O uso de drogas anticoagulantes e antiplaquetárias orais em pacientes cirúrgicos ambulatoriais: revisão de literatura

The oral anticoagulants (AOC) and platelet antiagregants are drugs used for the prevention of thromboembolic phenomena, such as pulmonary embolism in patients with atrial fribrilation heart valves, thrombosis and pulmonary embolism. For patients who are undergoing surgical procedures-dentistry were asked to discontinue the use of anticoagulants until the value of the INR remained = 2.0, that in order to avoid trans and hemorrhages in the postoperative period. However, the AOC can cause the formation of a clot, leading to obstruction of blood pathways. Thus, it became doubtful the medicine for surgery, in which local hemostatic measures would be sufficient to promote hemostasis. Thus, the objective of the review was to evaluate the risk of bleeding in patients AOC users that are subjected to surgical procedures, through a bibliographical survey carried out in relevant clinical studies published between 1990 and 2012, by the MedlinePubMed data. In this review of literature was concluded that the benefit of thromboembolism prevention overcomes the risk hemorrhage, therefore, it is recommended to keep the dose of anticoagulant therapy unchanged for patients undergoing oral surgery and implant dentistry, using appropriate INR levels with the assistance of local hemostatic. In addition, a refined surgical technique should be performed in these patients. With respect to the most invasive oral surgery, with a risk of bleeding, treatment may be necessary in conjunction with the medical staff.

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.

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.

Plástica gengival associada à laminados cerâmicos para resolução estética

Sometimes we face clinical situations in which the lack of harmony in the smile is caused by a major exhibition of the gingival tissue. In these cases the professional should be able to perform a detailed analysis of the static and dynamic components of the smile, in search of a satisfactory planning and treatment which may include different dental specialties. For these situations, the association of periodontics/prosthesis is a viable alternative that has been used positively in search of an aesthetic and functional condition that benefits the patient, without leaving aside the preservation of periodontal tissues and of the remaining structure of the tooth. Thus, the aim of this study was to describe a case in which the association between these two areas was proposed to correct gummy smile and dental vestibularization. Clinical results and the satisfaction of the patient indicate that this multidisciplinary treatment combining periodontal and prosthetic techniques is favorable to positive results in cases of compromised smile aesthetics due to excessive gum tissue.

Reabilitação estética com enfoque nas diferentes cores de substratos e na escolha da cor do cimento adesivo

The evolution of techniques and materials applied to adhesive ceramic restorations resulted in the intensification of its use, proving to be an excellent method of aesthetic restoration. Some important features of this technique are its conservative preparation, which avoids an excessive loss of tooth structure and its high aesthetic value provided by the ceramic even when utilized under different color of dental substrates. The aim of this paper was to report a clinical case with full crowns, porcelain veneers and non-prep veneers, enhancing peculiarities related to the material used, tooth preparation techniques, cementing, indications and contraindications.

Corrosion resistance of Ni-Cr alloys in different mouthwashes

Several alloys have been used for prosthodontics restorations in the last years. These alloys have a number of metals that include gold, palladium, silver, nickel, cobalt, chromium and titanium and they are used in oral cavity undergo several corrosion. Corrosion can lead to poor esthetics, compromise of physical properties, or increased biological irritation. The objective of this study was evaluated corrosion resistance of two alloys Ni-Cr and Ni-Cr-Ti in three types of mouthwashes with different active ingredients: 0.5g/l cetylpyridinium chloride + 0.05% sodium fluoride, 0.05% sodium fluoride + 0.03% triclosan (with fluor) and 0.12% chlorohexidine digluconate. The potentiodynamic curves were performed by means of an EG&G PAR 283 potentiostat/galvanostat. The counter electrode was a platinum wire and reference electrode was an Ag/AgCl, KCl saturated. Before each experiment, working electrodes were mechanically polished with 600 and 1200 grade papers, rinsed with distilled water and dried in air. All experiments were carried out at 37.0oC in conventional three-compartment double wall glass cell containing mouthwashes. The microstructures of two alloys were observed in optical microscopy. Analysis of curves showed that Ni-Cr alloy was less reactive in the presence of 0.12% chlorohexidine digluconate while Ni-Cr-Ti alloy was more sensitive for others two types of mouthwashes (0.5g/l cetylpyridinium chloride + 0.05% sodium fluoride  and 0.05% sodium fluoride + 0.03% triclosan). This occurred probably due presence of titanium in this alloy. Microstructural analysis reveals the presence of dendritic and eutectic microstructures for NiCr and Ni-Cr-Ti, respectively.