Avaliação in vitro da adaptação marginal e interna de coroas de cerâmica e resina composta fabricadas com o sistema CAD/CAM utilizando duas câmeras intraorais de moldagem digital

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2015.

Optical Impression Systems for CAD-CAM Restorations

Computer-aided design/computer-aided manufacturing images can be taken through either direct or indirect imaging. For the indirect systems, the digitalization is obtained from the impression material or cast, and for the direct ones the image is taken directly from the mouth using intraoral scanners.The direct acquisition systems have been constantly improved because these are less invasive, quicker, and more precise than the conventional method. Besides, the digital images can be easily stored for a long time. Therefore, the aim of this paper was to describe and discuss based on the literature the main direct image acquisition systems available on the market: CEREC Bluecam (Sirona), Lava C.O.S. System (3M ESPE), iTero System (Cadent/Straumann), and E4D System (D4D Technologies).

Soft Tissue Alterations in Esthetic Postextraction Sites: A 3-Dimensional Analysis.

Dimensional alterations of the facial soft and bone tissues following tooth extraction in the esthetic zone play an essential role to achieve successful outcomes in implant therapy. This prospective study is the first to investigate the interplay between the soft tissue dimensions and the underlying bone anatomy during an 8-wk healing period. The analysis is based on sequential 3-dimensional digital surface model superimpositions of the soft and bone tissues using digital impressions and cone beam computed tomography during an 8-wk healing period. Soft tissue thickness in thin and thick bone phenotypes at extraction was similar, averaging 0.7 mm and 0.8 mm, respectively. Interestingly, thin bone phenotypes revealed a 7-fold increase in soft tissue thickness after an 8-wk healing period, whereas in thick bone phenotypes, the soft tissue dimensions remained unchanged. The observed spontaneous soft tissue thickening in thin bone phenotypes resulted in a vertical soft tissue loss of only 1.6 mm, which concealed the underlying vertical bone resorption of 7.5 mm. Because of spontaneous soft tissue thickening, no significant differences were detected in the total tissue loss between thin and thick bone phenotypes at 2, 4, 6, and 8 wk. More than 51% of these dimensional alterations occurred within 2 wk of healing. Even though the observed spontaneous soft tissue thickening in thin bone phenotypes following tooth extraction conceals the pronounced underlying bone resorption pattern by masking the true bone deficiency, spontaneous soft tissue thickening offers advantages for subsequent bone regeneration and implant therapies in sites with high esthetic demand (Clinicaltrials.gov NCT02403700).

Time-dependent supraimplant mucosa changes: short communication

PURPOSE The aim of this short communication was to analyze time-dependent changes of the supraimplant mucosa architecture in the esthetic zone. MATERIALS AND METHODS Five patients underwent single-tooth replacement with implant crowns in the anterior maxilla. The supraimplant soft tissue was conditioned with fixed provisional crowns. Quadrantlike digital impressions were taken with an intraoral optical scanning device at three time points: t0, immediately after removal of the provisional (baseline); t1, after 5 minutes; and t2, after 10 minutes. To analyze time-dependent mucosal changes, the corresponding digital files were superimposed for each patient, and baseline (t0) scans were compared with t1 and t2 scans, respectively. Wilcoxon rank sum tests were used for statistical calculations with a strict level of significance at P < .01. RESULTS Mean values for supraimplant soft tissue changes were statistically significantly different after 5 minutes (5.5%; standard deviation ± 0.3%) in comparison to the results after 10 minutes (21.7%; standard deviation ± 1.8%). The direction of mucosa shrinkage showed a trend toward palatal sites. CONCLUSION Based on the findings of this analysis, changes in supraimplant mucosa architecture seem to be affected only slightly during the first 5 minutes after removal of soft tissue support.

Digital implant impressions with the "Individualized Scanbody Technique" for emergence profile support.

