Análise mecânica e microestrutural das ligas de cobalto-cromo de uso odontológico após sucessivas refundições

The cobalt-chromium alloy is extensively used in the Odontology for the confection of metallic scaffolding in partial removable denture. During the last few years, it has been reported an increasing number of premature imperfections, with a few months of prosthesis use. The manufacture of these components is made in prosthetic laboratories and normally involves recasting, using parts of casting alloy and parts of virgin alloy. Therefore, the objective of the present study was to analyze the mechanical properties of a commercial cobalt-chromium alloy of odontological use after successive recasting, searching information to guide the dental prosthesis laboratories in the correct manipulation of the cobalt-chromium alloy in the process of casting and the possible limits of recasting in the mechanical properties of this material. Seven sample groups were confectioned, each one containing five test bodies, divided in the following way: G1: casting only with virgin alloy; G2: casting with 50% of the alloy of the G1 + 50% of virgin alloy; G3: casting with 50% of the alloy of the G2 + 50% of virgin alloy; G4: casting with 50% of the alloy of the G3 + 50% of virgin alloy; G5: 50% of alloy of the G4 + 50% of virgin alloy; G6: 50% of alloy of the G5 + 50% of virgin alloy and finally the G7, only with recasting alloy. The modifications in the mechanical behavior of the alloy were evaluated. Moreover, it was carried the micro structural characterization of the material by optic and electronic scanning microscopy, and X ray diffraction.and fluorescence looking into the correlatation of the mechanical alterations with structural modifications of the material caused by successive recasting process. Generally the results showed alterations in the fracture energy of the alloy after successive recasting, resulting mainly of the increasing presence of pores and large voids, characteristic of the casting material. Thus, the interpretation of the results showed that the material did not reveal significant differences with respect to the tensile strength or elastic limit, as a function of successive recasting. The elastic modulus increased from the third recasting cycle on, indicating that the material can be recast only twice. The fracture energy of the material decreased, as the number of recasting cycles increased. With respect to the microhardness, the statistical analyses showedno significant differences. Electronic scanning microscopy revealed the presence of imperfections and defects, resulting of the recasting process. X ray diffraction and fluorescence did not show alterations in the composition of the alloy or the formation of crystalline phases between the analyzed groups. The optical micrographs showed an increasing number of voids and porosity as the material was recast. Therefore, the general conclusion of this study is that the successive recasting of of Co-Cr alloys affects the mechanical properties of the material, consequently leading to the failure of the prosthetic work. Based on the results, the best recommendadition is that the use of the material should be limited to two recasting cycles

Influence of microwave disinfection on the dimensional stability of intact and relined acrylic resin denture bases

Statement of problem. Microwave irradiation has been suggested as a method to disinfect denture bases. However, the effect of microwave heating on the dimensional stability of the relined denture bases is unknown.Purpose. The purpose of this study was to evaluate the dimensional stability of intact and relined acrylic resin denture bases after microwave disinfection.Material and methods. A standard brass cast simulating an edentulous maxillary arch was machined and used to fabricate 2- and 4-mm-thick denture bases (n=200), which were processed with heat-polymerized acrylic resin (Lucitone 550). The 2-mm thick-specimens (n=160) were relined with 2 mm of autopolymerizing resin (Tokuso Rebase Fast, Ufi Gel Hard, Kooliner, or New Truliner). Distances between 5 removable pins on the standard brass cast were measured with a Nikon optical comparator, and the area (mm(2)) formed by the distance between 5 pins was calculated and served as baseline. During fabrication, the pins were transferred to the intaglio surface of the specimens. Differences between the baseline area and those subsequently determined for the specimens were used to calculate the percent dimensional changes. The intact and relined denture bases were divided into 4 groups (n=10) and evaluated after: polymerization (control group P); 1 cycle of microwave disinfection (MW); daily microwave disinfection for 7 days (control group MW7); water storage for 7 days (WS7). Microwave irradiation was performed for 6 minutes at 650 W. Data were analyzed using 2-way ANOVA followed by Tukey's test (alpha=.05).Results. Intact specimens and those relined with Kooliner and New Truliner showed increased shrinkage after 1 (P=.05, .018, and .001, respectively) and 7 (P <.001, .003, and <.001, respectively) cycles of microwave disinfection. With the exception of specimens relined with Kooliner, intact specimens showed greater shrinkage than the relined specimens after 7 cycles of microwave disinfection.Conclusions. Microwave disinfection produced increased shrinkage of intact specimens and those relined with New Truliner and Kooliner.

