The Role of Implant/Abutment System on Torque Maintenance of Retention Screws and Vertical Misfit of Implant-Supported Crowns Before and After Mechanical Cycling

Purpose: This study aimed to evaluate the role of the implant/abutment system on torque maintenance of titanium retention screws and the vertical misfit of screw-retained implant-supported crowns before and after mechanical cycling. Materials and Methods: Three groups were studied: morse taper implants with conical abutments (MTC group), external-hexagon implants with conical abutments (EHC group), and external-hexagon implants with UCLA abutments (EHU group). Metallic crowns casted in cobalt-chromium alloy were used (n = 10). Retention screws received insertion torque and, after 3 minutes, initial detorque was measured. Crowns were retightened and submitted to cyclic loading testing under oblique loading (30 degrees) of 130 +/- 10 N at 2 Hz of frequency, totaling 1 x 10(6) cycles. After cycling, final detorque was measured. Vertical misfit was measured using a stereomicroscope. Data were analyzed by analysis of variance, Tukey test, and Pearson correlation test (P < .05). Results: All detorque values were lower than the insertion torque both before and after mechanical cycling. No statistically significant difference was observed among groups before mechanical cycling. After mechanical cycling, a statistically significantly lower loss of detorque was verified in the MTC group in comparison to the EHC group. Significantly lower vertical misfit values were noted after mechanical cycling but there was no difference among groups. There was no significant correlation between detorque values and vertical misfit. Conclusions: All groups presented a significant decrease of torque before and after mechanical cycling. The morse taper connection promoted the highest torque maintenance. Mechanical cycling reduced the vertical misfit of all groups, although no significant correlation between vertical misfit and torque loss was found.

Torque Stability of Different Abutment Screws Submitted to Mechanical Cycling

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

Mechanical behavior of dental implants in different positions in the rehabilitation of the anterior maxilla

Statement of problem. In dental rehabilitations that involve implants, the number of implants is sometimes smaller than the number of lost teeth. This fact can affect the biomechanical behavior and success of the implants.Purpose. The purpose of this study was to investigate the mechanical behavior of different implant positions in the rehabilitation of the anterior maxilla.Material and methods. Three-dimensional models of the maxilla were created based on computed tomography images for 3 different anterior prosthetic rehabilitations. In group IL, the implants were placed in the lateral incisor positions with pontics in the central incisor positions; in group IC, the implants were in the central incisor positions with cantilevers in the lateral incisor positions; and, in group ILIC, one implant was in a lateral incisor position and one was in a central incisor position, with a pontic and a cantilever in the remaining positions. A 150 N load was distributed and applied at the center of the palatal surface of each tooth at a 45-degree angle to the long axis of the tooth. The resulting stress-strain distribution was analyzed for each group.Results. The lowest displacement of the prosthetic structure was observed in group IC, although the same group exhibited the largest displacement of the bone tissue. In the bone tissue, the von Mises stress was mainly observed in the cortical bone in all groups. The maximum value of the von Mises stress shown in the cortical tissue was 35 MPa in the implant that neighbors the cantilever in group ILIC. The maximum von Mises stress in the trabecular bone was 3.5 MPa.Conclusion. The prosthetic configuration of group IC limited the displacement of the prosthetic structure but led to greater displacement of the bone structure. The use of a cantilever increased the stress concentration in the implant and in the bone structure adjacent to the cantilever under the conditions studied here.

