Comportamento biomecânico dos sistemas de retenção de overdentures

Objective: to the purpose of this study was to compare the stress distribution in the peri-implant hard tissue on different attachment systems for mandibular or maxillary implant-retained overdentures. Material and methods: the search for published studies was performed on PubMed/Medline database covering the period of January 2000 to April 2014. The selection of the eligible studies was performed according to including and excluding criteria. Results: a total of 140 studies were screened and according to the search strategy, 21 studies were selected for this review. Eight studies perfomed strain-gauge analysis, 5 evaluated the stress distribution though photoelastic test and 7 performed tridimensional finite element analysis. Only one study in vivo was included. Non-splinted O-rings showed better stress distribution than other bar-clip attachment systems. Conclusions: the present study did not find sufficient evidences regarding the most indicated attachment system for overdentures with better stress distribution for the peri-implant hard tissue. The methodologies analyzed should be complemented with other tests and used as a tool for further clinical studies.

Parafunção severa: reabilitação oral com prótese total mandibular x overlay maxilar: relato de caso

In many oral rehabilitation professionals seeking venture renew people smile. However, these procedures have functional implications and aesthetic criteria which must be satisfied so that the final result is predictable. The restoration of relations intermaxillary, phonetics, masticatory function, esthetics and patient comfort are the goals to be achieved. An effective way to achieve these goals when immediate reconstruction with permanent dentures is not possible, make use of a type of partial denture called overlay. Bruxism is a manifestation of biopsychological imbalance that affects the stomatognathic system, characterized by clenching and / or attrition of teeth together so centric or eccentric, can be manifestation of nocturnal or diurnal. Its effects can manifest themselves in different parts of the stomatognathic system, varying the severity of the damage as the resistance of the structures affected, the time of existence, its regularity and the general state of the wearer. The description of the steps followed in solving this case, in which the patient edentulous mandibular arch while the maxillary arch showed absence of teeth 16 and 26 and, except for the teeth 17 and 27, all other teeth showed wear very sharp in the sense denoting incisal cervical, severe impairment of the vertical dimension, the quality of masticatory function and a marked impairment phonetic, this case report aims to guide the beginning of a rehabilitation, as well as the transitional phase of treatment for recovery of functional and aesthetic relationships intermaxillary .

Pistas diretas para o tratamento de mordida cruzada posterior

The malocclusions are one focus of discussions in public health, due to which it is necessary to incorporate correction procedures that are inexpensive, easy to perform and which can be made in health services. Planas Direct Tracks meet such characteristics which make them advantageous for the crossbite correction. The aim of this study was to present a case in which correction of unilateral crossbite was performed with the resources available in a public clinic. This is a 6 year-old patient who presented functional unilateral crossbite in canines and posterior teeth. A cross decreased maxillary arch leading to a condition of unilateral posterior crossbite was detected. Occlusal adjustments were performed in canine and posterior teeth; however it was not enough to restore the occlusal balance. It was decided to prepare Planas Direct Tracks in canines, allowing functional balance, which prevented masticatory movement alteration during the growth phase and malocclusion correction. Controls were performed every six months to evaluate the patient's progress and whether or not new occlusal adjustments were necessary. Monitoring and treatment were conducted for 5 years, until stabilization of the permanent dentition ensuring treatment. It is concluded that Planas Direct Tracks were effective for the correction of unilateral posterior crossbite. So, it is essential to note that this procedure can be performed in public services.

Tratamento compensatorio da má oclusnao de classe lll: revisão de literatura

Class III malocclusion is less common occlusal relationship, covering less than 5% of the population. There are various forms of treatment in Class III malocclusion. Depending on how the form is expressed Class III and age of the patient, the therapy may be orthopedic and orthodontic surgical orthodontics. The objective was to review the literature of the last 10 years about ways to compensatory treatment of Class III malocclusion. Several articles were published between 04/2003 and 04/2013 in the Pubmed database from the keyword "Class III malocclusion". However, only 19 articles that addressed the compensatory treatment of Class III were selected. Based on the selected items it was concluded that the treatment of Class III malocclusions in children before the peak of pubertal growth has better prognosis with greater effects orthopedic and orthodontic minor effects. The ideal treatment option for this condition is the Rapid maxillary expansion associated with maxillary protraction of the same. The treatment of Class III malocclusion in young people after the peak of pubertal growth is doubtful prognosis. You can opt to treat rapid maxillary expansion and maxillary protraction of the same or fixed appliance, however, orthopedic effects can be the same or smaller than the orthodontic effects, depending on the age of the patient. Depending on the degree of Class III malocclusion in adults, the treatment will consist of dental compensations or orthognathic surgery.

