Adriana Cláudia Lapria Faria

Endodontically treated teeth: Characteristics and considerations to restore them

The restoration of endodontically treated teeth is a topic that is extensively studied and yet remains controversial. This article emphasizes the characteristics of endodontically treated teeth and some principles to be observed when restorations of these teeth are planned. It was concluded that the amount of remaining coronal tooth structure and functional requirements determine the best way to restore these teeth, indicating the material to be used, direct or indirect restorations, associated or not to posts.

Analysis of the relationship between the surface hardness and Wear resistance of indirect composites used as veneer materials

This study evaluated the surface hardness and wear resistance of indirect composites (Artglass and Solidex) and the existence of a correlation between these properties. Twenty-four specimens (12 per material) were fabricated using a polytetrafluoroethylene matrix (5.0 mm in diameter; 7.0 mm high) following an incremental technique. Polymerization was done with a xenon stroboscopic light curing unit. After polishing, the specimens were stored in water at 37 degrees C during either 1 day (n=6 per material) or 55 days (n=6 per material), after which Vickers surface hardness and wear resistance were assessed. Data were analyzed statistically by unpaired Student t-test, two-way ANOVA and Tukeys test. SURFACE HARDNESS: Artglass had higher surface hardness than Solidex after 1-day immersion period (p<0.01), but after 55 days there was no significant difference between the materials (p>0.05). Comparing the materials at both periods, Artglass means differed significantly to each other (p<0.01), while no significant difference was found between Solidex means (p>0.05). WEAR RESISTANCE: Solidex had higher wear than Artglass after 1-day immersion period (p<0.01), but no significant difference was found between the materials after 55 days (p>0.05). Comparing the materials at both periods, Artglass means differed significantly to each other (p<0.01), with higher wear at 55-day period, but no difference was found between Solidex means (p>0.05). These results suggest that Artglass was better than Solidex in terms of hardness and wear resistance after 1-day water immersion. However, it was more susceptible to degradation, showing greater wear after 55 days. In conclusion, there was an inverse correlation between surface hardness and wear resistance for both Artglass and Solidex indirect composites, that is the higher the hardness, the lower the wear.

An in vitro study of non‐axial forces upon the retention of an O‐ring attachment

OBJECTIVE The purpose of this study was to evaluate the retention force of an O-ring attachment system in different inclinations to the ideal path of insertion, using devices to compensate angulations. MATERIAL AND METHODS Two implants were inserted into an aluminum base, and ball attachments were screwed to implants. Cylinders with O-rings were placed on ball attachments and connected to the test device using positioners to compensate implant angulations (0 degrees , 7 degrees , and 14 degrees ). Plexiglass bases were used to simulate implant angulations. The base and the test device were positioned in a testing apparatus, which simulated insertion/removal of an overdenture. A total of 2900 cycles, simulating 2 years of overdenture use, were performed and 36 O-rings were tested. The force required for each cycle was recorded with computer software. Longitudinal sections of ball attachment-positioner-cylinder with O-rings of each angulation were obtained to analyze the relationship among them, and O-ring sections tested in each angulation were compared with an unused counterpart. A mixed linear model was used to analyze the data, and the comparison was performed by orthogonal contrasts (alpha=0.05). RESULTS At 0 degrees , the retention force decreased significantly over time, and the retention force was significantly different in all comparisons, except from 12 to 18 months. When the implants were positioned at 7 degrees , the retention force was statistically different at 0 and 24 months. At 14 degrees , significant differences were found from 6 and 12 to 24 months. CONCLUSIONS Within the limitations of this study, it was concluded that O-rings for implant/attachments perpendicular to the occlusal plane were adequately retentive over the first year and that the retentive capacity of O-ring was affected by implant inclinations despite the proposed positioners.

Retention and stress distribution in distal extension removable partial dentures with and without implant association

PURPOSE The present study aimed to evaluate the retention and stress distribution of conventional (C) RPD and compare to RPD associated to implant for support (IS) and retention (IR). METHODS Frameworks were cast from cp Ti (n=18) and Co-Cr alloy (n=18) by plasma and injected by vacuum-pressure. Conventional RPDs were compared to implant associated RPDs using a distal implant to support (IS) or to support and retain (IR) RPD. The specimens were subjected to insertion/removal cycles simulating 5 years of use and the retention force (N) was measured or evaluated. A mixed linear model was used to analyze the data (α=0.05). Photoelastic models were qualitatively examined for stress when an occlusal load of 15 kgf was applied over support teeth and RPD. RESULTS Retention force of IR RPDs is greater than IS and C RPDs for both cp Ti and Co-Cr alloy specimens. Retention force of cp Ti RPDs increased initially and was maintained throughout 5 years of simulation test while Co-Cr RPDs presented a decrease at the beginning of the test and had their retention force maintained throughout the test. Implant placement at residual alveolar ridge decreased stress around teeth, mainly in the first premolar. Stress concentration in the IS RPD is slightly greater than in the IR RPD. CONCLUSION The results suggest that implant placement at the distal extension improves retention and stress distribution of RPDs.

