Alfredo Júlio Fernandes Neto

Relation between implant/abutment vertical misfit and torque loss of abutment screws

This study investigated whether there is a direct correlation between the level of vertical misfit at the abutment/implant interface and torque losses (detorque) in abutment screws. A work model was obtained from a metal matrix with five 3.75 x 9 mm external hex implants with standard platform (4.1 mm). Four frameworks were waxed using UCLA type abutments and one-piece cast in commercially pure titanium. The misfit was analyzed with a comparator microscope after 20 Ncm torque. The highest value of misfit observed per abutment was used. The torque required to loose the screw was evaluated using a digital torque meter. The torque loss values, measured by the torque meter, were assumed as percentage of initial torque (100%) given to abutment screws. Pearsons correlation (alpha=0.05) between the misfit values (29.08 +/- 8.78 microm) and the percentage of detorque (50.71 +/- 11.37%) showed no statistically significant correlation (p=0.295). Within the limitations of this study, it may be concluded that great vertical misfits dot not necessarily implies in higher detorque values.

Postural evaluation of patients with temporomandibular disorders under use of occlusal splints

Objectives: Alterations in the temporomandibular complex can reflect in adaptations of the individuals entire muscular system, intervening with the head position and scapular waist, developing postural alterations and modifying all corporal biomechanics. The aim of this study was to evaluate the head position (HP) and head postural alterations before and after installation of occlusal splints. Material and Methods: Twenty patients with temporomandibular disorders (TMD) underwent clinical and postural examination, before the installation of an occlusal splint, and after 1 week and 1 month of use. Results: There were statistically differences for HP, between the initial values and after 1 week of use of the occlusal device (p= 0.048) and also between 1 week and 1 month of evaluation (p= 0.001). Decrease of the painful symptomatology and maintenance of the rectification were also observed. Conclusions: The individuals postural position can suffer biomechanical alterations due to stomatognathic alterations, causing clinically visible changes in dysfunctional individuals and affecting the performance of the involved structures.

Prosthetic laboratory influence on the vertical misfit at the implant/UCLA abutment interface

An inadequate fit at the abutment/implant interface can generate mechanical and biological problems. The laboratorial stages could induce misfit in such interface when the castable UCLA abutment type is used. The purpose of this study was to comparatively evaluate the performance of three prosthetic laboratories (Labs A, B and C) by vertical fit analysis of castable UCLA abutments on the casting and soldering stages of the same prosthesis. Four fixed prostheses were built by each laboratory using castable UCLA abutments. The evaluation was made by scanning electron microscopy under 500x magnification in the mesial and distal regions of each element of the prosthesis, totalizing 24 measurements per laboratory. The results were analyzed statistically by Kruskal-Wallis test (p<0.05). In the casting process, the values presented by the laboratories differed significantly to each other (p=0.004). After soldering, the values presented by the laboratories showed no significant difference (p=0.948). It may be concluded that the fit values obtained in the casting stage of UCLA abutments can be influenced when processed by different laboratories, and that conventional soldering itself increased the degree of framework misfit, regardless of which laboratory made it.

Shear bond strength of dental porcelains to nickel-chromium alloys

The continuous technological advance and increasing availability of new base metal alloys and ceramic systems in the market, coupled to the demands of daily clinical practice, have made the constant evaluation of the bond strength of metal/porcelain combinations necessary. This study evaluated the metal/porcelain shear bond strength of three ceramic systems (Duceram, Williams and Noritake) in combination with three nickel-chromium (Ni-Cr) alloys (Durabond, Verabond and Viron). Thirty cast cylinder specimens (15 mm high; 6 mm in diameter) were obtained for each alloy, in a way that 10 specimens of each alloy were tested with each porcelain. Bond strength was measured with an Emic screw-driven mechanical testing machine by applying parallel shear forces to the specimens until fracture. Shear strength was calculated using the ratio of the force applied to a demarcated area of the opaque layer. Mann-Whitney U test was used for statistical analysis of the alloy/ceramic combinations (p<0.05). Viron/Noritake had the highest shear bond sregnth means (32.93 MPa), while Verabond/Duceram (16.31 MPa) presented the lowest means. Viron/Noritake differed statistically from other combinations (p<0.05). Viron/Duceram had statistically significant higher bond strengths than Verabond/Duceram, Verabond/Williams and Durabond/Noritake (p<0.05). It was also found significant difference (p<0.05) between Verabond/Noritake, Verabond/Duceram and Durabond/Noritake. No statistically significant difference (p>0.05) were observed among the other combinations. In conclusion, the Noritake ceramic system used together with Viron alloy presented the highest resistance to shear forces, while Duceram bonded to Verabond presented the lowest bond strength. Viron/Duceram and Verabond/Noritake provided intermediate results. The combinations between the Williams ceramic system and Ni-Cr alloys had similar shear strengths among each other.

