Influência da fotopolimerização e da cor da resina composta na microdureza

Objective: To study the influence of color opacity and light-curing systems (halogen light vs blue LED) on the microhardness of a composite resin. Methods: Esthet-X composite resin (Dentsply), shades A2 and A2-O, was inserted in a stainless steel matrix (5 mm diameter and 2 mm deep) and was light cured for 40 seconds with a halogen light source (XL 3000; 3M/ESPE) or a blue LED (Optilight LD II; Gnatus). Eight groups of 15 specimens each were formed, and were further divided according to the light-curing systems, the exposed area (base and surface), and the opacity of the composite resin, producing 120 specimens. The specimens were next stored in distilled water for 24 hours, embedded in a chemically activated acrylic resin, then subjected to finishing and polishing with sandpaper and felt discs. Microhardness was measured with a Vickers Digital Microhardness meter, with a 50 g load for 30 seconds. The obtained microhardness means were analyzed by ANOVA and Tukey's multiple-comparison test at 5% significance level. Results: The surface microhardness was always greater than the base microhardness, regardless of the light-curing source. The halogen light lamp produced significantly higher composite resin microhardness means than the blue LED (57.61 vs. 42.53 HV) (p<0.05). Statistically significant differences (p<0.05) were obtained between the microhardness means for the different composite opacities; lowest microhardness in depth was produced by the A2-O shade. Conclusion: Composite resin opacity as well as the light-curing system influenced the microhardness of the material.

Color alteration of the paint used for iris painting in ocular prostheses

The purpose of this study was to assess color alteration of the paints used for iris painting in artificial eyes. Five disks of heat cured acrylic resin were confectioned by microwave energy for each paint analyzed, in a total of 40 specimens. Each specimen consisted of a colorless acrylic resin disk and another of equal size, of scleral white colored acrylic resin, with the painting interposed between the two disks. The specimens were submitted to an accelerated aging process in a chamber under ultraviolet radiation for 1,008 hours. To assess color variation, a reflective spectrophotometer was used. The results were statistically analyzed by ANOVA and the Tukey test (p < 0.05). All the paints underwent chromatic alteration. The oil paint presented the highest resistance to accelerated aging.

Comparison of the shear bond strengths of conventional mesh bases and sandblasted orthodontic bracket bases

This study aimed to compare in vitro the shear bond strength between metallic brackets (Abzil) with conventional mesh bases and metallic brackets with bases industrially sandblasted with aluminum oxide using three adhesive systems, in order to assess the influence of sandblasting on adhesiveness and to compare 3 different bonding systems. Two hundred and forty bovine incisors were used and randomly divided into 6 groups (40 teeth in each group), according to the bracket base and to the bonding system. The brackets were direct-bonded in bovine teeth with 3 adhesive systems: System A - conventional Transbond™ XT (3M -Unitek); System B - Transbond™ Plus Self Etching Primer + Transbond™ XT (3M - Unitek) and System C - Fuji ORTHO LC resin-reinforced glass ionomer cement in capsules (GC Corp.). Shear bond strength tests were performed 24 hours after bonding, in a DL-3000 universal testing machine (EMIC), using a load cell of 200 kgf and a speed of 1 mm/min. The results were submitted to statistical analysis and showed no significant difference between conventional and sandblasted bracket bases. However, comparison between the bonding systems presented significantly different results. System A (14.92 MPa) and system C (13.24 MPa) presented statistically greater shear bond strength when compared to system B (10.66 MPa). There was no statistically significant difference between system A and system C.

Effects of mandibular fixed implant-supported prostheses on masticatory and swallowing functions in completely edentulous elderly individuals

Purpose: To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and rive men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals.

Rehabilitation with zygomatic implants: a treatment option for the atrophic edentulous maxilla--9-year follow-up.

This article reports the 9-year clinical outcome of the two-stage surgical rehabilitation of a severely atrophic edentulous maxilla with a metal-resin fixed denture supported by implants anchored in the zygomatic bone and the maxilla. After clinical and radiographic examination, zygomatic implants were inserted bilaterally and four standard implants were placed in the anterior region of the maxilla. Six months later, the implants were loaded with a provisional acrylic resin denture, and the definitive implant-supported metal-resin fixed denture was provided 1 year after implant placement. After 9 years of follow-up, no painful symptoms, peri-implant inflammation or infection, implant instability, or bone resorption was observed. In the present case, the rehabilitation of severe maxillary atrophy using the zygomatic bone as a site for implant anchorage provided good long-term functional and esthetic results. Therefore, with proper case selection, correct indication, and knowledge of the surgical technique, the use of zygomatic implants associated with standard implants offers advantages in the rehabilitation of severely resorbed maxillae, especially in areas with inadequate bone quality and volume, without needing an additional bone grafting surgery, thereby shortening or avoiding hospital stay and reducing surgical morbidity.

