Wellington Cardoso Bonachela

Evaluation of fracture resistance of endodontically treated teeth restored with prefabricated posts and composites with varying quantities of remaining coronal tooth structure

OBJECTIVES The aim of this study was to evaluate the influence of remaining coronal tooth structure on endodontically treated teeth restored with prefabricated posts and two different composites for core build-up: dual-cured resin (Enforce Core) and light-cured resin (Z-250). METHODS Fourty freshly extracted canines were endodontically treated and divided into four groups: Group I - teeth with 3mm remaining coronal structure, restored with Enforce Core; Group II - teeth with 3mm remaining coronal structure, restored with Z-250; Group III - teeth with no remaining coronal structure, restored with Enforce; Group IV - teeth with no remaining coronal structure, restored with Z-250. After restoration, the teeth were embedded in acrylic resin and the fracture resistance was measured on a universal testing machine at 45 degrees to the long axis of the tooth until failure. RESULTS Data were analyzed by two-way analysis of variance, which showed significant differences between groups (p=0.00). The Tukey test did not show significant differences between specimens with and without remaining coronal structure. Conversely, significant difference was observed between groups with different core build-up. The highest values of fracture resistance were found in the group restored with light-cured resin. SIGNIFICANCE The remaining coronal tooth structure did not influence the resistance of endodontically treated teeth; however, the change of core build-up was able to modify this resistence.

Maximal bite force and its association with temporomandibular disorders

Individuals with temporomandibular disorders (TMD) are expected to have decreased maximum bite forces (MBF). This way, this study compared the MBF in subjects with TMD to a control group and also evaluated its association with age, gender, height and weight. Forty healthy adults with complete natural dentition divided into four groups according to gender and presence or absence of TMD signs/symptoms (based on the Research Diagnostic Criteria RDC) underwent a MBF test with a gnathodynamometer in molar and incisal areas. Statistical analysis was performed by ANOVA and Student-Newman-Keuls test (p=0.05), and the relationship between age, gender, weight, height and MBF was verified by Pearsons correlation test. There were no differences in MBF results between TMD and control groups (p>0.05). Female subjects exhibited lower MBF than male and MBF for the anterior area was lower than that for posterior area (p<0.05). Significant correlation was found between MBF and weight in TMD subjects (p<0.05), except for the anterior area in female subjects. There was a positive correlation between MBF and height in TMD male subjects (p<0.05). Within the limitations of this study, it is possible to conclude that bite force was not affected by TMD. Correlation between MBF and weight in TMD subjects and between MBF and height in TMD male subjects was observed.

Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses

UNLABELLED The extraction of teeth involves the elimination of extremely sensitive periodontal mechanoreceptors, which play an important role in oral sensory perception. OBJECTIVES The aim of this study was to evaluate the recovery of interocclusal sensory perception for micro-thickness in individuals with different types of implant-supported prostheses. MATERIALS AND METHODS Wearers of complete dentures (CDs) comprised the negative control group (group A, n=17). The experimental group consisted of wearers of prostheses supported by osseointegrated implants (Group B, n=29), which was subsequently divided into 4 subgroups: B(1) (n=5)--implant supported overdentures (ISO) occluding with CD; B(2) (n=6)--implant-supported fixed prostheses (ISFP) occluding with CD; B(3) (n=8)--wearers of maxillary and mandibular ISFP, and B(4) (n=10)--ISFP occluding with natural dentition (ND). Individuals with ND represented the positive control group (Group C, n=24). Aluminum foils measuring 10 microm, 24 microm, 30 microm, 50 microm, 80 microm, and 104 microm thickness were placed within the premolar area, adding up to 120 tests for each individual. RESULTS The mean tactile thresholds of groups A, B1, B2, B3, B4, and C were 92 microm, 27 microm, 27 microm, 14 microm, 10 microm, and 10 microm, respectively. [Correction added after publication online 18 April 2008: in the preceding sentence 92 microm, 27 microm, 14 microm, 10 microm and 10 microm, was corrected to 92 microm, 27 microm, 27 microm, 14 microm, 10 microm and 10 microm]. The Kruskal-Wallis test revealed significant difference among groups (P<0.05). The Dunn test revealed that group A was statistically different from groups C, B(3), and B(4), and that B(1) and B(2) were statistically different from group C. CONCLUSION Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses could be observed. Moreover, ISO and/or ISFP combinations may similarly maximize the recovery of osseoperception.

