Clinical evaluation of multisurface ART restorations

O objetivo deste estudo foi avaliar o comportamento de dois cimentos de ionômero de vidro: um de alta viscosidade (Ketac Molar - ESPE) e um modificado por resina (Fuji VIII – GC) em restaurações envolvendo duas ou mais superfícies dentárias, confeccionadas pela técnica do Tratamento Restaurador Atraumático. Sessenta restaurações (30 com cada material) foram inseridas em estudantes (9-16 anos) por dois operadores. Após 6 meses, dois examinadores independentes avaliaram as restaurações de acordo com os critérios utilizados em trabalhos prévios semelhantes. Os dados foram analisados pelos testes de McNemar e Fischer. A porcentagem de sucesso do tratamento foi de 98,3%. Uma restauração (Ketac Molar) foi substituída por outro material e classificada como falha. As porcentagens de sucesso das restaurações foram de 100% e 96,6% para o Fuji VIII e Ketac Molar, respectivamente. Não houve diferença estatisticamente significante no sucesso das restaurações entre o baseline e 6 meses (p>0,05). Da mesma forma, não houve diferença estatística entre os materiais, tipos de cavidade ou entre operadores.(p>0,05). A técnica ART foi altamente apropriada e efetiva em restaurações envolvendo duas ou mais superfícies, após 6 meses. Os resultados mostraram um comportamento promissor com ambos os materiais.

Sobrevivênvia e sucesso de implantes osseointegrados com superfície tratada por ataque ácido: avaliação retrospectiva de 8 a 10 anos

Pós-graduação em Odontologia - FOAR

Subluxação atlantoaxial canina

The atlantoaxial subluxation or luxation is an instability of this articulation that produces excessive flexion of this joint causing the cranial aspect of the axis to rotate dorsally into the vertebral channel with subsequent spinal cord compression. This disorder is most commonly found in young small breed dogs. The diagnosis of this disease is done by survey radiographs, where there is a larger distance between the atlas dorsal arch and the axis spinal process characterize the atlantoaxial subluxation. Surgical stabilization is the treatment of choice and multiple implants show the best results to stabilize the atlantoaxial joint. The main complications are sudden death or implant failure. The sudden death happens because of cardiorespiratory arrest and it is most likely caused by brainstem iatrogenic trauma. However, a larger study comparing different surgical stabilization techniques should be performed to evaluate relative success rates in dogs that have the same initial neurologic status

Implantes curtos em região posterior da mandíbula

The rehabilitation of edentulous areas with osseointegrated dental implants is a well-documented, predictable procedure in the literature, with high success rates. However, the lack of bone at the recipient bed or proximity to anatomic structures limits the rehabilitation procedure especially at the posterior mandible. Thus, short implants are an alternative treatment for such cases of severe bone resorption. The purpose of this study was to review the success rate of short implants, especially those based in the posterior mandible and to show a clinical case. A literature review was made on electronic databases PubMed and Bireme with articles published between the years 2005 to 2012, using the keywords "short dental implants". It was concluded that the success rates of short implants are similar to those presented by conventional implants but still related to their geometry and surface treatment. Also, short implants can be considered as a viable alternative for the rehabilitation of severely resorbed jaws. However, many authors consider that more research is necessary when a short implant is compared to a long dental implant.

Implantes dentais em pacientes com diabetes mellitus

Dental implants represent a great improvement in Dentistry in respect to rehabilitation of edentulous ridges due to the functional and aesthetic reestablishment with long-term predictability and success. However, the effectiveness of this treatment relies on successful osseointegration during the healing period. In this way, the applicability of dental implants in patients with diabetes mellitus (DM) remains controversial, by the fact that the hyperglycemic status presents a negative effect on the osseointegration. It is not clear yet if the therapy with dental implants is an absolute contraindication to these patients. For this reason, the aim of the present study is to review the literature about the treatment with dental implants in patients with diabetes and to propose a protocol to perform dental implants in patients with diabetes. Diabetes has been considered a relative contraindication to dental implants, as the patients with adequate metabolic control can be treated with this kind of therapy, because inadequate metabolic control can lead to the failure of the treatment. Besides, there are risk factors for the diabetic implant patient that may decrease the success rates of dental implants therapy. In this way, the dentist should understand all the relevant implications before considering the indication of dental implants to patients with diabetes. It is important to have more controlled studies to evaluate the effects of diabetes on the implant-tissue interface and further investigations are necessary in order to elucidate the role of insulin and molecular mechanisms that might interfere on the osseointegration in patients with diabetes.

Protocolo mandibular com implantes curtos

Jaws atrophy represents a great challenge to Implantology regarding rehabilitation of edentulous areas. This paper reports an extreme mandibular atrophy with only 9mm of height between the mental foramina. In these situations, treatment options include bone augmentation techniques, transmandibular, or short dental implants. It is well accepted that bone grafts to improve height do not have good predictability. Besides, osteogenic distraction is associated with a great patient discomfort and transmandibular implants are related with high failure rates. Also, surgical-prosthetic rehabilitations with short dental implants had been associated to good success rates. The purpose of this clinical case is to report a severe mandibular atrophy, successfully treated with four short dental implants between mental foramina for implant-supported prosthesis.

Predictability of short dental implants: a literature review

Introduction: In clinical situations where severe bone resorption has occurred following tooth loss, implant treatment options may comprise either a previous bone reconstruction or only the use of short implants. Objective: This non-systematic review summarizes and discusses some aspects of the use of short implants, such as: biomechanical aspects, success rate, longevity and surgical-prosthetic planning. Literature review: Current and relevant references were selected in order to compare short dental implants to conventional ones. Several studies have highlighted the great importance of wide-diameter implants. Dental short implants have shown high predictability and success rates when some biomechanical aspects are taken into consideration. Conclusion: Placement of short dental implants is a viable treatment method for patients with decreased bone height.

