Predictability of short dental implants: a literature review

Introduction: In clinical situations where severe bone resorption has occurred following tooth loss, implant treatment options may comprise either a previous bone reconstruction or only the use of short implants. Objective: This non-systematic review summarizes and discusses some aspects of the use of short implants, such as: biomechanical aspects, success rate, longevity and surgical-prosthetic planning. Literature review: Current and relevant references were selected in order to compare short dental implants to conventional ones. Several studies have highlighted the great importance of wide-diameter implants. Dental short implants have shown high predictability and success rates when some biomechanical aspects are taken into consideration. Conclusion: Placement of short dental implants is a viable treatment method for patients with decreased bone height.

Influência do desenho do implante na micromovimentação de implantes imediatos com carga imediata: análise multivariada em elementos finitos

The purpose of this paper was to evaluate the influence of different implant designs on the micromovements of immediately placed implants. CT-based finite element models comprising an upper central incisor socket and four commercially available internal connection implant designs (SIN SW®, 3i Certain®, Nobel ReplaceTM, and RN synOcta® ITI Standard) of comparable diameter and length were constructed. 50, 100 and 200N magnitude loads were applied over the implant. ANOVA at 95% level of significance was used to evaluate bone to implant relative displacement (micromovements). The implant design (68,80%) greatly influences the micromovement of immediately placed implants. However, the loading magnitude (68,80%) is the most important factor regarding the implant stability in this protocol.

Air abrasion before and/or after zirconia sintering: surface characterization, flexural strength, and resin cement bond strength

The purpose of this in vitro study was to evaluate the effect of air-abrasion/zirconia sintering order on the yttria partially stabilized tetragonal zirconia polycrystal (Y-TZP) surface characterization (roughness, morphology, and phase transformation), flexural strength (FS), and shear bond strength (SBS) to a resin cement. Y-TZP specimens were air abraded with 50-μm Al2O3 particles after (AS), before (BS), or before and after zirconia sintering (BAS). For roughness (Ra), 30 block specimens (12×12×3.0 mm; n=10) had their surfaces analyzed by a profilometer. Next, on the air-abraded surfaces of these specimens, composite resin discs (n=30) were bonded with RelyX ARC. The bonded specimens were stored for 24 hours in distilled water at 37°C before shear testing. Failure mode was determined with a stereomicroscope (20×). The surface morphology (n=2) was evaluated by SEM (500×). For the four-point flexural strength test (EMIC DL2000), 39 bar-shaped specimens (20×4.0×1.2 mm; n=13) were air abraded according to the three conditions proposed, and an additional group (nonabraded) was evaluated (n=13). The quantitative analysis of phase transformation (n=1) was completed with Rietveld refinement with X-ray diffraction data. Ra (μm) and SBS (MPa) data were analyzed by one-way analysis of variance (ANOVA) and the Tukey test (α=0.05). Pearson correlation analysis was used to determine if there was a correlation between roughness and SBS. For FS (MPa) data, one-way ANOVA and the Dunnett C-test (α=0.05) were used. The air-abrasion/zirconia sintering order influenced significantly (p<0.001) Ra, SBS, and FS. The BS and AS groups presented the highest (1.3 μm) and the lowest (0.7 μm) Ra. The highest SBS (7.0 MPa) was exhibited by the BAS group, followed by the AS group (5.4 MPa) and finally by the BS group (2.6 MPa). All groups presented 100% adhesive failure. A weak correlation (r=−0.45, p<0.05) was found between roughness and SBS. The air-abrasion/zirconia sintering order provided differences in the surface morphology. The nonabraded (926.8 MPa) and BS (816.3 MPa) groups exhibited statistically similar FS values but lower values than the AS (1249.1 MPa) and BAS (1181.4 MPa) groups, with no significant difference between them. The nonabraded, AS, BS, and BAS groups exhibited, respectively, percentages of monoclinic phase of 0.0 wt%, 12.2 wt%, 0.0 wt%, and 8.6 wt%. The rougher surface provided by the air-abrasion before zirconia sintering may have impaired the bonding with the resin cement. The morphological patterns were consistent with the surface roughness. Considering the short-term SBS and FS, the BAS group exhibited the best performance. Air abrasion, regardless of its performance order, provides tetragonal to monoclinic transformation, while sintering tends to zero the monoclinic phase content.

