Protocol for the Hall Technique study: A trial to measure clinical effectiveness and cost-effectiveness of stainless steel crowns for dental caries restoration in primary molars in young children

BACKGROUND: The Hall Technique (HT) is a carious primary molar treatment that does not require local analgesia, carious tissue removal or tooth preparation. The carious lesions in carefully selected teeth are sealed with a stainless steel crown (preformed metal crown). The study aims are to determine the clinical effectiveness, acceptability and cost-effectiveness of the HT for management of carious lesions in young dental patients. METHODS/DESIGN: Children, aged 3-7years, with a primary molar tooth with a carious lesion extending no further than the middle third of dentine, with no signs or symptoms of pulp inflammation or infection, and attending one of three community agencies are recruited. Target sample size is 220. A control tooth with an intra-coronal restoration is sourced from the same mouth. The primary outcome is the period of time free from further treatment. The assessments are scheduled at 6, 12 and 24months. In addition to the clinical assessment, acceptability of the HT will be assessed via questionnaires among patients and their primary carers at baseline, 6, 12 and 24months. Cost-outcome description and cost-effectiveness analysis from healthcare provider and societal perspective will be conducted. DISCUSSION: The clinical effectiveness, acceptability and cost-effectiveness of the HT in the community dental setting will be evaluated. The results of this study will determine the implementation of HT in the management of dental caries in young children.

Avaliação dos tipos de reabilitações fixas dento-suportadas em dentes anteriores

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Effects of Cobalt Chloride in Junctional Epithelium and Reduced Enamel Epithelium of the Rat Maxillary First Molar

Cobalt is one of the main components of cast metal alloys broadly used in dentistry. It is the constituent of 45 to 70% of numerous prosthetic works. There are evidences that metal elements cause systemic and local toxicity. The purpose of the present study was to evaluate the effects of cobalt on the junctional epithelium and reduced enamel epithelium of the first superior molar in rats, during lactation. To do this, 1-day old rats were used, whose mothers received 300mg of cobalt chloride per liter of distilled water in the drinker, during lactation. After 21 days, the rat pups were killed with an anesthetic overdose. The heads were separated, fixed in ""alfac"", decalcified and embedded in paraffin. Frontal sections stained with hematoxylin and eosin were employed. Karyometric methods allowed to estimate the following parameters: biggest, smallest and mean diameters, D/d ratio, perimeter, area, volume, volume/area ratio, eccentricity, form coefficient and contour index. Stereologic methods allow to evaluate: cytoplasm/nucleus ratio, cell and cytoplasm volume, cell number density, external surface/basal membrane ratio, thickness of the epithelial layers and surface density. All the collected data were subjected to statistic analysis by the non-parametric Wilcoxon-Mann-Whitney test. The nuclei of the studied tissues showed smaller values after karyometry for: diameters; perimeter, area, volume and volume/area ratio. Stereologically, it was observed, in the junctional epithelium and in the reduced enamel epithelium, smaller cells with scarce cytoplasm, reflected in the greater number of cells per mm3 of tissue. In this study, cobalt caused epithelial atrophy, indicating a direct action on the junctional and enamel epithelium.

Biomechanical evaluation of internal and external hexagon platform switched implant-abutment connections: An in vitro laboratory and three-dimensional finite element analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fracture strength of flared bovine roots restored with different intraradicular posts

Objective: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. Material and Methods: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI-cast metal post-and-core; GII-fiber posts plus accessory fiber posts; GIII-direct anatomic post; GIV-indirect anatomic post and GV-control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135 to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (alpha=0.05). Results: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100% of unfavorable failures. GII presented 20% of unfavorable failures. GIII, GIV and GV presented only favorable failures. Conclusions: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core.

Reliability and failure modes of internal conical dental implant connections

Objective: Biological and mechanical implant-abutment connection complications and failures are still present in clinical practice, frequently compromising oral function. The purpose of this study was to evaluate the reliability and failure modes of anterior single-unit restorations in internal conical interface (ICI) implants using step-stress accelerated life testing (SSALT). Materials and methods: Forty-two ICI implants were distributed in two groups (n = 21 each): group AT-OsseoSpeed™ TX (Astra Tech, Waltham, MA, USA); group SV-Duocon System Line, Morse Taper (Signo Vinces Ltda., Campo Largo, PR, Brazil). The corresponding abutments were screwed to the implants and standardized maxillary central incisor metal crowns were cemented and subjected to SSALT in water. Use-level probability Weibull curves and reliability for a mission of 50,000 cycles at 200 N were calculated. Differences between groups were assessed by Kruskal-Wallis along with Bonferroni's post-hoc tests. Polarized-light and scanning electron microscopes were used for failure analyses. Results: The Beta (β) value derived from use level probability Weibull calculation was 1.62 (1.01-2.58) for group AT and 2.56 (1.76-3.74) for group SV, indicating that fatigue was an accelerating factor for failure of both groups. The reliability for group AT was 0.95 and for group SV was 0.88. Kruskal-Wallis along with Bonferroni's post-hoc tests showed no significant difference between the groups tested (P > 0.27). In all specimens of both groups, the chief failure mode was abutment fracture at the conical joint region and screw fracture at neck's region. Conclusions: Reliability was not different between investigated ICI connections supporting maxillary incisor crowns. Failure modes were similar. © 2012 John Wiley & Sons A/S.