Effect of cyclic load on vertical misfit of prefabricated and cast implant single abutment

Objective The purpose of this in vitro study was to evaluate misfit alterations at the implant/abutment interface of external and internal connection implant systems when subjected to cyclic loading. Material and Methods Standard metal crowns were fabricated for 5 groups (n=10) of implant/abutment assemblies: Group 1, external hexagon implant and UCLA cast-on premachined abutment; Group 2, internal hexagon implant and premachined abutment; Group 3, internal octagon implant and prefabricated abutment; Group 4, external hexagon implant and UCLA cast-on premachined abutment; and Group 5, external hexagon implant and Ceraone abutment. For groups 1, 2, 3 and 5, the crowns were cemented on the abutments and in group 4 crowns were screwed directly on the implant. The specimens were subjected to 500,000 cycles at 19.1 Hz of frequency and non-axial load of 133 N in a MTS 810 machine. The vertical misfit (μm) at the implant/abutment interface was evaluated before (B) and after (A) application of the cyclic loading. Data were analyzed statistically by using two-away ANOVA and Tukey’s post-hoc test (p<0.05). Results Before loading values showed no difference among groups 2 (4.33±3.13), 3 (4.79±3.43) and 5 (3.86±4.60); between groups 1 (12.88±6.43) and 4 (9.67±3.08), and among groups 2, 3 and 4. However, groups 1 and 4 were significantly different from groups 2, 3 and 5. After loading values of groups 1 (17.28±8.77) and 4 (17.78±10.99) were significantly different from those of groups 2 (4.83±4.50), 3 (8.07±4.31) and 5 (3.81±4.84). There was a significant increase in misfit values of groups 1, 3 and 4 after cyclic loading, but not for groups 2 and 5. Conclusion The cyclic loading and type of implant/abutment connection may develop a role on the vertical misfit at the implant/abutment interface.

Detorque evaluation of dental abutment screws after immersion in a fluoridated artificial saliva solution.

PURPOSE Implant-abutment connections still present failures in the oral cavity due to the loosening of mechanical integrity by detorque and corrosion of the abutment screws. The objective of this study was to evaluate the detorque of dental abutment screws before and after immersion in fluoridated solutions. MATERIALS AND METHODS Five commercial implant-abutment assemblies were assessed in this investigation: (C) Conexão®, (E) Emfils®, (I) INP®, (S) SIN®, and (T) Titanium Fix®. The implants were embedded in an acrylic resin and then placed in a holding device. The abutments were first connected to the implants and torqued to 20 Ncm using a handheld torque meter. The detorque values of the abutments were evaluated after 10 minutes. After applying a second torque of 20 Ncm, implant-abutment assemblies were withdrawn every 3 hours for 12 hours in a fluoridated solution over a period of 90 days. After that period, detorque of the abutments was examined. Scanning electronic microscopy (SEM) associated to energy dispersive spectroscopy (EDS) was applied to inspect the surfaces of abutments. RESULTS Detorque values of systems C, E, and I immersed in the fluoridated solution were significantly higher than those of the initial detorque. ANOVA demonstrated no significant differences in detorque values between designs S and T. Signs of localized corrosion could not be detected by SEM although chemical analysis by EDS showed the presence of elements involved in corrosive processes. CONCLUSION An increase of detorque values recorded on abutments after immersion in fluoridated artificial saliva solutions was noticed in this study. Regarding chemical analysis, such an increase of detorque can result from a corrosion layer formed between metallic surfaces at static contact in the implant-abutment joint during immersion in the fluoridated solutions.

THE INFLUENCE OF SCREW TYPE, ALLOY AND CYLINDER POSITION ON THE MARGINAL FIT OF IMPLANT FRAMEWORKS BEFORE AND AFTER LASER WELDING

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. Objectives: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. Methods: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5 μm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukeys multiple comparisons test (α =0.05). Results: Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13μm) than the hexagonal screws (27.93 μm). Besides, no statistically significant differences were found after laser welding. Conclusions: 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values.

Marginal fit at cylinder-abutment interface before and after overcasting procedure.

