Zirconia-based dental crown to support a removable partial denture: a three-dimensional finite element analysis using contact elements and micro-CT data

Veneer fracture is the most common complication in zirconia-based restorations. The aim of this study was to evaluate the mechanical behavior of a zirconia-based crown in a lower canine tooth supporting removable partial denture (RPD) prosthesis, varying the bond quality of the veneer/coping interface. Microtomography (μCT) data of an extracted left lower canine were used to build the finite element model (M) varying the core material (gold core - MAu; zirconia core - MZi) and the quality of the veneer/core interface (complete bonded - MZi; incomplete bonded - MZi-NL). The incomplete bonding condition was only applied for zirconia coping by using contact elements (Target/Contact) with 0.3 frictional coefficients. Stress fields were obtained using Ansys Workbench 10.0. The loading condition (L = 1 N) was vertically applied at the base of the RPD prosthesis metallic support towards the dental apex. Maximum principal (σmax) and von Mises equivalent (σvM) stresses were obtained. The σmax (MPa) for the bonded condition was similar between gold and zirconia cores (MAu, 0.42; MZi, 0.40). The incomplete bonded condition (MZi-NL) raised σmax in the veneer up to 800% (3.23 MPa) in contrast to the bonded condition. The peak of σvM increased up to 270% in the MZi-NL. The incomplete bond condition increasing the stress in the veneer/zirconia interface.

The effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root thirds

The purpose of this study was to evaluate the effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root regions. Sixty single-rooted human teeth were decoronated, endodontically treated, post-space prepared, and divided into six groups. Glass-fiber (GF) posts (Exacto, Angelus) and fiber-reinforced composite (FRC) posts (EverStick, StickTeck) were cemented with self-adhesive resin cement (Breeze) (SA) (Pentral Clinical) and self-etching resin cement (Panavia-F) (SE) (Kuraray). Six 1-mm-thick rods were obtained from the cervical (C), middle (M), and apical (A) regions of the roots. The specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) at a crosshead speed of 0.5 mm/min. Microtensile bond strength data were analyzed with two-way ANOVA and Tukey's tests. Means (and SD) of the MPa were: GF/SA/C: 14.32 (2.84), GF/SA/M: 10.69 (2.72), GF/SA/A: 6.77 (2.17), GF/SE/C: 11.56 (4.13), GF/SE/M: 6.49 (2.54), GF/SE/A: 3.60 (1.29), FRC/SA/C: 16.89 (2.66), FRC/SA/M: 13.18 (2.19), FRC/SA/A: 8.45 (1.77), FRC/SE/C: 13.69 (3.26), FRC/SE/M: 9.58 (2.23), FRC/SE/A: 5.62 (2.12). The difference among the regions was statistically significant for all groups (p < 0.05). The self-adhesive resin cement showed better results than the self-etching resin cement when compared to each post (p < 0.05). No statistically significant differences in bond strengths of the resin cements when comparable to each post (p > 0.05). The bond strength values were significantly affected by the resin cement and the highest values were found for self-adhesive resin cement.

Regulation of hepatic TRB3/Akt interaction induced by physical exercise and its effect on the hepatic glucose production in an insulin resistance state

To maintain euglycemia in healthy organisms, hepatic glucose production is increased during fasting and decreased during the postprandial period. This whole process is supported by insulin levels. These responses are associated with the insulin signaling pathway and the reduction in the activity of key gluconeogenic enzymes, resulting in a decrease of hepatic glucose production. On the other hand, defects in the liver insulin signaling pathway might promote inadequate suppression of gluconeogenesis, leading to hyperglycemia during fasting and after meals. The hepatocyte nuclear factor 4, the transcription cofactor PGC1-α, and the transcription factor Foxo1 have fundamental roles in regulating gluconeogenesis. The loss of insulin action is associated with the production of pro-inflammatory biomolecules in obesity conditions. Among the molecular mechanisms involved, we emphasize in this review the participation of TRB3 protein (a mammalian homolog of Drosophila tribbles), which is able to inhibit Akt activity and, thereby, maintain Foxo1 activity in the nucleus of hepatocytes, inducing hyperglycemia. In contrast, physical exercise has been shown as an important tool to reduce insulin resistance in the liver by reducing the inflammatory process, including the inhibition of TRB3 and, therefore, suppressing gluconeogenesis. The understanding of these new mechanisms by which physical exercise regulates glucose homeostasis has critical importance for the understanding and prevention of diabetes.

