Evaluation of the Accuracy of Conventional and Digital Methods of Obtaining Dental Impressions / Evaluación de la Exactitud de los Métodos Convencionales y Digitales de la Obtención de Impresiones Dentales

ABSTRACT: The aim of this study was to carry out a literature review on the accuracy of conventional and digital dental impression methods, as well as present the various three-dimensional intraoral scanning systems. A bibliographic search was carried out in PUBMED's main health database, in which works published between 2008 and 2018 were collected. Laboratory studies, case reports and systematic reviews were included, addressing topics that deal with conventional digital materials, impression and precision. Articles that did not evaluate impression materials, their behavior and techniques to obtain a good impression of oral structures were excluded. Through a review in the literature, obtained the following findings: the most critical stage in macking a dental prothesis is to take the dental impression. The conventional technique of impression consists of obtaining a negative copy of the intra-oral situation that will be poured into gypsum, obtaining a positive copy, on which the work will be carried out. Digital scanning systems were not superior to conventional moldings when comparing fidelity, accuracy and detail reproduction; in contrast, they were superior to conventional impression when considering clinical chair time, patient and operator preference, and patient comfort.

RESUMEN: El objetivo de este estudio consistió en realizar una revisión bibliográfica sobre la precisión de los métodos de moldeo dental convencionales y digitales, así como presentar los diversos sistemas de escaneo intraoral tridimensionales. Se realizó una búsqueda bibliográfica en la base de datos de salud principal de PUBMED en la cual se recopilaron trabajos publicados entre 2008 y 2018. Se incluyeron estudios de laboratorio, informes de casos y revisiones sistemáticas, abordando temas que tratan con materiales digitales convencionales, moldeo y precisión. Se excluyeron los artículos que no evaluaron los materiales de moldeo, su comportamiento y técnicas para obtener una buena impresión de las estructuras orales. A través de una revisión exhaustiva en la literatura, obtuvimos los siguientes hallazgos: el paso más crítico en la preparación de una pieza protésica es la impresión de la preparación. La técnica convencional de moldeo consiste en obtener una copia negativa de la situación intraoral que se verterá en el yeso, obteniendo una copia positiva, sobre la cual se realizará el trabajo. Resulta que los sistemas de escaneo digital no fueron superiores a las molduras convencionales al comparar la fidelidad, precisión y reproducción de detalles; en cambio, fueron superiores a las molduras convencionales al considerar el tiempo de trabajo clínico, la preferencia del paciente y del operador y la comodidad del paciente.

Porosity of temporary denture soft liners containing antifungal agents

ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.

Efeito da incorporação de agentes antifúngicos na resistência à tração e porosidade de materiais resilientes temporários para base de próteses / Effect of incorporation of antifungal agents on the ultimate tensile strength and porosity of temporary soft denture liners

Este estudo investigou a resistência à tração (ou limite de resistência à tração- LRT) e a porosidade de reembasadores resilientes temporários modificados por concentrações inibitórias mínimas (CIMs) de agentes antifúngicos para o biofilme Candida albicans (SC5314). Para os testes de LRT, corpos de prova em forma de halteres (n=7) com uma área transversal de 33 mm x 6 mm x 3 mm foram produzidos para os materiais resilientes (Trusoft e Softone) sem (controle) ou com incorporação de cinco fármacos em suas CIMs: nistatina- 0,032 g; diacetato de clorexidina- 0,064; cetoconazol- 0,128 g; miconazol- 0,256 g; itraconazol-0,256 g (grama de fármaco por grama de pó de material resiliente). Após a plastificação, as amostras foram imersas em água destilada a 37°C durante 24 h, 7 e 14 dias e, então, testadas em tensão em uma máquina universal de ensaios (EMIC DL-500 MF) a 40 mm/min. A porosidade foi mensurada por absorção de água, com base na exclusão do efeito plastificante. Inicialmente, determinou-se por isotermas de sorção, que a solução de armazenagem adequada para os corpos de prova (65 mm x 10 mm x 3,3 mm) de ambos os materiais foi o cloreto de cálcio anidro a 50% (S50). Assim, o fator de porosidade (FP) foi calculado para os grupos de estudo (n=10) formados por espécimes sem (controle) ou com incorporação de fármaco em suas CIMs (nistatina, clorexidina ou cetoconazol) após a armazenagem em água destilada ou S50 por 24 h, 7 e 14 dias. Os dados de resistência à tração (MPa) e percentagem de alongamento (%) foram submetidos à ANOVA de 3 fatores seguida pelo teste de Tukey (=0,05). Os dados de porosidade foram analisados estatisticamente por ANOVA de medidas repetidas para 4 fatores e teste de Tukey (=0,05). Ao final de 14 dias, a resistência à tração para ambos os materiais foi significativamente menor nos grupos modificados pelo miconazol e itraconazol em relação aos outros grupos (P<0,0001), que não mostraram diferenças significativas entre si (P>0,05). Após 7 e 14 dias em água, o miconazol e itraconazol adicionados a ambos os materiais resultaram em percentagens significativamente menores de alongamento em comparação com os outros fármacos e ao controle (P<0,0001), que foram semelhantes entre si (P>0,05). O cetoconazol não resultou em alterações significativas no FP para ambos os materiais resilientes em água ao longo de 14 dias (P>0,05). Em comparação aos controles, houve aumento dos FPs do Softone e Trusoft aos 14 dias de imersão em água somente após a adição de nistatina e clorexidina e de clorexidina, respectivamente (P<0,05). Ambos os materiais não apresentaram alterações significativas no FP em até 14 dias de imersão na S50, em comparação aos controles (P>0,05). Em todas as condições experimentais, os FPs do Softone e Trusoft foram significativamente menores quando imersos em S50 em comparação com a água destilada (P<0,05). Concluiu-se que a adição de nistatina, clorexidina e cetoconazol nas CIMs para o biofilme de C. albicans não resultou em efeitos deletérios na resistência à tração e na percentagem de alongamento dos materiais resilientes temporários para base de prótese até o período de 14 dias. A adição de antifúngicos nas CIMs não resultou em efeitos adversos à porosidade de ambos os materiais resilientes temporários em diferentes períodos de imersão em água, com exceção da clorexidina e nistatina no Softone e clorexidina no Trusoft aos 14 dias. Não foram observados efeitos deletérios para a porosidade de ambos os materiais resilientes modificados com as CIMs dos fármacos durante os 14 dias de imersão na S50.(AU)