Evaluation of a new intraoral paralleling device for creating guiding planes: A pilot study

Aim: The aim of the study was to assess the accuracy of a new intraoral paralleling device for creating proximal guiding planes for removable partial dental prostheses. Methods and Materials: Thirty gypsum casts were divided into two groups in which the proximal surfaces of selected teeth were prepared using either a surveying device (Group 1) or the new ParalAB paralleling device (Group 2). In each cast guiding planes were prepared on the distal surface of the maxillary left canine (A), on the mesial and distal surfaces of the maxillary left second molar (B and C), and on the distal surface of the maxillary right canine (D). Each prepared surface formed an angle related to the occlusal plane that was measured five times and averaged by one operator using a tridimensional coordinate machine. Results: The mean guiding plane angles (± standard deviation) for the prepared surfaces were A=91.82° (±0.48°, B=90.47° (±0.47°, C=90.21° (±0.76°, and D=90.50° (±0.73°) for the dental surveyor (Group 1) and A=92.18° (±0.87°), B=90.90° (±0.85°), C=90.07° (±0.92°), and D=90.66° (±0.76°) for the ParalAB paralleling device (Group 2). A two-way ANOVA, Tukey's, and Levène's tests (at p<0.05) revealed statistically significant differences among surfaces prepared by both groups and that one surface Conclusions: The ParalAB device was able to prepare parallel surfaces and despite significant difference between groups, the ParalAB presented a small deviation from absolute parallelism and can be considered a valid method to transfer guide plans in the fabrication of removable partial dentures. Clinical Significance: The preparation of suitable guiding planes on abutment teeth during the fabrication of removable partial dentures is dependent on the ability of the operator and requires considerable chair time. When multiple teeth are involved, achieving parallelism between abutment surfaces can be technically challenging, especially in posterior regions of the mouth. The ParalAB prototype intraoral paralleling device can aid the clinician during the preparation of accurate guiding planes with a minimum degree of occlusal divergence. © 2010 Seer Publishing LLC.

Estética en prótesis removibles

Nowadays, aesthetics is very appreciated in the social context and a attractive smile is the object of desire in most of patients requiring prosthesis treatment. In case of removable prosthesis, total or partial, this feature is more significant since some or all teeth may be absents. Implants leading to a significant improvement in relation to function and comfort of removable prosthesis users, but the aesthetics of these prostheses had little attention in the current scientific literature. Thus, the aim of present article was to make a review of the literature on the aesthetic features related to rehabilitation with removable prostheses. In present study we found as significant factors for the aesthetics in removable partial and total prostheses: Selection of artificial teeth and their arrangement, characterization of acrylic resin basis and also the types and location of retainers for the removable partial prostheses. We conclude that the involvement and the aesthetic knowledge during the appropriate planning of this process is responsibility of the professional.

Effect of storage in artificial saliva and thermal cycling on Knoop hardness of resin denture teeth

Purpose: This study aimed to evaluate the effect of different storage periods in artificial saliva and thermal cycling on Knoop hardness of 8 commercial brands of resin denture teeth. Methods: Eigth different brands of resin denture teeth were evaluated (Artplus group, Biolux group, Biotone IPN group, Myerson group, SR Orthosit group, Trilux group, Trubyte Biotone group, and Vipi Dent Plus group). Twenty-four teeth of each brand had their occlusal surfaces ground flat and were embedded in autopolymerized acrylic resin. After polishing, the teeth were submitted to different conditions: (1) immersion in distilled water at 37 ± 2 °C for 48 ± 2. h (control); (2) storage in artificial saliva at 37 ± 2 °C for 15, 30 and 60 days, and (3) thermal cycling between 5 and 55 °C with 30-s dwell times for 5000 cycles. Knoop hardness test was performed after each condition. Data were analyzed with two-way ANOVA and Tukey's test (α= .05). Results: In general, SR Orthosit group presented the highest statistically significant Knoop hardness value while Myerson group exhibited the smallest statistically significant mean (P< .05) in the control period, after thermal cycling, and after all storage periods. The Knoop hardness means obtained before thermal cycling procedure (20.34 ± 4.45 KHN) were statistically higher than those reached after thermal cycling (19.77 ± 4.13 KHN). All brands of resin denture teeth were significantly softened after storage period in artificial saliva. Conclusion: Storage in saliva and thermal cycling significantly reduced the Knoop hardness of the resin denture teeth. SR Orthosit denture teeth showed the highest Knoop hardness values regardless the condition tested. © 2010 Japan Prosthodontic Society.

Influence of ridge type on mandibular distal extension removable partial denture.

