Denildo de Magalhães

The influence of cavity design and glass fiber posts on biomechanical behavior of endodontically treated premolars.

The aim of this study was to evaluate the effect of cavity design and glass fiber posts on stress distributions and fracture resistance of endodontically treated premolars. Fifty extracted intact mandibular premolars were divided into 5 groups (n = 10): ST, sound teeth (control); MOD, mesio-occlusal-distal preparation + endodontic treatment (ET) + composite resin restoration (CR); MODP, mesio-occlusal-distal + ET + glass fiber post + CR; MOD2/3, mesio-occlusal-distal + two thirds occlusal-cervical cusp loss + ET + CR; and MODP2/3, mesio-occlusal-distal + two thirds cusp loss + ET + glass fiber post + CR. The specimens were loaded on a cusp slope until fracture. Fracture patterns were classified according to four failure types. Stress distributions were evaluated for each group in a two-dimensional finite element analysis. The fracture resistance of the MODP, MOD2/3, and MODP2/3 groups was significantly lower than the ST and MOD groups (p < 0.05). The loss of dental structure and the presence of fiber post restoration reduced fracture resistance and created higher stress concentrations in the tooth-restoration complex. However, when there was a large loss of dental structure (MODP2/3), the post reduced the incidence of catastrophic fracture types.

Effect of different cements on the biomechanical behavior of teeth restored with cast dowel-and-cores-in vitro and FEA analysis.

PURPOSE To test the hypothesis that the type of cement used for fixation of cast dowel-and-cores might influence fracture resistance, fracture mode, and stress distribution of single-rooted teeth restored with this class of metallic dowels. MATERIALS AND METHODS The coronal portion was removed from 40 bovine incisors, leaving a 15 mm root. After endodontic treatment and standardized root canal relief at 10 mm, specimens were embedded in polystyrene resin, and the periodontal ligament was simulated with polyether impression material. The specimens were randomly divided into four groups (n = 10), and restored with Cu-Al cast dowel-and-cores cemented with one of four options: conventional glass ionomer cement (GI); resin-modified glass ionomer cement (GR); dual-cure resin cement (RC); or zinc-phosphate cement (ZP). Sequentially, fracture resistance of the specimens was tested with a tangential load at a 135 degrees angle with a 0.5 mm/min crosshead speed. Data were analyzed using one-way analysis of variance (ANOVA) and the Fisher test. Two-dimensional finite element analysis (2D-FEA) was then performed with representative models of each group simulating a 100 microm cement layer. Results were analyzed based on von Mises stress distribution criteria. RESULTS The mean fracture resistance values were (in N): RC, 838.2 +/- 135.9; GI, 772.4 +/- 169.8; GR, 613.4 +/- 157.5; ZP, 643.6 +/- 106.7. FEA revealed that RC and GR presented lower stress values than ZP and GI. The higher stress concentration was coincident with more catastrophic failures, and consequently, with lower fracture resistance values. CONCLUSIONS The type of cement influenced fracture resistance, failure mode, and stress distribution on teeth restored with cast dowel-and-cores.

Immediate implants placed into infected sockets: a case report with 3-year follow-up

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.

Effects of platelet-rich plasma on healing of alveolar socket: split-mouth histological and histometric evaluation in Cebus apella monkeys.

CONTEXT The prediction of implant treatment is directly influenced by the quality of the remaining bone after tooth extraction. AIMS The purpose of this experimental study was to, histologically and histometrically, evaluate the bone repair process in the central areas of extraction sockets filled with platelet-rich plasma. MATERIALS AND METHODS Four young adult male Cebus apella monkeys were used. The extraction of both right and left inferior second premolars was accomplished. After extraction, in one of the extraction sockets, coagulum was maintained while in the other it was removed; the alveolus was dried with gauze compress and filled up with platelet concentrate. For PRP production, Sonnleitners protocol was followed. The specimens for histological and histometric assessment were obtained in 30, 90, 120 and 180 days intervals. RESULTS In 30 days new bone formation was intense in both experimental and control sockets and no significant differences were observed between the two groups. After 90 days of the extraction, while the control group showed signs of decrease in osteogenesis, in the experimental unit, the process of bone formation and fibroblast-like cell proliferation remained intense. After 120 days, the PRP treated socket was occupied by large trabeculae of bone. After 180 days, the control unit was occupied mostly with bone marrow. The experimental unit remained occupied with large amounts of bone tissue. CONCLUSIONS It was possible to conclude that bone repair was enhanced by the use of platelet- rich plasma in alveolar sockets.

