Resposta dos tecidos periodontais frente ao recobrimento de cavidades radiculares restauradas por materiais resinosos: estudo histomorfométrico em cães

Pós-graduação em Odontologia - FOA

Comparison of shear bond strength of orthodontics brackets on composite resin restorations with different surface treatments

INTRODUÇÃO: frequentemente, os pacientes ortodônticos apresentam restaurações de resina composta; no entanto, existem poucos estudos que avaliam a melhor forma de colagem ortodôntica nessa situação. OBJETIVO: o objetivo do presente trabalho foi avaliar a força adesiva de braquetes ortodônticos em restaurações resinosas com tratamento de superfície. MÉTODOS: foram utilizados 51 incisivos inferiores bovinos divididos aleatoriamente em três grupos. No grupo controle (GC), os braquetes foram colados em esmalte dentário; nos grupos experimentais com tratamento (GCT) e sem tratamento (GST), os braquetes foram colados em restauração de resina previamente realizada, diferenciando-se pelo tratamento de superfície com broca diamantada. Os dentes foram incluídos em tubos de PVC com resina acrílica autopolimerizável. O ensaio de cisalhamento foi executado em máquina universal de ensaios Emic. Os grupos foram submetidos à ANOVA com pós-teste de Tukey para verificação da diferença estatística entre os grupos (α = 0,05). RESULTADOS: GC (6,62MPa) e GCT (6,82MPa) apresentaram resultados semelhantes, enquanto o GST (5,07MPa) obteve resultados estatisticamente menores (p < 0,05). CONCLUSÃO: conclui-se que a melhor técnica de colagem de braquetes ortodônticos em restaurações de resina composta é a de realização de desgaste sobre a superfície.

Adhesion of substrate-adherent combinations for early composite repairs: Effect of intermediate adhesive resin application

This study evaluated the effect of intermediate adhesive resin application (IAR) on tensile bond strength (TBS) for early composite repairs in situations where substrate and repair composite bonded together were once of the same kind with the substrate (similar) and once other than the substrate material (dissimilar). Specimens from three types of composites (TPH Spectrum (TPH), Charisma (CHA) and Filtek Z250 (Z250)) were fabricated. The specimens in each composite group (n=72) were randomly divided into six subgroups (n=12). In each composite group, the similar and two dissimilar composites were bonded onto the substrates once using an IAR (Adper Single Bond Plus) and once without. After water storage for I week at 37 degrees C, substrate-adherent combinations were submitted to tensile test. Data were analyzed with three-way ANOVA and Tukey's tests (alpha=0.05). The substrate-adherent combination (p=0.0001), adherent (repair) composite (p=0.0001), and application of IAR (p=0.0001) significantly affected the results. Utilization of IAR improved the repair bond strength for all composite combinations. (C) 2013 Elsevier Ltd. All rights reserved.

Desgaste e rugosidade superficial de um cimento de ionômero de vidro nanoparticulado