Effect of different investments and mold temperatures on titanium mechanical properties

PURPOSE The aim of the present study was to evaluate commercially pure titanium (CP Ti) casting quality when a specific to titanium and a conventional phosphate bonded investments were used under different mold temperatures. For this, the evaluated parameters were surface roughness, bending strength, Vickers microhardness, casting quality by radiographies and microstructure of CP Ti. METHODS Wax patterns (28 mm × 3 mm × 1 mm) were invested using two phosphate bonded investments: Rematitan Plus (REM), specific to titanium, and Castorit Super C (CAS), a conventional investment, fired and cooled until reaching two mold temperatures: 430 °C (430) and room temperature (RT). Specimens were cast from CP Ti by plasma. After casting, specimens were radiographically examined and submitted to Vickers microhardness, roughness and bending strength evaluation. Microstructure was analyzed in the center and at the surface of specimen. RESULTS Qualitative analysis of radiographs showed that specimens which were cast using CAS-RT presented more casting porosities while the specimens which were cast with REM-430 did not present any casting porosity. No significant difference was noted among the groups in the surface roughness and Vickers microhardness data, but the bending strength of the specimens cast using CAS was greater than REM groups. The microstructure of the specimens of the different groups was similar, presenting a feather-like aspect. CONCLUSION Casting porosities found in the specimens cast using conventional investments (CAS) and lower mold temperatures would limit their use, even mechanical properties were similar than in specimens cast using specific to titanium investment (REM) at temperatures recommended by the manufacturer.

Effect of temperature variation on the cytotoxicity of cast dental alloys and commercially pure titanium

Cell culture system has been used to evaluate alloy cytotoxicity under different environments, testing the extracts, but the effect of temperature variation on the cytotoxicity of dental alloys has not been analyzed. Objective: The aim of the present study was to investigate if temperature variation could affect dental alloy cytotoxicity, testing alloy extracts in an epithelial cell culture system. Material and methods: Discs of Ni-Cr, Co-Cr-Mo, Ni-Cr-Ti, Ti-6Al-4V and commercially pure titanium (cp Ti) were cast by arc melting, under argon atmosphere, injected by vacuum-pressure. Discs were immersed in artificial saliva and subjected to different temperatures: 37°C and thermocycling (37°C/5°C/37°C/55°C/37°C). After thermocycling, extracts were put in a subconfluent culture during 6 h, and the number of cells and their viability were used to evaluate cytotoxicity in these temperatures. For each alloy, data from temperature conditions were compared by Students t-test (α=0.05). Results: The cytotoxicity tests with alloy/metal extracts showed that Ni-Cr, Co-Cr-Mo, Ti-6Al-4V and cp Ti extracts (p>0.05) did not affect cell number or cell viability, while Ni-Cr-Ti (p<0.05) extract decreased cell number and viability when the alloy was subjected to thermocycling. Conclusion: Within the limitations of the present study, the Ni-Cr-Ti alloy had cell number and viability decreased when subjected to temperature variation, while the other alloys/metal extracts did not show these results.

Comparative study of two commercially pure titanium casting methods

The interest in using titanium to fabricate removable partial denture (RPD) frameworks has increased, but there are few studies evaluating the effects of casting methods on clasp behavior. Objective This study compared the occurrence of porosities and the retentive force of commercially pure titanium (CP Ti) and cobalt-chromium (Co-Cr) removable partial denture circumferential clasps cast by induction/centrifugation and plasma/vacuum-pressure. Material and Methods 72 frameworks were cast from CP Ti (n=36) and Co-Cr alloy (n=36; control group). For each material, 18 frameworks were casted by electromagnetic induction and injected by centrifugation, whereas the other 18 were casted by plasma and injected by vacuum-pressure. For each casting method, three subgroups (n=6) were formed: 0.25 mm, 0.50 mm, and 0.75 mm undercuts. The specimens were radiographed and subjected to an insertion/removal test simulating 5 years of framework use. Data were analyzed by ANOVA and Tukeys to compare materials and cast methods (α=0.05). Results Three of 18 specimens of the induction/centrifugation group and 9 of 18 specimens of plasma/vacuum-pressure cast presented porosities, but only 1 and 7 specimens, respectively, were rejected for simulation test. For Co-Cr alloy, no defects were found. Comparing the casting methods, statistically significant differences (p<0.05) were observed only for the Co-Cr alloy with 0.25 mm and 0.50 mm undercuts. Significant differences were found for the 0.25 mm and 0.75 mm undercuts dependent on the material used. For the 0.50 mm undercut, significant differences were found when the materials were induction casted. Conclusion Although both casting methods produced satisfactory CP Ti RPD frameworks, the occurrence of porosities was greater in the plasma/vacuum-pressure than in the induction/centrifugation method, the latter resulting in higher clasp rigidity, generating higher retention force values.

