Túlio Marcos Kalife Coêlho

A Review of Surface Treatment Methods to Improve the Adhesive Cementation of Zirconia-Based Ceramics

In spite of high mechanical strength, zirconia-based ceramics (ZrO2) has poor bond strength after conventional bond cementation procedures, requiring different surface treatment methods (STMs). This review gathered information about the STM for adhesive cementation (AC) to ZrO2 in the PubMed database, considering in vitro studies pertaining to AC for acid-resistant ceramics (ZrO2) limited to peer-reviewed papers published in English between 1965 and 2013 in dental journals. Different STMs have been proposed for ZrO2: air-abrasion (laboratory or chairside) with silica- (Si-) coated aluminum particles, the use of materials containing phosphate monomers, primer or silane application, laser irradiation, Si vapor phase deposition, and selective infiltration etching. In conclusion, STMs improve bond strength of resin luting cement to ZrO2 mainly when tested in short time. STMs must be correlated to the type of ZrO2 and the resin cement.

Joint disorder: nonreducing disc displacement with mouth opening limitation - report of a case.

The internal derangement of the temporomandibular joint (TMJ) represents 8% of all cases of temporomandibular disorders (TMD) posing difficulties to establish an accurate diagnosis and treatment because of its low prevalence. This article presents the case of an 18-year-old Caucasian female patient who came to our Orofacial Pain and TMD Outpatient Service with complaints of intense pain on the right TMJ and limitation of mouth opening (maximum interincisal opening of 29 mm) with deviation to right, which she had been experiencing for the past 3 years. After a detailed clinical interview, a diagnosis hypothesis of nonreducing disc displacement with mouth opening limitation was established. The proposed treatment consisted of intra-joint infiltration with anesthetic in the right TMJ followed by jaw manipulation to recapture the articular disc, which was impeding the complete translation movement of the affected TMJ. After jaw manipulation, a new evaluation was done and showed the re-establishment of jaw dynamics with mouth opening and closing without deviation to the right side, clicking, opening limitation or pain. The patient was followed up at 6 months intervals. Two years after treatment, the patient was reevaluated and her mandibular range of motion without aid increased to 54 mm with no clicking, deviation to right, trismus or pain on the TMJ, indicating success of the treatment approach without recurrence of the pathology.

Influência do tratamento das desordens temporomandibulares na dor e na postura global

JUSTIFICATIVA E OBJETIVOS: A disfuncao temporomandibular e uma sindrome clinica que acomete principalmente musculos mastigatorios e articulacoes temporomandibulares. Como a articulacao temporomandibular esta diretamente relacionada a regiao cervical e escapular por meio de cadeias musculares, alteracoes posturais da coluna podem acarretar disturbios de articulacao temporomandibular, e vice-versa. A relacao entre a postura corporal e a disfuncao temporomandibular pode estabelecer uma forma de prevencao e reabilitacao. Sendo assim o objetivo deste trabalho foi avaliar a influencia do tratamento da disfuncao temporomandibular muscular na postura global de individuos diagnosticados por meio do Research Diagnostic Criteria for Temporomandibular Disorders. METODOS: Trinta pacientes foram classificados em grupo controle (n=12) (sem diagnostico clinico de disfuncao temporomandibular) e tratamento (n=17) (com diagnostico de disfuncao temporomandibular). Esses pacientes passaram por avaliacao postural atraves da fotogrametria e analise pelo Software de Avaliacao Postural. O tratamento consistiu em aconselhamento, fisioterapia caseira e uso do dispositivo interoclusal, monitorado por dois meses. Os pacientes do grupo controle apenas utilizaram o dispositivo interoclusal pelo mesmo periodo. Apos o tratamento, uma nova avaliacao foi feita pela fisioterapia. RESULTADOS: Nos pacientes do grupo controle, nao ocorreram alteracoes nas medidas correspondentes ao inicio da intervencao comparado ao pos-tratamento. Ja no grupo tratamento, apenas o ângulo de alinhamento vertical da cabeca exibiu resultado estatisticamente significativo (p<0,05). Para analise da melhora da dor foi comparado antes e apos o tratamento e obtiveram-se resultados positivos para remissao de sintomas dolorosos. CONCLUSAO: Pode-se concluir que desvios posturais globais causam adaptacoes e realinhamento corporal que podem interferir na funcao e organizacao da articulacao temporomandibular. O tratamento foi efetivo para melhora da dor.

Estudo clínico da posição da cabeça e mandíbula em pacientes com disfunção temporomandibular muscular