Bonding strength between a hard chairside reline resin and a denture base material as influenced by surface treatment

Direct relining of dentures made with hard chairside reline resins is faster than laboratory-processed reline systems and the patient is not without the prosthesis for the time necessary to perform the laboratory procedures. However, a weak bond between the autopolymerizing acrylic reline resins and the denture base material has been observed. This study evaluated the effect of six different surface treatments on the bond strength between a hard chairside reline acrylic resin and ia heat-cured acrylic resin. Specimens of the heat-cured acrylic resin were divided into seven groups. one of these groups remained intact. In the other groups, a 10-mm square section was removed from the centre of each specimen. The bonding surfaces were then treated with (i) methyl methacrylate monomer, (ii) isobutyl methacrylate monomer, (iii) chloroform, (iv) acetone, (v) experimental adhesive and (vi) no surface treatment-control group. Kooliner acrylic resin was packed,into the square sections and polymerized. The bonding strength was evaluated by a three-point loading test. The results were submitted to one-way analysis of variance (ANOVA) followed by a Tukey multiple range test at a 5% level of significance. No significant difference was found between the surface treatment with Lucitone 550 monomer or chloroform, but both were stronger than the majority of the other groups. The bond strength provided by all the surface treatments was lower than that of the intact heat-cured resin.

The effect of disinfectant solutions on the hardness of acrylic resin denture teeth

This investigation studied the effects of disinfectant solutions on the hardness of acrylic resin denture teeth. The occlusal surfaces of 64 resin denture teeth were ground flat with abrasives up to 400-grit silicon carbide paper. Measurements were made after polishing and after the specimens were stored in water at 37 degreesC for 48 h. The specimens were then divided into four groups and immersed in chemical disinfectants (4% chlorhexidine; 1% sodium hypochlorite and sodium perborate) for 10 min. The disinfection methods were performed twice to simulate clinical conditions and hardness measurements were made. Specimens tested as controls were immersed in water during the same disinfection time. Eight specimens were produced for each group. After desinfection procedures, testing of hardness was also performed after the samples were stored at 37 degreesC for 7, 30, 60, 90 and 120 days. Data were analysed using two-way analysis of variance (anova) and Tukey's test at 95% confidence level. According to the results, no significant differences were found between materials and immersion solutions (P > 0.05). However, a continuous decrease in hardness was noticed after ageing (P < 0.05). It was conclude that the surfaces of both acrylic resin denture teeth softened upon immersion in water regardless the disinfecting solution.

Cytotoxicity of denture base and hard chairside reline materials: a systematic review

Statement of problem. Adverse reactions to the materials used for the fabrication and reline of removable denture bases have been observed.Purpose. The purpose of this study was to systematically review the published literature on the cytotoxicity of denture base and hard reline materials.Material and methods. MEDLINE via PubMed, Google Scholar, and Scopus databases for the period January 1979 to December 2009 were searched with the following key words: (biocompatibility OR cytotoxic* OR allergy OR burning mouth OR cell culture techniques) and (acrylic resins OR denture OR monomer OR relin* OR denture liners). The inclusion criteria included in vitro studies using either animal or human cells, in which the cytotoxicity of the denture base and hard chairside reline resins was tested. Studies of resilient lining materials and those that evaluated other parameters such as genotoxicity and mutagenicity were excluded. Articles published in the English language and in peer-reviewed journals focusing on the cytotoxicity of these materials were reviewed.Results. A total of 1443 articles were identified through the search. From these, 20 studies were judged to meet the selection criteria and were included in the review. In the majority of the studies, continuous cell lines were exposed to eluates of specimens made from the materials, and mitochondrial activity was used to estimate cell viability. The tested acrylic resins were grouped according to 5 major categories: (1) heat-polymerized; (2) microwave-polymerized; (3) autopolymerizing; (4) light-polymerized; and (5) hard chairside reliners.Conclusions. This review provided some evidence that the heat-polymerized resins showed lower cytotoxic effects than autopolymerizing denture base acrylic resins and light or dual polymerized reline resins. However, because of the large number of variables in the reviewed literature, a definitive conclusion could not be drawn. (J Prosthet Dent 2012;107:114-127)

Forças de mordida relacionadas a próteses parciais removíveis inferiores

A pesquisa teve como objetivo determinar as forças de mordida de 73 indivíduos, por meio de um gnatodinamômetro. Os pacientes eram portadores de próteses parciais removíveis inferiores classes I, II ou III. A arcada antagonista era prótese, parcial removível ou fixa, ou total. Os resultados permitiram concluir que: as selas de extremidade livre, principalmente em suas posições extremas, conduziram a forças de mordida muito baixas; o envolvimento de prótese total, também, conduziu a forças de mordida baixas; o sexo masculino alcançou valores maiores que o feminino; com prótese parcial removível classe III, os dentes naturais molares e pré-molares desenvolveram valores maiores do que com classes I e II.