Two‐Dimensional FEA of Dowels of Different Compositions and External Surface Configurations

PURPOSE The degree of stress generated in the endodontically treated and restored tooth can be influenced by the composition and configuration of the dowels used for the restoration. Using two-dimensional (2D) finite element analysis (FEA), this study tested the hypothesis that the characterization of the stress distribution can be influenced by which evaluation method is employed: protrusion loading and 4-point flexural strength test or varying the type of material (carbon and glass fiber) or the external configuration of the dowel (smooth and serrated). MATERIALS AND METHODS For simulation of the protrusion load test, models were generated with Mechanical-AutoCAD V6 software from an image of an anatomical plate, one maxillary central incisor, and two dowels and exported to Ansys 9.0. The bone region model was fixed, and a tangential load of 1 N with a 135 degrees inclination to the tooth longitudinal axis was applied at the level of the palatal surface of the crown. In the simulation of a 4-point flexural strength test, a 1 N perpendicular load was applied in two points to the dowel. The dental materials and structures were considered elastic, isotropic, homogeneous, and linear, with the exception of the dowel, which was assumed to exhibit orthotropic behavior. Mechanical properties were defined based on a review of the literature, and the model was meshed with an eight node tetrahedral element. RESULTS The stress results from both tests were analyzed according to von Mises criteria and principal stresses (Sx). Data from the 4-point flexural strength test simulation showed that, for the serrated dowels, a higher stress concentration was found; however, no difference in the occlusal load for material or dowel configuration was found. CONCLUSIONS These results suggest that although the external configuration of the dowel influences direct loading, when the dowel is integrated to the tooth and setting material, the influence on biomechanical behavior disappears.

Effect of bone loss simulation and periodontal splinting on bone strain: Periodontal splints and bone strain.

OBJECTIVES The influence of bone loss and periodontal splinting on strains in supporting bone is still not well understood. The aim of this study was to analyse the effect of bone loss and periodontal splints on strains in an anterior mandible structure. METHODS Ten anterior mandible models were fabricated using polystyrene resin. Eighty human teeth were divided in 10 groups (right first premolar to left premolar) and embedded in simulated periodontal ligament. Strain gauges were attached to the buccal and lingual mandible surfaces. The models were sequentially tested for 7 conditions: no bone alterations and no splinting; 5mm of bone loss between canine teeth; bone loss associated with resin splint between canine teeth; bone loss with wire splint; bone loss with wire/resin splint; bone loss with extracoronal fibre-glass/resin splint; and bone loss with intracoronal fibre-glass/resin splint. Oblique loads (50, 100, and 150N) were applied on the teeth. Data were analysed using 3-way ANOVA and Scheffes test (α=.05). RESULTS Strains on buccal surface were higher than on lingual surface. Bone loss resulted in strain increase at 100 and 150N loading. Dental splinting with resin resulted in strain values similar to the control levels. CONCLUSIONS Bone loss increased strain mainly in the buccal region. Dental splints with adhesive system and composite resin produced lower bone strains irrespective of occlusal load.