To compare the abrasion wear resistance and superficial roughness of different glass ionomer cements used as restorative materials, focusing on a new nanoparticulate material. Material and Method: Three glass ionomer cements were evaluated: Ketac Molar, Ketac N100 and Vitremer (3M ESPE, St. Paul, MN, USA), as well as the Filtek Z350 (3M ESPE, St. Paul, MN, USA). For each material were fabricated circular specimens (n=12), respecting the handling mode specified by the manufacturer, which were polished with sandpaper disks of decreasing grit. The wear was determined by the amount of mass (M) lost after brushing (10,000 cycles) and the roughness (Ra) using a surface roughness tester. The difference between the Minitial and Mfinal (ΔM) as well as beroughness of aesthetic restorative materials: an in vitro comparison. SADJ. 2001; 56(7): 316-20. 11. Yip HK, Peng D, Smales RJ. Effects of APF gel on the physical structure of compomers and glass ionomer cements. Oper. Dent. 2001; 26(3): 231-8. 12. Ma T, Johnson GH, Gordon GE. Effects of chemical disinfectants on the surface characteristics and color of denture resins. J Prosthet Dent 1997; 77(2): 197-204. 13. International organization for standardization. Technical specification 14569-1. Dental Materials – guidance on testing of wear resistance – PART I: wear by tooth brushing. Switzerland: ISO; 1999. 14. Bollen CML, Lambrechts P, Quirynen M. Comparison of surface roughness of oral hard materials to the threshold surface roughness for bacterial plaque retention: a review of the literature. Dent Mater.1997; 13(4): 258-9. 15. Kielbassa AM, Gillmann C, Zantner H, Meyer-Lueckel H, Hellwig E, Schulte-Mönting J. Profilometric and microradiographic studies on the effects of toothpaste and acidic gel abrasivity on sound and demineralized bovine dental enamel. Caries Res. 2005; 39(5): 380-6. 16. Tanoue N, Matsumara H, Atsuta M. Wear and surface roughness of current prosthetic composites after toothbrush/dentifrice abrasion. J Prosthet Dent. 2000; 84(1): 93-7. 17. Heath JR, Wilson HJ. Abrasion of restorative materials by toothpaste. J Oral Rehabil. 1976; 3(2): 121-38. 18. Frazier KB, Rueggeberg FA, Mettenburg DJ. Comparasion of wearresistance of class V restorative materials. J Esthet Dent. 1998; 10(6): 309-14. 19. Momoi Y, Hirosakil K, Kohmol A, McCabe JF. In vitro toothebrushdentifrrice abrasion of resin-modified glass ionomers. Dent Mater. 1997; 13(2): 82-8. 20. Turssi CP, Magalhães CS, Serra MC, Rodrigues Jr.AL. Surface roughness assessment of resin-based materials during brushing preceded by pHcycling simulations. Oper Dent. 2001; 26(6): 576-84. 21. Wang L, Cefaly DF, Dos Santos JL, Dos Santos JR, Lauris JR, Mondelli RF, et al. In vitro interactions between lactic acid solution and art glassionomer cements. J Appl Oral Sci. 2009; 17(4): 274-9. 22. Carvalho FG, Fucio SB, Paula AB, Correr GM, Sinhoreti MA, PuppinRontani RM. Child toothbrush abrasion effect on ionomeric materials. J Dent Child (Chic). 2008; 75(2): 112-6. 23. Coutinho E, Cardoso MV, De Munck J, Neves AA, Van Landuyt KL, Poitevin A, et al. Bonding effectiveness and interfacial characterization of a nano-filled resin-modified glass-ionomer. Dent Mater. 2009; 25(11): 1347-57. tween Rainitial and Rafinal (ΔRa) were also used for statistical analysis (α=0.05). Results: Except for the composite, significant loss of mass was observed for all glass ionomer cements and the ΔM was comparable for all of them. Significant increase in roughness was observed only for Vitremer and Ketac N100. At the end of the brushing cycle, just Vitremer presented surface roughness greater than the composite resin. Conclusion: All glass ionomer cements showed significant weight loss after 10,000 cycles of brushing. However, only Vitremer showed an increase of roughness greater than the Z350 resin, while the nanoparticulate cement Ketac N100 showed a smooth surface comparable to the composite.

Semidirect restorations in multidisciplinary treatment: viable option for children and teenagerssemidirect restorations in multidisciplinary treatment: viable option for children and teenagers

Due to the esthetic necessity required nowadays, the multidisciplinar treatment became a fundamental step in the restoration success. When the patient exhibits dental agenesis of one or more elements, he can show difficulty in social interactions. The age of the patient is a limiting factor to esthetic procedures, however, it should be evaluated as a real indicative with each case. The utilization of semi-direct restorations is a viable option due the cost, esthetic and improvement of physical and mechanical properties. The purpose of this paper is to present a case detailing the confection and cementation of anterior semi-direct restorations aimed at an anatomic reestablishment associated with integrated treatment with periodontics and orthodontics.