The aim of this study was to use photoelastic models to analyze the distribution of stress caused by the incidence of loads on a mandibular distal extension removable partial denture, both on the abutment teeth and on differently shaped residual ridges: distal ascending, descending-ascending, horizontal and distal descending. The best type of retainer and location of the rest on the last abutment tooth were determined for the different types of ridge. Four models were made from photoelastic resin (PL-1 for the teeth and PL-2 for the alveolar ridge), one for each kind of ridge. For each model, 4 removable partial dentures (RPD) were made (16 RPD altogether): T-bar retainer and distal rest, T-bar retainer and mesial rest, circumferential retainer and distal rest, and circumferential retainer and mesial rest. The models were placed on a circular polariscope and a 100 N axial load (point load) was applied to premolars and molars of the RPD. The formation of photoelastic bands was photographed for qualitative analysis. Results showed that the horizontal ridge had better distribution of stress, while the distal descending ridge had greater concentration of stress. The circumferential retainer had greater areas of stress for all types of ridges except the horizontal ridge, where there was no influence related to retainer type. The distribution of stress was similar among the different types of ridges when the rest was mesial or distal to the last abutment tooth, except for the distal descending ridge, where there was greater concentration of stress when the rest was located distally to the last abutment tooth. Thus, it may be concluded that (1) the situation was least favorable for the distal descending ridge and most favorable for the horizontal ridge, (2) the T-bar retainer had more favorable stress distribution, except when the ridge was horizontal, in which case there was no influence in relation to the type of retainer, (3) the location of the rest showed similar behavior in all except the distal descending ridge.

Effects of five carbamide peroxide bleaching gels on composite resin microhardness.

The purpose of this study was to evaluate the effects of five home bleaching products containing 15-16% carbamide peroxide on the microhardness of microhybrid composite resin Z-250 (3M/Espe). A total of 72 specimens were fabricated in cylindrical acrylic matrices (4 x 2 mm), filled with composite resin and photo-activated for 40 seconds. They were divided in 6 study groups (n = 12), according to the bleaching product: Review (SS White), Magic Bleaching (Vigodent), Opalescence (Ultradent), Whiteness Perfect (FGM), Claridex (Biodinâmica), and a control group (not bleached). Specimens were exposed to 1 cc of bleaching gel for 6 hours daily for 2 weeks. The control group specimens were kept in artificial saliva throughout this time. All the specimens were then analyzed in a microhardness tester. Knoop hardness measurements were performed, and the results were submitted to parametric statistical analysis (analysis of variance and Tukey's test). Mean Knoop values and standard deviation were: baseline, 68.52a (4.28); control, 63.42b (7.16); Whiteness Perfect, 57.57c (1.81); Magic Bleaching, 57.22c (3.84); Opalescence, 57.03cd (4.00); Claridex, 53.64de (3.33); Review 51.45e (2.82). Identical letters mean statistical equality according to Tukey's test at the 5% significance level. The products significantly decreased Z-250 (3M/Espe) microhardness.

Bond strength of a composite resin to an adhesive luting cement

This study evaluated the influence of surface treatment on the shear bond strength of a composite resin (CR), previously submitted to the application of a temporary cement (TC), to an adhesive luting cement. Eight-four CR cylinders (5 mm diameter and 3 mm high) were fabricated and embedded in acrylic resin. The sets were divided into 6 groups (G1 to G6) (n=12). Groups 2 to 6 received a coat of TC. After 24 h, TC was removed and the CR surfaces received the following treatments: G2: ethanol; G3: rotary brush and pumice; G4: air-abrasion; G5: air-abrasion and adhesive system; G6: air-abrasion, acid etching and adhesive system. G1 (control) did not receive TC or any surface treatment. The sets were adapted to a matrix and received an increment of an adhesive luting cement. The specimens were subjected to the shear bond strength test. ANOVA and Tukey's tests showed that G3 (8.53 MPa) and G4 (8.63 MPa) differed significantly (p=0.001) from G1 (13.34 MPa). The highest mean shear bond strength values were found in G5 (14.78 MPa) and G6 (15.86 MPa). Air-abrasion of CR surface associated with an adhesive system provided an effective bond of the CR to the adhesive luting cement, regardless the pre-treatment with the phosphoric acid.

