Joint sounds in complete denture wearers. Literature review.

Long-term denture wearers can present with prosthesis instability, reduced occlusal vertical dimension and incorrect positioning of the jaw. This can lead to muscular changes and joint vibration. This study presents the main considerations related to joint vibrations in partially or totally edentulous patients. Occlusal treatment improves the disc-condyle relationship in the mandibular fossa. Furthermore, a detailed clinical exam and anamnesis must be performed to identify the dysfunction and its etiology, so that appropriate treatment can be provided.

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.

Effect of phosphate-bonded investments on titanium reaction layer and crown fit

This study analyzed the reaction layer and measured the marginal crown fit of cast titanium applied to different phosphate-bonded investments, prepared under the following conditions (liquid concentration/casting temperature): Rema Exakt (RE) - 100%/237°C, 75%/287°C, Castorit Super C (CS)-100%/70°C, 75%/141°C and Rematitan Plus (RP)-100%/430°C (special to titanium cast, as the control group). The reaction layer was studied using the Vickers hardness test, and analyzed by two way ANOVA and Tukey's HSD tests (α = 0.05). Digital photographs were taken of the crowns seated on the die, the misfit was measured using an image analysis system and One-way ANOVA, and Tukey's test was applied (α = 0.05). The hardness decreased from the surface (601.17 VHN) to 150 μm (204.03 VHN). The group CS 75%/141°C presented higher hardness than the other groups, revealing higher surface contamination, but there were no differences among the groups at measurements deeper than 150 μm. The castings made with CS - 100%/70°C presented the lowest levels of marginal misfit, followed by RE -100%/237°C. The conventional investments CS (100%) and RE (100%) showed better marginal fit than RP, but the CS (75%) had higher surface contamination.

Evaluación de la deformación de dos siliconas para prótesis faciales, influencia de la pigmentación y desinfección química

The purpose of present study was to analyze the effect of pigmentation and chemical disinfection on the initial and the permanent deformation of two silicones (Silved Selant and Brascoved) for facial prosthesis. Initial and permanent deformation tests samples (20 mm × 12.5 mm) were made following the manufacturer's instructions. For each silicone (n= 40), ten samples were used for pigmentation with make up power, ten with iron oxide, ten with ceramics power and tem were tested without pigmentation. Five samples of each group were submitted to chemical disinfection using a 2 % Chlorhexidine spray. All samples were immersed in physiological saline and stored in an oven at 35 ° ± 1 °C. After 90 days, the samples were submitted to initial and permanent deformation tests using a dial indicator. For both properties, data were analyzed by Tukey's test (a= 0.05). The results showed that all the materials had initial and permanent deformation regardless of pigmentation and chemical disinfection. The groups were used for pigmentation with iron oxide showed less initial and permanent deformation when were submitted to the chemical disinfection regardless the silicone used.

Avaliação das condutas de biossegurança em laboratórios de prótese dentária de João Pessoa, PB, Brasil

Objective: To evaluate the biosecurity measures adopted in dental prosthesis laboratories of the city of João Pessoa, PB, Brazil with respect to prosthetic works sent by dentists. Method: Twenty-five dental prosthesis technicians (DPT) of the city of João Pessoa, PB, filled out a questionnaire referring to their knowledge of the biosecurity principles, disinfection of impressions and other prosthetic items, and the use of individual protection equipment (IPE). Results: Although 92% of the interviewees believed in the possible occurrence of cross-infection between dental prosthesis laboratories and dental offices, 64% declared that the prosthetic works received in their laboratories do not undergo any disinfection procedure. It was also observed that, for disinfection of impressions and stone casts, the chemical substances are not used as recommended by the manufacturers or are innocuous to microorganisms. Regarding the use of IPE, 60% of the DPT used mask, but only 4% used gowns. With respect to the measures taken regarding the impressions received from dental offices, 56% of the interviewees only wash them in running tap water, and 56% of the stone casts that arrive at the laboratory are not disinfected in any way. Conclusion: There is a need for more motivation and instructions to DPT regarding the prevention of cross-contamination during sending and receiving of prosthetic works between dental prosthesis laboratories and dental offices because the DPT evaluated in this study were found negligent with respect to disinfection procedures.

Effect of weathering and thickness on roughness of acrylic resin and ocular button

Purpose: The aim of this study was to evaluate the roughness of colorless ocular button and four brands of colorless acrylic resins designed to fabricate ocular prosthesis as a function of weathering (1008 h) and different thickness (1 and 3.5 mm). Materials and methods: One-hundred-and-twenty specimens were fabricated and distributed in 12 groups. The analysis was carried out by means of digital roughness meter. Results: Data were analyzed statistically by ANOVA and Tukey test at 1% significance. The results showed that there was no statistically significant difference after the weathering period. Both the Vipi Cril acrylic resin with 3.5 mm in thickness and ocular button with 1 mm in thickness presented the lowest roughness values (0.12. Ra). Conclusion: The roughness of the acrylic resins and the ocular button was not affect by the weathering of 1008 h. However, the thickness of the specimens proved to have a major influence on roughness property. © 2010.