Recovering Streptococcus mutans over restorations by the tray technique: a randomized clinical study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Abrasion resistance of direct and indirect resins as a function of a sealant veneer

Abrasive wear is one of the most common type of wear that not only affect teeth, as also dental restorations. Thus to investigate one of the etiological factors as tooth brushing procedure is clinical relevant in order to select the best material combination that may prevent damage of resin dental restoration's abrasion. This study evaluated the influence of tooth brushing on mass loss and surface roughness of direct Venus (Vs) and indirect Signum (Sg) resin composites, with and without a surface sealant, Fortify (F). Twenty-four specimens were prepared with each resin composite, using their proprietary curing units, according to manufacturer's instructions. All the specimens were polished and ultrasonically cleaned in distilled water for 5 minutes. Half of the specimens of each resin (n = 12) were covered with F (Vs F and Sg F ), except for the control (C) specimens (Vs C and Sg C ), which were not sealed. Mass loss (ML) as well as surface roughness (Ra ) was measured for all the specimens. Then, the specimens were subjected to toothbrush-dentifrice abrasion, using a testing machine for 67.000 brushing strokes, in an abrasive slurry. After brushing simulation, the specimens were removed from the holder, rinsed thoroughly and blot dried with soft absorbent paper. The abrasion of the material was quantitatively determined with final measurements of ML and surface roughness, using the method described above. ML data were analyzed by two-way analysis of variance (ANOVA) and the analysis indicated that resin composites were not statistically different; however, the specimens sealed with F showed higher ML. Ra mean values of the groups Vs F and Sg F significantly increased. Tooth brushing affects mainly the roughness of the direct and indirect resin composites veneered with a sealant.

Reabilitação de maxila atrófica com tecido ósseo homógeno e prótese fixa implantossuportada

The techniques of bone reconstruction for atrophic maxillae have been improved in order to promote bone tissue growth in both height and thickness. The grafts performed with use of autogenous bone is considered the gold standard by most researchers, for demonstrating osteogenic capacity and not to promote antigenic response. However, this type of grafting is not possible to get bone tissue in large quantity for extensive renovations. In recent years, alternatives have been researched to overcome the limitations of autogenous bone. Several alternatives have been investigated to supply the disadvantages of autogenous bone grafts. In such studies, allogeneic bone grafts which are obtained from individuals with different genetic load, but from the same species have been extensively used. They can be indicated in cases of arthrosplasty, surgical knee reconstruction, and large bone defects as well as in oral and maxillofacial reconstruction. Besides showing great applicability and biocompatibility, this type of bone is available in unlimited quantities. To rehabilitate atrophic maxillae an option that has been performed with high success rate is the reconstruction with bone graft followed by osseointegrated dental implants to rehabilitate the patient aesthetics and functionally. This paper aims to show the feasibility of allogenic bone as material for reconstruction of atrophic maxilla, and subsequent rehabilitation with metal ceramic fixed prosthesis implant and dental restoration with accompanying three years through literature review and clinical case report.

Comportamento biomecânico de estruturas multicamadas em restaurações protéticas

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

Avaliação da resistência de união de reparos em resinas compostas convencionais e bulkfill

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Conservative approach to restore the first molar with extensive destruction: a 30-month follow-up

The available options for restoring multiple surface cavities are: amalgam, composite resin, or indirect restorations. Adhesive system and intradentinal pin-retained composite resin restorations should have a similar performance to pin-retained amalgam, regarding resistance to support occlusal forces. Polymerization shrinkage is a major concern when performing direct posterior composite resin restorations and the incremental insertion technique can provide less stress and outstanding margin behavior. Intradentinal pins can potentially enhance composite resin's retention, while reducing gaps caused by polymerization shrinkage. This article reports a clinical case involving an extensive restoration on a posterior tooth with cusp loss that was successfully treated using an intradentinal pin and direct nano-hybrid composite resin restoration.

Funzionalizzazione della mandibola dopo ricostruzione con lembo libero rivascolarizzato di fibula "single strut". Al di là del deficit di verticalità.

