Wilkens Aurélio Buarque e Silva

Fracture Strength of Aged Monolithic and Bilayer Zirconia-Based Crowns.

The purpose of this study was to evaluate the effect of design and surface finishing on fracture strength of yttria-tetragonal zirconia polycrystal (Y-TZP) crowns in monolithic (1.5 mm thickness) and bilayer (0.8 mm zirconia coping and 0.7 mm porcelain veneer) configuration after artificial aging. Bovine incisors received crown preparation and Y-TZP crowns were manufactured using CAD/CAM technique, according to the following groups (n = 10): Polished monolithic zirconia crowns (PM); Glazed monolithic zirconia crowns (GM); Bi-layer crowns (BL). Crowns were cemented with resin cement, submitted to artificial aging in a chewing simulator (2.5 million cycles/80 N/artificial saliva/37°C), and tested for fracture strength. Two remaining crowns referring to PM and GM groups were submitted to a chemical composition analysis to measure the level of yttrium after aging. One-way ANOVA and Tukeys test (P = .05) indicated that monolithic zirconia crowns presented similar fracture strength (PM = 3476.2 N ± 791.7; GM = 3561.5 N ± 991.6), which was higher than bilayer crowns (2060.4 N ± 810.6). There was no difference in the yttrium content among the three surfaces evaluated in the monolithic crowns. Thus, monolithic zirconia crowns present higher fracture strength than bilayer veneered zirconia after artificial aging and surface finishing does not affect their fracture strength.

Electrognathographic evaluations of rehabilitated edentulous patients

This study investigated, through computerized electrognathographic evaluations (K6-I Diagnostic System, Myotronics-Noromed Inc., Tukwila, USA), the mandibular movement pattern of 16 patients rehabilitated with complete dentures presenting no symptoms of stomatognathic functional alterations. The patients were instructed to wear an intra-oral appliance for occlusal plane coverage over their usual superior denture and were then rehabilitated with new dentures preserving a free-way space of 3 mm. After sixty days, the occlusal vertical dimension was increased and the modified inferior dentures were used for another 60 days. The obtained results were submitted to the Tukey Test and to the Friedman test, depending on which variable was under consideration, both at a significance level of 5%. The data revealed a significant decrease in free-way space when the first and the last evaluations were compared. No significant differences were found during opening and closing. It was concluded that the presence of a free-way space at the end of the treatment confirms the importance of its existence for maintaining the balance of the masticatory system, assuming the occurrence of a postural repositioning.

Evaluation of the reproducibility of two techniques used to determine and record centric relation in angle's class I patients

The centric relation is a mandibular position that determines a balance relation among the temporomandibular joints, the chew muscles and the occlusion. This position makes possible to the dentist to plan and to execute oral rehabilitation respecting the physiological principles of the stomatognathic system. The aim of this study was to investigate the reproducibility of centric relation records obtained using two techniques: Dawson’s Bilateral Manipulation and Gysi’s Gothic Arch Tracing. Twenty volunteers (14 females and 6 males) with no dental loss, presenting occlusal contacts according to those described in Angle’s I classification and without signs and symptoms of temporomandibular disorders were selected. All volunteers were submitted five times with a 1-week interval, always in the same schedule, to the Dawson’s Bilateral Manipulation and to the Gysi’s Gothic Arch Tracing with aid of an intraoral apparatus. The average standard error of each technique was calculated (Bilateral Manipulation 0.94 and Gothic Arch Tracing 0.27). Shapiro-Wilk test was applied and the results allowed application of Student’s t-test (sampling error of 5%). The techniques showed different degrees of variability. The Gysi’s Gothic Arch Tracing was found to be more accurate than the Bilateral Manipulation in reproducing the centric relation records.

Experience of the Spiritist Hospital Chaplaincy Service: A Retrospective Study.

The Hospital Chaplaincy service is made of religious volunteer work done by representatives of various religions properly trained to offer spiritual support to hospitalized patients, as well as their families, contributing as a source of protection, comfort and restoring faith in the face of illness. The objective of this study is to present a retrospective analysis of records made by chaplains, guided by the Spiritist Medical Association of Piracicaba, through 7419 calls to 2191 patients admitted at Unimed Hospital of Piracicaba in 2014. The results contributed to the production of scientific documentation about this new holistic model that still lies in acceptance phase in the country.

Reestablishment of the condyle-fossa and maxillomandibular relationships using a flat occlusal plane splint and implant-supported denture: case report with a 2-year follow-up

Quando os componentes do sistema estomatognatico sofrem alteracoes na forma, estrutura e/ou funcao de uma das partes, tambem ocorrem modificacoes estruturais e fisiologicas para a absorcao ou compensacao das resultantes criadas. Assim, uma criteriosa reabilitacao deste tipo de paciente envolve procedimentos fundamentais, como: correta orientacao do plano oclusal, determinacao da dimensao vertical de oclusao adequada e a relacao maxilo-mandibular estavel e saudavel, sendo que a nao observacao destes aspectos pode levar ao fracasso da reabilitacao protetica. O objetivo do presente caso e relatar o planejamento pre-cirurgico e a reabilitacao protetica de um paciente edentulo com atrofia severa dos maxilares e sinais e sintomas de Desordens Temporomandibulares, que foi submetido a terapia com aparelhos oclusais planos e lisos para restabelecimento das relacoes condilo-fossa, maxilo-mandibular e da atividade muscular e, posterior reabilitacao oral com proteses totais fixas implantossuportadas,onde a determinacao da relacao maxilo-mandibular foi realizada pela tecnica do registro intraoral, com um periodo de proservacao de 24 meses.

Solução protética em paciente desdentado total em idade púbere

A indicacao de protese total na idade pubere e rara, porem se faz necessaria quando ocorre perda prematura de todos os dentes. E grande a preocupacao no que concerne a indicacao e confeccao de proteses totais para pacientes em fase de crescimento, visto que a protese e um fator limitante do crescimento dos maxilares. A proposta deste trabalho e descrever o caso clinico de um paciente com 13 anos de idade reabilitado com proteses totais com expansores localizados de acordo com os mameloes de crescimento. A proservacao protetica foi periodica para ajuste das proteses, permitindo o crescimento dos maxilares. Como resultado, as proteses foram essenciais no restabelecimento da funcao e da estetica, proporcionando ao paciente um convivio social saudavel.