that the use of dental prostheses, independently of the host's clinical condition, probably provides the necessary conditions for these strains to gain a growth-specific advantage over others.

Removable Partial Denture in Combination with a Milled Fixed Partial Prosthesis as Interim Restorations in Long-Term Treatment

Interim restorations are frequently used in prosthodontic treatments. Many complex situations require the combination of fixed and removable partial prostheses. An appropriate interim restoration design that accurately implements the treatment plan is necessary to prepare the oral cavity for the prostheses, and to contribute to the preservation and health of remaining natural teeth, bone support, and gingival tissues. This report describes a modified technique for construction of interim restorations with a combination of fixed and removable partial prostheses. The technique consists of the construction of a milled fixed prosthesis and removable partial denture with metallic framework for use during extensive treatment, improving masticatory function and esthetics and preserving the periodontal health of supporting structures. This interim restoration can also serve as a template for the definitive restoration, allowing patient and dentist to evaluate appearance and function and helping to ensure the success of the definitive restoration.