Fernanda Faot

Occlusal force, electromyographic activity of masticatory muscles and mandibular flexure of subjects with different facial types

Objective The aim of this study was to evaluate whether vertical facial patterns influence maximal occlusal force (MOF), masticatory muscle electromyographic (EMG) activity, and medial mandibular flexure (MMF). Material and Methods Seventy-eight dentate subjects were divided into 3 groups by Rickettss analysis: brachyfacial, mesofacial and dolychofacial. Maximum occlusal force in the molar region was bilaterally measured with a force transducer. The electromyographic activities of the masseter and anterior temporal muscles were recorded during maximal voluntary clenching. Medial mandibular flexure was calculated by subtracting the intermolar distance of maximum opening or protrusion from the distance in the rest position. The data were analyzed using ANOVA followed by Tukeys HSD test. The significance level was set at 5%. Results Data on maximum occlusal force showed that shorter faces had higher occlusal forces (P<0.0001). Brachyfacial subjects presented higher levels of masseter electromyographic activity and medial mandibular flexure, followed by the mesofacial and dolychofacial groups. Additionally, dolychofacial subjects showed significantly lower electromyographic temporalis activities (P<0.05). Conclusion Within the limitations of the study, it may be concluded that maximum occlusal force, masticatory muscle activity and medial mandibular flexure were influenced by the vertical facial pattern.

Chewing side, bite force symmetry, and occlusal contact area of subjects with different facial vertical patterns

Craniofacial dimensions influence oral functions; however, it is not known whether they are associated with function asymmetry. The objective of this study was to evaluate chewing side preference and lateral asymmetry of occlusal contact area and bite force of individuals with different craniofacial patterns. Seventy-eight dentate subjects were divided into 3 groups according to the VERT index as follows: (1) mesofacial, (2) brachyfacial and (3) dolichofacial. Chewing side preference was evaluated using jaw tracking equipment, occlusal contact area was measured by silicon registration of posterior teeth, and bite force was measured unilaterally on molar regions using 2.25 mm-thick sensors. Statistical analysis was performed using ANOVA on Ranks, Students t-test, and Mann-Whitney tests at a 5% significance level. Mesofacial, brachyfacial, and dolichofacial subjects presented more occlusal contact area on the left side. Only dolichofacial subjects showed lateral asymmetry for bite force, presenting higher force on the left side. No statistically significant differences were found for chewing side preference among all groups. Within the limitations of this study, it can be concluded that craniofacial dimensions play a role in asymmetry of bite force. ClinicalTrials.gov ID: NCT01286363.

Microwave disinfection: cumulative effect of different power levels on physical properties of denture base resins.

PURPOSE This study evaluated the cumulative effects of different microwave power levels on the physical properties of two poly(methylmethacrylate) (PMMA) denture base resins. MATERIALS AND METHODS Eight sets of four PMMA specimens each (two polymerized in a water bath and two using microwave energy) were immersed in beakers containing 200 ml of distilled water. Each beaker was subjected to microwave irradiation for 3 minutes at a power level of 450,630, or 900 W. The surface roughness, surface hardness, linear stability, flexural strength, elastic modulus, impact strength, and fractographic properties were evaluated after either 6 or 36 simulated disinfection cycles. The data were statistically analyzed using ANOVA and the Tukey post hoc test (α= 0.05). RESULTS The polymerization method did not influence any property (p > 0.05) except linear stability. The surface roughness (p < 0.001) and hardness (p= 0.011) increased after 36 irradiation cycles at 630 or 900 W. The resin polymerized using microwave energy exhibited greater linear distortion (p= 0.012), and there was a cumulative effect on linear stability for both resins (p < 0.001). No significant change (p > 0.05) was observed in flexural strength; however, the elastic modulus decreased (p= 0.008) after 36 disinfection cycles. The impact strength and crack propagation angles displayed no significant differences (p > 0.05). CONCLUSION Within the limitations of this study, it can be concluded that microwave disinfection at 450 W to 630 W for 3 minutes is safe for PMMA.

Impact and Flexural Strength, and Fracture Morphology of Acrylic Resins With Impact Modifiers

Objectives: This study evaluated the impact and flexural strength and analyzed the fracture behavior of acrylic resins. Methods: Eighteen rectangular specimens were fabricated of Lucitone 550, QC 20 (both unreinforced acrylic resins), Impact 1500 (extra strength impact), Impact 2000 (high impact) according to the manufacturers’ instructions. The impact strength was evaluated in notched specimens (50x6x4mm) and flexural strength in unotched (64x10x3.3mm), using three-point bending test, as well as, stress at yield, Young modulus and displacement at yield. Fragments from mechanical tests were observed by SEM. Data from impact strength, stress at yield and displacement at yield were analyzed by 1-way ANOVA and Tukey test (α=0.05). Young modulus values were analyzed by One-way ANOVA and Dunnett T3 multiple comparisons test (α=0.05). Results: Mean values of impact strength and stress at yield values were higher (P<.005) for Impact 2000 while Young modulus was higher (P<.05) for Lucitone 550; Impact 1500 and Impact 2000 showed significant values (P<.05) in the displacement at yield. Impact fractures of the all acrylic resins were brittle. Bending fractures of Lucitone 550 and Impact 2000 were brittle, QC 20 fractures were ductile and Impact 1500 showed brittle (75%) and ductile (25%) fractures. Conclusion: Within the limitations of this study, the Impact 2000 showed improved mechanical properties with high capacity of stress absorption and energy dissipation before the fracture.