Effect of surface treatments on the shear bond strength of luting cements to Y-TZP ceramic

Statement of problem Because zirconia is a glass-free material, alternative surface treatments such as airborne-particle abrasion or silica coating should be used for long-term bonding. However, these surface treatments in combination with different bonding agents and luting cements have not yet been studied. Purpose The purpose of the study was to evaluate the effect of surface treatments on the shear bond strength (SBS) of luting cements to Y-TZP ceramic. Material and methods Zirconia disks (N=240) were airborne-particle abraded with the following particles (n=48): 50 μm Al2O3; 120 μm Al2O3; 30 μm silica-coated Al2O3 (Rocatec Soft); 120 μm Al2O3+110 μm silica-coated Al2O3 (Rocatec Plus); and Rocatec Plus. After silanization of the zirconia surface, composite resin disks were bonded with (n=12) RelyX Luting 2; RelyX ARC; RelyX U100; and Panavia F. The bonded specimens were thermocycled (10 000 cycles) and tested for SBS. Failure mode was determined with a stereomicroscope (×20). The morphology and elemental composition of airborne-particle abraded surfaces were evaluated with scanning electron microscopy (×500) and energy-dispersive x-ray spectroscopy (×50). Results Surface treatments, cements, and their interaction were significant (P<.001). For RelyX ARC, Rocatec Soft and Rocatec Plus provided the highest SBS. In general, surface treatments did not influence the SBS of RelyX U100 and Panavia F. Regardless of the cement, no significant difference was found between 50 μm and 120 μm Al2O3 particles, between Rocatec Soft and Rocatec Plus, or between Rocatec Plus and 120 μm Al2O3 particles+Rocatec Plus. All groups showed adhesive failures. Different particle sizes provided differences in morphological patterns. The elemental composition comprised Al and Al/Si for alumina and silica-abraded zirconia. Conclusions Particle size did not influence the SBS of the groups abraded exclusively with alumina or silica-coated particles. RelyX ARC was more surface-treatment dependent than RelyX U100 or Panavia F.

Adaptação marginal do agregado de trióxido mineral com e sem cloreto de cálcio em retrocavidades

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

Influência do cimento obturador e agente de irrigação final na infiltração marginal em situações de sobreobturações endodônticas

Objective: The objective of this paper was to verify if the final irrigation at 17% EDTA, separately or followed by chlorhexidine digluconate at 2% interferes on the apical marginal leakage in root canal overfilling, due to the use of two root canal filling materials (Sealer 26TM or SealapexTM). Methods: Forty lower incisors extracted, with a single root canal, were biomechanically prepared, at 2.0mm beyond the radicular apex, with ProTaper SystemTM, finishing it with the F3 instrument. Irrigation was accomplished with 1.0 mL NaOCl at 2.5% at each change of equipment caliper and, in the end, with 5.0 mL normal saline solution. After achieving this procedure, the foraminal channels was standardized with a file K 25 until its DO appears in the foraminal opening. From this moment, the teeth were subdivided into two groups of 20 specimens each, because of the final irrigation method used: I – irrigation with EDTA at 17% for 3min and II – identical protocol, thus, after EDTA aspiration at17%, it was again irrigated with chlorhexidine digluconate at 2%, also kept intra-canal for 3min. Each group was again sub-divided into two sub-groups (ten teeth each), according to the cement used (Sealer 26TM or SealapexTM), and filled by using a single gutta-percha F1 (ProTaperTM, Universal Filling), in such a manner that it goes 2.0 mm beyond the radicular apex. Soon after that, the teeth were immersed in Rhodamine BTM for 72h, vacuum and after the roots have been bucolingually grooved, the leakages marked were measured with program Image ToolTM. Results and Conclusions: The leakage magnitude was similar among themselves (p > 0.05), except for group Sealapex®, thus the final use with chlorhexidine reduced apical leakage (p < 0.05).

Avaliação do pH, da solubilidade e da infiltração marginal em retrobturações com o Sealer 26 puro ou acrescido de iodofórmio

Sealer 26® cement contains bisphenol epoxy resin associated with calcium hydroxide, presenting smaller radiopacity than other endodontic cements. Aiming to improve this property, iodoform has been added in its composition. However, this addition's possible changes in physical and chemical properties still need to be studied. OBJECTIVE: To evaluate the apical sealing ability, solubility, and pH of Sealer 26® alone or with iodoform, at several proportions. MATERIAL AND METHODS: Three experimental mixtures of Sealer 26®, alone or with iodoform, were prepared and subjected to solubility test. Additionally, these combinations were inserted into polyethylene tubes and immersed in distilled water, and, their pH was evaluated after 24-h and 7-day periods. Subsequently, forty roots of extracted lower incisors subdivided into four groups of 10 specimens each, were retrograde filled with one of the previously described mixtures and gutta-percha points. The roots were immersed in Rhodamine B, under vacuum, for 72 hours. After this period, the specimens were longitudinally sectioned, root fragments photographed, these images scanned, and apical infiltration measured by Image tool software. The obtained data were subjected to statistical analysis, at a significance level of 5%. RESULTS: Marginal leakage and solubility tests did not show any difference among the experimental groups (p > 0.05). pH analysis was only statistically different at 24-h period and between Sealer 26® alone and 1.1g iodoform group (p < 0.05). CONCLUSION: The presence of iodoform in Sealer 26®, at the used proportions, did not alter the solubility, apical marginal leakage and pH properties of the original cement.

