Masticatory afficiency in denture wearers with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Confiabilidade da eficiência mastigatória com beads e correlação com a atividade muscular

TEMA: a avaliação da eficiência mastigatória pela análise colorimétrica com beads, pode ser um método promissor, mas não há relatos sobre a sua confiabilidade. OBJETIVO: investigar a confiabiabilidade das beads para teste de eficiência mastigatória e a correlação com a atividade eletromiográfica dos músculos masseter e temporal anterior. MÉTODO: participaram dezenove sujeitos adultos jovens, nove do gênero masculino e dez do feminino com idades entre dezoito e vinte-oito anos, com dentição completa, sem histórico de desordem temporomandibular, trauma, cirurgia na região de cabeça e pescoço, tratamento ortodôntico ou fonoaudiológico. O teste de eficiência mastigatória foi realizado com beads nas condições: mastigação habitual, mastigação unilateral direita e esquerda, com duração de 20 segundos. Simultaneamente, foi realizada a eletromiografia. A atividade em máxima intercuspidação habitual dos dentes também foi registrada. A quantidade de fucsina liberada após a mastigação foi medida usando o espectrofotômetro Beckman DU-7 UV-Visible (Beckman Inc., Palo Alto, CA, USA). RESULTADOS: houve alta confiabilidade do teste de eficiência mastigatória (r = 0,86, p < 0,01) e correlação significante com a atividade eletromiográfica (r = 0,76, p < 0,01). Também houve correlações positivas quando as provas foram analisadas separadamente. CONCLUSÃO: o teste de eficiência mastigatória realizado com beads mostrou-se um método confiável e correlacionado positivamente à atividade eletromiográfica dos músculos temporal anterior e músculos masseter.

Avaliação clínica e comparativa da oclusão balanceada bilateral e desoclusão com guia canino sobre a função mastigatória de usuários de prótese total removível

The maintenance of masticatory function is especially important for patients who wear complete dentures due to the limitations of this type of prosthesis. Thus, the bilateral balanced occlusion (BBO) is used to achieve, besides other advantages, greater masticatory efficiency. However, analyzing critically the literature, it is observed that there is not enough scientific evidence that support the BBO as the most appropriate occlusal concept in complete dentures. This way, the purpose of the present study was to verify if complete dentures wearers with BBO present better masticatory efficiency and capacity than those with canine guidance (CG). A double-blind controlled crossover clinical trial was conducted. The sample was made of 24 completely edentulous patients. The subjects wore sets of complete dentures with both occlusal concepts for equal periods of 3 months. Objective data were collected through the masticatory efficiency test, performed by the colorimetric method, in which capsules of a synthetic material enclosing fuchsine- containing granules were used. Subjective data were recorded by patient´s ratings of their chewing function, which is the masticatory ability. No significant statistical difference was found for masticatory efficiency (p=0,0952) and masticatory ability (x2=0,5711/ p=0,4498) between the two occlusal concepts studied, as well as there was no correlation between these two variables (p=0,2985). Based on these results, it seems reasonable to use CG for the setup of complete dentures, since it is an easier and quicker technical procedure, until that future researches can come to complement this question

Morphology of collagen fibers and elastic system fibers in actinic cheilitis

Background: Actinic cheilitis (AC) is a premalignant condition intimately related to exposure of the lips to sun rays. Aim: The objective of this study was to evaluate the elastic and collagen fibers in the lamina propria of AC. The degree of epithelial atypia was correlated with the quantity of elastic and collagen fibers. Materials and Methods: Fifty-one cases were investigated. One slide was stained with hematoxylin-eosin for the evaluation of atypia, the second was stained with Weigert′s resorcin-fuchsin for the assessment of elastic fibers, and the third slide was stained with Mallory′s trichrome for the analysis of collagen fibers. Results: Ordinal logistic regression analysis revealed a significant correlation between the presence of atypia and collagen fibers (P<0.05). Conclusions: It was concluded that there seems to be a reduction in the quantity of collagen fibers in cases of moderate and severe atypia. No correlation was observed between the degradation of elastic system fibers and the grade of dysplasia.

Low shrinkage composite resins: influence on sealing ability in unfavorable C-factor cavities

The present investigation observed the sealing ability of low shrinkage composite resins in large and deep cavities, placed and photocured in one increment. Large, deep cavities (5.0 mm diameter and 2.5 mm deep) surrounded by enamel were prepared in bovine teeth, which were then divided into five groups. Groups 1, 2, 3 and 4: acid conditioning + Adper Single Bond (3M/ESPE, St Paul, MN, USA) and restoration with Aelite LS Posterior (BISCO Inc. Schaumburg, IL, USA) (G1); Filtek Z-350 (3M/ESPE,St Paul, MN, USA) (G2); Filtek Z-350 Flow (3M/ESPE, St Paul, MN, USA) (G3); Premisa (KERR Corporation, Orange, CA, USA) (G4). Group 5: Silorane Adhesive system (3M/ESPE, St Paul, MN, USA) + restoration with Filtek Low Shrinkage Posterior P90 (3M/ESPE, St Paul, MN, USA). After polymerization, the teeth were immersed in 0.5% basic fuchsine solution and immediately washed. Using the Imagetool Software, the extent of dye along the margins was calculated as a percentage of total perimeter. The restorations were then transversally sectioned and the depth of dye penetration was calculated in mm, using the same software. Kruskal-Wallis analysis for all groups showed no statistical differences for extent (p = 0.54) or depth (p = 0.8364) of dye penetration. According to this methodology, the so-called low shrinkage composite resins had the same sealing ability compared to regular and flowable nanocomposite materials.