Strength of Denture Base Resins Repaired with Auto- and Visible Light-Polymerized Materials

PURPOSE Clinicians are still confused about the choice of repair method, which depends on factors such as the length of time required for processing, the mechanical strength of the repaired material, and the effect of stress concentration in the acrylic resins before the repair. The aim was to determine the impact and flexural strength characteristics, such as stress at yield, Youngs modulus, and displacement at yield of denture base resins fractured and repaired by three methods using heat-, auto-, and visible light-polymerized acrylic resins. MATERIAL AND METHODS For impact and flexural strength tests, 18 rectangular specimens measuring 50 x 6 x 4 mm(3) and 64 x 10 x 3.3 mm(3), respectively, were processed using Impact 2000, Lucitone 550, Impact 1500, and QC-20 acrylic resins. Fracture tests were performed according to ISO1567:1999. Afterward, all fractured specimens were stored in distilled water at 37 degrees C for 7 days, and then repaired with (1) the same acrylic resin used for specimen fabrication (n = 6), (2) an autopolymerized acrylic resin (TruRepair, n = 6), and (3) a visible light acrylic resin (Versyo.com, n = 6). The repaired specimens were again submitted to the same fracture tests, and the failures were classified as adhesive or cohesive. Data from all mechanical tests after repair by the different methods were submitted to two-way ANOVA, and mean values were compared by the Tukey test. RESULTS All acrylic resins showed adhesive fractures after impact and flexural strength tests. Differences (p < 0.05) were found among repair methods for all acrylic resins studied, with the exception of displacement at yield, which showed similar values for repairs with auto- and visible light-polymerized acrylic resins. The highest values for impact strength, stress, and displacement at yield were obtained when the repair was made with the same resin the specimen was made of. CONCLUSION Denture base acrylic resins repaired with the same resin they were made of showed greater fracture strength.

Evaluation of surface characteristics of Ti-6Al-4V and Tilite alloys used for implant abutments

The aim of this study was to evaluate surface free energy (SFE), surface roughness (SR) and surface hardness (SH) of two commercially available materials for fabricating dental implant abutments. In addition, the specimens were investigated by scanning electron microscopy (SEM) to determine the surface morphology. Twenty five discs (5 x 2 mm) of Ti-6Al-4V and Tilite (Ni-Cr-Ti) alloys were used in this study. Surface free energy was determined by the contact angle formed between a drop of distilled, deionized water and the surface of the specimen of each material. The surface roughness was measured with a mechanical profilometer and the surface hardness was evaluated by means of the Vickers hardness micro indentation test. SFE, SR and SH data were analyzed using one-way ANOVA (p < 0.05). Statistical differences (p < 0.05) were found between Ti-6Al-4V (36.2 erg x cm(-2); 0.2 microm) and Tilite (30.9 erg x cm(-2); 0.16 microm) for SFE and SR. However, the differences between the surface hardness values of Ti-6Al-4V (325.0 kg/mm(2)) and Tilite (324.3 kg/mm(2)) were not statistically significant (p > 0.05). Evaluations by SEM revealed different surface morphology. Within the limits of this study, it can be concluded that the Ti-6Al-4V and Tilite alloys showed differences in surface properties, except for surface hardness, suggesting that both alloys may be considered appropriate for producing abutments. Further studies are, however, necessary to elucidate the biological responses to implant abutments made with these alloys.

Masticatory function parameters in patients with varying degree of mandibular bone resorption.

PURPOSE This cross-sectional study analyzes how bone resorption affects the masticatory function and investigates the relation between perceived and measured masticatory function. METHODS Thirty complete dentures wearers were divided in two groups according to mandible bone atrophy based on the classification criteria from Cawood & Howell. Retention and stability of the mandibular complete denture, masticatory performance (MP) indexes (X_50 and B) and masticatory efficiency (ME, sieves 4 and 2.8) were evaluated. Geriatric Oral Health Assessment Index (GOHAI) and Dental Impact on Daily Living (DIDL) questionnaires were completed by the patients. RESULTS A strong correlation between bone atrophy and poor retention was found (P=0.0132). Neither masticatory performance indexes nor GOHAI and DIDL domains showed statistical differences (P>0.05) when patients were compared according to the atrophy criteria. Mandibular length showed a negative correlation with ME4, showing a positive association (R2=0.17, β=-0.67, P=0.029). Mandibular denture retention was significantly correlated with MPB (P=0.01) and ME2.8 (P=0.01). GOHAI showed a positive association between the physical and the functional domains and ME2.8 (R2=0.17; β=1.22; P=0.02). DIDL showed a negative association between ME4 and oral comfort domain (R2=0.16; β=-2.94; P=0.02). CONCLUSION Mandibular bone height does not directly affect the masticatory function and is inversely correlated with the self-perceived masticatory ability.

