Análise mecânica e microestrutural das ligas de cobalto-cromo de uso odontológico após sucessivas refundições

The cobalt-chromium alloy is extensively used in the Odontology for the confection of metallic scaffolding in partial removable denture. During the last few years, it has been reported an increasing number of premature imperfections, with a few months of prosthesis use. The manufacture of these components is made in prosthetic laboratories and normally involves recasting, using parts of casting alloy and parts of virgin alloy. Therefore, the objective of the present study was to analyze the mechanical properties of a commercial cobalt-chromium alloy of odontological use after successive recasting, searching information to guide the dental prosthesis laboratories in the correct manipulation of the cobalt-chromium alloy in the process of casting and the possible limits of recasting in the mechanical properties of this material. Seven sample groups were confectioned, each one containing five test bodies, divided in the following way: G1: casting only with virgin alloy; G2: casting with 50% of the alloy of the G1 + 50% of virgin alloy; G3: casting with 50% of the alloy of the G2 + 50% of virgin alloy; G4: casting with 50% of the alloy of the G3 + 50% of virgin alloy; G5: 50% of alloy of the G4 + 50% of virgin alloy; G6: 50% of alloy of the G5 + 50% of virgin alloy and finally the G7, only with recasting alloy. The modifications in the mechanical behavior of the alloy were evaluated. Moreover, it was carried the micro structural characterization of the material by optic and electronic scanning microscopy, and X ray diffraction.and fluorescence looking into the correlatation of the mechanical alterations with structural modifications of the material caused by successive recasting process. Generally the results showed alterations in the fracture energy of the alloy after successive recasting, resulting mainly of the increasing presence of pores and large voids, characteristic of the casting material. Thus, the interpretation of the results showed that the material did not reveal significant differences with respect to the tensile strength or elastic limit, as a function of successive recasting. The elastic modulus increased from the third recasting cycle on, indicating that the material can be recast only twice. The fracture energy of the material decreased, as the number of recasting cycles increased. With respect to the microhardness, the statistical analyses showedno significant differences. Electronic scanning microscopy revealed the presence of imperfections and defects, resulting of the recasting process. X ray diffraction and fluorescence did not show alterations in the composition of the alloy or the formation of crystalline phases between the analyzed groups. The optical micrographs showed an increasing number of voids and porosity as the material was recast. Therefore, the general conclusion of this study is that the successive recasting of of Co-Cr alloys affects the mechanical properties of the material, consequently leading to the failure of the prosthetic work. Based on the results, the best recommendadition is that the use of the material should be limited to two recasting cycles

Associação entre implantes odontológicos e próteses parciais removíveis: revisão de literatura

Unilateral or bilateral distal-extension removable partial dentures present complex biomechanics. The movements in different directions, associated with the alveolar ridge shape and soft tissue resilience can lead to damaging forces on the supporting structures. The association between implants / removable partial denture aims to provide better mechanical and biological properties to the stomatognathic system. OBJECTIVE: The aim of this paper was to review the articles about the effect of implant support on distal extension removable partial dentures. LITERATURE REVIEW AND CONCLUSION: Studies have shown that this combination provides greater support, retention and stability to the prosthesis, thus limiting their approach movement toward supporting tissues and providing functional and psychological comfort to patients.

Avaliação clínica do grau de paralelismo obtido no preparo de planos de guia de dentes suportes de prótese parcial remóvivel, utilizando paralelizador intrabucal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise mecânica e microestrutural das ligas de cobalto-cromo de uso odontológico após sucessivas refundições