BACKGROUND AND OBJECTIVES: Temporomandibular disorder is a collective term encompassing a wide range of clinical orofacial joint and muscle problems. The stomatognatic system is part of the postural system, so changes in one system may interfere with the other. This study aimed at observing whether there is change in jaw and head position before and after temporomandibular disorder treatment. METHODS: Participated in the study 16 volunteers, aged above 18 years, of both genders, who looked for assistance in the dentistry course clinic of a Public University, with diagnosis of temporomandibular disorder according to Diagnostic Criteria for Temporomandibular Disorder Research. Volunteers were submitted to X-rays (teleradiography with analysis of cephalometric points); posture in physiologic centric relation was evaluated by computerized photogrammetry and pain intensity was evaluated by the visual analog scale from zero to 10. Patients were evaluated before and after 8 weeks of treatment. RESULTS: Pain has decreased from 6.43±2.84 to 2.17±2.39, before and after treatment, respectively (p<0.05). Vertical head alignment, in initial angle, has changed from 21.84o±17.49o to 11.38o±14.61o (p<0.05). Jaw position has changed from A-NB (angle indicating mandible-jaw relationship in the anterior posterior direction): 4.95±2.52mm to A-NB: 4.64±2.52mm (p<0.05). CONCLUSION: Muscle temporomandibular disorder changes vertical head alignment and interferes with jaw position.BACKGROUND AND OBJECTIVES: Temporomandibular disorder is a collective term encompassing a wide range of clinical orofacial joint and muscle problems. The stomatognatic system is part of the postural system, so changes in one system may interfere with the other. This study aimed at observing whether there is change in jaw and head position before and after temporomandibular disorder treatment. METHODS: Participated in the study 16 volunteers, aged above 18 years, of both genders, who looked for assistance in the dentistry course clinic of a Public University, with diagnosis of temporomandibular disorder according to Diagnostic Criteria for Temporomandibular Disorder Research. Volunteers were submitted to X-rays (teleradiography with analysis of cephalometric points); posture in physiologic centric relation was evaluated by computerized photogrammetry and pain intensity was evaluated by the visual analog scale from zero to 10. Patients were evaluated before and after 8 weeks of treatment. RESULTS: Pain has decreased from 6.43±2.84 to 2.17±2.39, before and after treatment, respectively (p<0.05). Vertical head alignment, in initial angle, has changed from 21.840±17.490 to 11.380±14.610 (p<0.05). Jaw position has changed from A-NB (angle indicating mandible-jaw relationship in the anterior posterior direction): 4.95±2.52 millimeters to A-NB: 4.64±2.52 mm (p<0.05). CONCLUSION: Muscle temporomandibular disorder changes vertical head alignment and interferes with jaw position.

Influência do Método de Injeção na Resistência à Flexão e Dureza das Cerâmicas: Duceragold, Duceram Plus e Excelsior

Objetivo: Avaliar o comportamento mecânico das porcelanas feldspaticas convencionais Duceragold, Duceram Plus e Excelsior, por meio de ensaios de resistencia a flexao, em tres pontos, de dureza, analise TMA e posterior avaliacao em microscopio eletronico de varredura (MEV). Metodo: Dez corpos-de-prova (25 mm de comprimento, 5 mm de largura e 2 mm de espessura - ISO 6872) foram confeccionados pela sinterizacao convencional e pelo metodo de injecao. O ensaio de resistencia a flexao, em tres pontos, foi realizado em equipamento MTS 810 (Material Test System, EUA) com celula de carga de 50 kN e velocidade de 0,5 mm/min. No ensaio de dureza, na escala Vickers, cinco fragmentos de cada grupo foram submetidos a testes em durometro de Buheler (EUA), com carga de 30 gf, por 30 segundos. Seguiu-se com analise termica, considerando variacao do coeficiente de dilatacao, temperatura de transicao vitrea e temperatura de amolecimento. A avaliacao da superficie e microestrutura das cerâmicas foi realizada atraves de MEV. Para a avaliacao da dureza dos materiais estudados e do efeito do metodo de processamento sobre esta propriedade foi empregada analise de variância a dois criterios fixos. Para todos os testes estatisticos, adotou-se, como regra de decisao, o nivel de 5% de significância (p menor que 0,05). Resultados: Apos analise estatistica, as amostras mostraram-se parametricas, segundo teste de aderencia; no grupo do mesmo tipo de sinterizacao a analise de variância nao apresentou diferenca estatistica, porem ao comparar os metodos de coccao um comportamento melhor e mais estavel foi observado nas amostras injetadas quando comparadas com amostras sinterizadas. Conforme o MEV, as estruturas mostraram-se semelhantes no mesmo metodo de confeccao, entretanto quando comparados os metodos de obtencao dos corpos-de-prova as amostras injetadas apresentaram melhor estrutura e menor porosidade. Conclusao: o metodo de injecao mostrou-se de importante indicacao para processamento de cerâmicas odontologicas, pelas vantagens mecânicas e estruturais.(AU) Objective: The purpose of this study was to evaluate the mechanical behavior of Duceragold, Duceram Plus and Excelsior conventional feldspathic ceramics processed by conventional sintering and heat pressing methods, by means of flexural strength test (three-point bending), hardness test, thermal analysis, and scanning electron microscopy (SEM). Method: Ten specimens of each ceramic were prepared for the three-point bending flexural test (25 mm long x 5 mm wide x 2 mm thick - ISO 6872) in a MTS 810 machine (Material Test System, USA), with a 50 kN load cell and crosshead speed of 0.5 mm/min. Five specimens of each ceramic were prepared for analysis of hardness in a Vickers hardness tester (Buehler, USA) with 30 gf load for 30 seconds. The thermal analysis comprised the assessment of expansion coefficient variation, glass transition temperature and melting temperature. Ceramic surface and microstructure were examined by SEM. The samples were parametric by the adherence test. Two-way ANOVA analyzed statistically the results of hardness and the effect of the processing method on this property at 5% significance level (p less than 0.05). Results: When the ceramics had the same processing method, no statistically significant difference was found among them. However, when the processing methods were compared, better performance and stability were observed for the heat-pressed ceramics compared with those processed by conventional sintering. In the SEM analysis, similar structures were observed when the ceramics had the same processing method, but the heat-pressed samples showed better structure and less porosity when the processing methods were compared. Conclusion: The heat pressing method was found to be a valuable indication for dental ceramic processing due to its mechanical and structural advantages.(AU)