Influence of light intensity and curing cycle on microleakage of Class V composite resin restorations

O objetivo deste estudo foi determinar o efeito da polimerização gradual, mediante a utilização de aparelhos de Quartzo-Tungustênio-Halógena (QTH) e Arco de Plasma de Xenônio (PAC), no selamento marginal de restaurações classe V em resina composta com margens localizadas em dentina. Setenta e cinco incisivos bovinos receberam preparos de cavidades classe V, na raiz, com o intuito de situar as margens cavitárias em dentina. Os dentes foram divididos em cinco grupos de acordo com o método de fotoativação. As cavidades, depois de condicionadas, foram tratadas com o sistema adesivo Single Bond (3M Dental) e restauradas com a resina composta Z100 (3M Dental) pela técnica incremental. A fotoativação foi realizada para cada grupo como descrito a seguir: Grupo I: PAC pelo método de fotoativação constante: 1600mW/cm² – 3s; Grupo II: PAC pelo método de fotoativação por passos (800mW/cm² – 2s, subindo automaticamente para 1600mW/cm² – 4s); Grupo III: QTH pelo método de fotoativação constante: 400 mW/cm² – 40s; Grupo IV: QTH pelo método de fotoativação em rampa: 100 a 600 mW/cm² – 15s, permanecendo a 600mW/cm² por mais 25s; Grupo V: QTH pelo método de fotoativação por pulso: 200 mW/cm² – 3s, tempo de espera de 3min.e a seguir 600mW/cm² – 30s. Os dentes foram armazenados em água destilada a 37ºC por 30 dias e então submetidos à ciclagem térmica, por 500 ciclos à 5 ºC e 55 ºC. Os ápices dos dentes foram selados com resina composta e os dentes foram cobertos com duas camadas de esmalte para unha, antes da sua imersão em fucsina básica a 0,5%. Os dentes foram seccionados e os cortes foram escaneados para avaliação da área infiltrada por corante por um programa de computador (Image Tools). Os cortes foram também visualizados com lupa para a determinação do grau de penetração do corante na interface dente-restauração por escores. Diferenças estatisticamente significantes foram observadas entre os grupos quanto ao grau e à área de penetração de corante (p < 0,05). Os grupos I e II apresentaram valores significantemente mais altos de infiltração e penetração do corante que os grupos III, IV e V. Em conclusão, o uso da fonte de PAC, no modo constante e por passos, resultou em valores significantemente maiores de infiltração marginal quando comparados com a intensidade de luz média emitida pelos aparelhos de QTH. Os métodos de fotoativação por pulso, rampa e continuo com a fonte de QTH resultaram num grau similar de microinfiltração.

Comparison among gold standard techniques used for the validation of methods for occlusal caries detection

The aim of this in vitro study was to assess the agreement among four techniques used as gold standard for the validation of methods for occlusal caries detection. Sixty-five human permanent molars were selected and one site in each occlusal surface was chosen as the test site. The teeth were cut and prepared according to each technique: stereomicroscopy without coloring (1), dye enhancement with rhodamine B (2) and fuchsine/acetic light green (3), and semi-quantitative microradiography (4). Digital photographs from each prepared tooth were assessed by three examiners for caries extension. Weighted kappa, as well as Friedman's test with multiple comparisons, was performed to compare all techniques and verify statistical significant differences. Results: kappa values varied from 0.62 to 0.78, the latter being found by both dye enhancement methods. Friedman's test showed statistical significant difference (P < 0.001) and multiple comparison identified these differences among all techniques, except between both dye enhancement methods (rhodamine B and fuchsine/acetic light green). Cross-tabulation showed that the stereomicroscopy overscored the lesions. Both dye enhancement methods showed a good agreement, while stereomicroscopy overscored the lesions. Furthermore, the outcome of caries diagnostic tests may be influenced by the validation method applied. Dye enhancement methods seem to be reliable as gold standard methods.

Microhardness and marginal adaptation of pre-warmed composites

Objectives: The aim of this study was to examine the effect of pre-warmed composite on the microhardness and marginal adaptation. Methods: Ninety six identical class II cavities were prepared in extracted human molars and filled/cured in three 2 mm increments using a metal matrix. Two composites (Tetric Evo Ceram (IvoclarVivadent) and ELS(Saremco)) were cured with a LED curing unit (Bluephase (IvoclarVivadent)) using curing cycles of 20 and 40 seconds. The composite was used at room temperature or pre-warmed at 54.5ºC (Calset(AdDent)). Twelve teeth were filled for every composite-curing time-composite temperature combination. The teeth were thermocycled (1000 cycles at 5º and 55ºC) and then stored at 37° C for seven days . Dye penetration (basic fuchsine 5% for 8 hours) was measured using a score scale. Knoop microhardness was determined 100, 200, 500, 1000, 1500, 2500, 3500, 4500 and 5500µm from the occlusal surface at a distance of 150 and 1000µm from the metal matrix. The total degree of polymerization of a composite specimen was determined by calculating the area under the hardness curve. Results: Statistical analyses showed no difference in marginal adaptation (p>0.05). Hardness values at 150µm from the matrix were lower than those at 1000µm. There was an increase of the microhardness at the top of each increment and decrease towards the bottom of each increment. Longer curing times resulted in harder composite samples. Multiple linear regression showed that only the curing time (p<0.001) and composite material (p<0.001) had a significant association with the degree of polymerization. The degree of polymerization was not influenced by pre-warming the composite at a temperature of 54.5ºC (p=4.86). Conclusion: Polymerization time can not be reduced by pre-warming the composite on a temperature of 54.5ºC. The marginal adaptation is not compromised by pre-warming the composite.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.