OBJECTIVE The Short Communication presents a clinical case in which a novel procedure--the "Individualized Scanbody Technique" (IST)--was applied, starting with an intraoral digital impression and using CAD/CAM process for fabrication of ceramic reconstructions in bone level implants. MATERIAL AND METHODS A standardized scanbody was individually modified in accordance with the created emergence profile of the provisional implant-supported restoration. Due to the specific adaptation of the scanbody, the conditioned supra-implant soft tissue complex was stabilized for the intraoral optical scan process. Then, the implant platform position and the supra-implant mucosa outline were transferred into the three-dimensional data set with a digital impression system. Within the technical workflow, the ZrO2 -implant-abutment substructure could be designed virtually with predictable margins of the supra-implant mucosa. RESULTS After finalization of the 1-piece screw-retained full ceramic implant crown, the restoration demonstrated an appealing treatment outcome with harmonious soft tissue architecture. CONCLUSIONS The IST facilitates a simple and fast approach for a supra-implant mucosal outline transfer in the digital workflow. Moreover, the IST closes the interfaces in the full digital pathway.

Impressions of April

Poem

Validité, fiabilité et reproductibilité des modèles digitaux obtenus avec iTero (Align Technology) et Unitek TMP Digital (3M) en comparaison avec les modèles de plâtre

Objectif: L'objectif primaire de cette étude était d'évaluer la validité, la fiabilité et la reproductibilité des mesures dentaires obtenues sur les modèles digitaux iTero (Align Technology, San Jose, Californie) et Unitek TMP Digital (3M, Monrovia, Californie) en comparaison avec celles obtenues sur les modèles de plâtre (gold standard). L'objectif secondaire était de comparer les deux différents matériaux à empreinte (l'alginate et le polyvinylsiloxane-PVS) afin de déterminer si le choix du matériau affectait la précision des mesures. Méthodes: Le premier volet de l'étude impliquait les modèles digitaux Unitek et iTero, obtenus à partir de 25 paires de modèles de plâtre choisis de façon randomisée et provenant de la pratique privée d'un des co-auteurs. Des empreintes d'alginate et de PVS ont été prises sur les modèles de plâtre et numérisées par le scanner Unitek. Les modèles ont ensuite été numérisés avec le scanner iTero. Le deuxième volet de l'étude cherchait à comparer les modèles digitaux iTero (numérisation intra-orale) avec les modèles de plâtre (empreintes d'alginate et de PVS) obtenus à partir de 25 patients de la clinique d'orthodontie de l'Université de Montréal ayant besoin d'un traitement orthodontique. Dans les deux volets de l'étude, deux auteurs ont pris les mesures suivantes sur les différents modèles: largeur mésio-distale de chaque dent de la première molaire à l'autre première molaire, le périmètre d'arcade, les distances intermolaire et intercanine, le surplomb vertical et le surplomb horizontal. Les ratios et excès Bolton 6 et 12, l'espace requis et les différentiels d'espace au maxillaire et à la mandibule, ont été calculés. Résultats: La fiabilité (ICC) entre les modèles digitaux (Unitek et iTero) et les modèles de plâtre était bonne à excellente pour toutes les mesures [ICC=0,762–0,998], et la fiabilité entre les deux matériaux à empreinte était excellente [ICC=0,947–0,996]. Dans les deux volets de l'étude, les mesures faites sur les modèles iTero étaient généralement plus grandes que celles faites sur les modèles de plâtre. Les plus grandes différences moyennes pour la comparaison iTero-plâtre étaient trouvées au niveau de l'espace disponible au maxillaire et à la mandibule (systématiquement plus grande pour cette variable), soit 2,24 mm et 2,02 mm respectivement dans le premier volet, et 1,17 mm et 1,39 mm respectivement dans le deuxième volet. Les différences étaient considérées cliniquement non significatives pour toutes les variables. La reproductibilité intra-examinateur était bonne à excellente pour les modèles de plâtre et les modèles digitaux, à l'exception du différentiel d'espace à la mandibule pour les modèles Unitek [ICC=0,690-0,692]. La reproductibilité inter-examinateur était bonne à excellente pour les modèles de plâtre et les modèles digitaux dans les deux volets de l'étude, mais acceptable à modérée pour les modèles Unitek au niveau des analyses Bolton 6 et 12, et des différentiels d'espace au maxillaire et à la mandibule [ICC=0,362-0,548]. Conclusions: La précision et la fiabilité des mesures dentaires faites sur les modèles digitaux Unitek et iTero étaient cliniquement acceptables et reproductibles en comparaison avec les celles faites sur les modèles de plâtre. Le choix de matériel à empreinte entre l'alginate et le PVS n'affectait pas la précision des mesures. Cette étude semble démontrer que les modèles digitaux Unitek et iTero, utilisés avec leur logiciel respectif, sont une alternative fiable et reproductible aux modèles de plâtre pour le diagnostic et l’analyse des modèles orthodontiques.