This study investigated the tensile strength (ultimate tensile strength- UTS) and porosity of temporary soft denture liners modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm (SC5314). For UTS tests, dumbbell-shaped specimens (n=7) with a central cross-sectional area of 33 mm x 6 mm x 3 mm were produced by resilient materials (Trusoft and Softone) without (control) or with incorporation of five drugs at MICs: nystatin- 0.032 g; chlorhexidine diacetate-0.064 g; ketoconazole- 0.128 g; miconazole- 0.256 g; itraconazole- 0.256 g (each per gram of soft liner powder). After plasticization, specimens were immersed in distilled water at 37°C for 24 h, 7 and 14 days, and then tested in tension in a universal testing machine (EMIC DL-500 MF) at 40 mm/min. The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65 mm x 10 mm x 3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin, chlorhexidine or ketoconazole) after storage in distilled water or S50 for 24 h, 7 and 14 days. Data of tensile strength (MPa) and elongation percentage (%) were submitted to 3-way ANOVA followed by Tukey's test (=0.05). Data of porosity were statistically analyzed by 4-way repeated measures ANOVA and Tukeys test (=0.05). At the end of 14 days, the tensile strength for both materials was significantly lower in the groups modified by miconazole and itraconazole compared to the other groups (P<0.0001), which showed no significant difference between them (P>0.05). After 7 and 14 days in water, miconazole and itraconazole added into both materials result in significant lower elongation percentages compared to the other drugs and control (P<.0001), which were similar to each other (P>0.05). Ketoconazole resulted in no significant changes in PF for both liners in water over 14 days (P>0.05). Compared to the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of nystatin and chlorhexidine, and chlorhexidine, respectively (P<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared to the controls (P>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared to distilled water (P<0.05). It was concluded that the addition of the nystatin, chlorhexidine and ketoconazole at MICs for C. albicans biofilm resulted in no harmful effects on the ultimate tensile strength and elongation percentage of the temporary soft denture liners up to 14-day period. The addition of antifungals at MICs resulted in no detrimental effects for the porosity of both temporary soft liners in different periods of water immersion, except for chlorhexidine and nystatin in Softone and chlorhexidine in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.(AU)

Alternativa para resolução protética de reabilitação oral utilizando parafusamento lateral como mecanismo de retenção da protese fixa sobre implante: relato de caso clínico / Alternative for resolution of oral rehabilitation prosthetic using abutment with lingual retaining screw as the retention mechanism of fixed prosthesis on implants: report of a clinical case

A utilização de implantes osseointegrados teve um progresso significativo nos últimos 30 anos. Os Implantes dentários estão se tornando, cada vez mais, a primeira opção para a reposição de dentes por parte do profissional, bem como por parte do paciente. Os implantes dentários passaram a ser realidade diante do melhor domínio da técnica cirúrgica e protética, dos avanços dos materiais dentários, desta forma compreendendo os fatores de risco mecânicos e biológicos envolvivos. Todavia, juntamente com a crescente difusão destes implantes, muitos profissionais passaram a ter duvidas sobre como executar o trabalho com próteses sobre implante. Problemas relacionados à estética, função, seleção de intermediários protéticos e por limitações devido ao mau posicionamento dos implantes, impossibilitavam a confecção de próteses adequadas. O objetivo do presente trabalho foi apresentar uma alternativa de fixação das próteses sobre implante (parafusamento lateral) através do relato de um caso clínico

The use of osseointegrated implants had a significant progress in the last 30 years. Dental implants are becoming, increasingly, the first choice for replacement of teeth. Dental implants have become a reality actually, instead of novelty due to several factors, as well as the wider dissemination of treatment possibilities. However, along with the increasing spread of these implants, many professionals now have doubts about how to perform the work with prostheses on implants. Problems related to aesthetics, function, selection of the abutment and limitations due to a wrong positioning of implants, making it impractical an adequate prostheses. The present study seeks to provide solutions for questions in relation to the restraint to be used, is screwed or cemented presenting an alternative for the correction of the vestibular inclination of the implants through a system of Lateral fixation screw that holds together aesthetics and reversibility