Caracterização Microestrutural e Tribocorrosiva de Sistemas Metalocerâmicos Odontológicos do Tipo Ni-Cr/Porcelana E Ni-Cr/Ti/Porcelana

The partial fixed prosthodontics restoration is used to rehabilitate form and function of partial or total compromised teeth, having to remain permanently joined to remainder tooth. The most useful material on prosthodontics is the feldspar porcelain, commercialized as aluminosilicate powders. Dental porcelains are presented with limited mechanical properties to rehabilitate extensive spaces. The association with Ni-Cr metallic systems (metal-ceramic system) allows that the metallic substructure compensates the fragile porcelain nature, preserving the thermal insulation and aesthetics desirable, as well as reducing the possibility of cracking during matication efforts. Cohesive flaws by low mechanical strength connect the metallic substructure to the oral environment, characterized by a electrolytic solution (saliva), by aggressive temperature, pH cyclic changes and mechanical requests. This process results on ionic liberation that could promote allergic or inflammatory responses, and/or clinical degradation of ceramometal system. The aim of this study was to evaluate the presence of an intermediate titanium layer on the microscopic fracture behavior of porcelains on ceramometal systems. Plasma deposition of titanium films result in regular passivating oxide layers which act as barriers to protect the metallic substrate against the hazardous effects of corrosive saliva. Tribocorrosion tests were performed to simulate the oral environment and mechanical stress, making it possible the early detection of crack formation and growth on metal-ceramic systems, which estimate the adherence between the compounds of this system. Plain samples consisting of dental feldspar porcelain deposited either onto metallic substrates or titanium films were fired and characterized by scanning electron microscopy. The result showed that the titanium film improved the adherence of the system compared to conventional metal-ceramic interfaces, thus holding crack propagation

Estudo de pré-formulação para dose fixa combinada dos tuberculostáticos rifampicina, isoniazida, pirazinamida e etambutol (4 em 1)

According to the global framework regarding new cases of tuberculosis, Brazil appears at the 18th place. Thus, the Ministry of Health has defined this disease as a priority in the governmental policies. As a consequence, studies concerning treatment and prevention have increased. Fixed-dose combination formulations (FDC) are recognized as beneficial and are recommended by WHO, but they present instability and loss on rifampicin bioavailability. The main purpose of this work was to carry out a pre-formulation study with the schedule 1 tuberculosis treatment drugs: rifampicin, isoniazid, pyrazinamide and ethambutol and pharmaceutical excipients (lactose, cellulose, magnesium stearate and talc), in order to develop an FDC product (150 mg of rifampicin + 75 mg of isoniazid + 400 mg of pyrazinamide + 250 mg of ethambutol). The studies consisted of the determination of particle size and distribution (Ferret s diameter) and shape through optical microscopy, as well as rheological and technological properties (bulk and tapped densities, Hausner Factor, Carr s Index, repose angle and flux rate) and interactions among drugs and drug excipient through thermal analysis (DSC, DTA, TG and your derivate). The results showed that, except isoniazid, the other drugs presented poor rheological properties, determined by the physical characteristics of the particles: small size and rod like particles shape for rifampicin; rectangular shape for pyrazinamide and ethambutol, beyond its low density. The 4 drug mixture also not presented flowability, particularly that one containing drug quantity indicated for the formulation of FDC products. In this mixture, isoniazid, that has the best flowability, was added in a lower concentration. The addition of microcrystalline cellulose, magnesium stearate and talc to the drug mixtures improved flowability properties. In DSC analysis probable interactions among drugs were found, supporting the hypothesis of ethambutol and pyrazinamide catalysis of the rifampicin-isoniazid reaction resulting in 3- formylrifamycin isonicotinyl hydrazone (HYD) as a degradation product. In the mixtures containing lactose Supertab® DSC curves evidenced incompatibility among drugs and excipient. In the DSC curves of mixtures containing cellulose MC101®, magnesium stearate and talc, no alterations were observed comparing to the drug profiles. The TG/DTG of the binary and ternary mixtures curves showed different thermogravimetrics profiles relating that observed to the drug isolated, with the thermal decomposition early supporting the evidences of incompatibilities showed in the DSC and DTA curves