Desidratação e balanço hídrico de um anfíbio anuro (Rhinella schneideri)

A manutenção do balanço hídrico ou de água é particularmente desafiadora para os anfíbios em virtude de seu tegumento altamente permeável e o risco associado de perda evaporativa de água. Neste sentido, anuros terrestres exibem uma grande diversidade de mecanismos que atuam na diminuição da perda evaporativa de água e contribuem para a manutenção de um balanço hídrico adequado. Ademais, algumas espécies de anuros são conhecidas por tolerar altos níveis de desidratação e por engajar-se em atividades de rotina na natureza, ainda que sob níveis variáveis de desidratação. Finalmente, o próprio nível de desidratação pode acarretar alterações nos fatores envolvidos na manutenção do balanço de água dos anuros, aspecto muito pouco explorado em espécies terrestres neotropicais. Dessa forma, no presente estudo, mensuramos as taxas de perda evaporativa de água (PEA), reidratação a partir de água livre (Re) e calculamos a resistência da pele a desidratação (RP) em indivíduos adultos de Rhinella schneideri submetidos experimentalmente a diferentes níveis de desidratação (99%, 90%, 80% e 70% da massa corpórea inicial). Ademais, medimos as alterações causadas pela desidratação na osmolalidade plasmática (Osm), hematócrito (Htc), concentração de hemoglobina no sangue ([Hb]) e massa percentual dos órgãos viscerais. O objetivo central deste estudo foi avaliar os efeitos potenciais de diferentes níveis de desidratação sobre indicadores e repostas fisiológicas relevantes para a manutenção do balanço hídrico em uma espécie de anfíbio anuro terrestre. Nossos resultados mostram que quanto mais desidratados os animais, maiores a RP, a Re, a Osm, o Htc e a [Hb], e menores a PEA, e a massa percentual do fígado e do rim. O aumento da Osm, Htc e [Hb] indicam uma diminuição do compartimento aquoso do sangue, o que pode estar relacionado ao aumento da Re. A relação entre diminuição da PEA e aumento da...

Modificação de nanopartículas de óxido de ferro por dextranas

A modificação de nanopartículas de óxido de ferro tem sido motivo de diversos estudos devido ao grande potencial em aplicações tecnológicas, em especial a área biomédica, pela aliança das propriedades magnéticas dos óxidos com a funcionalidade que a dextrana confere a esse material. O presente trabalho tem como objetivo sintetizar e caracterizar o sistema óxido de ferro/dextranas. O óxido de ferro foi obtido pela reação de co-precipitação de sais de ferro (II) e ferro (III) - na razão molar 1:2 - com hidróxido de sódio e a modificação das partículas magnéticas se deu por dois métodos: (I) a co-precipitação na presença de dextrana e carboximetil dextrana e (II) a co-precipitação seguida da modificação. Para modificação proposta pelo método (II) se fez necessário enxertar a dextrana em ácido acrílico, utilizando o íon Ce(IV) como iniciador da reação de polimerização. Nessa etapa se averiguou a concentração de iniciador ótima para a síntese e, através da técnica de espectroscopia de infravermelho, se pode confirmar a eficiência do enxerto. A concentração 0,3% de íon Ce(IV) apresentou melhor distribuição de tamanho, obtidos por análises de microscopia eletrônica de varredura e espalhamento de luz dinâmico, sendo escolhida para síntese junto a partícula magnética. A difratometria de raio X permitiu determinar a formação de estrutura cristalina da magnetita e maghemita, que são muito parecidas entre si, porém os espectros de infravermelho apontaram desdobramentos da ligação Fe - O característica da maghemita. A relação Fe2+/ Fe3+ obtida por espectrofotometria também resultou em oxidação. A estabilidade coloidal dos sistemas foi avaliada através de medidas de potencial zeta. A modificação da partícula magnética com carboximetil dextrana foi equivalente para os dois métodos empregados, entretanto a modificação com ...

Registro do perfil de emergência para mimetização dos dentes naturais na região estética

Introdução: o tratamento com implantes dentários para a reposição de dentes na região estética exige a utilização de materiais e técnicas que permitam o máximo de naturalidade entre a restauração, os dentes vizinhos e o tecido gengival. Dessa forma, torna-se necessário criar o correto perfil de emergência para o dente, assim como a utilização de materiais com alto potencial estético. Objetivo: o objetivo do presente trabalho foi ilustrar, através de um caso clínico, a utilização de uma técnica de moldagem para a correta cópia do perfil de emergência do dente e sua transferência para o modelo de trabalho, tornando possível a confecção de uma restauração totalmente cerâmica, perfeitamente integrada ao tecido gengival. Caso clínico: paciente de 30 anos, procurou o clínica de prótese dentária com desejo de melhorar a estética dos dentes. Após diagnóstico e planejamento, foram confeccionadas 2 coroas totalmente cerâmicas sobre os dentes 12 e 21, e confecção de 1 coroa cerâmica sobre um pilar de zircônia após o estabelecimento e registro do perfil de emergência do dente 11. Conclusão: após a conclusão do tratamento, observou-se naturalidade, estética e perfeita integração entre as restaurações, os dentes remanescentes e o tecido gengival.