The cobalt-chromium alloy is extensively used in the Odontology for the confection of metallic scaffolding in partial removable denture. During the last few years, it has been reported an increasing number of premature imperfections, with a few months of prosthesis use. The manufacture of these components is made in prosthetic laboratories and normally involves recasting, using parts of casting alloy and parts of virgin alloy. Therefore, the objective of the present study was to analyze the mechanical properties of a commercial cobalt-chromium alloy of odontological use after successive recasting, searching information to guide the dental prosthesis laboratories in the correct manipulation of the cobalt-chromium alloy in the process of casting and the possible limits of recasting in the mechanical properties of this material. Seven sample groups were confectioned, each one containing five test bodies, divided in the following way: G1: casting only with virgin alloy; G2: casting with 50% of the alloy of the G1 + 50% of virgin alloy; G3: casting with 50% of the alloy of the G2 + 50% of virgin alloy; G4: casting with 50% of the alloy of the G3 + 50% of virgin alloy; G5: 50% of alloy of the G4 + 50% of virgin alloy; G6: 50% of alloy of the G5 + 50% of virgin alloy and finally the G7, only with recasting alloy. The modifications in the mechanical behavior of the alloy were evaluated. Moreover, it was carried the micro structural characterization of the material by optic and electronic scanning microscopy, and X ray diffraction.and fluorescence looking into the correlatation of the mechanical alterations with structural modifications of the material caused by successive recasting process. Generally the results showed alterations in the fracture energy of the alloy after successive recasting, resulting mainly of the increasing presence of pores and large voids, characteristic of the casting material. Thus, the interpretation of the results showed that the material did not reveal significant differences with respect to the tensile strength or elastic limit, as a function of successive recasting. The elastic modulus increased from the third recasting cycle on, indicating that the material can be recast only twice. The fracture energy of the material decreased, as the number of recasting cycles increased. With respect to the microhardness, the statistical analyses showedno significant differences. Electronic scanning microscopy revealed the presence of imperfections and defects, resulting of the recasting process. X ray diffraction and fluorescence did not show alterations in the composition of the alloy or the formation of crystalline phases between the analyzed groups. The optical micrographs showed an increasing number of voids and porosity as the material was recast. Therefore, the general conclusion of this study is that the successive recasting of of Co-Cr alloys affects the mechanical properties of the material, consequently leading to the failure of the prosthetic work. Based on the results, the best recommendadition is that the use of the material should be limited to two recasting cycles

Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study

The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12-month follow-up.A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Loe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re-examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non-parametric statistic was applied.The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III.The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.

Dual path: A concept to improve the esthetic replacement of missing anterior teeth with a removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.

Influence of ridge type on mandibular distal extension removable partial denture.

The aim of this study was to use photoelastic models to analyze the distribution of stress caused by the incidence of loads on a mandibular distal extension removable partial denture, both on the abutment teeth and on differently shaped residual ridges: distal ascending, descending-ascending, horizontal and distal descending. The best type of retainer and location of the rest on the last abutment tooth were determined for the different types of ridge. Four models were made from photoelastic resin (PL-1 for the teeth and PL-2 for the alveolar ridge), one for each kind of ridge. For each model, 4 removable partial dentures (RPD) were made (16 RPD altogether): T-bar retainer and distal rest, T-bar retainer and mesial rest, circumferential retainer and distal rest, and circumferential retainer and mesial rest. The models were placed on a circular polariscope and a 100 N axial load (point load) was applied to premolars and molars of the RPD. The formation of photoelastic bands was photographed for qualitative analysis. Results showed that the horizontal ridge had better distribution of stress, while the distal descending ridge had greater concentration of stress. The circumferential retainer had greater areas of stress for all types of ridges except the horizontal ridge, where there was no influence related to retainer type. The distribution of stress was similar among the different types of ridges when the rest was mesial or distal to the last abutment tooth, except for the distal descending ridge, where there was greater concentration of stress when the rest was located distally to the last abutment tooth. Thus, it may be concluded that (1) the situation was least favorable for the distal descending ridge and most favorable for the horizontal ridge, (2) the T-bar retainer had more favorable stress distribution, except when the ridge was horizontal, in which case there was no influence in relation to the type of retainer, (3) the location of the rest showed similar behavior in all except the distal descending ridge.

The use of a magnetic attachment in a removable partial denture of a patient with periodontal tissue loss

O uso dos magnetos em prótese parcial removível é uma alternativa viável para eliminar a estrutura metálica que pode interferir na estética sem perder retenção e estabilidade. Os magnetos podem ser recomendados para pacientes com perda de tecido periodontal, desde que eles diminuam a transmissão de forças ao dente remanescente. O objetivo deste relato de caso clínico foi apresentar uma alternativa de tratamento protético para dentes pilares comprometidos periodontalmente e descrever as vantagens e desvantagens do uso dos magnetos em prótese parcial removível sobre os pontos de vista funcionais, biológicos e estéticos.