Combined therapy with mineral trioxide aggregate, and guided tissue regeneration for a large radicular cyst: a 13-year follow-u

Biomaterials such as membrane barriers and/or bone grafts are often used to enhance periapical new bone formation. A combination of apical surgery and these biomaterials is one of the latest treatment options for avoiding tooth extraction. In case of periapical lesions, guided tissue regeneration (GTR) is attempted to improve the self-regenerative healing process by excluding undesired proliferation of the gingival connective tissue or migration of the oral epithelial cells into osseous defects. In many cases, GTR is necessary for achieving periodontal tissue healing. This report describes the healing process after surgery in a challenging case with a long-term followup. In this case report, endodontic surgery was followed by retrograde sealing with mineral trioxide aggregate (MTA) in the maxillary right central incisor and left lateral incisor. Apicectomy was performed in the maxillary left central incisor and a 1-mm filling was removed. The bone defect was filled with an anorganic bone graft and covered with a decalcified cortical osseous membrane. No intraoperative or postoperative complications were observed. After 13 years of follow-up, the patient showed no clinical signs or symptoms associated with the lesion and radiographic examination showed progressive resolution of radiolucency. In conclusion, the combination of apical surgery and regenerative techniques can successfully help the treatment of periapical lesions of endodontic origin and is suitable for the management of challenging cases

Root reconstructed with mineral trioxide aggregate and guided tissue regeneration in apical surgery: a 5-year follow-up

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

Dental bleaching with a 10% hydrogen peroxide product: a six-month clinical observation

Context: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. Aim: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). Materials and Methods: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. Statistical Analysis Used: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. Results: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. Conclusion: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Emprego de técnica cirúrgica e materiais adesivos diretos no fechamento de diastema

The following is a clinical case report of a patient whose main complaint was the presence of a generalized spacing in the anterior maxillary segment. After meticulous clinical analysis and discussions of the clinical procedures to be adopted, a labial frenectomy was our first choice, so that we could reduce the diastemas directly using composite resin. It was observed that the association of clinical and restorative procedures was capable of giving back shape, function and dental aesthetics, allowing to the young patient the satisfaction of smiling without any fear.

Diastemas: reestablishment of an attractive smile

A healthy and attractive smile is very valued in today s society. Yet this requires better aesthetic and cosmetic solutions from dental surgeons.The present paper presents a case report of diastema closure using an association of tooth movement induced by orthodontic elastics,dental cosmetics and resin-bonded prosthesis. The female patient L.B.A.J., aged 19 years, visited the Integrated Clinic of Araçatuba DentalSchool UNESP mainly complaining of missing teeth and poor esthetics. After anamnesis, clinical and radiographic examination revealedhypodontia of the maxillary right and left first premolars, abnormal maxillary right lateral incisor shape and diastema between the maxillaryright lateral incisor and canine and between the maxillary left lateral incisor and canine. Planning was done which included indication ofdiastema closure with composite resin restoration and metal-free resin-bonded prosthesis, with a structure made of Vectris (Ivoclar VivadentInc., Amherst, NT, USA). The option for dental cosmetics associated with resin-bonded prosthesis after movement with orthodontic elasticsresulted in an excellent aesthetic outcome of low cost and short treatment duration.Indexing terms: composite resins; diastema; fixed resin bonded partial denture.