Effect of periodontal therapies on indirect restoration: a scanning electron microscopic analysis

The aim of this study was to evaluate the influence of different periodontal therapies on the integrity of indirect restorations by scanning electron microscopy (SEM). Sixty single-rooted bovine teeth were selected and randomly assigned to 12 groups. Inlay cavities were prepared in the cervical region on the center of the cementoenamel junction, and were restored with laboratory processed resin and luted with a resin cement. Twelve periodontal therapies were used (n= 5): C: control (no treatment); MS: manual scaling with Gracey curettes; US: ultrasonic scaling; PP: prophylaxis with prophylactic paste; PS: prophylaxis with pumice-stone; SBJ: sodium bicarbonate jet; MS/PP; MS/PS; MS/SBJ; US/PP; US/PS; US/SBJ. The specimens were prepared and analyzed by SEM. SEM micrographs at x100 to x1000 magnification were obtained from the surface of the laboratory resin and the interface of the indirect restorations. The images were evaluated by 3 skillful, calibrated, blinded observers as to the presence of grooves, microcavities and fracture of margins. The results showed that PS produced groves on restoration surface. MS and US produced groves and marginal fractures on the restorations. SBJ resulted in resin cement degradation. These results suggest that except for PS, all procedures had deleterious effects on the marginal integrity of indirect restorations.

The Influence of Interproximal Contact on Implant-Supported Fixed Partial Dentures in the Posterior Jaw: A Photoelastic Analysis

The aim of this study was to analyze the effect of the separation of prosthetic crowns from fixed partial dentures by means of stress gradient evaluation. Three photoelastic models were created to examine contiguous implants with varying contact between the crowns (contact point [CP], contact surface [CS], splinted [SP]). The SP group presented the best results, followed by the CS group, indicating that the use of splinted prosthetic crowns and crowns with broad surface contacts is viable when considering the stress values.

Cytotoxicity of bovine and porcine collagen membranes in mononuclear cells

This study compared the cytotoxicity and the release of nitric oxide induced by collagen membranes in human mononuclear cells. Peripheral blood was collected from each patient and the separation of mononuclear cells was performed by Ficoll. Then, 2x10(5) cells were plated in 48-well culture plates under the membranes in triplicate. The polystyrene surface was used as negative control. Cell viability was assessed by measuring mitochondrial activity (MTT) at 4, 12 and 24 h, with dosage levels of nitrite by the Griess method for the same periods. Data had non-normal distribution and were analyzed by the Kruskal-Wallis test (p<0.05). Statistically significant differences (p<0.05) were observed between the membranes and the control in the experimental period, although there was a significant reduction in viability over time (p<0.01). At 4 and 12 h, the porcine membrane induced a higher release of nitrite compared with the control and bovine membrane, respectively (p<0.01), and this difference was maintained at 24 h (p<0.05). This in vitro study showed that the porcine collagen membrane induces an increased production of proinflammatory mediators by mononuclear cells in the first hours of contact, decreasing with time.

Biological Effects of a Root Conditioning Treatment on Periodontally Affected Teeth - An In Vitro Analysis

The aim of this study was to evaluated the root surfaces modifications resulted by application of different chemicals agents, and their influence on the fibrin network and fibroblasts attachment. From 96 anterior mandibular human extracted incisor teeth, 192 dentin blocks of buccal and lingual surface were obtained and randomly divided into 6 groups: Cont- control group, which received no treatment; Root surface scaling and root planing (Srp); Citric acid-Srp; EDTA-Srp; Tetracycline capsule-Srp; Tetracycline gel-Srp. After dentin treatments the specimens were analyzed as follows: 1) demineralization level and residues of the product by scanning electron microscopy (SEM); 2) adhesion of blood components after 20 min of surface treatment by SEM; 3) fibroblast attachment after 24 h by SEM; 4) cell metabolism after 24 h by MTT assay. Data were analyzed using Fisher Exact, One-way ANOVA test followed by Dunns test, Tukey test and Dunnett test (α=0.05). Citric acid, EDTA and Tetracycline gel resulted in adequate demineralization with no completely smear layer and smear plug removal on root dentin surface. Tetracycline capsule produced great tetracycline residues with several demineralization areas. Tetracycline gel and EDTA groups presented more fibroblast fixation than other experimental groups. The highest mean blood clot adhesion score was observed in roots treated with tetracycline gel. EDTA and Tetracycline gel surface treatment removed the smear layer over dentin surface and promoted adhesion of fibrin network and fibroblast cells attachment.