Wear resistance of a pressable low-fusing ceramic opposed by dental alloys.

Dental alloys have increasingly replaced by dental ceramics in dentistry because of aesthetics. As both dental alloys and ceramics can be present in the oral cavity, the evaluation of the wear resistance of ceramics opposed by dental alloys is important. The aim of the present study was to evaluate wear resistance of a pressable low-fusing ceramic opposed by dental alloys as well as the microhardness of the alloys and the possible correlation of wear and antagonist microhardness. Fifteen stylus tips samples of pressable low-fusing ceramic were obtained, polished and glazed. Samples were divided into three groups according to the disk of alloy/metal to be used as antagonist: Nickel-Chromium (Ni-Cr), Cobalt-Chromium (Co-Cr) and commercially pure titanium (cp Ti). Vickers microhardness of antagonist disks was evaluated before wear tests. Then, antagonist disks were sandblasted until surface roughness was adjusted to 0.75μm. Wear tests were performed at a speed of 60 cycles/min and distance of 10mm, in a total of 300,000 cycles. Before and after wear tests, samples were weighted and had their profile designed in an optical comparator to evaluate weight and height loss, respectively. Ni-Cr and cp Ti caused greater wear than Co-Cr, presenting greater weight (p=.009) and height (p=.002) loss. Cp Ti microhardness was lower than Ni-Cr and Co-Cr (p<.05). There is a positive correlation between weight and height loss (p<.05), but weight (p=.204) and height (p=.05) loss are not correlated to microhardness. The results suggest that pressable low-fusing ceramic presents different wear according to the dental alloy used as antagonist and the wear is not affected by antagonist microhardness.

Effect of cyclic loading on the vertical microgap of long-span zirconia frameworks supported by 4 or 6 implants.

STATEMENT OF PROBLEM Few studies have investigated the microgap of long-span complete-arch fixed dental prosthesis zirconia frameworks. PURPOSE The purpose of this study was to evaluate the effects of cyclic loading on the vertical microgap of maxillary 12-unit prostheses supported by 4 implants and on 14-unit prostheses supported by 6 implants. MATERIAL AND METHODS One-piece zirconia frameworks were fabricated with a computer-aided design/computer-aided manufacturing technique and divided into 2 groups (n=5): a group of 12-unit prostheses and a group of 14-unit prostheses. The vertical microgap between the frameworks and prosthetic abutments was measured with an optical microscope (80×) under 2 reading conditions. Condition 1 (1-screw test): 1A, the screw on implant 1 was tightened and readings were made on all implants; 1B, the screw was changed to implant 4 (implant 6 for the 14-unit group) and readings were made on all implants. Condition 2: the microgap was measured with all screws tightened before cyclic loading (2A). Specimens were submitted to 200 N underwater (37°C) cyclic loading at a 2-Hz frequency for 1×10(6) cycles. Microgap reading condition 2 was repeated after cyclic loading (2B). The data were submitted to a linear mixed-effects model for statistical comparison (α=.05). RESULTS A lower (P<.05) vertical microgap (μm) was found for the 12-unit group (reading conditions: 1A, 47.93; 1B, 43.83; 2A, 11.77; and 2B, 11.25) compared to the 14-unit group (1A, 94.87; 1B, 112.56; 2A, 21.28; and 2B, 16.90). No differences were found when each group was compared before and after cyclic loading (P>.05). CONCLUSIONS The vertical microgap was significantly reduced after tightening all the screws in the framework, possibly leading to a nonpassive situation. Longer-span frameworks showed an increased microgap. Cyclic loading had no influence on the vertical microgap within each group.

Mechanical analysis of conventional and small diameter conical implant abutments.

PURPOSE The aim of the present study was to evaluate if a smaller morse taper abutment has a negative effect on the fracture resistance of implant-abutment connections under oblique compressive loads compared to a conventional abutment. MATERIALS AND METHODS Twenty morse taper conventional abutments (4.8 mm diameter) and smaller abutments (3.8 mm diameter) were tightened (20 Ncm) to their respective implants (3.5 × 11 mm) and after a 10 minute interval, implant/abutment assemblies were subjected to static compressive test, performed in a universal test machine with 1 mm/min displacement, at 45° inclination. The maximum deformation force was determined. Data were statistically analyzed by student t test. RESULTS Maximum deformation force of 4.8 mm and 3.8 mm abutments was approximately 95.33 kgf and 95.25 kgf, respectively, but no fractures were noted after mechanical test. Statistical analysis demonstrated that the evaluated abutments were statistically similar (P=.230). CONCLUSION Abutment measuring 3.8 mm in diameter (reduced) presented mechanical properties similar to 4.8 mm (conventional) abutments, enabling its clinical use as indicated.