Composite occlusal surfaces for acrylic resin denture teeth

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to a loss of chewing efficiency and a loss of vertical dimension of occlusion. The use of metal occlusal surfaces on the acrylic resin denture teeth will minimize occlusal wear. Several articles have described methods to construct metal occlusal surfaces; however, these methods are time-consuming, costly, and sometimes considered to be unesthetic. These methods also require that the patient be without the prosthesis for the time necessary to perform the laboratory procedures. This article presents a quick, simple, and relatively inexpensive procedure for construction of composite occlusal surfaces on complete and partial dentures.

Biofilm microbial communities of denture stomatitis

Introduction: Denture stomatitis is a common lesion that affects denture wearers. Its multifactorial etiology seems to depend on a complex and poorly characterized biofilm. The purpose of this study was to assess the composition of the microbial biofilm obtained from complete denture wearers with and without denture stomatitis using culture-independent methods.Methods: Samples were collected from healthy denture wearers and from patients with denture stomatitis. Libraries comprising about 600 cloned 16S ribosomal DNA (rDNA) bacterial sequences and 192 cloned eukaryotic internal transcribed spacer (ITS) region sequences, obtained by polymerase chain reactions, were analyzed.Results: The partial 16S rDNA sequences revealed a total of 82 bacterial species identified in healthy subjects and patients with denture stomatitis. Twenty-seven bacterial species were detected in both biofilms, 29 species were exclusively present in patients with denture stomatitis, and 26 were found only in healthy subjects. Analysis of the ITS region revealed the presence of Candida sp. in both biofilms.Conclusion: The results revealed the extent of the microbial flora, suggesting the existence of distinct biofilms in healthy subjects and in patients with denture stomatitis.

Shear bond strength fatigue limit of rest seats made with dental restoratives

Purpose: This study compared the shear bond strength (SBS) to enamel of rest seats made with a glass-ionomer cement (Fuji IX GP Fast), a resin-modified glass-ionomer cement (Fuji II LC), and a composite resin (Z100 MP) under monotonic and cyclic loading. Materials and Methods: Rest seats were built up onto the lingual surfaces of 80 intact human mandibular incisors. Specimens (n=10) were stored in distilled water at 37°C for 30 days and subjected to shear forces in a universal testing machine (0.5 mm/min) until fracture. The SBS values were calculated (MPa) using the bonding area (9.62 mm2) delimited by adhesive tags. A staircase approach was used to determine the SBS fatigue limit of each material. Specimens were submitted to either 10,000 cycles (5 Hz) or until specimen fracture. A minimum of 15 specimens was tested for each material. Scanning electron microscopy was used to examine the mode of failure. Data were statistically analyzed with one-way ANOVA and Tukey HSD tests (α = 0.05). Results: Z100 MP yielded higher (p < 0.05) SBS (12.25 MPa) than Fuji IX GP Fast (7.21 MPa). No differences were found between Fuji II LC (10.29 MPa) and the other two materials (p > 0.05). Fuji II LC (6.54 MPa) and Z100 MP (6.26 MPa) had a similar SBS limit. Fuji IX GP Fast promoted the lowest (p < 0.05) SBS fatigue limit (2.33 MPa). All samples showed cohesive failure patterns. Conclusion: Fatigue testing can provide a better means of estimating the performance of rest seats made with dental restoratives.

Severe fracture of the maxillary alveolar process associated with extrusive luxation and tooth avulsion: A case report

Aim: The aim of this report is to present a case of severe fracture of the maxillary anterior alveolar process with substantial bone dislodgement associated with extrusive tooth luxation and avulsion. Background: Dentoalveolar trauma is a challenge to dentistry, especially in young patients, for it can lead to early tooth loss which compromises oral function, esthetics, self-esteem, and alter the long-term plan of care for the victim. Case Report: A 12-year-old girl with severe dentoalveolar trauma to the maxillary anterior region presented for emergency care for her injury. Treatment consisted of fracture reduction of the alveolar process, repositioning of the teeth that had suffered extrusive luxation, placement of a semi-rigid splint, and suturing of soft tissue lacerations. The traumatized teeth presented with pulpal necrosis and were treated endodontically. After 24 months of follow up, the fracture of the alveolar process was completely healed and the displaced teeth presented no signs of ankylosis or root resorption. Summary: First-aid care contributed remarkably to this case allowing the re-establishment of esthetics, function, and patient's self-esteem. In spite of trauma extension the treatment outcomes were favorable. Clinical Significance: Cases of dentoalveolar trauma should be evaluated on an individual basis. However, early emergency management and adequate follow-up can prevent further complications and contribute to treatment success.

