Avaliação da influência da inclinação das cúspides e da direção das cargas oclusais na distribuição das tensões em próteses implanto-suportadas: estudo através do método dos elementos finitos tridimensionais

Pós-graduação em Odontologia - FOA

Análise das tensões em próteses unitárias implantossuportadas com diferentes tipos de conexões e qualidade óssea: estudo pelo método dos elementos finitos tridimensionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Photoelastic Analysis of Stress Distribution With Different Implant Systems

The aim of this study was to evaluate stress distribution with different implant systems through photoelasticity. Five models were fabricated with photoelastic resin PL-2. Each model was composed of a block of photoelastic resin (10 x 40 x 45 mm) with an implant and a healing abutment: model 1, internal hexagon implant (4.0 X 10 mm; Conect AR, Conexao, Sao Paulo, Brazil); model 2, Morse taper/internal octagon implant (4.1 x 10 mm; Standard, Straumann ITI, Andover, Mass); model 3, Morse taper implant (4.0 x 10 mm; AR Morse, Conexao); model 4, locking taper implant (4.0 x 11 mm; Bicon, Boston, Mass); model 5, external hexagon implant (4.0 x 10 mm; Master Screw, Conexao). Axial and oblique load (45) of 150 N were applied by a universal testing machine (EMIC-DL 3000), and a circular polariscope was used to visualize the stress. The results were photographed and analyzed qualitatively using Adobe Photoshop software. For the axial load, the greatest stress concentration was exhibited in the cervical and apical thirds. However, the highest number of isochromatic fringes was observed in the implant apex and in the cervical adjacent to the load direction in all models for the oblique load. Model 2 (Morse taper, internal octagon, Straumann ITI) presented the lowest stress concentration, while model 5 (external hexagon, Master Screw, Conexao) exhibited the greatest stress. It was concluded that Morse taper implants presented a more favorable stress distribution among the test groups. The external hexagon implant showed the highest stress concentration. Oblique load generated the highest stress in all models analyzed.

Effect of mechanical cycling on screw torque in external hexagon implants with and without platform switching

This in vitro study evaluated the effect of mechanical cycling on the torque of retaining screw in external hexagon implants with platform switching (PS), regular platform (RP) and wide platform (WP). A total of 30 specimens were equally divided into 3 groups: PS, PR and WP. Each specimen was prepared with implants: 3.75 x 10 mm for RP group and 5.0x10 mm for PS and WP groups and its respective abutment with 32 Ncm torque. All groups were subjected to 106 cycles with 100 N (corresponding to about 40 months of chewing). The results were obtained with the reverse torque of each specimen and data were evaluated using ANOVA and Tukey test (p<0.05). The PS group showed statistically significant difference in screw removal torque (30.06±5.42) compared with RP (23.75±2.76) and WP (21.32±3.53) (p<0.05) groups; the RP and WP groups showed no statistically significant difference between them. It was concluded that the PS group showed higher reverse torque value, suggesting lower susceptibility of the abutment screw loosening.

Streptococcus mutans adhesion and releasing of metallic ions in dental alloys

AIM: To evaluate the adherence of Streptococcus mutans to the surface of the amalgam and copper/aluminum alloy samples and also evaluate the release of metallic ions. METHODS: The prepared medium was changed every 72 h and analyzed by atomic absorption spectrophotometer. Samples were removed from the prepared medium at 15, 30, 48 and 60 days. RESULTS: The result shows that ions released were statistically different among all groups, and so were both biofilm and pits formation and the corrosion induced by the S. mutans in both types of samples. SEM observation of the samples immersed in the prepared medium with S. mutans showed adherence of microorganisms on the whole surface, in all groups. CONCLUSIONS: The S. mutans adhere to both amalgam and copper/aluminum alloy causing corrosion of those restorations. S. mutans produced a greater ions release in Cu/Al alloy; in amalgam, the ions release was not influenced by exposure to S. mutans.

