Influence of convergence angle of tooth preparation on the fracture resistance of Y-TZP-based all-ceramic restorations

Objective: To investigate the influence of the convergence angle of tooth preparation on the fracture load of Y-TZP-based ceramic (YZ-Vita YZ) substructure (SB) veneered with a feldspathic porcelain (VM9-Vita VM9). Methods: Finite element stress analysis (FEA) was performed to examine the stress distribution of the system. Eighty YZ SB were fabricated using a CAD-CAM system and divided into four groups (n = 20), according to the total occlusal convergence (TOC) angle: G6-6° TOC; G12-12° TOC; G20-20° TOC; and G20MOD-20° TOC with modified SB. All SB were veneered with VM9, cemented in a fiber reinforced epoxy resin die, and loaded to failure. Half of the specimens from each group (n = 10) were cyclic fatigued (106 cycles) before testing. Failure analysis was performed to determine the fracture origin. Data were statistically analyzed using Anova and Tukey's tests (α = 0.05). Results: The greatest mean load to fracture value was found for the G20MOD, which was predicted by the FEA. Cyclic fatigue did not significantly affect the load of fracture. Catastrophic failure originating from the internal occlusal surface of the SB was the predominant failure mode, except for G20MOD. Significance: The YZ-VM9 restorations resisted greater compression load than the usual physiological occlusal load, regardless of the TOC angle of preparations. Yet, the G20MOD design produced the best performance among the experimental conditions evaluated. © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Considerações gerais sobre prótese fixa adesiva

The success rate of resin-bonded fixed partial dentures is directly related to the adhesive system and the tooth preparation design for good retention. These resin-bonded bridges represent a prosthodontic alternative, based on their costeffectiveness, conservative techniques, and ease of laboratory manufacturing. Through a thorough review of the literature, this study aimed to report on cavity designs, types of materials used, and the advantages and disadvantages of the resin-bonded fixed partial denture. One of significant advantages of the resin-bonded fixed partial dentures is the conservation of the tooth structure, whereas its main disadvantage includes aesthetic limitations, given that the alloy may in fact be visible. Preparation design, cement type, and casting alloy type, as well as surface treatment, are among the factors that influence the longevity of resin-bonded fixed partial dentures. Treatments with resin-bonded fixed partial dentures present a bright outlook regarding the conservation of tooth structures, as well as a high level of success.

High-speed cavity preparation techniques with different water flows

Statement of problem. Cavity and tooth preparations generate heat because the use of rotary cutting instruments on dental tissues creates friction. Dental pulps cannot survive temperature increases greater than 5.5degreesC.Purpose. This study evaluated the efficiency of 3 different water flows for 2 different tooth preparation techniques to determine which are safe for use.Material and methods. Thermocouples were placed in the pulpal chambers of 30 bovine teeth, and 1 of 2 tooth preparation techniques was used: a low-load intermittent tooth preparation technique or a high-load tooth preparation technique without intervals. Water flows of 0, 30, and 45 mL/min were associated with each technique, for a total of 6 different groups. The results were analyzed with a 2-factor analysis of variance (P<.05).Results. Temperature increases with the high-load technique were 16.40&DEG;C without cooling (group 1), 11.68&DEG;C with 30 mL/min air-water spray cooling (group III), and 9.96&DEG;C with 45 mL/min cooling (group V). With the low-load tooth preparation technique, a 9.54&DEG;C increase resulted with no cooling (group II), a 1.56&DEG;C increase with 30 mL/min air-water spray cooling (group TV), and a 0.04&DEG;C decrease with 45 mL/min cooling (group VI). The low-load technique was associated with more ideal temperature changes.Conclusion. The results of this study confirm the necessity of using a low-load technique and water coolants during cavity and tooth preparation procedures.

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.

Different methods of finishing and polishing enamel

Statement of problem. Highly polished enamel surfaces arc recommended for axial tooth surfaces that will serve as guiding planes and be contacted by component parts of a removable partial denture. There is little evidence to support the assumption that this tooth modification will provide accurate adaptation of the framework and prevent build-up of plaque.Purpose. The aim of this investigation was to evaluate the surface roughness of the tooth enamel, prepared to serve as guiding planes, with different polishing systems.Material and methods. Four different methods (designated A, B, C, and D) for finishing and polishing the prepared enamel surfaces of 20 freshly extracted third molar teeth were studied. Each method involved 3, 4, or 5 different steps. The roughness of each specimen was measured at the start of each method before recontouring, after recontouring, and after each step of the 4 finishing and polishing procedures. The 4 experimental finishing methods were applied after recontouring the axial surfaces (buccal, lingual, and proxinial) of each tooth. Thus the 20 teeth (60 surfaces) were finished and polished by use of 1 of the experimental methods. Surface roughness was measured with a profilometer (mum); the readings of the unpolished enamel Surfaces were recorded as control measurements. Results were statistically analyzed with one-way analysis of variance followed by Tukey's test at the 95% level of confidence.Results. The highest roughness mean values (14.41 mum to 16.44 mum) were found when the diamond bur was used at a high speed for tooth preparation. A significant decrease in roughness values was observed with the diamond bur at a low speed (P<.05). Analysis of the roughness values revealed that all polishing methods produced surface roughness similar to that of the corresponding control teeth.Conclusion. Within the limitations of this study, all finishing procedures tested effectively promoted an enamel surface similar to the original unpolished enamel.

