Reabilitação oral de paciente com síndrome da combinação: relato de caso

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and loss of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Avaliação da alteração dimensional de modelos obtidos a partir de moldagens com alginato tradicional e outro com desinfetante

The present study aims at evaluating dimensional alteration of stone casts made from impressions with a standard irreversible hydrocolloid and an antimicrobial one. For this, an alginate without disinfectant (Type II Jeltrate) and other containing chlorhexidine (Type II Avagel) were used, which rose by the same regime of treatment: without disinfection; immersion; and spraying. A 1% sodium hypochlorite solution was used for 10 minutes. To obtain the impressions, a perforated impression tray was made from a standard metal model. After molding, the molds were washed in running water for 30 seconds to simulate removal of saliva. Then, with the exception of the control group, these molds were subjected to disinfection treatment. After 10 minutes they were washed again. 60 samples poured with type V special gypsum (Durone) were obtained, that were measured 3 times in a stereomicroscope (SZX12, Olympus) to record the average of dimensional alterations. The disinfection treatment did not bring significant changes in the models obtained from both alginate tested (standard p = 0.7102; with chlorhexidine p = 0.5832). The results showed a statistically significant and additional advantage of the traditional alginate on alginate with chlorhexidine, with respect to dimensional alteration (p < 0.05).

Reabilitação estético-funcional sobre implantes agulhados e endósseos

This report shows the resolution of a case study whose aim was promote the aesthetic and functional rehabilitation of upper left hemi-arch over endosseous and needle implant prostheses. To improve the position of the needle implants, we performed the bucco-palatal bending of needles splinting them with composite resin; we removed the screwed implant prosthesis in the regions of the premolars (24 and 25) and molar (26). The mini-abutments of the last two implants were replaced, and in the first premolar and canine, we used cemented abutments due to implant angulation having planned soldering because of implant size and contact with one needle implant that could interfere with intimate contact bone/implant damaging biomechanics. Pick-up impressions were performed with an open tray, using a retractor cord in the needle implants and respective transfer copings. Therefore, models were related on semi-adjustable articulator after a face-bow recording and interocclusal indexes. After working cast fabrication and try-in of infra-structures, these were adjusted and related into the articulator again. Then, after ceramic build-up, adjustments, finishing, and torque, chemically-activated resin cement was applied on units 21 to 24. At the end of the case, we concluded that a good aesthetic and functional rehabilitation depends on thorough knowledge of techniques for each clinical situation.

Matriz Bertholdo/Ricci/Barrotte (BRB): uma simplificação de técnica para obtenção de guia de estratificação com compósitos

Advanced Layering composite resins can be facilitated by a technique called "Lingual Matrix", where a guide is made of elastomer by molding a previously waxed tooth or sculped in an intraoral test drive restoration. This technique has many advantages to sophisticated layering, facilitation stratification, anatomic construcrion and the stages of finishing and polishing. However, in some clinical situations, the unfolding of the steps to obtains this matrix can be time consuming or even infeasible. To facilitate the achievement of this apparatus, a technique was idealized allowing significant reducrion in clinical time. This matrix, called the "BRB Matrix" is widly discussed in a didactic and clinical manner in this article, presenting its advantages in clinical cases where it is imperative to use a guide for conduction a controlled layering. The simplicity of this approach, as well as reduced clinical time and finacial costs turn it feasible in an everyday clinical practice.

Fracture resistance of simulated immature teeth after different intra-radicular treatments

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after different intra-radicular treatments. Crowns and roots of bovine incisors were cut transversally and removed to simulate immature teeth. Root canal preparation and flaring were performed using a bur in crown-apex and apex-crown direction. The samples were distributed into 5 groups (n=10): Positive control (PoC) - no root canal flaring or filling; Negative control (NeC) - teeth were sectioned and their root canals were flared; Direct anatomical glass fiber post (RaP) - #2 Reforpost main glass fiber post relined with composite resin; Double tapered conical glass fiber posts (ExP) - #3 Exacto glass fiber post; and #2 Reforpost main glass fiber + Reforpin accessory glass fiber posts (RrP). In RaP, ExP and RrP, 4.0-mm apical plugs were done with MTA Angelus. The specimens were embedded in polystyrene resin inside cylinders and the periodontal ligament was simulated with a polyether-based impression material. The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° relative to the long axis of the tooth) in a servo-hydraulic mechanical testing machine MTS 810. Data were subjected to one-way ANOVA and Dunnett's C or Tukey's tests (α=0.05). The control groups (PoC and NeC) showed lower fracture strength than the experimental groups. NeC presented the lowest resistance and ExP presented the highest resistance among the experimental groups. The flaring procedures produced a detrimental effect on the fracture resistance of the bovine teeth. Glass fiber intra-radicular posts increased significantly the fracture resistance of simulated immature teeth.