Obiettivi: Valutare la modalità  più efficace per la riabilitazione funzionale del limbo libero di fibula "single strut", dopo ampie resezioni per patologia neoplastica maligna del cavo orale. Metodi: Da una casistica di 62 ricostruzioni microvascolari con limbo libero di fibula, 11 casi sono stati selezionati per essere riabilitati mediante protesi dentale a supporto implantare. 6 casi sono stati trattati senza ulteriori procedure chirurgiche ad eccezione dell'implantologia (gruppo 1), affrontando il deficit di verticalità  della fibula attraverso la protesi dentaria, mentre i restanti casi sono stati trattati con la distrazione osteogenetica (DO) della fibula prima della riabilitazione protesica (gruppo 2). Il deficit di verticalità  fibula/mandibola è stato misurato. I criteri di valutazione utilizzati includono la misurazione clinica e radiografica del livello osseo e dei tessuti molli peri-implantari, ed il livello di soddisfazione del paziente attraverso un questionario appositamente redatto. Risultati: Tutte le riabilitazioni protesiche sono costituite da protesi dentali avvitate su impianti. L'età  media è di 52 anni, il rapporto uomini/donne è di 6/5. Il numero medio di impianti inseriti nelle fibule è di 5. Il periodo massimo di follow-up dopo il carico masticatorio è stato di 30 mesi per il gruppo 1 e di 38.5 mesi (17-81) di media per il gruppo 2. Non abbiamo riportato complicazioni chirurgiche. Nessun impianto è stato rimosso dai pazienti del gruppo 1, la perdita media di osso peri-implantare registrata è stata di 1,5 mm. Nel gruppo 2 sono stati riportati un caso di tipping linguale del vettore di distrazione durante la fase di consolidazione e un caso di frattura della corticale basale in assenza di formazione di nuovo osso. L'incremento medio di osso in verticalità è stato di 13,6 mm (12-15). 4 impianti su 32 (12.5%) sono andati persi dopo il periodo di follow-up. Il riassorbimento medio peri-implantare, è stato di 2,5 mm. Conclusioni: Le soluzioni più utilizzate per superare il deficit di verticalità  del limbo libero di fibula consistono nell'allestimento del lembo libero di cresta iliaca, nel posizionare la fibula in posizione ideale da un punto di vista protesico a discapito del profilo osseo basale, l'utilizzo del lembo di fibula nella versione descritta come "double barrel", nella distrazione osteogenetica della fibula. La nostra esperienza concerne il lembo libero di fibula che nella patologia neoplastica maligna utilizziamo nella versione "single strut", per mantenere disponibili tutte le potenzialità  di lunghezza del peduncolo vascolare, senza necessità  di innesti di vena. Entrambe le soluzioni, la protesi dentale ortopedica e la distrazione osteogenetica seguita da protesi, entrambe avvitate su impianti, costituiscono soluzioni soddisfacenti per la riabilitazione funzionale della fibula al di là  del suo deficit di verticalità . La prima soluzione ha preso spunto dall'osservazione dei buoni risultati della protesi dentale su impianti corti, avendo un paragonabile rapporto corona/radice, la DO applicata alla fibula, sebbene sia risultata una metodica con un numero di complicazioni più elevato ed un maggior livello di riassorbimento di osso peri-implantare, costituisce in ogni caso una valida opzione riabilitativa, specialmente in caso di notevole discrepanza mandibulo/fibulare. Decisiva è la scelta del percorso terapeutico dopo una accurata valutazione di ogni singolo caso. Vengono illustrati i criteri di selezione provenienti dalla nostra esperienza.