Durability of feldspathic veneering ceramic on glass-infiltrated alumina ceramics after long-term thermocycling.

This study compared the bond strength durability of a feldspathic veneering ceramic to glass-infiltrated reinforced ceramics in dry and aged conditions. Disc shaped (thickness: 4 mm, diameter: 4 mm) of glass-infiltrated alumina (In-Ceram Alumina) and glass-infiltrated alumina reinforced by zirconia (In-Ceram Zirconia) core ceramic specimens (N=48, N=12 per groups) were constructed according to the manufacturers' recommendations. Veneering ceramic (VITA VM7) was fired onto the core ceramics using a mold. The core-veneering ceramic assemblies were randomly divided into two conditions and tested either immediately after specimen preparation (Dry) or following 30000 thermocycling (5-55 oC±1; dwell time: 30 seconds). Shear bond strength test was performed in a universal testing machine (cross-head speed: 1 mm/min). Failure modes were analyzed using optical microscope (x20). The bond strength data (MPa) were analyzed using ANOVA (α=0.05). Thermocycling did not decrease the bond strength results for both In-Ceram Alumina (30.6±8.2 MPa; P=0.2053) and In-Ceram zirconia (32.6±9 MPa; P=0.3987) core ceramic-feldspathic veneering ceramic combinations when compared to non-aged conditions (28.1±6.4 MPa, 29.7±7.3 MPa, respectively). There were also no significant differences between adhesion of the veneering ceramic to either In-Ceram Alumina or In-Ceram Zirconia ceramics (P=0.3289). Failure types were predominantly a mixture of adhesive failure between the veneering and the core ceramic together with cohesive fracture of the veneering ceramic. Long-term thermocycling aging conditions did not impair the adhesion of the veneering ceramic to the glass-infiltrated alumina core ceramics tested.

Clinical evaluation of two packable resin-based composite restorations: A three-year report

This randomized clinical trial sought to evaluate the performance of two packable composites over a period of 36 months. A total of 39 Class I and II restorations were placed in the permanent teeth of 20 patients. Using United States Public Health Services criteria, two investigators evaluated the restorations immediately after placement and again after 12 and 36 months, examining color match, marginal discoloration, marginal integrity, recurrent caries, proximal contact, anatomical shape, surface texture, and postoperative sensitivity. It was concluded that the packable composites evaluated showed satisfactory clinical performance after three years.

Hardness evaluation of prosthetic silicones containing opacifiers following chemical disinfection and accelerated aging

We evaluated the effects of disinfection and aging on the hardness of silicones containing opacifiers and intended for use in facial prosthetics. A total of 90 samples were produced using a cylindrical metal mold 3 mm in height and 30 mm in diameter. The samples were fabricated from Silastic MDX 4-4210 silicone in three groups: GI contained no opacifier, GII contained barium sulfate (Ba), and GIII contained titanium dioxide (Ti). The samples were disinfected using effervescent tablets (Ef), neutral soap (Ns), or 4% chlorhexidine (Cl) 3 times a week for 60 days. After this period the samples underwent 1,008 hours of accelerated aging. The hardness was measured using a durometer immediately following the disinfection period and after 252, 504, and 1,008 hours of aging. The data were statistically analyzed using 3-way ANOVA and the Tukey test (p < .05). The GIII group exhibited the greatest variation in hardness regardless of elapsed time. All groups displayed greater hardness after 1,008 hours of accelerated aging independent of disinfectant type. All of the hardness values were within the clinically acceptable range.

Assessment of color fidelity of several composite resins compared to their Vita Classical shade registration

This study compared the color fidelity of different composite resins with their registration in the Vita Classical Shade Guide. Using a prefabricated Teflon mold, 120 specimens were divided into four groups fn - 30), according to the resin tested. Three subgroups (a = 10) were prepared for each resin group; these subgroups tested enamel shade, dentin shade, and enamel and dentin shade. Three measurements were performed to verily whether the tooth shade matched that of the Vita Classical Shade Guide. The color was evaluated and the shade variations were calculated. The data were submitted to a three-way AN OVA test (time, color match, and composite type), followed by Tukey's test. It was concluded that all composite resins showed color differences in relation to the Vita Classical Shade Guide.

Evaluation of a two-step pouring technique for implant-supported prostheses impression

The aim of this study was to evaluate the efficacy of a pouring technique for implant-supported prostheses impressions. A metallic matrix (control group) with two implants positioned at 90 and 65 degrees was fabricated. The matrix was submitted to the direct transfer impression technique. In group CP (conventional pouring - n = 10), casts were obtained by the conventional pouring technique. In group EP (experimental pouring - n = 10), the analogs were embraced with latex tubes before the first pouring and then submitted to a second pouring. Vertical misfit and implants/analogs inclinations were evaluated. Data were analyzed by analysis of variance and Tukey's test (p < .05). Results demonstrated significant difference (p < .05) between control and experimental groups for misfit measurement in perpendicular implant/analog and between control group and group EP in leaning implant/analog. Considering inclination, there were significant differences (p < .05) between control and experimental groups for leaning analogs. Independently of the pouring technique, perpendicular implants produced more accurate casts.