Análise comparativa da distribuição de tensões em incisivo central superior, restaurado com diferentes sistemas de pinos intra-radiculares

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

Avaliação da ação bactericida e bacteriostática das nanopartículas TiO2 e Ag aplicadas em pinos intraradiculares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fratura precoce da porcelana em restaurações com infra-estrutura de zircônia: influência de gradientes térmicos no desenvolvimento e magnitude de tensões residuais e transitórias

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mechanical Evaluation of Four Narrow-Diameter Implant Systems

Purpose: This study aimed to evaluate the survival probability of four narrow-diameter implant systems when subjected to fatigue loading. Materials and Methods: Seventy-two narrow-diameter implants to be restored with single-unit crowns were divided into four groups (n = 18): Astra Tech (3.5-mm diameter), with a standard connection (ASC); BioHorizon (3.4-mm diameter), with a standard connection (BSC); Intra-Lock (3.4-mm diameter), with a standard multilobular connection (ISC); and Intra-Lock (3.4-diameter), with a modified square connection (IMC). The corresponding abutments were screwed onto the implants, and standardized metal crowns (maxillary central incisors) were cemented and subjected to step-stress accelerated life testing in water. Use-level probability Weibull curves and reliability for 100,000 cycles at 150 and 200 N (90% two-sided confidence intervals) were calculated. Polarized light and scanning electron microscopes were used to access the failure modes. Results: The calculated survival probability for 100,000 cycles at 150 N was approximately 93% in group ASC, 98% in group BSC, 94% in group ISC, and 99% in group IMC. At 200 N, the survival rate was estimated to be approximately < 0.1% for ASC, 77% for BSC, 34% for ISC, and 93% for IMC. Abutment screw fracture was the main failure mode for all groups. Conclusions: Although the probability of survival was not significantly different among systems at a load of 150 N, a significant decrease was observed at 200 N for all groups except IMC.

Análise histopatológica do comportamento pulpar, pós cimentação de coroas totais metálicas com cimentos de ionômero vítreo e fosfato de zinco

Pós-graduação em Odontologia Restauradora - ICT

Discrepâncias de assentamento ocorrido em coroas totais metálicas, com e sem alívio interno, variando-se os términos cervicais e os agentes cimentantes

Pós-graduação em Odontologia Restauradora - ICT

Avaliação in vitro da adaptação cervical de coroas totais metálicas, variando os preparos dos términos cervicais, aliviando ou não as superfícies internas das coroas e empregando diferentes cimentos definitivos

Este trabalho avaliou a qualidade das adaptações cervicais de coroas totais metálicas, tendo como fonte de variação: a) o término do ombro cervical do preparo - biselado, inclinado em 1350; reto em 900, chanfro e gume de faca; b) o alívio ou não das superfícies internas das coroas; e, c) os tipos de agente de cimentação permanente, cimentos - fosfato de zinco Harvard; ionômero de vidro Ketac-Cem, policarboxilato de zinco Durelon e resinoso Panavia Ex. Inicialmente, foram confeccionados corpos-de-prova em modelos-padrão de aço inoxidável usinado, de acordo com o tipo de preparo dos términos cervicais experimentais. As cápsulas metálicas de aço inoxidável preparadas, tendo ou não alívio da superfície interna de 30 micrometros até a distância de 0,5 mm do limite do término cervical, justapunham-se precisamente e formavam um conjunto com adaptação e assentamento exatos. Estas foram cimentadas nos corpos-de-prova com os diferentes agentes cimentantes, os quais foram manipulados de acordo com as instruções dos fabricantes. Desenvolveram-se metodologias de reaproveitamento dos corpos-de-prova, estabilidade das cápsulas impedindo seu deslocamento durante a tomada das medidas e mensuração precisa. Concluiu-se que: a) as melhores médias de adaptações cervicais, semelhantes entre si, foram obtidas em modelos-padrão com ombros: lâmina de faca, ombro inclinado em 1350 e chanfro; b) as piores médias de adaptações cervicais, semelhantes entre si, foram obtidas em modelos-padrão com ombros reto em 900 e degrau em 900 com bisel de 450; c) houve melhora significativa na adaptação quando cápsulas metálicas foram cimentadas com alívio de sua superfície interna; d) os cimentos...(Resumo completo, clicar acesso eletrônico abaixo)

Análise macro e micrográfica da liga AA-356 conforme a taxa de resfriamento

The present work aims to study the characteristics of the alloy Al - 7 % Si - 0 , 3Mg ( AA356 ) , more specifically characterize the macrostructure and microstructure and mechanical properties of the alloy ingots AA356 obtained in metal molds and sand molds for power studying the structures through the difference of cooling rates . This alloy is explained by the fact of referring league has excellent combination of properties such as low solidification shrinkage and good fluidity, good weldability , high wear resistance , high strength to weight ratio, has wide application in general engineering , and particularly in the automotive and aerospace engineering . In this work we will verify this difference in properties through two different cooling rates . We monitor the solid solidification temperatures by thermocouples building with them the cooling curve as a tool that will aid us to evaluate the effectiveness of the grain refining because it achieved with some important properties of the alloy as the latent heat of solidification fraction the liquid and solid temperatures, the total solidification time, and identify the presence of inoculants for grain refinement. Thermal analysis will be supported by the study of graphic software “Origin “will be achieved where the cooling curve and its first derivative that is the cooling rate. Made thermal analysis, analysis will be made in macrographs ingots obtained for observation of macrostructures obtained in both types of ingots and also analysis of micrographs where sampling will occur in strategic positions ingots to correlate with the microstructure. Finally will be collecting data from Brinell hardness of ingots and so then correlating the properties of their respective ingots with cooling rate. We found that obtained with cast metal ingots showed superior properties to the ingots obtained with sand mold

Análise da espessura da película de cimentos de ionômero vítreo e fosfato de zinco, empregados na cimentação de coroas totais metálicas, preparadas in vivo

Pós-graduação em Odontologia Restauradora - ICT