Subjective impressions of child cochlear-implant users: effects of conversational fluency, intelligibility, speech perception, and communication mode

This paper investigates the conversational fluency of young cochlear implant users. The study compares objective measures and subjective impressions of conversation fluency, relates how children’s communication skills influence both objective and subjective measures of conversational fluency, and compares the performance of children who use an oral mode with those who use a total communication mode in everyday conversation.

Evaluation of a digital methodology for human identification using palatal rugoscopy

Palatal rugoscopy, or palatoscopy, is the process by which human identification can be obtained by inspecting the transverse palatal rugae inside the mouth. Aim: This study evaluated a digital method for human identification using palatoscopy, by comparing photographs of the palate against the images of cast models of the maxilla photographed with and without highlighting of the palatal rugae. Methods: Condensation silicone impressions were made from the upper arches of 30 adult subjects of both genders and their palates were then photographed. The first impression was made with heavy silicone, the second impression with light silicone, and then the models were cast in improved type IV dental stone. The casts were photographed, the palatal rugae of each one were highlighted with a pencil, and then the models were photographed again. Using a free image-editing software, the digital photographs were overlapped over the images of the palatal rugae of the models with and without highlighting of the palatal rugae, in order to identify the pairs. Results: The result of overlapping the digital photographs with the images of the models without highlighted palatal rugae resulted in 90% positive identification. For the overlapping of the digital photographs with the images of models with highlighted palatal rugae, there was 100% positive identification. Conclusions: The digital method evaluated in this study was proven effective for human identification.

Human identification by means of conventional and digital Cheiloscopy: a study of the literature

One of the areas of human identification is Cheiloscopy, the name given to the study of the lips, their characteristics (such as thickness, position of the grooves and grooves) and the record of the impressions left by them. There are variations in the layout of the lines and fissures of the lips, which are unique to each individual, permanent and unchanging. The lip print rarely changes, enduring minor traumas such as inflammation or sores. In criminal investigations, lip prints, visible through the presence of lipstick, can be found on glasses, napkins, clothes, cigarettes, indicating a relationship between the subject and the scene of the crime. Latent impressions may be revealed employing specific chemicals such as powder of silver and aluminum nitrate. Although it is not a very common method, Cheiloscopy may become very useful in forensics due to the extensive amount of valuable information that it brings. The objective of this study was to review the literature on the use of Cheiloscopy in human identification, using traditional and digital methods. It was found that the literature is still in need of studies in this area. The advent of new digital technologies can facilitate the implementation of technical expertise, generating speed and objectivity. New research studies are necessary, especially in the development of digital methods. The application of Cheiloscopy can greatlyhelp with Law, in the identification of living suspects and dead individuals. In the end the benefit will fall to society as a whole.

Reproducibility and accuracy of linear measurements on dental models derived from cone-beam computed tomography compared with digital dental casts.