Reabilitação total bimaxilar e o restabelecimento da tríade: função, fonética e estética

O tratamento de indivíduos totalmente desdentados, desde os primórdios dos conceitos e fundamentos da reabilita-ção oral, tem sido um grande desafio para os profissionais da odontologia, especialmente em relação à retenção, suporte e estabilidade das próteses totais. Esses pré-requisitos protéticos estão geralmente deficientes em pacientes que apresentam um longo período de desdentamento, com grande atrofia e reabsor-ção dos rebordos alveolares, especialmente no arco mandibular. Com o advento da implantodontia e com a evolução sequencial dos estudos envolvendo o processo de osseointegração essa filosofia se tornou otimizada pelas próteses totais fixas implantossuportadas, denominadas próteses protocolo, repre-sentando uma modalidade clinicamente previsível no âmbito da dontologia moderna. Com base nessa premissa, o objetivo do presente trabalho é elucidar a sequência clínica de uma reabilitação total bimaxilar, conjugando-se uma prótese total convencional superior e uma prótese protocolo inferior.

A oclusão nas próteses totais implantossuportadas mediatas e imediatas

Rehabilitation of edentulous patients has been a challenge for professionals since the primary concepts and fundaments of occlusal rehabilitation. However, this philosophy has been improved by implant-supported fixed dentures that represent a predictable clinical modality on modern dentistry. Nevertheless, considering that the traditional protocol requires a long period for bone healing and definitive rehabilitation, immediate loading of implants has been advantageous for functional and esthetic rehabilitation of patients in a reduced period. The aim of this study is to discuss the biomechanical and functional fundaments of occlusion for implant-supported fixed dentures with mediate and immediate loading to provide clinical evidences for longevity of this treat ment modality based on the current literature. According to this, some prerequisites as proper bone quality, excellent primary stability, sufficient number of implants, rigid splinting, and control and mastering of biomechanical fundamentals of static and dynamic occlusion are mandatory for treatment predictability and longevity.

Resolução estética associando prótese sobre implante e prótese convencional na região anterior

The combination of several methods for solving aesthetics in a clinical case can be a complicating factor. The diagnosis and planning of the event held in conjunction with the dental technician expand the possibilities of success. The present case illustrates the aesthetic resolution through the association of implant- and tooth-supported prostheses using metal free ceramic systems. A 38-year old male patient presented with a complex smile. After diagnosis and treatment planning, two ceramic crowns were made, one on tooth 11 and one on the implant region 21, along with a laminated porcelain veneer on the region of 12. Aesthetic needs of the patient are predictable only with a sound diagnosis.

Straight and angulated abutments in platform switching: influence of loading on bone stress by three-dimensional finite element analysis

PURPOSE: In view of reports in the literature on the benefits achieved with the use of platform switching, described as the use of an implant with a larger diameter than the abutment diameter, the goal being to prevent the (previously) normal bone loss down to the first thread that occurs around most implants, thus enhancing soft tissue aesthetics and stability and the need for implant inclination due to bone anatomy in some cases, the aim of this study was to evaluate bone stress distribution on peri-implant bone, by using three-dimensional finite element analysis to simulate the influence of implants with different abutment angulations (0 and 15 degrees) in platform switching. METHODS: Four mathematical models of an implant-supported central incisor were created with varying abutment angulations: straight abutment (S1 and S2) and angulated abutment at 15 degrees (A1 and A2), submitted to 2 loading conditions (100 N): S1 and A1-oblique loading (45 degrees) and S2 and A2-axial loading, parallel to the long axis of the implant. Maximum (σmax) and minimum (σmin) principal stress values were obtained for cortical and trabecular bone. RESULTS: Models S1 and A1 showed higher σmax in cortical and trabecular bone when compared with S2 and A2. The highest σmax values (in MPa) in the cortical bone were found in S1 (28.5), followed by A1 (25.7), S2 (11.6), and A2 (5.15). For the trabecular bone, the highest σmax values were found in S1 (7.53), followed by A1 (2.87), S2 (2.85), and A2 (1.47). CONCLUSIONS: Implants with straight abutments generated the highest stress values in bone. In addition, this effect was potentiated when the load was applied obliquely.

The influence of the alveolar ridge shape on the stress distribution in a free-end saddle removable partial denture supported by implant

The alveolar ridge shape plays an important role in predicting the demand on the support tooth and alveolar bone in the removable partial denture (RPD) treatment. However, these data are unclear when the RPD is associated with implants. This study evaluated the influence of the alveolar ridge shape on the stress distribution of a free-end saddle RPD partially supported by implant using 2-dimensioanl finite element analysis (FEA). Four mathematical models (M) of a mandibular hemiarch simulating various alveolar ridge shapes (1-distal desceding, 2- concave, 3-horizontal and 4-distal ascending) were built. Tooth 33 was placed as the abutment. Two RPDs, one supported by tooth and fibromucosa (MB) and other one supported by tooth and implant (MC) were simulated. MA was the control (no RPD). The load (50N) were applied simultaneously on each cusp. Appropriate boundary conditions were assigned on the border of alveolar bone. Ansys 10.0 software was used to calculate the stress fields and the von Mises equivalent stress criteria (σvM) was applied to analyze the results. The distal ascending shape showed the highest σvM for cortical and medullar bone. The alveolar ridge shape had little effect on changing the σvM based on the same prosthesis, mainly around the abutment tooth.