Effect of root canal preparation, type of endodontic post and mechanical cycling on root fracture strength

Objective: To evaluate the impact of the type of root canal preparation, intraradicular post and mechanical cycling on the fracture strength of roots. Material and Methods: Eighty human single rooted teeth were divided into 8 groups according to the instruments used for root canal preparation (manual or rotary instruments), the type of intraradicular post (fiber posts-FRC and cast post and core-CPC) and the use of mechanical cycling (MC) as follows: Manual and FRC; Manual, FRC and MC; Manual and CPC; Manual, CPC and MC; Rotary and FRC; Rotary, FRC and MC; Rotary and CPC; Rotary, CPC and MC. The filling was performed by lateral compactation. All root canals were prepared for a post with a 10 mm length, using the custom # 2 bur of the glass fiber post system. For mechanical cycling, the protocol was applied as follows: an angle of incidence of 45 degrees, 37 degrees C, 88 N, 4 Hz, 2 million pulses. All groups were submitted to fracture strength test in a 45 degrees device with 1 mm/min cross-head speed until failure occurred. Results: The 3-way ANOVA showed that the root canal preparation strategy (p<0.03) and post type (p<0.0001) affected the fracture strength results, while mechanical cycling (p=0.29) did not. Conclusion: The root canal preparation strategy only influenced the root fracture strength when restoring with a fiber post and mechanical cycling, so it does not seem to be an important factor in this scenario.

Determinant factors for mortality of patients receiving mechanical ventilation and effects of a protocol muscle training in weaning

Introduction: Prognostic factors are used in the Intensive Care Unit (ICU) to predict morbidity and mortality , especially in patients on mechanical ventilation (MV ) . Training protocols are used in MV patients with the aim of promoting the success of the weaning process. Objective: To assess which variables determine the outcome of patients undergoing mechanical ventilation and compare the effects of two protocols for weaning. Method: Patients under MV for more than 48 hours had collected the following information: sex, age , ideal weight, height , Acute Physiology and Chronic Health Evaluation (APACHE II), risk of mortality, Glasgow Coma Scale (GCS) and index Quick and perfunctory (IRRS) breathing. Patients with unsuccessful weaning performed one of weaning protocols: Progressive T - tube or tube - T + Threshold ® IMT. Patients were compared for outcome (death or non- death in the ICU ) and the protocols through the t test or Mann-Whitney test was considered significant when P <0.05. Results: Of 128 patients evaluated 56.25% were men, the mean age was 60.05 ± 17.85 years and 40.62 % patients died, and they had higher APACHE II scores, mortality risk, time VM and IRRS GCS and the lower value (p<0.05). The age, initial and final maximal inspiratory pressure, time of weaning and duration of MV was similar between protocols. Conclusion: The study suggests that the GCS, APACHE II risk of mortality, length of MV and IRRS variables determined the evolution of MV patients in this sample. Not found differences in the variables studied when comparing the two methods of weaning.

Methods to evaluate and strategies to improve the biocompatibility of dental materials and operative techniques

Objective. The general aim of this article is to describe the state-of-the-art of biocompatibility testing for dental materials, and present new strategies for improving operative dentistry techniques and the biocompatibility of dental materials as they relate to their interaction with the dentin-pulp complex.Methods. The literature was reviewed focusing on articles related to biocompatibilty testing, the dentin-pulp complex and new strategies and materials for operative dentistry. For this purpose, the PubMed database as well as 118 articles published in English from 1939 to 2014 were searched. Data concerning types of biological tests and standardization of in vitro and in vivo protocols employed to evaluate the cytotoxicity and biocompatibility of dental materials were also searched from the US Food and Drug Administration (FDA), International Standards Organization (ISO) and American National Standards Institute (ANSI).Results. While there is an ongoing search for feasible strategies in the molecular approach to direct the repair or regeneration of structures that form the oral tissues, it is necessary for professionals to master the clinical therapies available at present. In turn, these techniques must be applied based on knowledge of the morphological and physiological characteristics of the tissues involved, as well as the physical, mechanical and biologic properties of the biomaterials recommended for each specific situation. Thus, particularly within modern esthetic restorative dentistry, the use of minimally invasive operative techniques associated with the use of dental materials with excellent properties and scientifically proved by means of clinical and laboratory studies must be a routine for dentists. This professional and responsible attitude will certainly result in greater possibility of achieving clinical success, benefiting patients and dentists themselves.Signcance. This article provides a general and critical view of the relations that permeate the interaction between dental materials and the dentin-pulp complex, and establish real possibilities and strategies that favor biocompatibility of the present and new products used in Dentistry, which will certainly benefit clinicians and their patients. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effects of aging procedures on the topographic surface, structural stability, and mechanical strength of a ZrO2-based dental ceramic