Zirconia in dentistry

The above factors emphasize the scope of this thesis for further investigations on zirconia, the improvement of all-ceramic zirconia restorations, and especially the interaction of zirconia and veneering and its influence on the performance of the whole restoration. The introduction, chapter 1, gave a literature overview on zirconia ceramics. In chapter 2, the objective of the study was to evaluate the effect of abrading before and after sintering using alumina-based abrasives on the surface of yttria-tetragonal zirconia polycrystals. Particular attention was paid to the amount of surface stress–assisted phase transformation (tetragonal→monoclinic) and the presence of microcracks. Chapter 3 is based on the idea that the conventional sintering techniques for zirconia based materials, which are commonly used in dental reconstruction, may not provide a uniform heating, with consequent generation of microstructural flaws in the final component. As a consequence of the sintering system, using microwave heating, may represent a viable alternative. The purpose of the study was to compare the dimensional variations and physical and microstructural characteristics of commercial zirconia (Y-TZP), used as a dental restoration material, sintered in conventional and microwave furnaces. Chapter 4 described the effect of sandblasting before and after sintering on the surface roughness of zirconia and the microtensile bond strength of a pressable veneering ceramic to zirconia.

Changes in the volume and density of calvarial split bone grafts after alveolar ridge augmentation

OBJECTIVES: One main problem occurring after bone grafting is resorption, leading to insufficient bone volume and quality, and may subsequently cause dental implant failure. Comparison of graft volume and bone density of iliac crest and calvarial transplants determined by animal studies demonstrates significantly lower resorption of bone grafts harvested from the skull. This paper is the first clinical study evaluating bone volume and density changes of calvarial split bone grafts after alveolar ridge reconstruction. MATERIAL AND METHODS: Bone volume and density were determined using CT scans and the software program Dicom Works in a total of 51 calvarial grafts after alveolar ridge augmentation in 15 patients. CT scans were taken in all 15 patients immediately after grafting (T0) and before implantation after a postoperative period of 6 months (T1). In five patients (26 calvarial grafts), a 1-year follow-up was performed (T2). RESULTS: A mean volume reduction of 16.2% at T1 (15 patients) and 19.2% at T2 (five patients) was observed. Bone density was high--about 1000 Hounsfield units--and did not change during the 1-year period. At the time of implantation, 41 transplants were classified as quality 1 bone and 10 as quality 2-3 bone. Grafting area and the technique used for grafting (inlay or onlay graft) did not affect the postoperative bone volume reduction. Generalized osteoporosis did not increase the resorption rate of calvarial transplants. CONCLUSION: Based on these findings, calvarial split bone grafts are a promising alternative for alveolar ridge reconstruction in dental implantology.

Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes

Objectives: This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step-stress accelerated life-testing (SSALT) in water. Materials and methods: Eighty four dental implants (3.3 × 10 mm) were divided into four groups (n = 21) according to implant macrogeometric design at the crestal region and crown fixation method: Microthreads Screwed (MS); Smooth Screwed (SS); Microthreads Cemented (MC), and Smooth Cemented (SC). The abutments were torqued to the implants and standardized maxillary central incisor metallic crowns were cemented (MC, SC) or screwed (MS, SS) and subjected to SSALT in water. The probability of failure versus cycles (90% two-sided confidence intervals) was calculated and plotted using a power law relationship for damage accumulation. Reliability for a mission of 50,000 cycles at 150 N (90% 2-sided confidence intervals) was calculated. Differences between final failure loads during fatigue for each group were assessed by Kruskal-Wallis along with Benferroni's post hoc tests. Polarized-light and scanning electron microscopes were used for failure analyses. Results: The Beta (β) value (confidence interval range) derived from use level probability Weibull calculation of 1.30 (0.76-2.22), 1.17 (0.70-1.96), 1.12 (0.71-1.76), and 0.52 (0.30-0.89) for groups MC, SC, MS, and SS respectively, indicated that fatigue was an accelerating factor for all groups, except for SS. The calculated reliability was higher for SC (99%) compared to MC (87%). No difference was observed between screwed restorations (MS - 29%, SS - 43%). Failure involved abutment screw fracture for all groups. The cemented groups (MC, SC) presented more abutment and implant fractures. Significantly higher load to fracture values were observed for SC and MC relative to MS and SS (P < 0.001). Conclusion: Since reliability and strength to failure was higher for SC than for MC, our postulated null hypothesis was rejected. © 2012 John Wiley & Sons A/S.