Pulpal temperature increases with Er : YAG laser and high-speed handpieces

Statement of problem. During tooth preparation, both high-speed handpieces and lasers generate heat, which, if not controlled, can cause pulpal necrosis.Purpose. The aim of this study was to compare temperature increases produced by a high-speed dental handpiece with those produced by a relatively new instrument, the Er:YAG (erbium: yttrium-aluminum-garnet) laser.Material and methods. Thirty bovine mandibular incisors were reduced to an enamel/dentin thickness of 2.5 mm. Class V preparations were completed to a depth of 2.0 mm, measured with a caliper or by a mark oil the burs. A thermocouple was placed inside the pulp chamber to determine temperature increases (degreesC). Analysis was performed on the following groups (n = 10): Group 1, high-speed handpiece without water cooling, Group 11, high-speed handpiece with water cooling (30 mL/min), and Group III, the noncontact Er:YAG laser (2.94 mum at 350 mJ/10 Hz) with water cooling (4.5 mL/min). The temperature increases were recorded by a computer linked to the thermocouples. The data were analyzed using the Kruskal-Wallis test. The Dunn multiple comparison test was used as post hoc test (alpha = .05).Results. The average temperature rises were: 11.64degreesC (+/-4.35) for Group 1, 0.96degreesC (+/-0.71) for Group 11, and 2.69degreesC (+/-1.12) for Group III. There were no statistical differences between Groups 11 and III, both 11 and III differed from Group I significantly (P = .000 and P = .002, respectively).Conclusion. The preparations made with the high-speed and the laser instrument generated similar heat increases under water cooling. Water cooling was essential to avoid destructive temperature increases when using both the high-speed handpiece and laser.

The influence of cervical finish line, internal relief, and cement type on the cervical adaptation of metal crowns

Objective: the aim of this investigation was to evaluate the cervical adaptation of metal crowns under several conditions, namely (1) variations in the cervical finish line of the preparation, (2) application of internal relief inside the crowns, and (3) cementation using different luting materials. Method and Materials: One hundred eighty stainless-steel master dies were prepared simulating full crown preparations: 60 in chamfer (CH), 60 in 135-degree shoulder (OB), and 60 in rounded shoulder (OR). The finish lines were machined at approximate dimensions of a molar tooth preparation (height: 5.5 mm; cervical diameter: 8 mm; occlusal diameter: 6.4 mm; taper degree: 6; and cervical finish line width: 0.8 mm). One hundred eighty corresponding copings with the same finish lines were fabricated. A 30-mu m internal relief was machined 0.5 mm above the cervical finish line in 90 of these copings. The fit of the die and the coping was measured from all specimens (L0) prior to cementation using an optical microscope. After manipulation of the 3 types of cements (zinc phosphate, glass-ionomer, and resin cement), the coping was luted on the corresponding standard master die under 5-kgf loading for 4 minutes. Vertical discrepancy was again measured (L1), and the difference between L1 and L0 indicated the cervical adaptation. Results: Significant influence of the finish line, cement type, and internal relief was observed on the cervical adaptation (P < .001). The CH type of cervical finish line resulted in the best cervical adaptation of the metal crowns regardless of the cement type either with or without internal relief (36.6 +/- 3 to 100.8 +/- 4 mu m) (3-way analysis of variance and Tukey's test, alpha = .05). The use of glass-ionomer cement resulted in the least cervical discrepancy (36.6 +/- 3 to 115 +/- 4 mu m) than those of other cements (45.2 +/- 4 to 130.3 +/- 2 mu m) in all conditions. Conclusion: the best cervical adaptation was achieved with the chamfer type of finish line. The internal relief improved the marginal adaptation significantly, and the glass-ionomer cement led to the best cervical adaptation, followed by zinc phosphate and resin cement.

Method for marginal measurements of restorations: accessory device for toolmakers microscope.

Standardization of measurements for marginal fit of castings is critical. This study describes the fabrication of a device that allowed fixation of specimens on a Toolmakers microscope with identical conditions according to tri-dimensional positioning of specimens, measuring location, and seating force. The device also allows mapping of the marginal discrepancies on the entire marginal perimeter of the tooth preparation.

Marginal fit of nickel-chromium copings before and after internal adjustments with duplicated stone dies and disclosing agent.