Quality of life and satisfaction of patients wearing implant-supported fixed partial denture: a cross-sectional survey of patients from Aracatuba city, Brazil

ObjectivesThe aim of this study was to evaluate the quality of life and satisfaction of patients wearing implant-supported fixed partial dentures.Materials &methodsA total of 106 patients were selected and submitted to clinical examination and collection of the demographic data for evaluation of the implant-supported fixed dentures conditions. All participants agreed to answer to the Oral Health Impact Profile (OHIP-EDENT) questionnaire and another questionnaire about satisfaction with the implant-supported prostheses. The patients were classified into the following three groups for statistical analysis: patients wearing splinted implant-supported prosthesis (E), patients wearing single implant-supported prosthesis (U), and patients wearing single implant-supported prosthesis associated with splinted prosthesis (E+U). Kruskal-Wallis test was used to compare the answers between the groups, and a logistic regression model was measured to verify the relation between variables of the patients and the questionaries'items.ResultsThere were significant differences among groups (P=0.006) for discomfort during surgery itself of the satisfaction questionnaire. The marital status, groups, and hygiene condition were significant mainly for physical pain item.ConclusionsIt was concluded that the patients presented high level of satisfaction and quality of life for the most of the items evaluated as well as the groups showed similar results.

Effect of the parafunctional occlusal loading and crown height on stress distribution

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

Aspectos clínicos influentes no planejamento das próteses sobre implantes tipo overdenture e protocolo

The aim of his study was to review the current scientific literature in order to discuss the surgical, prosthetics and psychological/psychosocial aspects during the treatment planning of edentulous patients, when a total fixed prosthesis or overdenture is indicated. To identify studies to take part in this review, a search was conducted for the following databases: PubMed, Dentistry and Oral Sciences Source, Journals@Ovid, SpringerLink, Wiley Online Library, Nature (NPG), Oxford Journals. It was used as descriptors: total fixed prostheses and overdentures. Inclusion criteria were: clinical articles, clinical case reports, case series, literature reviews and systematic reviews that addressed the study and comparison of total fixed prostheses and overdentures for a surgical- prosthetic planning. Exclusion criteria were: laboratory and in vitro studies and those whose first language was not English or Portuguese. Of a total of 454 articles, after an analysis according to inclusion and exclusion criteria, 76 articles were selected. During an implantsupported prosthesis rehabilitation with dental in edentulous patients, the use of alternative procedures appear to be effective when compared to more invasive surgical techniques, and thus, the amount of dental implants possible to install associated with prosthetic issues such as lip support, smile line, quantity and quality of mucosa, phonetics, etc., will allow an appropriate treatment planning to each clinical case

Prótese total imediata: relato de caso clínico

The immediate complete denture is defined as a removable or partial denture made to be installed immediately after the extraction of the natural teeth. This type of prosthesis can be used for a short period of time, for aesthetic reasons, mastication, occlusal support, convenience or for the adaptation of the patients to the edentulous state, until the final prosthesis is installed. The objective of this study was to report a surgical and prosthetic rehabilitation planning of a patient by means of an immediate complete maxillary denture, and the results obtained with this treatment modality. The immediate complete denture is a necessary, well-established, useful and effective prosthetic procedure for patients who, inevitably, will present an edentulous state, despite it is a slightly more expensive and it requires more sessions for adjust

Análise Biomecânica em implantes com diferentes tipos de conexão: estudo pelo MEF-3D

The aim of this study was to evaluate the biomechanical behavior of different implant connection types, by means of three-dimensional finite element analysis. 3 Three-dimensional models were created with a graphic modeling software: SolidWorks 2006 and Rhinoceros 4.0, and InVesalius (CTI, São Paulo, Brasil), the bone was obtained by computerized tomography of a sagittal section of the molar region. The model was composed by bone block with an implant (4 x 10 mm) (Conexão Sistemas de Prótese, São Paulo), with different implant connections: external hex, internal hex and Morse-taper with the corresponding prosthetic component Ucla or Morse-taper abutment. The Three-dimensional models were transferred to finite element software Femap 10.0 (Siemens PLM Software Inc., CA, USA), to generate a mesh, boundary conditions and loading. An axial (200N) and oblique load (100N) was applied on the occlusal surface of the crowns. Analyses were performed using the finite element software NEiNastran 9.0 (Noran Engineering, Inc., USA) and transferred to the Femap 10.0 to obtain the results; after the results were visualized using von Mises stress maps and Maximum stress principal. The results showed the stress distribution was similar between models, with a little superiority of Morse-taper connection. It was concluded that: the three connection types were biomechanical viable; The Morse-taper connection presented the better internal stress distribution; there was not significant biomechanical differences on the bone.