Effect of accelerated aging on the microhardness and color stability of flexible resins for dentures

Acrylic resins have been widely used due to their acceptable esthetics and desirable characteristics such as easy handling, good thermal conductivity, low permeability to oral fluids and color stability. Flexible resins were introduced on the market as an alternative to the use of conventional acrylic resins in the construction of complete and partial removable dentures. Although these resins present advantages in terms of esthetics and comfort, studies assessing chromatic and microhardness alterations of these materials are still scarce in the related literature. The aim of this study was to evaluate the chromatic and microhardness alterations of two commercial brands of flexible resins in comparison to the conventional resin Triplex when submitted to accelerated aging. The resins were manipulated according to manufacturers' instructions and inserted into a silicone matrix to obtain 21 specimens divided into 3 groups: Triplex, Ppflex and Valplast. Triplex presented the highest microhardness value (p < 0.05) for all the aging periods, which was significantly different from that of the other resins, followed by the values of Valplast and Ppflex. Comparison between the flexible resins (Ppflex and Valplast) revealed a statistically significant difference (p < 0.05) as regards color. The flexible resin Ppflex and the conventional resin Triplex presented no statistically significant difference (p < 0.05) as regards aging. The accelerated aging significantly increased the microhardness values of the resins, with the highest values being observed for Triplex. Valplast presented the greatest chromatic alteration after accelerated aging.

Impact strength of denture base and reline acrylic resins subjected to long-term water immersion

Water may influence the mechanical properties of the acrylic resins. Thus, the effect of water storage on the impact strength (IS) of one denture base (Lucitone 550 - L) and four reline resins (Tokuyama Rebase II - T; UfiGel Hard - U; Kooliner - K; New Truliner - NT) was evaluated. Bars of L were made (60 x 6 x 2 mm) and relined (2 mm) with T, U, K, NT and L. Intact specimens of each material (60 x 6 x 4 mm) were also fabricated for comparative purposes. Specimens were submitted to Charpy impact tests without water storage (control) and after immersion in water for 7, 90 and 180 days. Data (kJ/m 2) analyzed by two-way ANOVA and Tukey's test (p=0.05) revealed that after 90 days, U exhibited an increase in the IS (0.93) compared to 7 days (0.58). K (1.48) and L/K (7.21) exhibited a decrease at the 7-day period (1.01 and 3.23, respectively). NT (0.60) showed an increase in the IS after 180 days (1.52), whereas L/ NT (7.70) showed a decrease (3.17). Water immersion improved the IS of U and NT, and decreased the IS of K, L/K, and L/NT. Water may affect differently the IS of acrylic resins and, consequently, the resistance to fracture of relined denture bases.

Effect of axial loads on implant-supported partial fixed prostheses by strain gauge analysis

Objectives: The present study used strain gauge analysis to perform an in vitro evaluation of the effect of axial loading on 3 elements of implant-supported partial fixed prostheses, varying the type of prosthetic cylinder and the loading points. Material and methods: Three internal hexagon implants were linearly embedded in a polyurethane block. Microunit abutments were connected to the implants applying a torque of 20 Ncm, and prefabricated Co-Cr cylinders and plastic prosthetic cylinders were screwed onto the abutments, which received standard patterns cast in Co-Cr alloy (n = 5). Four strain gauges (SG) were bonded onto the surface of the block 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 with a 10 Ncm torque and an axial load of 30 kg was applied at five predetermined points (A, B, C, D, E). The data obtained from the strain gauge analyses were analyzed statistically by RM ANOVA and Tukey's test, with a level of significance of p<0.05. Results: There was a significant difference for the loading point (p=0.0001), with point B generating the smallest microdeformation (239.49 με) and point D the highest (442.77 με). No significant difference was found for the cylinder type (p=0.748). Conclusions: It was concluded that the type of cylinder did not affect in the magnitude of microdeformation, but the axial loading location influenced this magnitude.

Opportunistic microorganisms in individuals with lesions of denture stomatitis

The aim of this study was to isolate, quantify, identify, and compare opportunistic microorganisms (Candida and Staphylococcus genera and Enterobacteriaceae/Pseudomonadaceae families) from prosthesis-fitting surfaces, the hard palate, and mouth rinses of individuals wearing removable maxillary prosthesis with (50) and without (50) lesions of denture stomatitis (DS). The strains were collected and identified using phenotypic, biochemical and molecular tests. The counts of microorganisms were significantly higher in the group of individuals with DS (P < 0.05). C. albicans was the most frequently isolated yeast species in both groups, following by C. tropicalis and C. glabrata. Six isolates were identified as C. dubliniensis. S. aureus and S. epidermidis were the most frequent Staphylococcus species in both groups. Klebsiella pneumoniae was the predominant species in both groups. The association between Candida spp. and bacteria isolated in this study with DS suggests that these microorganisms may play important roles in the establishment and persistence of this disease. © 2013 Elsevier Inc.

Avaliação do nível de inserção óssea do dente suporte em prótese parcial removível mandibular classe I associada a implante osseointegrado: análise pelo método dos elementos finitos

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