Bond strength of three dental porcelains to Ni-Cr and Co-Cr-Ti alloys

Ceramometal bond strength has played an important role for the replacement of gold alloys by nickel-chromium alloys in dentistry. This study evaluated the metal/porcelain bond strength of three ceramic systems (Vita VMK 88, Williams and Duceram) associated with three nickel-chromium alloys (Durabond, Lite Cast B and Resistal P) and one experimental cobalt-chromium-titanium alloy. Thirty cast cylinder specimens (15 mm in height; 6 mm in diameter) were obtained for each alloy, in away that 10 specimens of each alloy were tested with each porcelain. Bond strength was measured with an Emic screw-driven mechanical testing machine by applying parallel shear forces to the specimens until fracture. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis of the alloy/ceramic combinations (p<0.05). Resistal P/Duceram had significantly higher bond strength (44.38+/-9.12 MPa) (p<0.05) than the other combinations, except for Co-Cr-Ti alloy/Vita VMK 88 (38.41+/-12.64 MPa). The association of the experimental Co-Cr-Ti alloy with Williams porcelain had significantly higher bond strength (28.20+/-3.86 MPa) than the combination of other alloys with the same porcelain (p<0.05). Based of these results and within the limitations of an in vitro study, it may be concluded that the bond strength of the three ceramic systems to the Ni-Cr and Co-Cr-Ti alloys varied significantly, indicating that metal/ceramic compatibility was very important to the bond strength.

Evaluation of intracanal post removal using ultrasound.

The aim of this study was to determine the effect of ultrasonic vibration on the force necessary to remove pre-fabricated and anatomic and cast posts. Two hundred and forty teeth were divided into two groups. In group I, a 0.8-mm metallic pre-fabricated post, Unimetric-Maillefer, was utilized; in group II, cast copper-aluminum alloy posts measuring 0.8, 1.0 and 1.2 mm in diameter were used. The root canals were prepared in three different diameters: 0.8, 1.0 and 1.2 mm, with a length of 10 mm. The posts were cemented with glass ionomer cement resulting in 20 specimens for each subgroup. Half of the sample was submitted to ultrasonic vibration for 3 min, while the other half did not receive any vibration. The specimens were submitted to traction in a universal testing machine. The results were analyzed by non-parametric Mann-Whitney U, Wilcoxon and Kruskal-Wallis tests. The application of ultrasonic vibration significantly reduced the retention provided by the glass ionomer cement in the fixation of intracanal posts. The ultrasonic action was effective in both pre-fabricated and anatomic and cast posts. The effectiveness of the ultrasonic vibration was not related to the cementation line or the diameter of the post.

Polytetrafluorethylene added to acrylic resins: mechanical properties

The addition of different polymers, such as polytetrafluorethylene (PTFE), to denture base resins could be an option to modify acrylic resin mechanical properties. This study evaluated the surface hardness, impact and flexural strength, flexural modulus and peak load of 2 acrylic resins, one subjected to a long and another subjected to a short polymerization cycle, which were prepared with or without the addition of 2% PTFE. Four groups were formed according to the polymerization cycle and addition or not of PTFE. Forty specimens were prepared for each test (10 per group) with the following dimensions: hardness (30 mm diameter x 5 mm thick), impact strength (50 x 6 x 4 mm) and flexural strength (64 x 10 x 3.3 mm) test. The results of the flexural strength test allowed calculating flexural modulus and peak of load values. All tests were performed in accordance with the ISO 1567:1999 standard. Data were analyzed statistically by ANOVA and Tukeys test with the level of significance set at 5%. No statistically significant differences (p>0.05) were found for surface hardness. Flexural strength, impact strength and peak load were significantly higher (p<0.05) for resins without added PTFE. The flexural modulus of the acrylic resin with incorporated 2% PTFE polymerized by long cycle was significantly higher (p<0.05) than that of the other resins. Within the limits of this study, it may be concluded that the addition of PTFE did not improve the mechanical properties of the evaluated acrylic resins.

Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals

STATEMENT OF PROBLEM Studies of the condyle-mandibular fossa relationship are common, although the role of this relationship in the development of a temporomandibular disorder remains controversial. PURPOSE The purpose of this study was to quantitatively evaluate the condyle-mandibular fossa relationship in young individuals with intact dentitions and compare it to that between individuals with and without symptoms of temporomandibular disorder. MATERIAL AND METHODS Volunteers were classified as asymptomatic (n=20) or symptomatic (n=20) according to research diagnostic criteria for temporomandibular disorders. Each participant underwent 2 cone beam-computed tomography scans of the middle and lower third of the face: 1 scan of the maximum intercuspation position and 1 of the centric relationship position. The distance between the condyle and mandibular fossa was measured on frontal and lateral images of the temporomandibular joint. The condylar position was compared across groups (asymptomatic, symptomatic) by using the Mann-Whitney U test (α=.05). Within each group, the condylar position was compared across maximum intercuspation and centric relationship positions by using the Mann-Whitney U test (α=.05). RESULTS No statistically significant differences were found in condylar positions between centric relationships and maximum intercuspation in either asymptomatic or symptomatic young adults, and no significant differences were found between asymptomatic and symptomatic young adults. CONCLUSIONS The condyle-mandibular fossa relationships of these young adults were similar in the centric relationships and maximum intercuspation positions when evaluated by computed tomography. The presence or absence of temporomandibular disorder was not correlated with the condyle position in the temporomandibular joint.

Soy milk as a storage medium to preserve human fibroblast cell viability: an in vitro study

Soy milk (SM) is widely consumed worldwide as a substitute for cow milk. It is a source of vitamins, carbohydrates and sugars, but its capacity to preserve cell viability has not been evaluated. The purpose of the present study was to investigate the efficacy of SM to maintain the viability of human fibroblasts at short periods compared with different cow milks. Human mouth fibroblasts were cultured and stored in the following media at room temperature: 10% Dulbeccos Modified Eagle Medium (DMEM) (positive control group); long shelf-life ultra-high temperature whole cow milk (WM); long shelf-life ultra-high temperature skim cow milk (SKM); powdered cow milk (PM); and soy milk (SM). After 5, 15, 30 and 45 min, cell viability was analyzed using the MTT assay. Data were analyzed statistically by the Kruskal-Wallis test with post-analysis using the Dunns method (α=0.05). SKM showed the lowest capacity to maintain cell viability in all analyzed times (p<0.05). At 30 and 45 min, the absorbance levels in control group (DMEM) and SM were significantly higher than in SKM (p<0.05). Cell viability decreased along the time (5-45 min). The results indicate that SM can be used as a more adequate storage medium for avulsed teeth. SKM was not as effective in preserving cell viability as the cell culture medium and SM.

Comparative analysis between mandibular positions in centric relation and maximum intercuspation by cone beam computed tomography (CONE-BEAM)

ABSTRACT This research consisted of a quantitative assessment, and aimed to measure the possible discrepancies between the maxillomandibular positions for centric relation (CR) and maximum intercuspation (MI), using computed tomography volumetric cone beam (cone beam method). The sample of the study consisted of 10 asymptomatic young adult patients divided into two types of standard occlusion: normal occlusion and Angle Class I occlusion. In order to obtain the centric relation, a JIG device and mandible manipulation were used to deprogram the habitual conditions of the jaw. The evaluations were conducted in both frontal and lateral tomographic images, showing the condyle/articular fossa relation. The images were processed in the software included in the NewTom 3G device (QR NNT software version 2.00), and 8 tomographic images were obtained per patient, four laterally and four frontally exhibiting the TMA’s (in CR and MI, on both sides, right and left). By means of tools included in another software, linear and angular measurements were performed and statistically analyzed by student t test. According to the methodology and the analysis performed in asymptomatic patients, it was not possible to detect statistically significant differences between the positions of centric relation and maximum intercuspation. However, the resources of cone beam tomography are of extreme relevance to the completion of further studies that use heterogeneous groups of samples in order to compare the results.