Objective. To determine the effects of different aging methods on the degradation and flexural strength of yttria-stabilized tetragonal zirconia (Y-TZP)Methods. Sixty disc-shaped specimens (0, 12 mm; thickness, 1.6 mm) of zirconia (Vita InCeram 2000 YZ Cubes, VITA Zahnfabrik) were prepared (ISO 6872) and randomly divided into five groups, according to the aging procedures (n=10): (C) control; (M) mechanical cycling (15,000,000 cycles/3.8 Hz/200N); (T) thermal cycling (6,000 cycles/5-55 degrees C/30 s); (TM) thermomechanical cycling (1,200,000 cycles/3.8 Hz/200N with temperature range from 5 C to 55 C for 60s each); (AUT) 12h in autoclave at 134 degrees C/2 bars; and (STO) storage in distilled water (37 degrees C/400 days). After the aging procedures, the monoclinic phase percentages were evaluated by X-ray diffraction (XRD), and topographic surface analysis was performed by 3D profilometry. The specimens were then subjected to biaxial flexure testing (1 mm/min, load 100 kgf, in water). The biaxial flexural strength data (MPa) were analyzed by 1-way ANOVA and Tukey's test (alpha = 0.05). The data for monoclinic phase percentage and profilometry (Ra) were analyzed by Kruskal-Wallis and Dunn's tests.Results. ANOVA revealed that flexural strength was affected by the aging procedures (p = 0.002). The M (781.6 MPa) and TM (771.3 MPa) groups presented lower values of flexural strength than did C (955 MPa), AUT (955.8 MPa), T (960.8 MPa) and STO (910.4 MPa). The monoclinic phase percentage was significantly higher only for STO (12.22%) and AUT (29.97%) when compared with that of the control group (Kruskal-Wallis test, p = 0.004). In addition, the surface roughnesses were similar among the groups (p = 0.165).Signcance. Water storage for 400 days and autoclave aging procedures induced higher phase transformation from tetragonal to monoclinic; however, they did not affect the flexural strength of Y-TZP ceramic, which decreased only after mechanical and thermomechanical cycling. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Finite element evaluation of three methods of stable fixation of condyle base fractures

The surgical treatment of mandibular condyle fractures currently offers several possibilities for stable internal fixation. In this study, a finite element model evaluation was performed of three different methods for osteosynthesis of low subcondylar fractures: (1) two four-hole straight plates, (2) one seven-hole lambda plate, and (3) one four-hole trapezoidal plate. The finite element model evaluation considered a load applied to the first molar on the contralateral side to the fracture. Results showed that, although the three methods are capable of withstanding functional loading, the lambda plate displayed a more homogeneous stress distribution for both osteosynthesis material and bone and may be a better method when single-plate fixation is the option.

INFLUENCE OF THE VENEER-FRAMEWORK INTERFACE ON THE MECHANICAL BEHAVIOR OF CERAMIC VENEERS: A NONLINEAR FINITE ELEMENT ANALYSIS

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

Effect of Ceramic Thickness and Shade on Mechanical Properties of a Resin Luting Agent