Evaluation of the influence of location of osseointegrated implants associated with mandibular removable partial dentures

Purpose: The aim of this research was to assess, by means of, the bi-dimensional finite element method, the best implant location in the alveolar edge, through stress distribution and support structure displacement of a distal extension removable partial denture associated with an osseointegrated implant of 10.0 x .75 mm, acting as abutment for the denture base.Methods and Materials: Five models in sagittal cut were used to represent: model A-hemi arch containing natural tooth 33 and the distal alveolar edge; model B-similar to model A, but with a conventional removable partial denture to replace the absent teeth; model C (MC)-similar to the previous one, with an implant in the distal region of the edge under the denture base; model D-similar to MC, with the implant in the central region of the edge; model E-similar to MC, with an implant in the mesial region of the edge. With the aid of the finite element program ANSYS 8.0, the models were loaded with strictly vertical forces of 50 N on each cusp tip. Displacement and von Mises Maps were plotted for visualization of results.Results: The introduction of implant diminished the tendency of intrusion of the removable partial denture in all situations. The maximum stress was observed on implant in all situations. Approximating implant in direction of support teeth was benefit for stress distribution.Conclusion: Model D presented the lowest value for maximum tendency to displacement when compared with those found in the other models; model E demonstrated better relief with regard to demand from the abutment tooth; locating the implant near of the abutment tooth influenced positively the distribution of stresses on the analyzed structures.

Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva

Objectives: To correlate the presence and number of Candida spp. in the saliva of wearers of removable partial dentures retained with precision attachments with the proportion of metal/acrylic resin present in the dentures. Methods: Saliva samples from 40 removable partial denture wearers (test) and one paired sample of individuals, non- wearers of any type of removable denture (control) were collected, seeded, and the colony forming units of Candida counted and identified. The metal/acrylic resin proportion of each denture was quantified, using silicone plates pressed over each denture. Results: Candida spp. was found in the saliva of 80% of the individuals in the test group and 65% of the control, with C. albicans being themost prevalent species. The test group presented with the highest number of colony forming units of Candida per ml of saliva, and there wasweak correlation between this number and the metal and resin area of the denture (Pearson's coefficient of correlation). Greater prevalence and a higher number of colony forming units of Candida per ml of saliva occurred in removable partial denture wearers ( p = 0.04) with a weak positive correlation between the metal and resin area and the number of colony forming units of Candida per ml of saliva. However, this correlation was more significant for the area of resin. Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva

Influence of length and diameter of implants associated with distal extension removable partial dentures

PURPOSE

Retention strength of cobalt-chromium vs nickel-chromium titanium vs Cp titanium in a cast framework association of removable partial overdenture

Aim: There is little information considering the framework association between cast clasps and attachments. The aim of this study was to evaluate the retention strength of frameworks match circumferential clasps and extra resilient attachment cast in three different alloys (cobalt-chromium, nickel-chromium titanium and commercially pure titanium), using two undercut (0.25 and 0.75 mm) and considering different period of time (0, 1/2, 1, 2, 3, 4 and 5 years). Methods: Using two metallic matrices, representing a partially edentulous mandibular right hemiarch with the first molar crown, canine root and without premolars, 60 frameworks were fabricated. Three groups (n = 20) of each metal were cast and each group was divided into two subgroups (n = 10), corresponding the molar undercut of 0.25 mm and 0.75 mm. The nylon male was positioned at the matrix and attached to the acrylic resin of the prosthetic base. The samples were subjected to an insertion and removal test under artificial saliva environment. Results: The data were analyzed and compared with ANOVAs and Tukey's test at 95% of probability. The groups cast in cobaltchromium and nickel-chromium-titanium had the highest mean retention strength (5.58 N and 6.36 N respectively) without significant difference between them, but statistically different from the group cast in commercially pure titanium, which had the lowest mean retention strength in all the periods (3.46 N). The association frameworks using nickel-chromium-titanium and cobalt-chromium could be used with 0.25 mm and 0.75 mm of undercut, but the titanium samples seems to decrease the retention strength, mainly in the 0.75 mm undercut. The circumferential clasps cast in commercially pure titanium used in 0.75 mm undercuts have a potential risk of fractures, especially after the 2nd year of use. Conclusion: This in vitro study showed that the framework association between cast clasp and an extra resilient attachment are suitable to the three metals evaluated, but strongly suggest extra care with commercially pure titanium in undercut of 0.75 mm. Clinical significance: Frameworks fabricated in Cp Ti tend to decrease in retentive strength over time and have a potential risk of fracture in less than 0.75 mm of undercut.