Is the internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? A systematic review

This systematic review aimed to evaluate if the internal connection is more efficient than the external connection and its associated influencing factors. A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Is internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? An electronic search of the MEDLINE and the Web of Knowledge databases was performed for relevant studies published in English up to November 2013 by two independent reviewers. The keywords used in the search included a combination of dental implant and internal connection or Morse connection or external connection. Selected studies were randomized clinical trials, prospective or retrospective studies, and in vitro studies with a clear aim of investigating the internal and/or external implant connection use. From an initial screening yield of 674 articles, 64 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full texts of these articles were obtained with 29 articles fulfilling the inclusion criteria. Morse taper connection has the best sealing ability. Concerning crestal bone loss, internal connections presented better results than external connections. The limitation of the present study was the absence of randomized clinical trials that investigated if the internal connection was more efficient than the external connection. The external and internal connections have different mechanical, biological, and esthetical characteristics. Besides all systems that show proper success rates and effectiveness, crestal bone level maintenance is more important around internal connections than external connections. The Morse taper connection seems to be more efficient concerning biological aspects, allowing lower bacterial leakage and bone loss in single implants, including aesthetic regions. Additionally, this connection type can be successfully indicated for fixed partial prostheses and overdenture planning, since it exhibits high mechanical stability.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Avaliação longitudinal de duas técnicas de sinus lift

The implant has high success rates and predictability in this decade. However, bone availability is a factor that may limit the installation technique of dental implants in subsequent rehabilitation of the maxillary arch has been proposed technique’s maxillary sinus lifting when it presents itself pneumatized, for installation of dental implants The aim of this paper is to present two clinical cases using the surgical technique and rehabilitation to the patient with surgery maxillary sinus lifting with the use of a biomaterial alone or in combination with autogenous bone and the prosthetic resolution radiographic and clinical follow-up of three years.

Implantes pós-exodônticos: relato de caso

With the search for treatments faster and aesthetic improvement of materials and surgical techniques, immediate implants have become a clinical reality increasingly practiced. Thus, based on literature the specific purpose of this study was to address critically the concepts of immediate implants, discussing issues related to dental extraction, milling technique, care of the periodontal tissues support and protection, prosthetic replacement, benefits, indications and contraindications. To this end, from Pubmed electronic crawler Medline, 54 articles published between 1990 and 2009, over 4 items classics, all in English were selected. The Studies have shown success rates for this technique Conventional techniques like two-stage surgery, many different techniques and planning are present among these techniques, and implants more immediate subject to failures.

Estudo retrospectivo de implantes osseointegrados instalados imediatamente após exodontias

Objectives: to evaluate implant survival immediately placed after tooth extraction considering different sites, prosthodontic modalities, and the need for biomaterials. Material and methods: dental records of 500 patients treated with dental implants between 2004 and 2011 were screened. Results: only 200 records (20%) corresponded to immediate implants. Reasons for tooth extraction included extensive caries, bone loss, and root fractures. From the 197 immediate dental implants, 86 were placed in the maxilla with a survival rate of 93.9% and 111 in the mandible (survival rate of 99.1%). The overall survival rate was 97.46%. Prosthodontic modalities identified were: Brånemark classic complete denture screwed prostheses (36%), overdentures (5.6%), fixed partial denture (31%), and single-tooth prostheses (27.4%). Also, it was observed that in 33% of cases there was a need for the use of grafts and/or biomaterials. Conclusion: it can be concluded that, when correctly indicated, immediate implants are an excellent choice. The anterior mandibular region, screwed and overdenture-type prostheses presented higher success rates when associated to immediate implant placement. The need for bone graft/biomaterial does not affect the clinical results.

Avaliação do índice de sucesso dos enxertos autógenos e dos implantes instalados em região de seio maxilar

Maxillary sinus lifting surgery is considered an excellent option for patient rehabilitation in cases of maxillary sinus pneumatization. This longitudinal study was performed in 41 patients to evaluate 51 maxillary sinus lifting procedures concomitant to autogenous bone grafted from mandibular ramus. Of the 107 implants installed, 28 were immediate fixations. Success index achieved regarding to bone graft was of 98.04%. The implants installed immediately or after bone grafting resulted in success rates of 92.86% and 94.59% respectively, with no statistically significant differences between them. Surgeries for bone grafting and immediate installation are considered a reliable treatment alternative provided that both anatomical structures and tissue physiology are kept in good conditions, with appropriate indication and techniques for good implant stability.

Influência da inalação da fumaça de cigarro na regeneração óssea guiada em enxertos autógenos onlay em ratas com deficiência estrogênica: estudo histomorfométrico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Improving Students’ Story Problem Solving Abilities

In this action research study of my classroom of 8th grade mathematics students, I investigated if learning different problem solving strategies helped students successfully solve problems. I also investigated if students’ knowledge of the topics involved in story problems had an impact on students’ success rates. I discovered that students were more successful after learning different problem solving strategies and when given problems with which they have experience. I also discovered that students put forth a greater effort when they approach the story problem like a game, instead of just being another math problem that they have to solve. An unexpected result was that the students’ degree of effort had a major impact on their success rate. As a result of this research, I plan to continue to focus on problem solving strategies in my classes. I also plan to improve my methods on getting students’ full effort in class.