Avaliação clínica e comparativa da oclusão balanceada bilateral e desoclusão com guia canino sobre a função mastigatória de usuários de prótese total removível

The maintenance of masticatory function is especially important for patients who wear complete dentures due to the limitations of this type of prosthesis. Thus, the bilateral balanced occlusion (BBO) is used to achieve, besides other advantages, greater masticatory efficiency. However, analyzing critically the literature, it is observed that there is not enough scientific evidence that support the BBO as the most appropriate occlusal concept in complete dentures. This way, the purpose of the present study was to verify if complete dentures wearers with BBO present better masticatory efficiency and capacity than those with canine guidance (CG). A double-blind controlled crossover clinical trial was conducted. The sample was made of 24 completely edentulous patients. The subjects wore sets of complete dentures with both occlusal concepts for equal periods of 3 months. Objective data were collected through the masticatory efficiency test, performed by the colorimetric method, in which capsules of a synthetic material enclosing fuchsine- containing granules were used. Subjective data were recorded by patient´s ratings of their chewing function, which is the masticatory ability. No significant statistical difference was found for masticatory efficiency (p=0,0952) and masticatory ability (x2=0,5711/ p=0,4498) between the two occlusal concepts studied, as well as there was no correlation between these two variables (p=0,2985). Based on these results, it seems reasonable to use CG for the setup of complete dentures, since it is an easier and quicker technical procedure, until that future researches can come to complement this question

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

Análise comparativa na influência da técnica de moldagem funcional em arcos parcialmente edêntulos sobre os pontos de contato oclusais, a integridade da fibromucosa e a extensão da base da prótese

There is a lack of clinical studies evaluating techniques of functional impression for partially edentulous arches. The aim of this double-blind non-randomized controlled clinical trial was to compare the efficacy of altered cast impression (ACI) and direct functional impression (DFI) techniques. The efficacy was evaluated regarding the number of occlusal units on denture teeth, mucosa integrity at 24-hour follow-up and denture base extension. The sample included 51 patients (female and male) with mean age of 58.96 years treated at Dental Department of UFRN. The patients, exhibiting edentulous maxilla and mandibular Kennedy class I, were divided into two groups (group ACI, n=29; group DFI, n=22). Clinical evaluation was based on the number of occlusal units on natural and/or artificial teeth, mucosa integrity at 24-hour follow-up, and denture base extension. Statistical analysis was conducted using the software SPSS 17.0® (SPSS Inc., Chicago, Illinois). Student T-test was used to reveal association between number of occlusal units and impression technique while chi-square test showed association between mucosa integrity and impression technique. Fischer s exact test was applied for association between denture base extension and impression technique at 95% level of significance. No significant difference was observed between the groups regarding number of occlusal units, mucosa integrity and denture base extension. The altered cast technique did not provide significant improvement in comparison to the direct technique when the number of occlusal units, mucosa integrity and denture base extension

Falhas e complicações com o uso de prótese parcial removível inferior de extremidade livre bilateral