Associação de facetas diretas e fibra de reforço para restabelecimento estético do sorriso: relato de caso clínico

Esse artigo tem como objetivo demonstrar o restabelecimento estético do sorriso obtido por meio da associação de facetas diretas e fibra de reforço. As fibras de reforço são utilizadas como alternativa para substituição de elementos dentários perdidos e possuem indicações precisas, sendo empregadas em diversas especialidades da Odontologia, devido à sua capacidade de aumentar a resistência à tração dos compósitos, o que aumenta a resistência à compressão das fibras. Para o completo restabelecimento do sorriso, muitas vezes é necessário reanatomizar os dentes adjacentes, considerando as condições em que esses se apresentam. Sendo assim, o profissional deve ter conhecimento para aplicação correta da técnica e restabelecimento da estética ao paciente.

Visão contemporânea sobre pinos anatômicos

As an alternative to improve the adaptation of prefabricated posts in flared canals and weakened roots, the option is for relining prefabricated pin, known as a technique of anatomical post. This technique, which can be made with composite resin increases the adjustment post to the walls of the canal and reduces the cementing line, causing the retaining post is less dependent on the mechanical properties of the cementing agent. This article aims to provide an overview of anatomical posts, specifically in the last two decades, based on studies extracted from Scielo, Scopus and Pubmed, referring to the following terms of MeSH Data Base: custom made fiber post, indirect fiber glass posts, root canal therapy and post and core tecnique. According to the literature review in this article, it can be concluded that this technique has been used by several authors and has been shown effective and promising, it creates an individualized retainer with better adaptation and decreased mechanical imbrication cementing line .

Importância da correta confecção do prontuário odontológico para identificação humana: relato de caso

The clinical records correspond to a set of documents where all information of the patient is stored. When properly confectioned and filed by the dentist, it may serve as a tool for success in dental expertise. The aim of this paper is to present the importance of proper confection of dental records in human identification by means the presentation of a case of identification, occurred in a São Paulo state city. The notes present in the dental records of the alleged victim were very poor, even with a contradiction. However, having endodontic treatment been performed, the comparative analysis between the radiographs of the skull of the victim (postmortem) and the endodontic treatment of tooth 22 (antemortem) permitted to observe total coincidence between the details of such treatment, and anatomical features present in other dental elements. These important parameters of comparison indicated that the body was of the suspect and, due to the number of coincidences, it could not belong to another individual. Nevertheless, the clinical documentation provided was deficient, and presented contradictory data. Because of its fundamental importance for human identification, it is essential that dental professionals take the necessary care to ensure its proper confection and custody, seeking to make the clinical records also an efficient instrument of consultation in identification cases.

Reabilitação estético-funcional sobre implantes agulhados e endósseos

This report shows the resolution of a case study whose aim was promote the aesthetic and functional rehabilitation of upper left hemi-arch over endosseous and needle implant prostheses. To improve the position of the needle implants, we performed the bucco-palatal bending of needles splinting them with composite resin; we removed the screwed implant prosthesis in the regions of the premolars (24 and 25) and molar (26). The mini-abutments of the last two implants were replaced, and in the first premolar and canine, we used cemented abutments due to implant angulation having planned soldering because of implant size and contact with one needle implant that could interfere with intimate contact bone/implant damaging biomechanics. Pick-up impressions were performed with an open tray, using a retractor cord in the needle implants and respective transfer copings. Therefore, models were related on semi-adjustable articulator after a face-bow recording and interocclusal indexes. After working cast fabrication and try-in of infra-structures, these were adjusted and related into the articulator again. Then, after ceramic build-up, adjustments, finishing, and torque, chemically-activated resin cement was applied on units 21 to 24. At the end of the case, we concluded that a good aesthetic and functional rehabilitation depends on thorough knowledge of techniques for each clinical situation.

Técnica estrutural: confecção de pilar personalizado cerâmico para otimizar a estética

Na reabilitação protética com implantes, a reconstituição das características anatômicas do tecido peri-implantar é fundamental para a obtenção de uma estética ótima. Como os componentes metálicos não transmitem a luz, fazem com que os pacientes com fenótipos gengivais finos apresentem uma coloração escurecida, resultante da limitação estética desses componentes. Pilares cerâmicos (alumina ou zircônia) têm sido utilizados para resolver esse problema, os quais possibilitam a complementação com próteses metal free. A indústria fornece, para alguns sistemas, componentes pré-fabricados cerâmicos a serem personalizados por desgastes e componentes personalizados confeccionados com sistemas CAD/CAM e CAD/MAN. Tendo em vista as limitações de algumas das conexões desses componentes, o objetivo desse estudo é apresentar a técnica laboratorial para confecção de um pilar personalizado cerâmico realizado sobre pilar UCLA de sobrefundição. Concluiu-se que a utilização da cerâmica feldspática proporciona ótima estética, boa transparência, resistência mecânica, baixo custo, melhor capacidade adesiva, com utilização de cimentos resinosos, e, principalmente, técnica de amplo domínio dos laboratórios.