The role of prosthetic abutment material on the stress distribution in a maxillary single implant-supported fixed prosthesis

PURPOSE Evaluate the influence of abutments material and geometry on stress distribution in a single implant-supported prosthesis. MATERIALS AND METHODS Three-dimensional models were made based on tomographic slices of the upper middle incisor area, in which a morse taper implant was positioned and a titanium (Ti) or zirconia (ZrN) universal abutments was installed. The commercially available geometry of titanium (T) and zirconia (Z) abutments were used to draw two models, TM1 and ZM1 respectively, which served as control groups. These models were compared with 2 experimental groups were the mechanical properties of Z were applied to the titanium abutment (TM2) and vice versa for the zirconia abutment (ZM2). Subsequently, loading was simulated in two steps, starting with a preload phase, calculated with the respective friction coefficients of each materials, followed by a combined preload and chewing force. The maximum von Mises stress was described. Data were analyzed by two-way ANOVA that considered material composition, geometry and loading (p<0.05). RESULTS Titanium and zirconia abutments showed similar von Mises stresses in the mechanical part of the four models. The area with the highest concentration of stress was the screw thread, following by the screw body. The highest stress levels occurred in screw thread was observed during the preloading phase in the ZM1 model (931MPa); and during the combined loading in the TM1 model (965MPa). Statistically significant differences were observed for loading, the material×loading interaction, and the loading×geometry interaction (p<0.05). Preloading contributed for 77.89% of the stress (p<0.05). There were no statistically significant differences to the other factors (p>0.05). CONCLUSION The screw was the piece most intensely affected, mainly through the preload force, independent of the abutments material.

Fractographic analysis, accuracy of fit and impact strength of acrylic resin

This study evaluated accuracy of fit, impact strength, types and morphology of fractures of a microwave acrylic resin polymerized with a cycle alternative to that recommended by the manufacturer. Onda Cryl was polymerized according to the manufacturers instructions (MC), 3 min at 360 W, 4-min pause, and 3 min at 810 W; and with an alternative cycle (AC) of 6 min at 630 W. Accuracy of fit was measured at 3 points at the right (A) and left (B) ridge crests and at the midline (C) on the posterior palatal seal for each denture base (n = 10/group). The measurements were taken immediately after finishing and after 30-day storage in water. The impact strength test (Charpy method) was performed with a 40 kJ/cm load (n = 20/group). Fractographic analysis was accomplished for all fragments and the fracture types were characterized by means of their morphology, crack propagation angles and microstructure. Accuracy of fit data were analyzed by ANOVA, impact strength and radius values were compared by the t test, and the fractographic analysis data, by the Wilcoxon Mann-Whitney test. The significance level was fixed at p < 0.05. No statistical differences were found between the two cycles of polymerization used. However, after the 30-day storage period in water, the denture bases showed better fit (P < .05). Most of the fractures were classified as brittle (MD: 70%, AC: 80%). Based on the results of this study, it could be concluded that both polymerization cycles are adequate to polymerize the denture resin studied.

Comparison between tapered and cylindrical implants in the posterior regions of the mandible: A prospective, randomized, split-mouth clinical trial focusing on implant stability changes during early healing

BACKGROUND Companies affirm that tapered implants show adequate initial stability, while their installation in the lower arch is uncommon in clinical practice. PURPOSE To compare the clinical outcomes of tapered and cylindrical implants and to study their effect on bone site characteristics and peri-implant health during healing. MATERIALS AND METHODS The implant site dimensions were assessed by linear measurements using CBCT prior to the installation of 40 implants in the posterior mandible (20 tapered and 20 cylindrical). The bone type was registered during drilling via the surgeons tactile perception, following the classification of Lekholm and Zarb. Primary stability (PS) was determined by the insertion torque (IT) and the implant stability quotient (ISQ). Secondary stability (SS) and the peri-implant health was monitored for 3 months through the visible plaque index (VPI), the peri-implant inflammation (PI), the probing depth index (PDI), and the gingival bleeding index (GBI). Significant differences were investigated with t-tests for independent samples, chi-square tests or Fishers exact test. Pearsons correlation test was used to investigate the relationship between the bone site characteristics and PS (IT and ISQ), as well as the relationships between IT and ISQ for each implant type. RESULTS Tapered and cylindrical implants showed no significant differences for any outcome variable (P > .05). A significant decrease in ISQ was observed after 7 days of healing (P = .0002), followed by a gradual increase beginning at 21 days (P = .0010) until the last follow-up time at 90 days (P = .0319). The cortical height was correlated with IT; while medullary bone dimensions were correlated with the PS as evidenced by the ISQ values. The insertion torque was significantly correlated with the PS only for the cylindrical dental implants. CONCLUSIONS Tapered and cylindrical implants have similar biological behavior during the healing process. Bone site characteristics can influence insertion torque and implant stability.