Avaliação clínica e microbiológica do tratamento da estomatite protética com tintura de Schinus terebinthifolius Raddi (Aroeira)

Objective: To evaluate the clinical efficacy of Schinus terebinthifolius Raddi (aroeira) tincture in the treatment of denture stomatitis. Method: Eighteen removable denture wearers with clinical diagnosis of type II denture stomatts and presence of candidosis associated to the denture use, as confirmed by clinical and mycological examinations, were selected for the study. The patients were allocated to two groups: TG (test group) - treatment with Schinus terebinthifolius Raddi (aroeira) tincture; CG (control group), treatment with nystatin. All patients were instructed to clean the dentures with toothbrush and dentifrice, and then apply the product on the palatal mucosa and on denture surface 3 times a day, during 15 consecutive days, removing the denture at bedtime and keeping it in a receptacle with water. At the 15th day of use, the clinical and mycological examinations were redone to evaluate treatment efficacy. Data were analyzed statistically by Wilcoxon and Mann-Whitney tests at 5% significance level. Results: The inflammatory process and Candida spp. infect on were eliminated in 66.7% and 77.8% of the cases, respectively, in TG. In CG, elimination of the inflammatory process and fungal infect on occurred in 77.8% and 88.9% of the cases, respectively. These results were statistically significant (p=0.01). There was no statistically significant difference between the treatments (p>0.05). In all cases, fungal infect on was detected only on the denture, and C. albicans was the most prevalent microorganism, being present in 94.4% of the cases. Conclusion: The treatment with Schinus terebinthifolius Raddi (aroeira) tincture was effective in the treatment of denture stomatitis, promoting remission of the inflammatory process and Candida spp infection.

Effect of occlusal splint treatment on the temperature of different muscles in patients with TMD

Purpose: The aim of this study was to evaluate the effect of occlusal splint treatment on the temperature of masseter (inferior, intermediate and superior), anterior temporal, digastric and trapezius muscles in patients with temporomandibular disorder (TMD). Materials and methods: Thirty patients (6 male and 24 female) aged from 16 to 57 years (mean 37.8. ± 11.4 years) were selected. The patients were diagnosed with muscular TMD by clinical examination (application of Research Diagnostic Criteria questionnaire and physical examination). Occlusal splints in acrylic resin were inserted in all patients with a weekly follow-up. The superficial thermography (°C) on the both sides of the muscles was performed using a digital thermometer in a controlled temperature room. This procedure was performed before occlusal splint insertion (patient with pain) and after the completion of the treatment (patient without pain). The data were analyzed by 2-way repeated-measures ANOVA and means were compared by Tukey HSD test (P< .05). Results: After occlusal splint treatment a significant increase in temperature was observed in each muscle, both in the right and left sides. When the muscles were compared in the same period (before or after therapy) there was no significant difference among them. Conclusion: It can be concluded that the use of occlusal splint promoted a significant increase on the muscles temperature. There was symmetry in the temperature of muscles on the right and left sides both before and after the treatment. © 2010 Japan Prosthodontic Society.

Functional and esthetic rehabilitation with In-Ceram alumina and zirconia system: A multidisciplinary approach

The development of all-ceramic systems following metalceramics restorations allowed simulation of natural dentition due to favorable esthetics and resistance. In-Ceram is an alternative when esthetics is primordial as well as resistance required in rehabilitation. However, an ideal smile is associated to not only shape, color, texture and translucency but also harmony with gingival tissue. So, the aim of this study is to report a clinical case based on periodontal and fixed partial dentures principles to perform periodontal plastic surgery followed by esthetic rehabilitation. A female patient, 40-year-old, presented complaint about dental esthetics. After clinical and radiographic exams, metal-ceramics crowns (teeth 11, 12, 13, 21, 22 and 23) were considered unsatisfactory due to marginal leakage, color change in gingival tissue associated to metallic margin, and gummy smile. So, a crown lengthening surgery of anterior teeth was performed followed by rehabilitation of superior teeth with In-Ceram single crowns. Clinical significance: The interaction between periodontics and fixed prosthodontic area is the key of an adequated treatment planning which involves gingival smile to provide function and an esthetic condition in association with an esthetic, resistant and predictable material.

Influence of the construction bite vertical and horizontal dimensions on dentoskeletal structures induced by the Klammt appliance in Class II treatment

Aim: To evaluate the influence of construction bite in the dentoskeletal changes induced by Klammt Appliance. Methods: The sample consisted of 17 children, with Class II malocclusion and initial mean age of 8.5 years. The construction bite was obtained using an Exactobite on edge-toedge anteroposterior relationship with 3 mm interincisal clearance. The height of the acrylic was determined by initial overbite associated to interincisal clearance and measured with digital caliper. The amount of advancement was obtained and measured by initial overjet in the lateral radiography. Pearson's correlation, linear regression and ANOVA were used to determine the relationship between dentoskeletal and construction bite variables. Results: The increase in the height of the acrylic promotes a greater inhibition of the forward displacement of the nasal spine and reduction in the facial growth index. The increase in the mandibular advancement induces more downward displacement of nasal spine and pogonion; a counter-clockwise rotation of palatine plane; an increase in mandibular length, maxillary alveolar height and interincisal angle; a decrease in mandibular alveolar height, the intermaxillary discrepancy and overjet; and palatal tipping of upper incisors. Conclusions: The different dimensions of the construction bite influence the dentoskeletal changes induced by the appliance in Class II treatment.