Obtenção e caracterização de compósitos de benzoxazina/fibra de carbono

Pós-graduação em Engenharia Mecânica - FEG

Uso da avaliação do ciclo de vida para a determinação na redução de emissões de gases do efeito estufa e do consumo de energia associados a reciclagem de EPS

Pós-graduação em Engenharia Mecânica - FEG

Estudo do efeito da cristalinidade nas propriedades mecânicas de compósitos termoplásticos com aplicações aeronáuticas

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

Compósitos preparados a partir de resíduo industrial de couro com elastômeros termoplásticos obtidos através de blendas de polietileno de baixa densidade e borracha natural

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

Aumento de gengiva queratinizada em mucosa peri-implantar

Introduction: Recent studies have evaluated the relationship between the width of keratinized mucosa and peri-implant tissue health. Insufficiently wide keratinized tissue can be increased surgically, for example by free gingival grafting. The presence or reconstruction of keratinized tissue around the implant can facilitate restorative procedures, promote aesthetics and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. Objective: To describe a patient who underwent free gingival graft surgery to increase the width of keratinized tissue in the region of previously implants to support a type of prosthetic protocol. Case report: A patient who had received dental implants to support a type of prosthetic protocol presented with inflamed peri-implant mucosa, but with no keratinized tissue. Free gingival tissue was obtained from the palate and grafted into the anterior maxilla. Sixty days after muco-gingival surgery, we observed that the free gingival graft favored peri-implant health and prosthetic casting. Conclusion: The free gingival graft technique is both easy to perform and effective in increasing the width of keratinized mucosa following implantation.

Compatibilidade entre alginato e gesso ortodônticos: capacidade de umedecimento sob influência da desinfecção do molde

The dental trade has offered dental impression and dental stone for orthodontic use ensuring accurate models. The compatibility between these materials is defined by the wetting of the model surfaces by the mixture water/stone poured over it and the influenced by the method of disinfection of model and disinfectant solution used. It was evaluated the influence of spray disinfection with sodium hypochlorite 1% on the wettability of two commercial alginate (Jeltrate ® - Dentsply and Orthoprint ® - Zhermack) at two commercial type III gypsum (Rio ® - ME and AOBussoli Orthogesso Orthogesso ®-SA). Twenty models were fabricated for each type of alginate, which were divided into two groups (water and sodium hypochlorite), receiving respectively water and sodium hypochlorite 1% spray. Each group of models was then further divided into two subgroups, and on their surface were poured 2 ml of type III gypsum (Gesso Rio® or Orthogesso®). Reached the final setting of the gypsum specimens were sectioned vertically and medially, settled water with sandpaper No. 400 and mounted on suitable device for reading (in the right and left) of the contact angle Carl Zeiss microscope (precision, 001). The results were submitted to ANOVA and founded statistical significance for solutions used. It was concluded that sodium hypochlorite spray improved wettability of alginates studied.

Efeito da desinfecção e do tempo de armazenagem na molhabilidade de moldes de alginato

The cares at the manipulation of the alginate (condensation, disinfection of the impression and the time elapsed until the leak of the plaster) deserve special attention considering the great amount of distortions occurring every time the impression is not fill of plaster in a brief space of time and appropriate storage conditions. Besides its adaptation to the plaster suffers influence of the events happened after the impression is removed of the mouth. The purpose of this research was to evaluate the wetting capacity of three brands of alginate (Jeltrate™,Hydrogum™ e Orthoprint™) by the plaster type III (Rio™) under the influence of disinfection by sodium hypochlorite 1% sprays and the time of storage of 15 minutes,30 minutes, 1 hour, 6, 12 and 24 hours. There were made 60 impressions of each brand of alginate divided in two groups (water and sodium hypochlorite 1%) rearranged after the application of the sodium hypochlorite spray according to the storage time (15 or 30 minutes and 1,6,12, or 24 hours). On the surface of the impressions 2ml of plaster were flowed, proportioned and condensed in agreement with manufacturer‘s instructions. After the final setting expansion the casts were sectioned vertically and medially, regularized at the cut surface (emery paper 400) and setted for reading the contact angle at the microscope Carl Zeiss. The obtained results, submitted to statistical treatment (ANOVA) revealed significant differences when compared the employed solutions (water and sodium hypochlorite 1%) and the time of storage. The sodium hypochlorite 1% exhibited the smallest contact angles and the times of storage of 15 minutes and 6 hours the smallest and larger angles, respectively. It can be concluded that the alginate impressions exhibited larger adaptation to the plaster when disinfected by hypochlorite of sodium 1% and stocked by 15 minutes.

Moldagens em prótese total

The anatomical and functional impressions philosophies are presented to the professionals who are active in the area, so that they can review concepts and thus obtain more precise molds, based on scientific knowledge. In parallel, impression techniques recommended by the Prosthodontics subject from Araçatuba Dental School – UNESP are also commented.

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.

La relacion entre la calidad de la ensenanza y mala prática odontológica: relato de un caso clínico

The activities developed in health area are of great importance, because they have the aim to preserve the life of the men, and therefore, must be performed by authorized persons. The increase of the number of dental schools, the decline at the education quality and a higher admission of students with low ability to exercise their profession, are facts that bring disastrous consequences for society. These facts are, also, reflected at the moral, ethical and technical-scientific performance of the professional. The purpose of this clinic case is to show that although there is a significant suplly of education institutions, there is a lack of scientific and adequate technical knowledgement from the graduated dentals surgeons. The patient MSL, 17 year old, female, went to a dental clinic presenting a tray type Vernis, attached to the lower arch. After clinical evaluation, it was showed that an incorrect material was used for the impression technique, being impossible to take out the tray by the conventional manner. The planning for the removal of the tray was through the divide of it. Thus, the consequence of the lack of knowledge in the use of impression materials had caused a great incovinience to the patient. It can be concluded that the rate of malpractice is directly related to the professional preparation, highlighting the importance of quality dental education for a responsible clinical practice.