Considerações clínicas em implantes imediatos

The biological principles of osseointegration caused the rehabilitation treatment with osseointegrated implant become a safe, well alternative accepted by the dental community for the high success rate, allowing the preparation of functional and aesthetic prostheses in edentulous and partial patients. We passed the initial phase of functional vision for an aesthetic approach, too, depending on the demands of the patient and the quest for excellence by professionals. Over these last years, implant treatment has undergone many changes in surgical and prosthetic protocols. The less invasive surgical techniques and the development of restorative materials, especially ceramics allow the prosthetic rehabilitation of high functional quality and aesthetics. The installation of implants in sockets immediately after extraction of teeth involved by fracture, periodontal disease, endodontic lesions, is part of the arsenal of techniques for rehabilitating a number of advantages that we get to the outcome of multidisciplinary treatment. For this, we must consider several criteria in its planning as a fundamental unit, adjacent teeth, multiple losses, system, form and number of implants, type of retention of the prosthesis components, the patient expectation of the outcome perspective, gingival biotype, standard of ridge resorption, the smile line, etc. occlusal analysis. With the three-dimensional placement of the implant can immediately join the biological processes of repair of the socket, implant osseointegration, speeding treatment time. Much has been made by companies in the surface treatment of endosseous implants to be osseointegration shortened and restorative procedures started earlier, bringing benefits to the patient and professional. Among the main advantages we can emphasize the preservation of the structures adjacent to the teeth replaced, minor resorption of bone tissue involved... (Complete abstract click electronic access below)

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.

Relação entre materiais dentários e o complexo dentino-pulpar

Despite the strong valorization of the esthetics and its relationship with restorative materials, the biological principles of any clinical procedure are extremely important to maintain the vitality of the dentin-pulp complex. Dentin and pulp tissue are susceptible to different kinds of irritants such as toxins from microorganisms, traumatic procedures of cavity preparation, as well as toxic components released by restorative materials applied in non recommended clinical situations. Initially, the pulp responds to irritation by starting an inflammatory reaction which involves outward movement of dentinal fluid and intratubular deposition of immunoglobulins, upregulation of odontoblast activities, presence of immune cells and their cytokines as well as local expression of neuropeptides and chemokines. After these initial events, the inflammation process can be resolved associated or not to sclerotic dentin formation and reactionary dentin deposition. If high intensity offensive stimuli are applied to the dentin-pulp complex, death of odontoblasts takes place and consequently pulp ageing or even partial necrosis of this tissue may occurs. Thereby, clinicians need to be aware about the physiological and pathological features of the dentin-pulp complex as well as the possible biological consequences of different clinical procedures. In this way, the dentists should be able to carry out minimally aggressive operative techniques and to select the more appropriate restorative materials for each specific clinical situation in order to obtain excellent clinical results associated to the maintenance of pulp vitality.

Incorporation of chlorhexidine gluconate or diacetate into a glass-ionomer cement: porosity, surface roughness, and anti-biofilm activity

To evaluate the porosity, surface roughness and anti-biofilm activity of a glass-ionomer cement (GIC) after incorporation of different concentrations of chlorhexidine (CHX) gluconate or diacetate. Methods: For the porosity and surface roughness tests, 10 test specimens were fabricated of the GIC Ketac Molar Easy Mix (KM) and divided into the following groups: Control, GIC and 0.5% CHX diacetate; GIC and 1.0% CHX diacetate; GIC and 2.0% CHX diacetate; GIC and 0.5% CHX gluconate; GIC and 1.0% CHX gluconate; GIC and 2.0% CHX gluconate. To evaluate porosity, the test specimens were fractured. The fragments were photographed by scanning electron microscopy (SEM), and the images analyzed with the aid of the software program Image J. The surface roughness (Ra) was obtained by the mean value of three readouts performed on the surface of each specimen, always through the center. To analyze the anti-biofilm activity, strains of S. mutans ATCC 35688 were used, and the groups control and GIC +CHX diacetate 1% were divided as follows: GIC (1 day); GIC (7 days), GIC (14 days), GIC (21 days); GIC+CHX (1 day), GIC+CHX (7 days), GIC+CHX (14 days), GIC+CHX (21 days); GIC+ CHX (1 day), GIC+ CHX (7 days), GIC+ CHX (14 days) and GIC+ CHX (21 days) using 10 test specimens per group. For biofilm growth, the specimens were placed in a vertical position in 24-well plates and incubated overnight 10 times. The culture medium was renewed every 24 hours. The suspension was diluted and seeded on BHI agar for quantification of the bacteria present. For evaluation of all the tests the two-way ANOVA was used, and if necessary, the Tukey test was applied, with a level of significance of 5%. Results: Regarding GIC porosity, the ANOVA showed that the presence of CHX increased the porosity (P< 0.001) proportionally to the increase in concentrations (P= 0.001), without however, presenting interaction between material and concentration (P= 0.705). Regarding the number of pores, a significant increase in pores was observed with the increase in CHX concentration (P= 0.003). The surface roughness test demonstrated no statistically significant effect as to increase or reduction in roughness at any of the CHX concentrations used (P> 0.05). Anti-biofilm activity analysis pointed out a significant effect of the factors material (P= 0.006) and time (P< 0.001), with CHX diacetate CHX presenting greater effectiveness in reducing microorganisms.