The aim of this study was to measure marginal fit at cylinder-abutment interface, before and after overcasting procedure. A hexagonal implant was fixed to a stainless steel base and a Estheticone-like abutment used during all the experiment. Before casting procedure, gold (Group I) and Ni-Cr-Be (Group II) premachined cylinders were tightened to the abutment with gold and titanium screws (in both groups), with 10Ncm and 20Ncm torque values for the same screw type. Vertical measures were taken at the light microscope (Mitutoyo 5050, Tokyo, Japan) three times in six different parts along the abutment-cylinder interface for each torque value. Cylinders were overcast with Ag-Pd (Group I) or Ni-Cr-Be (Group II) alloy. After casting, the same measures and torque values were repeated. Intragroup differences (10 or 20Ncm torque values, before and after casting) and intergroup differences (10 and 20Ncm torque values, before or after casting) were analyzed by the Paired t Test; (p<0.05). Intragroup differences were observed for G-I (gold, 20Ncm, titanium screw, p=0.044) and for G-II (Ni-Cr-Be, 10Ncm, gold screw, p=0.002). Intergroup differences only were not observed in the G-II group (Ni-Cr-Be, 10 and 20Ncm, titanium screw, p=0.534). Within the limits of this study, the following conclusions can be drawn: 1) Regardless of screw type, marginal misfit was higher for Ni-Cr-Be cylinders after casting, but within acceptable levels of fit; 2) The combination of gold cylinders with gold or titanium screws was the most effective to reduce marginal misfit; 3) Both screw types did not improve marginal fit of Ni-Cr-Be cylinders after overcastting, and 4) Although a 20Ncm torque improved marginal fit in all situations, its use is not recommended due to the increased risk of prosthesis failure. Ni-Cr-Be alloys may be successfully used in single-tooth implant restorations, with no damage to the fit between abutment and prosthetic cylinder.

Mouth floor enlargements related to the sublingual glands in edentulous or partially edentulous patients: a microscopic study

Mouth floor enlargements (MFE) are observed in edentulous and partially edentulous patients, impairing denture fitting, and have recently been described in the literature as hyperplasias of the sublingual glands. Objective: This study aims at describing the microscopic aspects of MFE that contribute to their final diagnosis. Methods: Twenty-four specimens were surgically removed from the enlarged mouth floor of 19 patients (15 females and 4 males). Patient age ranged from 48 to 74 years, with a mean of 57 years. The main surgical indication was to permit or improve the fitting of dentures. Six patients were completely edentulous and 13 were partially edentulous. The material was processed for microscopic examination and stained with hematoxylin-eosin, Mallorys trichrome and periodic-acid Schiff (PAS). Results and Conclusions: The epithelium of the mouth floor was normal in 17 cases, hyperplastic in 4 and atrophic in 3. Six of the 24 sublingual glands removed were microscopically normal, while the other specimens presented acinar atrophy with hyperplasia of duct-like structures. Interstitial fibrosis was observed in 18 cases and was accompanied by adipose tissue infiltration in 15. Decreased lymphoid tissue was observed in 16 samples and oncocytosis was present in 5 cases. We suggest that MFE in edentulous or partially edentulous patients should be considered as an entity for the text books.

Avaliação comparativa da perda de retenção de quatro sistemas de encaixes do tipo ERA e O-Ring empregados sob overdentures em função do tempo de uso

O objetivo deste trabalho foi avaliar e comparar a capacidade retentiva entre dois sistemas O-ring e O-SO (Grupo I) e dois sistemas ERA - capsulas de retencao cinza e brancas - (Grupo II), em funcao simulada, com ciclos de insercao e remocao, do inicio, 6 meses, 1, 2, 3, 4 e 5 anos depois. Dois implantes do tipo Branemark foram fixados em duas bases metalicas trapezoidais, sendo os testes de insercao e remocao feitos numa maquina de costura ajustada para este proposito, usando um sistema de correias e polias, movendo um virabrequim. Uma platina de delineador foi usada para fixacao dos corpos de prova as bases metalicas na maquina de costura. Os testes de resistencia ao movimento axial das capsulas por tensao foram feitos numa maquina de ensaios universal em periodos de tempo pre-estabelecidos, antes e apos o termino do ciclo na maquina de costura. Baseado nos resultados, esse estudo pode concluir que houve perda de retencao de todos os sistemas testados, porem o sistema ERA apresentou, desde o inicio, maior retencao quando comparado aos outros sistemas e a capsula cinza mostrou o melhor resultado no final da simulacao.The aim of this study was to evaluate and compare the retentive capacity between two O-ring and O-SO system (Group I), and two ERA system types - white and gray retention caps - (Group II), respectively, in simulated function in database, 6 months, 1, 2, 3, 4, and 5 years later, with insertion and removal cycles. Two Brånemark implants were fixed in two trapezoidal metallic bases for the tests. Removal and insertion tests were done in a sewing machine, adjusted for this purpose using a belt and a pulley system, moving a steel crankshaft. A delineator platinum hold was used for body trial fixation to the metallic base of the sewing machine. Resistance test to axial movement of the caps by tension was done in a Universal test machine in an established period of time, before and after the cycle accomplishments in the adapted sewing machine. Based on the results, this study concludes that all the attachment systems tested showed retention loss during the experiment; the ERA system showed, since the beginning, higher retention compared to the other systems and the gray colored attachment showed the best result in the end of the simulated use test.