Aim: To determine the frequency and type of complications related to removable partial denture (RPD) less, Kennedy Class I, over time . Materials and Methods: This observational study consisted of a sample of 65 users PPR lower arches in Kennedy Class I and dentures, rehabilitated in the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). Patients were followed through periodic controls during periods of 60 days, 6 months and 1 year from installation. After the first year of control had other returns annually. The occurrence of complications or prosthetic failure was observed and recorded in a specific clinical record over 39 months. The patterns of failures observed were classified in the following situations: occurrence of traumatic ulcers after 2 months of installation, lack of retention, fracture or caries in the rest, fracture or dislocation of the artificial teeth, the larger connector fracture, fracture clip fracture support, poor support (need to reline the denture) and prosthesis fracture. Results: The incidence of complications was low frequency, being higher in the second year of use of the prosthesis. Among the complications that occurred more is the loss of retention (31.57%). Failures more severe and difficult to solve as the fracture elements of the metal structure of the PPR had low occurrence and were represented by only one case of the larger connector (5.3%) fractures. Conclusion: Removable partial dentures mandibular free end opposing of the conventional dentures have a low complication rate after 39 months of use when subjected to periodic controls

Passividade na interface prótese/pilar intermediário de infraestrutura implantossuportadas confeccionadas pela tecnologia CAD/CAM e método convencional

The objective of this research was to evaluate the passivity and strain induced in infrastructures screwed on abutments, made by CAD/CAM technology, and to compare these samples with parts manufactured by conventional casting. Using CAD/CAM technology, 4 samples were made from zirconia (Zircad) and 4 samples were manufactured from cobaltchrome (CoCrcad). The control groups were 4 specimens of cobalt-chrome, made by onepiece casting (CoCrci), for a total of 12 infrastructures. To evaluate the passivity, the infraestructures were installed on the abutments. One end was tightened and the vertical gap between the infrastructure and the prosthetic abutment was measured with scanning electron microscopy (250×). The mean strain in these infrastructures was analyzed via the photoelasticity test. A significant difference (p = 0.000) in passivity was observed between the control (CoCrci) and sample groups (CoCrcad and CoCrci). CoCrcad exhibited the best value of passivity (48.76 ± 13.45 μm) and CoCrci the worst (187.55 ± 103.63 μm), Zircad presented an intermediate value (103.81 ± 43.15 μm). When compared to the other groups, CoCrci showed the highest mean strain around the implants (17.19 ± 7.22 kPa). It was concluded that the zirconia infrastructure made by CAD / CAM showed a higher vertical marginal misfit than those made in cobalt-chromium alloy with the same methodology, however, the tension generated in the implants was similar. The CAD/CAM technology is more accurate for passivity and mean strain of infrastructure screwed on abutments than conventional manufacturing techniques

Emprego de prótese intra-ocular de resina acrílica. Estudo experimental em ratos

Foram eviscerados os globos oculares esquerdos de 32 ratos, linhagem Wistar, divididos em quatro grupos (A, B, C, D) constituídos, cada um, de cinco testemunhas e três controles. Nos animais-testemunha introduziu-se, dentro da capa córneo-escleral, uma esfera de resina acrílica (metilmetacrilato), previamente confeccionada e esterilizada por autoclavagem, ao passo que nos controles a cavidade eviscerada foi mantida sem prótese. Os ratos dos grupos A, B, C e D foram sacrificados respectivamente aos 7, 15, 30 e 90 dias de pós-operatório, quando os conteúdos orbitários esquerdos foram exenterados e preparados para o exame histopatológico. Observou-se que os animais-testemunha tiveram resposta inflamatória do tipo tecido de granulação ao redor da prótese de cavidade, com edema inflamatório da córnea especialmente nos grupos A e B, quando se iniciou a regressão da inflamação aguda. A cavidade orbitária manteve o tamanho em todos os grupos nos animais-testemunha e houve contração significativa nos animais-controle. Com estas observações, foi possível concluir que a esfera de resina acrílica é uma opção, de baixo custo e fácil confecção, para correção de defeito estético causado pela perda do globo ocular.