Efeito das dimensões dos corpos de prova na resistência à flexão de compósitos restauradores

The aim of this study was to evaluate the influence of specimen size, in comparison with the ISO Standard, on the three point flexural strength of resin composite restorative materials Filtek Supreme and Filtek Z-250. Forty specimens were fabricated for each material with the following length, width and thickness measurements (n = 10): 1) 20 × 2 × 2 mm (ISO 4049); 2) 10 × 2 × 1 mm; 3) 10 × 1 × 1 mm; 4) 8 × 0.8 × 0.8 mm. The composites were inserted in a single increment into two-piece metal device and light-polymerized. The specimens were dry stored at 37 ± 1 °C and protected from light for 7 days. After this period, flexural strength was measured by three-point flexure test using MTS 810 equipment, with a load cell of 10 kN at a speed of 0.5 mm/min. For the evaluated sizes, the results showed significant variability (p = 0.00) with values when compared with the ISO Standard (116.700 MPa), being statistically higher for the test specimens measuring 10 × 1 × 1 mm (142.530 MPa), similar for those of 10  ×  2  ×  1  mm (115.815 MPa) and lower for those of 8 × 0.8 × 0.8 mm (86.650 MPa). There was statistical equality (p = 0.08) for the studied composites (Filtek Supreme, 125.270 MPa; Filtek Z-250, 108.130 MPa). Specimens measuring 10 × 2 × 1 mm provided flexural strength values equivalent to those obtained in the sizes recommended by the ISO 4049 standard, with lower consumption of material, energy and time.

Planning and clinical strategy in direct composite restorations

Patients are seeking increasingly the expertise of dental surgeons for esthetic dental improvement. The dental surgeons should know the restorative materials and techniques in order to optimize the clinical practice and to obtain satisfactory results. Also the dentist should know the average heights and widths of the anterior teeth to detect the esthetic disharmony and to eliminate it for reproducing the correct dental anatomy. Thus, this study aimed to describe a clinical case report of direct restoration using the palatal barrier technique.

Coroas estéticas anteriores em cerâmica metal-free: relato de caso clínico

Society's change of parameters for health and aesthetics has resulted in an increased demand for dental treatments. Nowadays, ceramics systems have shown a substantial development, becoming more reliable and predictable. Dental ceramics, besides being chemically stable, present excellent optical properties when compared to dental structures, thus assuring a special position in the list of aesthetic restorative materials. OBJECTIVE, CASE REPORT AND CONCLUSION: This article describes a successful clinical procedure involving the anterior teeth aesthetics, which were restored with all-ceramic crowns (IPS e.max® Ivoclar Vivadent).

Fluorescence Level of Composites Assessed by Computer Processing of Digital Images - ScanWhite

The human dentition is naturally translucent, opalescent and fluorescent. Differences between the level of fluorescence of tooth structure and restorative materials may result in distinct metameric properties and consequently perceptible disparate esthetic behavior, which impairs the esthetic result of the restorations, frustrating both patients and staff. In this study, we evaluated the level of fluorescence of different composites (Durafill in tones A2 (Du), Charisma in tones A2 (Ch), Venus in tone A2 (Ve), Opallis enamel and dentin in tones A2 (OPD and OPE), Point 4 in tones A2 (P4), Z100 in tones A2 ( Z1), Z250 in tones A2 (Z2), Te-Econom in tones A2 (TE), Tetric Ceram in tones A2 (TC), Tetric Ceram N in tones A1, A2, A4 (TN1, TN2, TN4), Four seasons enamel and dentin in tones A2 (and 4SD 4SE), Empress Direct enamel and dentin in tones A2 (EDE and EDD) and Brilliant in tones A2 (Br)). Cylindrical specimens were prepared, coded and photographed in a standardized manner with a Canon EOS digital camera (400 ISO, 2.8 aperture and 1/ 30 speed), in a dark environment under the action of UV light (25 W). The images were analyzed with the software ScanWhite©-DMC/Darwin systems. The results showed statistical differences between the groups (p < 0.05), and between these same groups and the average fluorescence of the dentition of young (18 to 25 years) and adults (40 to 45 years) taken as control. It can be concluded that: Composites Z100, Z250 (3M ESPE) and Point 4 (Kerr) do not match with the fluorescence of human dentition and the fluorescence of the materials was found to be affected by their own tone.