INTRODUCTION The aim of this study was to determine the reproducibility and accuracy of linear measurements on 2 types of dental models derived from cone-beam computed tomography (CBCT) scans: CBCT images, and Anatomodels (InVivoDental, San Jose, Calif); these were compared with digital models generated from dental impressions (Digimodels; Orthoproof, Nieuwegein, The Netherlands). The Digimodels were used as the reference standard. METHODS The 3 types of digital models were made from 10 subjects. Four examiners repeated 37 linear tooth and arch measurements 10 times. Paired t tests and the intraclass correlation coefficient were performed to determine the reproducibility and accuracy of the measurements. RESULTS The CBCT images showed significantly smaller intraclass correlation coefficient values and larger duplicate measurement errors compared with the corresponding values for Digimodels and Anatomodels. The average difference between measurements on CBCT images and Digimodels ranged from -0.4 to 1.65 mm, with limits of agreement values up to 1.3 mm for crown-width measurements. The average difference between Anatomodels and Digimodels ranged from -0.42 to 0.84 mm with limits of agreement values up to 1.65 mm. CONCLUSIONS Statistically significant differences between measurements on Digimodels and Anatomodels, and between Digimodels and CBCT images, were found. Although the mean differences might be clinically acceptable, the random errors were relatively large compared with corresponding measurements reported in the literature for both Anatomodels and CBCT images, and might be clinically important. Therefore, with the CBCT settings used in this study, measurements made directly on CBCT images and Anatomodels are not as accurate as measurements on Digimodels.

The Perks of Playing Dress-Up: Psychological Impressions of Fashion and Feminism.

Research on the psychological impact of women's fashion has focused on fashion's negative influence over how women think and feel about themselves. Several studies have examined the relationship between fashion and women's self-appraisals (Martin & Gentry, 1997; Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999; Tiggemann, Polivy, & Hargreaves, 2009), although few investigations have explored the range of viewpoints that arise when women interact with their own personal style or with other forms of fashion media. This paper presents a narrative review of what has been written about fashion in clinical research. I briefly discuss why this is an important topic and why fashion has psychological meaning. Cognitive behavioral therapy (CBT) is considered in the exploration of fashion's impact on conjuring unproductive and productive schemas (Beck, 1976; Wright, Basco, & Thase, 2006). This discussion includes a presentation of interviews with female consultants, hypothetical examples, my own accounts, and feminist perspectives. While emphasizing the potential biases of women's interactions with fashion, I discuss matters of gender performance and reflections on clinical work. The purpose of this article is to present a pro-social defense of fashion. I do this by acquiring personal chronicles, applying those findings to the current body of research, and adding to the continued investigation of why women's fashion is still important in a postfeminist world.

Perceivers' impressions of self -presentation tactics: The effects of age and gender

Eighty-four young and 84 older men and women participants, read scenarios in which a male or female target uses either a self-enhancement or a self-deprecation tactic to present him/herself in front of either a close friend or a new acquaintance. Then participants i.e., perceivers) rated their impressions of the self-enhancing or self-deprecating target on six scales: likable, self-knowledgeable, honest, depressed, happy, and anxious. Overall, both young and old perceivers gave more favorable ratings to self-enhancing targets than to self-deprecating targets. Both young and old perceivers' impressions did not differ for a target who presented him/herself in front of a friend or in front of an acquaintance. Also, perceivers completed Singelis' (1994) Self-Construal Measurement, which measures both interdependent and independent self-construals. As predicted, older perceivers had a higher level of interdependent self-construal than did young perceivers. Unexpectedly, female perceivers had a higher level of independent self-construal than did male perceivers. Neither the age-related nor gender-related differences in self-construals were associated with any age-related or gender-related differences in perceivers' impressions of the self-enhancing and self-deprecating targets. That is, the moderator effects of self-construals on the relationships between self-presentation tactic conditions and ratings of targets were not-significant. ^