Purpose: This study aimed to investigate the influence of ceramic thickness and shade on the Knoop hardness and dynamic elastic modulus of a dual-cured resin cement.Materials and Methods: Six ceramic shades (Bleaching, A1, A2, A3, A3.5, B3) and two ceramic thicknesses (1 mm, 3 mm) were evaluated. Disk specimens (diameter: 7 mm; thickness: 2 mm) of the resin cement were light cured under a ceramic block. Light-cured specimens without the ceramic block at distances of 1 and 3mm were also produced. The Knoop hardness number (KHN), density, and dynamic Young's moduli were determined. Statistical analysis was conducted using ANOVA and a Tukey B rank order test (p = 0.05).Results: The bleaching 1-mm-thick group exhibited significantly higher dynamic Young's modulus. Lower dynamic Young's moduli were observed for the 3-mm-thick ceramic groups compared to bleaching 3-mm-thick group, and no difference was found among the other 3-mm groups. For the KHN, when A3.5 3-mm-thick was used, the KHN was significantly lower than bleaching and A1 1-mm-thick ceramic; however, no difference was exhibited between the thicknesses of the same shade.Conclusions: The dual-cured resin cement studied irradiated through the 1-mm-thick ceramic with the lightest shade (bleaching ceramic) exhibited a better elastic modulus, and there was no effect in KHN of the resin cement when light cured under different ceramic shades and thicknesses (1 and 3 mm), except when the A3.5 3-mm-thick ceramic was used.Clinical Significance: Variolink II irradiated through ceramic with the lowest chroma exhibited the highest elastic modulus; therefore, the light activation method might not be the same for all clinical situations.

Sex chromosome composition revealed in Characidium fishes (Characiformes: Crenuchidae) by molecular cytogenetic methods

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

Microtensile Bond Strenh Between Indirect Composite Resin Inlays and Dentin: Effect of Cementation Strategy and Mechanical Aging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

In vitro biomechanical comparison of six different fixation methods following 5-mm sagittal split advancement osteotomies

The sagittal split ramus osteotomy (SSRO) is a surgical technique used widely to treat many congenital and acquired mandibular discrepancies. Stabilization of the osteotomy site and the potential for skeletal relapse after the procedure are still major problems. The aim of this study was to compare the mechanical stability of six methods of rigid fixation in SSRO using a biomechanical test model. Sixty polyurethane replicas of human hemimandibles were divided into six groups. In group I, the osteotomies were fixed with two four-hole titanium miniplates; in group II, with one four-hole miniplate; in group III, with one four-hole miniplate + a bicortical screw; in group IV, with a grid miniplate; in group V, with a four-hole locking miniplate; and in group VI, with a six-hole miniplate. A linear load in the premolar region was applied to the hemimandibles. The resistance forces (N) needed to displace the distal segment by 1, 3, and 5 mm were recorded and the data transmitted from the load cell to a computer. One-way analysis of variance with Tukey's post hoc test was performed to compare the means between groups. For the three displacement conditions, there was a strong tendency for the 2.0-mm plate + screw and the grid plate to have higher values.

Effect of thermal and mechanical cycles on the hardness and roughness of artificial teeth

In this study the effects of thermal and mechanical cycles on the hardness and roughness of artificial teeth were evaluated. Materials and Methods:Specimens were prepared and stored in distilled water at 37ºC for 48 hours (n=10).The hardness and roughness readings were made in the following time intervals, according to each group:G1: after specimen storage in distilled water at 37°C for 48 hours; G2: after 600.000 constant mechanical cycles; G3: after 1.200.000 constant mechanical cycles; G4: after 2.500 thermalcycling baths, alternated between hot water (55°C) and cold water (5°C) and G5: after 5.000 thermalcycling baths, alternated between hot water (55°C) and cold water (5°C). After cycling and storage procedures, the specimens of each group were submittedto surface roughness and hardness readouts. Statistical evaluation was performed by three-way analysis of variance, complemented by the Tukey multiple comparisons of means test. The level of significance adopted was 5%. There was no significant difference between G1, G4 and G5 as regards mean roughness of different brands of artificial teeth. Groups G2 and G3 showed higher mean roughness values, and generally equivalent values in all time intervals, except for Trilux (G3> G2). Significant differences in hardness values were observed in different brands of artificial teeth, and differences in values after thermal and mechanical cycling. In conclusion, our findings suggest that thermal cyclingdid not change the roughness of the artificial teeth tested, but after the mechanical cycling the roughness values increased. Thermal and mechanical cycling influenced the hardness of the artificial teeth tested.

Mechanical properties of components of the bonding interface in different regions of radicular dentin surfaces

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