Avaliação das dimensões transversas na maxila e mandíbula em pacientes na fase da dentição mista tratados com aparelho ortodôntico removível superior

Objeti vo: Avaliar os efeitos da expansão lenta na maxila e na mandíbula com o aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, nas regiões oclusal, gengival e alveolar de pacientes jovens com atresia maxilar. Método: A amostra compreendeu 18 indivíduos leucodermas (11 meninas e 7 meninos; idade média: 8 anos e 10 meses no início do tratamento) que apresentavam atresia da maxila, acompanhadas ou não de mordida cruzada posterior uni ou bilateral na fase de denti ção mista. Todos os pacientes foram tratados com aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, sendo o tempo médio de tratamento de 15,4 meses (± 7,6). Para avaliar a infl uência do tratamento nas mensurações dos pontos demarcados nas regiões oclusal, gengival e alveolar, foram uti lizados os modelos de gesso dos arcos superior e inferior (36 pares) obti dos em dois tempos: T1: início do tratamento e T2: ao fi nal do tratamento. Para cada paciente em ambos os tempos, foram mensuradas as distâncias transversas na região oclusal entre caninos decíduos, 1o molares decíduos ou 1o pré-molares permanentes e entre 1o molares permanentes, superiores e inferiores. Para verifi car se a movimentação ocorreu por inclinação ou por movimento de corpo, foram uti lizadas também medidas nas regiões gengival e alveolar. Os dados foram avaliados estati sti camente pelo teste “t student para amostras pareadas (5%). Resultados: Observou-se que em T2, todas as distâncias mensuradas para as regiões oclusal, gengival e alveolar apresentaram valores estati sti camente superiores às mesmas medidas em T1 (p<0,05). Conclusão: O aparelho ortodônti co removível superior é efeti vo nos casos de expansão lenta da maxila, agindo também indiretamente nas dimensões transversas do arco inferior.

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 bleaching agent on dental ceramics roughness.

The aim of this study was to assess the effect of bleaching agents (10% and 16% carbamide peroxide) on the roughness of two dental ceramics in vitro, and to analyze the surface by scanning electronic microscopy (SEM). Two bleaching agents (10% and 16%/Whiteness, FGM Gel) and two microparticle feldspathic ceramics (Vita VM7 and Vita VM13) were used. Forty disks of Vita VM7 and Vita VM13 ceramic were manufactured, measuring 4 mm in diameter and 4 mm high, in accordance with the manufacturers' recommendations, and were divided into 4 groups (n = 10): (1) VM7 + Whiteness 10%; (2) VM7 + Whiteness 16%; (3) VM13 + Whiteness 10%; (4) VM13 + Whiteness 16%. The bleaching agent was applied for 8 hours a day for 15 days and during the intervals the test specimens were stored in distilled water at 37 degrees C. The roughness (Ra) of the test specimens was evaluated before and after exposure to the bleaching agents using a laser roughness meter and the topographic description was analyzed by SEM. The statistical analysis of roughness data showed significant differences in the VM7 groups, using paired t-test, p = 0.05 (VM7 + Whiteness 10%: p = 0.002; VM7 + Whiteness 16%: p = 0.001) and two-sample t-test (VM7 p = 0.047), and no significant difference was found among VM13 groups. The qualitative SEM analysis showed different degrees of surface changes. The results suggest that the roughness of the tested ceramic surfaces increased after exposure to the bleaching agents.

Effect of unilateral misfit on preload of retention screws of implant-supported prostheses submitted to mechanical cycling

Purpose: The aim of this study was to evaluate the effect of different levels of unilateral angular misfit on preload maintenance of retention screws of single implant-supported prostheses submitted to mechanical cycling. Materials and methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n=12). The crowns presented no misfit in Group A (control group) and unilateral misfits of 50μm, 100μm and 200μm in the groups B, C and D, respectively. The crowns were attached to external hexagon implants with a titanium retention screw with torque of 30N/cm. Oblique loading of 130N at 2Hz was applied on each replica, totalizing 5×104 and 1×106cycles. Detorque values were measured initially and after each cycling period. Data were evaluated by analysis of variance and Tukey's HSD test (p<0.05). Results: All groups presented reduced initial detorque values (p< 0.05) in comparison to the insertion torque (30. ± 0.5. N/cm) and Group A (25.18. N/cm) exhibited the lowest reduction. After mechanical cycling, all groups presented detorque values from 19.5. N/cm to 22.38. N/cm and the mechanical cycling did not statistically influence the detorque values regardless the misfit level of the replicas. Conclusion: The unilateral misfit influenced the preload maintenance only before mechanical cycling. The mechanical cycling did not influence the torque reduction. © 2010 Japan Prosthodontic Society.