Surface roughness analysis of dental ceramics treated with hydrofl uoric acid and aluminum oxide jet

The aim of this study was to evaluate the surface roughness of 5 indirect restorative materials treated with hydrofluoric acid to 10%, with aluminum oxide jet and a combination of both. The specimens was prepared with 10 mm in diameter and 2 mm thickness, divided into fi ve groups: (1) Ceromer (CeseadII-Kuraray), (2) Leucite crystals ceramics (IPS EmpressIIIvoclarforcasket), (3) glass ceramic with fluorapatite (IPS D. Sign-Ivoclar), (4) lithium disilicate ceramic (IPS Empress II-Ivoclar restorations), (5) ceramics (Cergogold-Degussa). For all groups were performed the controls, and the surfaces with the 3 types of treatment. For testing roughness used the rugosimeter Taylor/Hobson-Precision, model form tracerSV-C525 high sensitivity. After confi rmation of variance analysis with a signifi cance level of 1% (p < 0.01), there was equality between the average roughness of materials from groups 1, 3 and 5, and the group 2 was different from the others. It was also found that the ceramics of the group 5 behaved similar to group 4. However the lowest average roughness was observed in group 2 ceramic. In the evaluation between the types of treatment, the aluminum oxide jet and associations and blasting with hydrofl uoric acid were similar, and different isolated hydrofl uoric acid, and 3 types of treatment signifi cantly higher than the control group. All treatments promoted superfi cial alterations in all tested materials.

Influência da geometria oclusal e material restaurador na carga para fratura e distribuição de tensões em coroas totais

Pós-graduação em Odontologia Restauradora - ICT

Effect of postpolymerization method on the color stability of composite resins submitted to ultraviolet aging

The aim of this research was to evaluate the effect of postpolymerization method on the color stability of resin-based composites. Samples of direct and indirect restorative materials were polymerized with two photo-curing units (Visio photo-curing oven system and LED Elipar Freelight 2). All samples were submitted to an initial chromatic analysis using a spectrometer and submitted to ultraviolet-accelerated artificial aging. The direct material showed less color change than the indirect material, independent of the photo-activation method used. Samples photo cured with the LED system showed less change than those photo cured with the Visio system. The postpolymerization oven did not improve the color stability of direct and indirect resin-based composites.

Comportamento do esmalte de dentes decíduos após desafio desmineralizante em função de materiais restauradores: estudo ao microscópio de luz polarizada

Pós-graduação em Biopatologia Bucal - ICT

Composite resin susceptibility to red wine staining after water sorption

Color stability of restorative materials is essential for longevity of esthetic composite restoration over time. The aim of this investigation was assess the effect of prior water immersion on the color stability of a composite resin to red wine staining. Seventy disccshaped specimens (6mm x 1.5mm) were carried out and randomized in 7 groups (n = 10), according to distilled water immersion time at 0 (control), 24, 48, 72,120,192, and 240 h. Baseline color was measured according to the ciel*a*b* system using a reflection spectrophotometer(uvc2450, shimadzu).After that, the specimens were storage in red wine for 7 days. Color difference (∆e) after aging was calculated based on the color coordinates before(baseline) and after storage period.Data were subjected to onecway anova(alpha=0.05).The different times of immersion in.Water before to the red wine storage showed similar behavior on the color stability, without statistical difference compared to control group, immersed directly in the wine(p=0.7057).The previous water uptake of composite resin evaluated did not decrease the susceptibility to red wine staining.

Emprego de ma teriais rest auradores adesivos direto no ângulo incisal de incisivos centrais fra turados

A case report of a patient who presents as chief complaint presence of stained restorations in the anterior teeth. After analysis and discussion of the clinical therapeutic approaches to be adopted, it was observed the presence of type class IV restorations on teeth 11 and 21, due to an oblique coronal fracture in the past. But the patient was not satisfied with the aesthetic result, then where was planned the realization of the removal of the restorations, for subsequently be used direct restorative materials for the correction of form, function and esthetics. The final result showed that the restorations were able to return the form, function and aesthetic dental, thereby evidencing the proven development of restorative dentistry in the solution of aesthetic problems.

In vitro reduction of Streptococcus mutans biofilm on silver nanoparticle-modified resin composite

Introduction: Currently, new methods to reduce biofilm formation on biomaterials are very studied, for example the use of silver nanoparticles, which were bactericidal. However, there are few studies investigating the benefits of these particles in dental restorative materials. Objective: This study aimed to compare in vitro the Streptococcus mutans biofilm formation on conventional light-cured composite resin with that on experimental light-cured composite resin, modified with silver nanoparticles. Material and methods: Discs were produced with either conventional resin (control group) and resin modified with different concentrations of silver nanoparticles, 0.1%, 0.3% and 0.6 % wt. (groups 1, 2 and 3, respectively). The samples were incubated in bacterial suspension (S. mutans) enriched with 20% sucrose to promote biofilm growth on the surfaces. Incubation times were 1, 4 and 7 days. After each period, adherent biofilms were disaggregated by ultrasound. Then, the numbers of viable cells recovered from the biofilms were counted through the serial dilution method. A morphological analysis of biofilm was also performed by Scanning Electron Microscopy. The data were subjected to Anova and Tukey’s test (α = 0.05). Results: The number of viable cells was statistically lower in groups 2 and 3 than in group 1 and control group, after the three incubation periods, without statistical difference between groups 2 and 3. The number of viable cells was statistically lower in group 1 than in control group, after 4 and 7 days of incubation. Conclusion: Resins modified with silver presented reduction of S. mutans biofilm on their surfaces, according to the conditions of this study.