Sobredentaduras mandibulares inmediatas: revisión de literatura

Conventional complete denture even though well confectioned, could present deficiencies in the retention, stability and support, in addition uncomfortable and retention of food below it. The overdentures have been considered an alternative to resolve problems and negative experiences with the conventional dentures, thus also can be an alternative to the complex treatments (surgical/prosthetic) with implant-supported prosthesis. In the attempt to reduce the healing time for the confection of the dentures showed higher rates of success to the implants when immediate mandibular overdentures were used in the rehabilitation of edentulous patients. The aim of this paper was to discuss by means of a Literature review, the viability of the use of mandibular implant-supported overdentures. The immediate mandibular overdentures have been showed like a reproducible method, predictable and confidence to provide an efficient function to the total edentulous patients.

Implantes Platform Switching: longevidade e preservação óssea: revisão crítica da literatura

The concept of switching platform is the use of an implant by platform wider than the abutment. Recently, researches have shown that this type of dental implant design tends to offer a higher preservation of crestal bone when compared to the traditional pattern of bone loss. The present study aims to perform a critical review on the switching platform concept establishing possible advantages of the technique. A search was performed on Medline/Pubmed about the topic “dental implant” and “platform switching”, and after applying inclusion criteria 40 studies were selected. The literature on longevity present prospective studies that show less bone loss, studies in biomechanics exhibit better or similar stress distribution around the bone crest, however, is not yet defined the role of the biological width. Thus, studies of longevity, and randomized prospective studies are of a great relevance to be performed in order to confirm the benefits of this technique and to establish a protocol indication. It is possible, based on this literature review, to conclude that longitudinal and randomized studies show that the platform switching implants have longevity and less bone loss. Biomechanically, the technique is possible.

Microhardness of luting agents used for fiber post cementation submitted to thermo cycling

Aims and Objectives: The aim of this study was to analyze the microhardness of three resin cements used in cementing glass fiber posts in bovine incisor. The microhardness was analyzed in cervical, middle and apical thirds before and after thermocycling process. Materials and Methods: Bovine teeth were instrumented and divided into 3 groups composed of 10 teeth each. Then, the teeth were sectioned and obturated and had their canals prepared at a depth of 12mm. Once proceeded the desobturation, the roots and glass fiber posts were prepared for adhesive cementation. After cementation, the microhardness reading was carried out. After initial reading, the samples were placed in a thermocycler and subjected to 2,000 cycles and a new microhardness reading. The data collected were subjected to analysis of variance (ANOVA) and Turkey’s test. Results: It was observed a statistical difference among the microhardness of resin cements. However, the statistical difference of microhardness before and after thermocycling appeared only in group U-200. Conclusion: Thermocycling reduced microhardness values in all cements evaluated in this study. The autopolymerizing cement Multilink presented the most stable microhardness mean values after thermocycling in the coronal, middle and apical thirds.

Implantes tipo plataforma modificada: revisión de literatura

The purpose of this revision was to explore the concept of Platform Switching in implantology and its acting in the clinical practice. The concept of platform switching will be considered together with a revision of pertinent literature, with the purpose of providing guidelines based on scientific evidences. The following databases were used: Pubmed, Library Cochrane and ISI in the last 17 years. The inclusion approaches were: clinical articles, laboratorials and of revision on the topic, in English language. 41 articles were selected, using the describers "platform switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". In accordance with this revision, implant them platform switching they present a rate of more favorable bony remodeling that you implant them conventional. This fact seems to be resulting of a group of biological factors and mechanics. The concept of platform switching has important relevance in the aesthetic area.

Influência do material oclusal na distribuição de tensões em próteses implantossuportadas unitárias

Objective: the aim of this study was to evaluate the influence of occlusal veneering material in single fixed implant-supported crowns through the 3-D finite element method. Material and methods: Four models were fabricated using the Rhinoceros 4.0, SolidWorks, and InVesalius softwares. Each model represented a block of mandibular bone with an external hexagon implant of 5 mm x 10 mm and different veneering materials including NiCr (1), porcelain (2), composite resin (3), and acrylic resin (4). An axial load of 200 N and an oblique load of 100 N were applied. Results: model (2) with porcelain veneering presented a lower stress concentration for the NiCr framework, followed by the composite resin and acrylic resin. The stress distribution to the implant and bone tissue was similar for all models. Conclusions: there is no difference of stress distribution to the implant and supporting structures by varying the veneering material of a single implant-supported prosthesis.