Expansão rápida de maxila assistida cirurgicamente por meio da piezocirurgia: relato de caso

Aim: the purpose of this study is to present a case of surgically assisted rapid maxillary expansion using piezosurgery and describe the benefits of using this device in this type of procedure. Case description: patient had adento-skeletal deformity Cl III with asevereatresia of jaw and underwent a rapid maxillary expansion and surgically assisted with the use of piezosurgery. Conclusion: the piezosurgerycan be used as an alternative in oral and maxillofacial surgery wich features provide greater accuracy and safety in surgery

Avaliação clínica e radiográfica de pacientes submetidos ao levantamento da membrana do seio maxilar

Implant dentistry is a dental specialty which presents great predictability in the rehabilitation at posterior, partially edentulous maxillary areas. Early tooth loss results in significant jaw remodeling. The maxillary sinus lifting followed by implant placement is a predictable technique initially described in 1980. Since then, several different techniques have been investigated varying filling materials and the management of complications in order to provide effective guidance in the rehabilitation of these patients. The current study evaluated ten patients who underwent sinus lifting before implant placement and crown installation. First, a retrospective analysis of the medical records was conducted to obtain information about possible postoperative complications. Clinical and radiographic analyses were performed at baseline and 180 days after surgeries. The sinus lifting with immediate implant placement provided satisfactory outcomes and can be considered a safe procedure. Treatment predictability was demonstrated in 90% of patients and for 86.96% of implants placed. It is important to highlight knowledge of anatomical structures at this area, the use of delicate surgical techniques, and strict patient follow-up.

Oral focal mucinosis: clinical case presentation with a focus on aesthetic and functional surgical resolution

Introduction: When planning excisional surgery, alterations in the oral mucosa, particularly in esthetically important areas, represent a challenge. For cases involving an exophytic lesion with a vegetative tumoral aspect, a clinician may prioritize obtaining a definitive diagnosis by histopathologic and histochemical examinations over the preservation of esthetics or maintenance of the involved tooth. Case Presentation: A painless, hard lesion with normal coloration was present in the maxillary left central incisor of a patient for at least 6 years. A biopsy was performed to preserve oral mucosa and a treatment plan was established that included endodontic retreatment and prosthetic restoration. The histopathologic diagnosis was oral focal mucinosis, an uncommon and poorly characterized type of lesion. Conclusion: A conservative biopsy of the lesion facilitated an accurate diagnosis, promoted the patient’s comfort, and achieved satisfactory esthetic results.

Estudio de las caracteristicas de oclusión de niños de 12 años del municipio de Cáceres, Mato Grosso, Brasil

The aim of this study was to evaluate the occlusal condition of 12 year-old children examined by the Oral Health Brazil 2003 Project in Cáceres city. The sample consisted of 170 children, boys and girls, selected at random among 20 schools that took part in this project. It was used for the analysis of the occlusal condition the Dental Aesthetic Index (DAI), as manual of basic epidemic rising in Oral Health extolled by the World Health Organization which describes the occlusal conditions in relation to dentition, space and occlusion of the permanent dentition. It was observed that the prevalence of the normal occlusion and of the malocclusion were, respectively, 21.18% and 78.82%. This last one was present due to the tooth crowding (74.93%), spacing in the incisor segment (23.88%), diastema (17.17%), anterior maxillary misalignment (58.95%) and anterior mandibular (61.19%), excessive overjet (11.94%), negative overjet (4.47%), open bite (1.5%) and molar relationship Class II or III (26.87%). It was concluded that the studied sample presents a high index of factors to compose the malocclusion.

The use of a bite fork to help mobilize the maxilla after downfracture during the Le Fort I osteotomy: a technical note

Introduction The Le Fort I osteotomy is indicated to reposition the maxilla in the surgical correction of dentofacial deformities. Although it is a known surgical step, like any surgical procedure, it can have complications and difficulties; among these, the initial mobility of the jaw is very common after completing all corticotomies. Methods The authors present a technique in which the bite fork is used as an auxiliary tool in maxilla downfracture, especially in cases of maxillary impaction where vertical space is created on the walls of the corticotomy. Findings As the bite fork acts as a scraper with a long leverage arm, an advantage would be the better distribution of forces along the corticotomy, minimizing the risk of bad fracture and facilitating maxillary downfracture movement.