STATEMENT OF PROBLEM: Despite careful procedures, master stone dies may be damaged during laboratory procedures. The dentist routinely adjusts castings because the marginal fit of casting is not as accurate as on the dies. PURPOSE: This study evaluated the technique of internal adjustment of castings with use of duplicated stone dies and a disclosing agent to improve marginal fit discrepancy. MATERIAL AND METHODS: Thirty-two nickel-chromium copings were fabricated and simulated standard clinical and laboratory procedures with 2 variables: tooth preparation convergence angles of 6 and 18 degrees, with or without internal relief. Master stone dies and their duplicates were selected for coping construction and internal adjustment, respectively. A specimen positioning device was coupled with a Toolmakers microscope to allow reproducibility of measurements. Each coping was evaluated at 8 locations of its marginal perimeter, before and after internal adjustment. RESULTS: Marginal fit discrepancy of copings were significantly reduced with an internal adjustment technique (mean > 52%) for all experimental groups. Tooth preparations with greater convergence and internally relieved castings recorded a better marginal fit. CONCLUSION: The casting internal adjustment technique with use of duplicated stone dies and a disclosing agent substantially reduced marginal fit discrepancy.

Aesthetic posts and cores for metal-free restoration of endodontically treated teeth.

Utilization of contemporary post and core systems has facilitated the aesthetic restoration of endodontically treated teeth. Light transmission and biocompatibility have been enhanced by the introduction of metal-free post systems. The periodontal and endodontic status, root length, and histological structure of the devitalized teeth must be considered in order to achieve successful restoration following endodontic treatment. This article presents various restorative criteria for the aesthetic placement and buildup of post and core materials, as well as the preservation of maximum coronal and root structure.

Dual path: A concept to improve the esthetic replacement of missing anterior teeth with a removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.

Retention strength of cobalt-chromium vs nickel-chromium titanium vs Cp titanium in a cast framework association of removable partial overdenture

Aim: There is little information considering the framework association between cast clasps and attachments. The aim of this study was to evaluate the retention strength of frameworks match circumferential clasps and extra resilient attachment cast in three different alloys (cobalt-chromium, nickel-chromium titanium and commercially pure titanium), using two undercut (0.25 and 0.75 mm) and considering different period of time (0, 1/2, 1, 2, 3, 4 and 5 years). Methods: Using two metallic matrices, representing a partially edentulous mandibular right hemiarch with the first molar crown, canine root and without premolars, 60 frameworks were fabricated. Three groups (n = 20) of each metal were cast and each group was divided into two subgroups (n = 10), corresponding the molar undercut of 0.25 mm and 0.75 mm. The nylon male was positioned at the matrix and attached to the acrylic resin of the prosthetic base. The samples were subjected to an insertion and removal test under artificial saliva environment. Results: The data were analyzed and compared with ANOVAs and Tukey's test at 95% of probability. The groups cast in cobaltchromium and nickel-chromium-titanium had the highest mean retention strength (5.58 N and 6.36 N respectively) without significant difference between them, but statistically different from the group cast in commercially pure titanium, which had the lowest mean retention strength in all the periods (3.46 N). The association frameworks using nickel-chromium-titanium and cobalt-chromium could be used with 0.25 mm and 0.75 mm of undercut, but the titanium samples seems to decrease the retention strength, mainly in the 0.75 mm undercut. The circumferential clasps cast in commercially pure titanium used in 0.75 mm undercuts have a potential risk of fractures, especially after the 2nd year of use. Conclusion: This in vitro study showed that the framework association between cast clasp and an extra resilient attachment are suitable to the three metals evaluated, but strongly suggest extra care with commercially pure titanium in undercut of 0.75 mm. Clinical significance: Frameworks fabricated in Cp Ti tend to decrease in retentive strength over time and have a potential risk of fracture in less than 0.75 mm of undercut.

Influência da angulação do preparo coronário na resistência à fratura de restaurações cerâmicas à base de Y-TZP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do ciclo de sinterização da porcelana na adaptação marginal de infraestruturas de NiCrTi em função da biomecânica do preparo

A metal coping may undergo changes during porcelain firing, which compromises its marginal adaptation. The use of NiCrTi alloy proposes to minimize this effect through the high melting point of titanium present in its composition. This study evaluated the influence of porcelain firing cycle on the marginal adaptation of NiCrTi copings in different preparation designs. Forty standardized metal dies were fabricated with the following combinations finish line/convergence of the axial walls: 1) shoulder/6°; 2) shoulder/20°; 3) sloping shoulder/6°; 4) sloping shoulder/20°. On each die a metal ceramic restoration coping was made. The die/coping set was stabilized with orthodontic elastics, divided into four equidistant areas with three measurement points each and a cementation pressure was simulated. The measurements were taken under a stereomicroscope (32×). After the first measurement, the copings were submitted to sintering cycles simulating porcelain application. For repeated measurements, the same procedures described above were performed. Data were submitted to Student’s-t test, 1-way ANOVA and Tukey´s test (α = 0.05). Adaptation means (µm) before and after porcelain firing in different preparations were: 1) 111.92 and 127.31; 2) 124.15 and 135.48; 3) 122.19 and 138.77; 4) 166.09 and 186.72; respectively. The porcelain firing impaired adaptation, regardless of the preparation design. The preparation in a 20° sloping shoulder provided a worse adaptation when compared with preparations that had 6° and 20° shoulder, which were statistically equal. The 6° sloping shoulder was statistically equal to the other three preparation designs.