Avaliação quantitativa das dimensões óculo-palpebrais em portadores de cavidade anoftálmica em uso de prótese ocular externa

OBJETIVOS: Avaliar o posicionamento palpebral em portadores de cavidade anoftálmica com e sem prótese ocular externa, utilizando o processamento de imagem digital. MÉTODOS: Dezoito pacientes foram avaliados qualitativa e quantitativamente na Faculdade de Medicina de Botucatu - Universidade Estadual Paulista - UNESP, com e sem a prótese externa. Usando imagens obtidas por filmadora e processadas usando o programa Scion Image, mediu-se a altura do sulco palpebral superior, a altura da fenda palpebral e os ângulos palpebrais dos cantos interno e externo. RESULTADOS: Pseudo-estrabismo e sulco palpebral superior profundo foram as alterações mais freqüentes ao exame externo. Houve diferença significativa em todas as variáveis estudadas, com diminuição da altura do sulco palpebral superior, aumento da área da fenda palpebral e aumento dos ângulos palpebrais interno e externo quando o paciente estava usando a prótese externa. CONCLUSÃO: Todos os pacientes avaliados apresentaram algum tipo de anormalidade órbito-palpebral, o que reflete a dificuldade em se proporcionar ao portador de cavidade anoftálmica um aspecto idêntico ao que existe na órbita normal. O processamento de imagens digitais permitiu avaliação objetiva das dimensões óculo-palpebrais, o que poderá contribuir nas avaliações seqüenciais dos portadores de cavidade anoftálmica.

Estudo experimental do poliuretano de óleo de mamona (Ricinus communis) como substituto parcial do tendão calcâneo comum em coelhos (Oryctolagus cuniculus)

Com o objetivo de avaliar a eficiência da prótese de poliuretano de mamona como substituto parcial do tendão calcâneo comum, foram utilizadas 30 coelhas da raça Nova Zelândia, entre dois e três meses de idade e peso médio de 2kg. Após anestesia geral, o procedimento cirúrgico em ambos os membros constou de incisão caudo-lateral no sentido longitudinal do terço médio ao distal da tíbia e exposição do tendão calcâneo comum. Após a tenectomia do tendão do músculo gastrocnêmio, a prótese de poliuretano de cerca de 0,5cm de extensão por 0,5cm de diâmetro foi fixada aos cotos proximal e distal do tendão, empregando-se o fio de polipropileno monofilamentar 4-0, conforme técnica modificada de Kessler. A prótese de poliuretano na forma elastomérica revelou propriedades como textura e flexibilidade semelhantes à do tecido tendinoso, pode ser confeccionada na forma e no tamanho almejados e permite ser moldada, cortada e esterilizada por calor úmido. Todos os animais apoiaram os membros operados imediatamente após o retorno anestésico. Não se observaram sinais clínicos de infecção e não ocorreu deiscência de ferida. Percebeu-se aumento de volume local devido ao edema, evidente na primeira semana pós-cirúrgica, que gradualmente desapareceu . À palpação foi possível delimitar com facilidade a prótese que se conservou fixa no local e intacta. Clinicamente o poliuretano de mamona não induziu reação desfavorável que comprometesse a cicatrização tendínea, podendo ser indicado como substituto temporário de tendão.

Microestrutura e resistência à corrosão do Ti c.p. soldado a laser utilizando em prótese sobre implantes

Foram realizados estudos para avaliar a microestrutura, a dureza e a resistência à corrosão do titânio comercialmente puro-Ti c.p. soldado por laser e utilizado na confecção de prótese sobre implantes. Verificou-se que na soldagem a laser a microestrutura apresentou três regiões distintas: o cordão de solda, a zona afetada pelo calor - ZAC e o metal base. O Ti c.p. possui microestrutura granular, a microestrutura do cordão de solda é mais refinada e de maior dureza do que o metal base. A ZAC obtida por este processo de soldagem foi relativamente pequena quando comparada com o processo de soldagem por brasagem. Os ensaios eletroquímicos mostraram que a região da solda apresentou menor resistência à corrosão em meio de NaCl 0,15 molL-1 à temperatura ambiente.

Estudo microestrutural e resistência à corrosão de uma liga de Au soldada a laser, empregada em prótese sobre implantes

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

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .