Assessment of Subgingival Biofilm and its Relationship with the Status of Tumors in a Population with Breast Cancer

This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.

El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.

Injectable Composite Resin Technique: An Alternative for Anterior Esthetic Restorations - Case Report / Técnica de Resina Compuesta Inyectable: Una Alternativa para Restauraciones Estéticas Anteriores - Reporte de Caso

This article aims to describe a clinical case of the use of the injectable restorative technique with composite resin in a patient with an esthetic complaint in the anterior teeth. Producing direct restorations in anterior teeth when performed with composite resin demands a long clinical time. Results often depend on the operator's ability to reproduce proper form, function, and esthetics. Lately, the versatility of composite resins has increased. As this material evolved, new techniques were introduced to simplify the restorative process and save time. The restorative technique with injectable fluid composite resin, in addition to delivering faster and with a certain ease, is capable of increasing the predictability of treatment results. However, it is known that flowable resins have lower wear resistance and color stability compared to conventional resins. Thus, a version of this material with a higher filler content in its composition was introduced to the market, to improve wear resistance and gloss retention. Long-term studies evaluating the use of low-viscosity resins are needed. The injectable technique can accurately reproduce the morphology obtained in the wax-up of the case, generating a satisfactory esthetic and functional result. Despite simplifying the fabrication of restorations when compared to the conventional technique, it is still necessary for the operator to have some experience and aptitude. The clinical time for the production of restorations has been considerably reduced. The material showed good flow, shine, and polish in the immediate result. However, the finishing and polishing of the restorations required a longer clinical period than usual and in the short- term follow-up, flaws in the gingival margins and a new finishing and polishing procedure were necessary. Therefore, the technique described in this article can be considered a restorative alternative, but it is still not able to replace the tradit ional method of making previous esthetic restorations.

Este artículo tiene como objetivo describir un caso clínico del uso de la técnica restauradora inyectable con resina compuesta en un paciente con una queja estética en los dientes anteriores. Producir restauraciones directas en dientes anteriores cuando se realizan con resina compuesta demanda un largo tiempo clínico. Los resultados a menudo dependen de la capacidad del operador para reproducir la forma, la función y la estética adecuadas. Últimamente, la versatilidad de las resinas compuestas ha aumentado. A medida que este material evolucionó, se introdujeron nuevas técnicas para simplificar el proceso de restauración y ahorrar tiempo. La técnica restauradora con resina compuesta fluida inyectable, además de una entrega más rápida y segura, es capaz de aumentar la previsibilidad de los resultados del tratamiento. Sin embargo, se sabe que las resinas fluidas tienen menor resistencia al desgaste y estabilidad del color en comparación con las resinas convencionales. Así, se introdujo en el mercado una versión de este material con un mayor contenido de relleno en su composición, con el objetivo de mejorar la resistencia al desgaste y la retención del brillo. Se necesitan estudios a largo plazo que evalúen el uso de resinas de baja viscosidad. La técnica inyectable es capaz de reproducir fielmente la morfología obtenida en el encerado del caso, generando un resultado estético y funcional satisfactorio. A pesar de simplificar la fabricación de restauraciones en comparación con la técnica convencional, todavía es necesario que el operador tenga cierta experiencia y aptitud. El tiempo clínico para la producción de restauraciones se ha reducido considerablemente. El material mostró buena fluidez, brillo y pulido en el resultado inmediato. Sin embargo, el acabado y pulido de las restauraciones requirió de un período de tiempo clínico más largo de lo habitual y en el seguimiento a corto plazo, fueron necesarios defectos en los márgenes gingivales y un nuevo procedimiento de acabado y pulido. Por lo tanto, la técnica descrita en este artículo puede considerarse una alternativa restauradora, pero aún no es capaz de reemplazar el método tradicional de realizar restauraciones estéticas previas.

Current Insights on Neoplasms and Adequate Dental Care for Patients with Oral Cancer / Actualización sobre Neoplasmas y su Correcta Atención Odontológica en Pacientes con Cancer Oral

The present study aimed to review the literature on the main complications of antineoplastic therapies and the degree of knowledge of dental surgeons about these complications. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1987 to 2023 were collected. Laboratory studies, case reports, systematic and literature reviews, which were developed in living individuals, about the main neoplastic genes and their relationship with the cells of individuals affected by neoplasms in the head and neck region, and studies on the care with this group of patients, were included. Therefore, articles that did not deal with neoplasm and the main complications of antineoplastic therapies were excluded. Neoplasm is a clonal disorder, caused by mutations, resulting from changes in the genetic structure of cells. Each healthy cell has instructions on how to grow and divi de. In the presence of any error in these instructions (mutation), it can result in a diseased cell that, when proliferating, may cause a tumor. Countless knowledge has been accumulated over the years on the main characteristics of neoplasms, whether they are cancer cell biology, carcinogenesis mechanism, neoplasms of the maxillofacial system and sequels of antineoplastic treatments. In this context, methods have been developed that offer a better quality of life for patients diagnosed with this pathology, as well as preventive vaccine models that may, in the not too distant future, contribute to this goal to be successfully achieved.

El presente estudio tuvo como objetivo revisar la literatura sobre las principales complicaciones de las terapias antineoplásicas y el grado de conocimiento de los odontólogos sobre este abordaje. Se realizó una búsqueda bibliográfica en las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en la que se recopilaron estudios publicados entre 1987 y 2023. Fueron incluidos estudios de laboratorio, relatos de casos, revisiones de la literatura y revisiones sistemáticas, desarrolladas en individuos vivos, que incluyeran los principales genes neoplásicos y su relación con las células de individuos afectados por neoplasias en la cabeza y el cuello. También, se tuvieron en cuenta estudios relacionados con la atención a este grupo de pacientes. La neoplasia es un trastorno clonal, causado por mutaciones, como resultado de cambios en la estructura genética de las células. Cada célula sana tiene instrucciones sobre cómo crecer y dividirse. En presencia de cualquier error en estas instrucciones (mutación), puede provocar una célula alterada que, al proliferar, puede causar un tumor. Se han acumulado innumerables conocimientos a lo largo de los años sobre las principales características de las neoplasias, ya sea sobre biología de células cancerosas, el mecanismo de la carcinogénesis, la neoplasias del sistema maxilofacial y las diferentes secuelas de tratamientos antineoplásicos. En este contexto, se han desarrollado métodos que ofrecen una mejor calidad de vida para los pacientes diagnosticados con esta patología, así como modelos de vacunas preventivas que, en un futuro no muy lejano, pueden contribuir a alcanzar este objetivo con éxito.

Mechanical behavior of implant-supported full-arch prostheses in different locations in the maxilla: 3D-FEA and strain gauge analysis / Comportamento mecânico de próteses de arco inteiro implanto-suportadas em localizações diferentes na maxila: análise 3D-FEA e strain gauge

The maxillary bone restriction can limit the implants position to support a full-arch prosthesis. Objective:Therefore, this study evaluated the biomechanical behavior of a full-arch prosthesis supported by six implants in different configurations: group A (implants inserted in the region of canines, first premolars and second molars), group B (implants inserted in the region of first premolar, first molar and second molar) and group C (implants in second premolar, first premolar and second molar). Material and Methods: The models were analyzed by the finite element method validated by strain gauge. Three types of loads were applied: in the central incisors, first premolars and second molars, obtaining results of von-Mises stress peaks and microstrain. All registered results reported higher stress concentration in the prosthesis of all groups, with group C presenting higher values in all structures when compared to A and B groups. The highest mean microstrain was also observed in group C (288.8 ± 225.2 µÎµ/µÎµ), however, there was no statistically significant difference between the evaluated groups. In both groups, regardless of the magnitude and direction of the load, the maximum von-Mises stresses recorded for implants and prosthesis displacements were lower in group A. Conclusion: It was concluded that an equidistant distribution of implants favors biomechanical behavior of full-arch prostheses supported by implants; and the placement of posterior implants seems to be a viable alternative to rehabilitate totally edentulous individuals. (AU)

A limitação óssea maxilar totais pode limitar o posicionamento dos implantes para suportar uma prótese de arco total. Objetivo: Sendo assim, este estudo avaliou o comportamento biomecânico de uma prótese de arco total suportada por seis implantes em diferentes configurações: grupo A (implantes inseridos na região de caninos, primeiros pré-molares e segundos molares), grupo B (implantes inseridos na região de primeiro pré-molar, primeiro molar e segundo molar) e grupo C (implantes em segundo pré-molar, primeiro pré-molar e segundo molar). Materiais e métodos: Os modelos foram analisados pelo método de elementos finitos validados por extensometria. Foram aplicados três tipos de cargas: nos incisivos centrais, primeiros pré-molares e nos segundos molares, obtendo resultados de picos de tensão de von-Mises e microdeformação. Todos os resultados registrados mostraram maior concentração de tensão na prótese de todos os grupos, sendo que o grupo C apresentou maiores valores em todas as estruturas quando comparado com os grupos A e B. A maior média de microdeformação também foi observada no grupo C (288,8 ± 225,2 µÎµ/µÎµ), no entanto, não houve diferença estatisticamente significativa entre os grupos avaliados. Em todos os grupos, independentemente da magnitude e direção da carga, as tensões máximas de von-Mises registradas para os implantes e deslocamentos de próteses foram menores no grupo A. Conclusão: Concluiu-se que a distribuição de implantes de forma equidistante favorece o desempenho biomecânico das próteses de arco total suportada por implantes; e o posicionamento de implantes posteriores parece ser uma alternativa viável para reabilitar indivíduos densdentados totais. (AU)

Posterior rehabilitation using 3D-printed dental implants and synthetic regenerative biomaterials / Reabilitação posterior com implantes impressos e biomateriais sintéticos

Aim: To describe through a clinical case report the surgical sequence of rehabilitation with 3D-printed implants associated with maxillary sinus floor lift with synthetic regenerative materials, including biphasic bioceramic. Case Report: Patient had an agenesis of the upper left premolars (#12 and #13), a vertical bone deficiency caused by maxillary sinus' pneumatization, and a horizontal alveolar resorption around the missing teeth area. During the surgical procedures, incisions, detachment, and osteotomy were performed in the lateral region of the maxillary sinus. The sinus membrane was detached and lifted 10 mm. Then, a thick poly(dioxanone)-based synthetic resorbable membrane (Plenum) was inserted and adapted inside the sinus to protect the sinus membrane. After the osteotomies with sub-instrumentation, 3D-printed implants (Plenum) were installed in the #12 area (3.5mm x 11.5 mm; 30N) and #13 area (4.0mm x 10mm; 20N). The maxillary sinus was entirely filled with a biphasic bioceramic, HA/ß-TCP (70:30) 500-1000 µm (Plenum) and covered by the same synthetic resorbable membrane. Connective tissue graft from the palatal area was positioned internally to the flap and stabilized with sutures to improve the vestibular tissue architecture. The entire surgical wound was sutured, and the tissues stabilized. No complications occurred in the postoperative period. Conclusion: The use of synthetic regenerative memberane and 3D-printed implants seems to be a promising option in areas of deficient bone remnants (AU)

Objetivo: Descrever por meio de um relato de caso clínico a sequência cirúrgica de reabilitação com implantes obtidos por impressão 3D associados à elevação do assoalho do seio maxilar com materiais regenerativos sintéticos, incluindo uma biocerâmica bifásica. Relato de Caso: Paciente apresentava agenesia dos pré-molares superiores esquerdos (24 e 25), deficiência óssea vertical causada pela pneumatização do seio maxilar e reabsorção alveolar horizontal ao redor da área dos dentes ausentes. Durante os procedimentos cirúrgicos foram realizados incisões, descolamento e osteotomia na região lateral do seio maxilar. A membrana sinusal foi descolada e elevada 10 mm. Em seguida, uma membrana reabsorvível sintética à base de poli(dioxanona) espessa (Plenum) foi inserida e adaptada dentro do seio para proteger a membrana do seio. Após as osteotomias com subinstrumentação, implantes impressos em 3D (Plenum) foram instalados na área do 24 (3,5mm x 11,5mm; 30N) e na área do 25 (4,0mm x 10mm; 20N). O seio maxilar foi inteiramente preenchido com biocerâmica bifásica, HA/ß-TCP (70:30)500-1000 µm (Plenum) e recoberto pela mesma membrana sintética reabsorvível. O tecido conjuntivo da região palatina foi posicionado internamente ao retalho e estabilizado com suturas para melhorar a arquitetura do tecido vestibular. Toda a ferida cirúrgica foi suturada e os tecidos estabilizados. Não ocorreram complicações no pós-operatório. Conclusão:A utilização de biomateriais regenerativos sintéticos e implantes impressos parece ser uma opção promissora em áreas de remanescentes ósseos deficientes.(AU)

Effect of Titanium Hardness on the Integrity and Stress Concentration of External Hexagon Dental Implants

ABSTRACT: The aim of this study was to evaluate the influence of overtorque on integrity, strength and stress on external hexagonal implants (EH), with two different grades (N=10): conventional (C), grade 4; and modified (M), grade 4 with thermal treatment. The dimensions of EH were 3.75 x 13 mm; the specimens were fixed and submitted to SEM analysis and image acquisition. The abutment was then retained with 70 N/cm, re-analyzed by SEM, and a second image was obtained. The images were analyzed by Image J software (1.44o- NIH, USA) for dimensional variations measurement on surface of the hexagonal area. The finite element method was applied with a similar compliance to calculate the resultant stress (MPa) during the torque. Results were statistically analyzed with t-student test (5 %). The dimensional accuracy of M (0.22 mm2) was statistically significant (p<0.05). Minimum principal stress and von-Mises stress of C (-19.95 MPa, -19.94 MPa), were lower than M values (-55.83 MPa, -55.96 MPa), respectively. However, the M group showed lower deformation than C group. Therefore, more rigid titanium alloy is a promising alternative to avoid plastic deformation of prosthetic connec tions even concentrating higher stress magnitude on its structure.

RESUMEN: El objetivo de este estudio fue evaluar la influencia del sobrepar en la integridad, la fuerza y la tensión en los implantes hexagonales externos (EH), con dos grados diferentes (N = 10): convencional (C), grado 4; y modificado (M), grado 4 con tratamiento térmico. Las dimensiones de EH eran 3,75 de diámetro x 13 mm de longitud; las muestras se fijaron y se sometieron a análisis SEM y adquisición de imágenes. A continuación, el pilar se retuvo con 70 N / cm, se volvió a analizar por SEM y se obtuvo una segunda imagen. Las imágenes se analizaron con el software Image J (1.44o-NIH, EE. UU.) Para medir las variaciones dimensionales en la superficie superior del área hexagonal, que fue causada por un par excesivo. El método de los elementos finitos se aplicó con un cumplimiento similar para calcular la tensión resultante (MPa) durante el par. Los resultados se analizaron estadísticamente con la prueba t-student (5 %). La precisión dimensional de M (0,22 mm2) fue estadísticamente significativa (p <0,05). La tensión principal mínima y la tensión de von-Mises de C (-19,95 MPa, -19,94 MPa), fueron inferiores a los valores de M (-55,83 MPa, -55,96 MPa), respectivamente. Sin embargo, el hexágono del grupo M mostró menor deformación que el grupo C. Por lo tanto, la aleación de titanio más rígida es una alternativa prometedora para evitar la deformación plástica de las conexiones protésicas incluso concentrando una mayor magnitud de tensión en su estructura.

Metal Alloys in Dentistry: An Outdated Material or Required for Oral Rehabilitation?

ABSTRACT: The present study aims to describe through a literature review, the main types of noble and non-noble alloys in dentistry looking to identify the adhesion mechanisms, compositions and mechanical properties, and its applicability as a rehabilitation resource nowadays. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1971 to 2021 were collected. Laboratory studies, case reports, systematic and literature reviews, which were developed in living individuals. Articles that did not deal with metal alloys and its use in dentistry were excluded. Through the review, it was possible to ver ify that all works presented the metal alloys and their main properties, indicating that they are divided into three main types: hi gh noble alloys, noble alloys and base metal alloys differing in their levels of constituent noble metals. Several alloys and meta ls are available for the dental market each presenting advantages and disadvantages, mainly based on its specific composition.Continuous research and development are resulting in the production of new technologies and products, giving dental surgeons even more options in the design and manufacture of restorations using metal alloys and understanding that these resources will still be viable alternatives in oral rehabilitations. However, further studies on metal alloys are needed to better understand this subject.

RESUMEN: El presente trabajo tuvo como objetivo describir a través de una revisión de la literatura, los principales tipos de aleaciones nobles y no nobles utilizados en odontología buscando identificar los mecanismos de adhesión, composiciones y propiedades mecánicas, así como reflejar su aplicabilidad como recurso rehabilitador en la actualidad. Realizamos una búsqueda bibliográfica em las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en la que se recopilaron estudios publicados desde 1971 hasta 2021. Estudios de laboratorio, informes de casos, revisiones sistemáticas y bibliográficas, que se desarrollaron en individuos vivos. Sin embargo, se excluyeron los artículos que no trataban sobre aleaciones metálicas y su uso en odontología. Se pudo observar que todos los trabajos presentaban las aleaciones metálicas y sus principales propiedades indicando que se estas dividen en tres tipos principales: aleaciones altamente nobles, aleaciones nobles y aleaciones de metales base que difierenen sus niveles de metales nobles constituyentes. Hay varias aleaciones y metales disponibles para el mercado dental, cada uno presenta ventajas y desventajas, principalmente en función de su composición específica. La investigación y el desarrollo continuo están dando como resultado la producción de nuevas tecnologías y productos, brindando a los cirujanos dentistas aún más opciones en el diseño y fabricación de las restauraciones, utilizando aleaciones metálicas y, permite concluir que estos recursos seguirán siendo alternativas viables en los tratamientos de rehabilitación. Sin embargo, se necesitan más estudios sobre el tema abordado en el trabajo, para una comprensión más profunda del tema.

Influence of Finishing/Polishing in Surface Roughness of Conventional Nanocomposites and Bulk-Fill / Influência do Acabamento/Polimento na Rugosidade de Superfície das Resinas Compostas Nanoparticuladas Convencional e Bulk-Fill

The choice of the best finishing/polishing methods for composite resin restorations is critical to the choice of excellence results related to longer clinical longevity. The objective of the study was to evaluate the influence of finishing and polishing systems on the surface roughness of a Nanoparticulate and Bulk-fill resin. For the research, 40 sample disks were prepared for each composite: single-increment (BF) (Bulk Fill 3M), both 2 mm thick and 10 mm in diameter (FZ) (Filtek Z350, 3M). The specimens were randomly divided into 4 groups with 10 samples each, according to the different materials to which they were subjected to the finishing and polishing protocols: control [C]- diamond tip (FG 4137F FAVA); [EN] polishing discs (Enhance, Dentsply); [SL] Abrasive discs (Sof-Lex Pop-on, 3M) and [PD] felt disc + Polishing paste (Diamond Excel, FGM). A surface roughness (Ra) was verified with a roughness meter in three different data volumes and calculated as arithmetic means. Data were statistically treated by one way ANOVA followed by test t and student t test. Regardless of the data tested, evidence of the systemic controlling against different systems for polishing control with control (p <0.05). PD presented statistically greater roughness to the EN and SL (p <0.001), these in turn obtained similar performance and presented the lowest values of roughness for both composites (p> 0.05). The different finishing / polishing methods influenced the surface roughness of both composites, observing for Sof-lex and Enhance lower Ra values. (AU)

A escolha dos adequados métodos de acabamento/polimento para restaurações de resina composta é fundamental para obtenção de resultados de excelência, relacionados a maior longevidade clínica. O objetivo desse estudo foi avaliar a influência dos sistemas de acabamento e polimento na rugosidade de superfície das resinas nanoparticuladas convencional e bulk-fill. Para a pesquisa foram confeccionados 40 discos de amostra para cada compósito: Convencional [FZ] (Filtek Z350, 3M) e de incremento único [BF] (Filtek Bulk Fill, 3M), ambas com 2 mm de espessura e 10 mm de diâmetro. Foram divididos aleatoriamente em 4 grupos com 10 amostras cada, de acordo com os diferentes protocolos que receberam, sendo: controle (C) ponta diamantada (FG 4137F, FAVA); (EN) discos de silicone (Enhance, Dentsply); (SL) discos abrasivos (Sof-Lex Pop-on, 3M); (PD) Feltro + Pasta diamantada (Diamond Excel, FGM). A rugosidade de superfície (Ra) foi verificada com um rugosímetro em três leituras de diferentes direções e calculadas as médias aritméticas. Os dados foram tratados estatisticamente pelos testes ANOVA 1 fator seguido pelo teste t e t de student (p<0,05). Independente da resina testada, evidenciou-se diminuição da rugosidade pelos diferentes sistemas de polimento frente ao grupo controle (p<0,05). PD apresentou rugosidade estatisticamente maior à EN e SL (p<0,001), estes últimos que por sua vez obtiveram desempenho semelhante e apresentaram os menores valores de rugosidade para ambos os compósitos (p>0,05). Os diferentes métodos de acabamento/polimento influenciaram na rugosidade de superfície dos dois compósitos testados, observando para Sof-lex e Enhance menores valores de Ra. (AU)

Incidence of Fracture in Single Ceramic Crowns in Patients with Chronic Tooth Wear: A Clinical Follow-up

ABSTRACT: The aim of this study was to identify the incidence of fractures in single crowns placed in individuals with chronic tooth wear. The sample selection was performed based on the evaluation of 218 patient records rehabilitated with single crowns placed by the same professional from a private clinic. After exclusion criteria, 43 individuals (18 males and 25 females) were included and a total of 112 single crowns distributed in both jaws. Three ceramic systems were evaluated: 34 feldspathic all-ceramic, 38 metal-ceramic with a core in gold electropositive alloy, and 40 In-Ceram Alumina. The intraoral photograph analysis adopted a diagnosis method of tooth wear according to the morphological variations of the teeth. Of the 112 crowns evaluated, 47 were placed in male and 65 in female patients, aged between 21 to 74 years (mean 27.5 years old). The variables gender (p = 0.83), presence of chronic tooth wear (p = 0.91), ceramic system (p = 0.24) and crown location (p = 0.86) did not present a statistically difference. However, the variables pulp vitality (p = 0.04) and survi val time (p = 0.01) presented a statistically significant difference. The evaluated ceramic systems can be considered as alternativ es of restorative material, even in individuals with clinical characteristics suggestive of chronic tooth wear.

RESUMEN: El objetivo de este estudio fue identificar la incidencia de fracturas en coronas individuales colocadas en individuos con desgaste dental crónico. La selección de la muestra se realizó en base a la evaluación de 218 registros de pacientes rehabilitados con coronas individuales colocadas entre 1999 y 2009 por el mismo profesional de una clínica privada. Después de analizar los criterios de exclusión, se incluyeron 43 individuos (18 hombres y 25 mujeres) y un total de 112 coronas individuales distribuidas en ambas mandíbulas. Este estudio evaluó coronas hechas de tres sistemas cerámicos: 34 de cerámica totalmente feldespática, 38 de cerámica de metal con un núcleo de aleación electropositiva de oro y 40 de alúmina enceram. El análisis de la fotografía intraoral adoptó un método de diagnóstico del desgaste dental de acuerdo con las variaciones morfológicas de los dientes. De las 112 coronas evaluadas, 47 se colocaron en hombres y 65 en mujeres, con edades comprendidas entre 21 y 74 años (media de 27,5 años). Con respecto a las coronas individuales, las variables género (p = 0,83), presencia de desgaste dental crónico (p = 0,91), sistema cerámico (p = 0,24) y ubicación de la corona (p = 0,86) no presentaron una diferencia estadísticamente significativa. Sin embargo, las variables vitalidad pulpar (p = 0.04) y tiempo de supervivencia (p = 0.01) presentaron una diferencia estadísticamente significativa. Los sistemas cerámicos evaluados pueden considerarse como alternativas de material restaurador, incluso en individuos con características clínicas que sugieren desgaste dental crónico.

Characterization of Bulk-Fill Resin Composites in Terms of Physical, Chemical, Mechanical and Optical Properties and Clinical Behavior

ABSTRACT: This study aims to evaluate the physical, chemical, mechanical and optical properties of Bulk-Fill resin, in relation to the literature and its proper clinical uses. A bibliographic search was performed in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which articles published from 1994 to 2020 were collected. Laboratory studies, case reports, systematic reviews and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the characteristics of the Bulk-Fill resin and its proper clinical uses were excluded. The use of Bulk-Fill resin has been progressively increasing over the years, presenting good properties, achieving success in clinical performance, ease of handling and thus has become the material of choice for dentists. In addition, its longevity demonstrates durability with mechanical properties and resistance to tooth structure. Bulk - Fill resins have characteristics similar to traditional composite resins, when performed according the usage protocol. With the use of this group of resins in a single increment, possible failures that occur during the restorative procedure can be minimized, such as: less chance of incorporating bubbles and a volumetric contraction with less stress on the interface.

RESUMEN: Este estudio tuvo como objetivo evaluar las propiedades físicas, químicas, mecánicas y ópticas de la resina Bulk-Fill, en relación con la literatura y sus usos clínicos apropiados. Realizamos una búsqueda bibliográfica en las bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en la que se recopilaron trabajos que se publicaron entre 1994 y 2020. Fueron incluidos estudios de laboratorio, informes de casos, revisiones sistemáticas y revisiones de literatura, desarrollados en individuos vivos. Por tanto, se excluyeron los artículos que no trataban las características de la resina Bulk-Fill y sus usos clínicos adecuados. El uso de la resina Bulk-Fill ha ido aumentando progresivamente a lo largo de los años, presentando buenas propiedades, logrando éxito en el rendimiento clínico, facilidad de manejo y, por lo tanto, se ha convertido en el material elegido por los dentistas. Además, su longevidad demuestra durabilidad, con propiedades mecánicas y resistencia a la estructura dental.Las resinas Bulk-Fill tienen características similares a las resinas compuestas tradicionales, cuando se realizan siguiendo el protocolo de uso. Con el uso de este grupo de resinas mono incremental, es posible eliminar el paso de varios incrementos, disminuyendo a su vez el tiempo clínico. Además, se pueden minimizar las posibles fallas que se producen durante el procedimiento de restauración, tales como: menos posibilidades de incorporar burbujas y una contracción volumétrica con menos estrés en la interfaz.

Microhardness and Diametral Compression Strength of Single Fill Composite

ABSTRACT: To evaluate Knoop microhardness and diametral compression strength at different polymerization times. A total of 80 cylindrical samples with Filtek resin™ One Bulk Fill were made to perform the in vitro study, using half of total samples (n=40) for each test and divided equally between groups (n=10). All samples were made according to ISO 4049 using 2 mm thickness Teflon matrix and a central orifice with 4 mm diameter. Four different times of light-curing in Standard mode suggested by the light-unit manufacturer were selected, therefore, group 1 samples (G1) were light-cured for 5 seconds; group 2 (G2) for 10 seconds; group 3 (G3) for 15 seconds, and group 4 (G4) for 20 seconds. A radiant display, which means a power in mW/cm2 by time in seconds was expressed in Joules (J). The samples were stored in a dark container with distilled water at a temperature of 37°C for 48 hours before testing. One-way analysis of variance (ANOVA) with T-Test (LSD) of multiple comparisons of the mean values of Knoop hardness and diametral compression strength was performed, with significance index α=0.05. Regarding the Knoop microhardness test, G1 (35.73 ± 6.2) presented the lowest values, followed by G2, while G3 and G4 did not present statistical differences between them. For the diametral compression test, G1 (1387.76 ± 190.51) obtained the lowest value when compared to the other groups. G2, G3, and G4 did not present significant statistical differences. The different polymerization times influenced the Knoop microhardness and the diametral compression strength of Bulk Fill resin.

RESUMEN: El objetivo de este trabajo fue evaluar la microdureza Knoop y la resistencia a la compresión diametral en diferentes tiempos de polimerización. En el estudio realizado in vitro, se analizó un total de 80 muestras cilíndricas con la resina Filtek™ One Bulk Fill, utilizando la mitad (n=40) para cada prueba realizada y dividida en partes iguales entre los grupos (n=10). Todas las muestras se tomaron de acuerdo con ISO 4049 utilizando matrices de teflón de 2 mm de espesor y orificio central con 4 mm de diámetro. Se seleccionó cuatro veces el fotocurado de manera estándar, sugerido por el fabricante. Por lo tanto, las muestras del grupo 1 (G1) se fotopolimerizaron durante 5 segundos; grupo 2 (G2) durante 10 segundos; grupo 3 (G3) durante 15 segundos y grupo 4 (G4) durante 20 segundos. La exposición radiante, que indica la potencia en mW / cm2 a lo largo del tiempo en segundos, se expresó en julios (J). Las muestras se almacenaron en un recipiente oscuro con agua destilada en una estufa a una temperatura de 37°C durante 48 horas antes del ensayo. Se realizó para comparaciones múltiples de los valores medios, análisis de varianza (ANOVA) de un criterio con la prueba T (LSD) tanto de la dureza de Knoop como de la compresión diametral con un índice de significación α=0.05. Con respecto a la prueba de microdureza de Knoop, G1 (35,73 ± 6,2) tuvo los valores más bajos, seguido de G2, mientras que G3 y G4 no mostraron diferencias estadísticas entre ellos. Para la prueba de compresión diametral, G1 (1387.76 ± 190.51) obtuvo el valor más bajo en comparación con los otros grupos. G2, G3 y G4 no presentaron diferencias estadísticamente significativas. Los diferentes tiempos de polimerización influyeron en la microdureza de Knoop y la resistencia a la compresión diametral de la resina compuesta mono incremental.

Homogenous Bone Grafts as an Alternative in Oral Rehabilitation Treatments with Dental Implants / Los Injertos Óseos Homogéneos como una Alternativa en los Tratamientos de Rehabilitación Oral con Implantes Dentales

ABSTRACT: The present study aims to describe, through a case report, the functioning of bone grafts, where they are obtained including bone banks and the different dental areas in which it is used. A 50-year.old female patient HMR, sought the postgraduate college of dentistry CECAPE for oral rehabilitation. The initial clinical examination revealed the absence of several dental elements in both the maxilla and mandi ble, bone resorption in the entire maxillary extension where there was an absence of elements in the anterior region and the presence of a torus in the palatal region. Initial tomographic examinations of the maxilla and mandible were performed, looking for the best conduct regarding the diagnosis and planning of the case. After the clinical and radiographic examinations was performed, and the diagnosis was reached, it was determined as a treatment for oral rehabilitation of the maxilla, bone grafting and an Implant-supported Removable Partial Prosthesis and for the mandible a Dento-muco-supported Removable Partial Prosthesis. Dental treatments and oral rehabilitation from the use of bone tissues and bone grafting have become commonly used. Procedures that would normally lead to failure started to increase the percentage of successes due to the use of these biomaterials. The use of bone grafts in dentistry has been shown to be a very effective and useful resource, considering its great applicability in bone reconstructions in different areas of dentistry.

RESUMEN: El presente estudio tiene como objetivo describir a través de un informe de caso, el funcionamiento de los injertos óseos, donde se obtienen, incluidos los bancos de huesos y las diferentes áreas dentales en las que se emplea. Una paciente HMR, de 50 años de edad, asistió el centro universitario de posgrado CECAPE para rehabilitación oral. El examen clínico inicial reveló la ausencia de varios dientes tanto en el maxilar como en la mandíbula, la resorción ósea en toda la extensión maxilar donde había ausencia de dientes en la región anterior y la presencia de un torus en la región palatina. Se realizaron exámenes tomográficos iniciales del maxilar y mandíbula, buscando la mejor conducta con respecto al diagnóstico y la planificación del caso. Después de los exámenes clínicos y radiográficos realizados y el diagnóstico listo, se determinó como un tratamiento para la rehabilitación oral del maxilar, el injerto óseo y una prótesis removible implantosoportada y para la mandíbula una prótesis parcial removible dento-muco-soportada. Los tratamientos dentales y la rehabilitación oral a partir del uso de tejidos óseos y el injerto óseo se han utilizado comúnmente. Los procedimientos que normalmente conducirían al fracaso comenzaron a aumentar el porcentaje de éxitos debido al uso de estos biomateriales. Se ha demostrado que el uso de injertos óseos en odontología es un recurso muy eficaz y útil, considerando su gran aplicabilidad en las reconstrucciones óseas en diferentes áreas de la odontología.

Considerações Atuais Quanto as Cerâmicas Odontológicas e Seus Respectivos Sistemas de União / Current Considerations for Dental Ceramics and Their Respective Union Systems

Objetivo: avaliar as principais caracteristicas das cerâmicas odontológicas, cimentos resinosos, tratamentos de superfície e verificação dos seus devidos modos de falha, frente à literatura e suas respectivas utilizações clínicas. Material e Métodos: foi realizada uma busca bibliográfica nos principais bancos de dados de saúde PUBMED (www.pubmed.gov) e Scholar Google (www.scholar.google.com.br), no qual coletou-se trabalhos que foram publicados de 2002 a 2020. Foram inclusos estudos laboratoriais, relatos de casos, revisões sistemáticas e revisões de literatura, que fossem desenvolvidos em indivíduos vivos. Logo, foram excluídos artigos que não tratavam a respeito das caracteristicas das cerâmicas odontológicas, cimentos resinosos, tratamentos de superfície e verificação dos seus devidos modos de falha, frente à literatura e suas respectivas utilizações clínicas. Resultados: as cerâmicas podem ser classificadas em cerâmicas vítreas, cerâmicas policristalinas e as cerâmicas híbridas. Do mesmo modo que existem diferentes composições das cerâmicas e agentes de união, há também alguns protocolos de tratamento de superfície que se diferem de acordo com a escolha desses materiais. Conclusão: diversos sistemas cerâmicos estão disponíveis no mercado, fazendo com que os profissionais da área protética necessitem de uma constante reciclagem acerca das suas propriedades e indicações, visto que bons resultados não são devidos exclusivamente ao tipo de material utilizado, mas sim, à seleção do melhor material, tipo de preparo em conjunto à habilidade do profissional, cimentos resinosos, tratamentos de superfície e verificação dos seus devidos modos de falha. Nesse contexto, fazem-se necessários maiores estudos com relação às cerâmicas odontológicas e seu devido uso em um cenário clínico

Objective: to evaluate the main characteristics of dental ceramics, resin cements, surface treatments and verification of their failure modes, in relation to the literature and their respective clinical uses. Material and Methods: a bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 2002 to 2020 were collected. Laboratory studies, case reports, systematic and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the main characteristics of dental ceramics, resin cements, surface treatments and verification of their failure modes, in relation to the literature and their respective clinical uses were excluded. Results: ceramics can be classified into glass-matrix ceramics, polycrystalline ceramics and hybrid ceramics. Just as there are different compositions of ceramics and bonding agents, there are also some surface treatment protocols that vary according to the choice of these materials. Conclusion: several ceramic systems are available, making professionals in the prosthetic area need a constant update about their properties and indications, since good results are not due exclusively to the type of material used, but also to the selection of the best material, type of preparation, professional's skill, resin cements, surface treatments and verification of their failure modes. In this context, further studies are needed in relation to dental ceramics and their proper clinical use

Influência do Condicionamento Ácido na Resistência de União entre Cerâmica Feldspática e Cimento Resinoso / Influence of Acid Etching on Bond Strength Between Feldspathic Ceramics and Resin Cement

Objetivo: Analisar a influência da resistência de união entre cimento resinoso e cerâmica feldspática utilizando concentrações e tempos de aplicação diferentes de acído fluorídrico (HF). Material e Métodos: Foram confeccionados 18 discos de cerâmica feldspática (Ø10mm - 2mm de espessura) através da técnica incremental, que foram incluídos em resina acrílica e regularizados com lixas de carbeto de silício com granulações de 600, 1200 e 2000 através de uma máquina de polimento com velocidade de 600 rpm para regularização. Logo após foram mergulhadas em água destilada durante 10 minutos em cuba ultrassônica. Todos corpos de prova foram condicionados com HF e silanizados. Foram confeccionados quatro cilindros de cimento sobre cada corpo de prova (n=12), feitos com cimento resinoso Relyx ARC. Logo após, dividiu-se em seis grupos de acordo com o protocolo de tratamento de superfície: G1 (5% - 40s); G2 (5% - 60s); G3 (5% - 80s); G4 (10% - 40s); G5 (10% - 60s) e G6 (10% - 80s). Os corpos de prova foram submetidos ao Teste de Microcisalhamento, com força vertical a uma velocidade de 0,5 mm/min sobre a peça. A resistência de união ao microcisalhamento foi calculada e expressa em Megapascal (MPa). Os dados foram submetidos à análise de variância (ANOVA) dois fatores e para comparações múltiplas foi utilizado o Teste de Tukey, sendo o nível de significância de 5%. Resultados: Quando analisado a concentração do HF, não houve diferenças estatísticas (p>0,05). Na comparação dos tempos de aplicação, G3 (5% - 80s) e G6 (10% - 80s) obtiveram maiores resultados de resistência ao microcisalhamento que os demais grupos. Conclusão: As diferentes concentrações de HF não influenciaram na resistência de união entre cerâmica feldspática e cimento resinoso. Já o aumento do tempo de condicionamento com HF afetou na resistência de união

Objective: analyze the influence of bond strength between resin cement and feldspathic ceramics using different concentrations and application times of hydrofluoric acid (HF). Materials and Methods: 18 feldspathic ceramic discs (Ø10mm - 2mm thickness) were made through the incremental technique, which were included in acrylic resin and regularized with silicon carbide sandpaper with granulations of 600, 1200 and 2000 through a polishing machine with a speed of 600 rpm. Soon after, they were immersed in distilled water for 10 minutes in an ultrasonic bath. All specimens were conditioned with HF and silanized. Four cement cylinders were made on each specimen (n=12), manufactured with Relyx ARC resin cement. After that, it was divided into six groups according to the surface treatment protocol: G1 (5% - 40s); G2 (5% - 60s); G3 (5% - 80s); G4 (10% - 40s); G5 (10% - 60s) e G6 (10% - 80s). The specimens were subjected to the Microshear Test, with vertical force at a speed of 0.5 mm min on the specimen. The microshear bond strength was calculated and expressed in Megapascal (MPa). The data were submitted to two-way analysis of variance (ANOVA) and Tukey's test for multiple comparisons, with a significance level of 5%. Results: when the concentration of HF was analyzed, there were no statistical differences (p>0.05). In the comparison of application times, G3 (5% - 80s) and G6 (10% - 80s) obtained higher results of microshear resistance than the other groups. Conclusion: The different concentrations of HF did not influence the bond strength between feldspathic ceramics and resin cement. However, the increase in the time of HF conditioning affected in the bond strength.

Evaluation of coronally advanced flap in ''l'' associated with subepithelial connective tissue graft in the treatments of Miller's class i and ii gingival recessions / Evaluación de colgajo coronalmente avanzado en ''l'' asociado con injerto subepitelial de tejido conectivo en el tratamiento de recesiones gingivales de clases I y II de Miller

To evaluate clinically the results of two surgical techniques used for root coverage, the coronally advanced flap in '' L '' isolated (CAF) or associated with subepithelial connective tissue graft (SCTG). The surgical procedures were performed in seventeen individuals, ten individuals in the control group (coronally advanced flap in "L") and seven individuals in the test group (coronally advanced flap in "L" associated with SCTG), who presented Miller class I and II gingival recession. The depth gingival recession (GR) index was evaluated in the following periods: immediate preoperative and 180 postoperative days. The control group had a success rate of 85 +/- 18 % and the test group had a success rate of 95 +/- 4 %. The variable success rates (p=0.36) did not present a statistically significant difference. The isolated CAF or its association with SCTG showed favorable outcomes in the treatments of Miller's class I and II gingival recessions.

El objetivo fue evaluar clínicamente los resultados de dos técnicas quirúrgicas utilizadas para la cobertura radicular, el colgajo coronalmente avanzado en "L" aislado (CAF) o asociado con injerto de tejido conectivo subepitelial (SCTG). Los procedimientos quirúrgicos se realizaron en diecisiete individuos, diez individuos en el grupo de control (colgajo coronario avanzado en "L") y siete individuos en el grupo de prueba (colgajo coronalmente avanzado en "L" asociado con SCTG), que presentaron la clase I de Miller y II recesión gingival. El índice de recesión gingival profunda (RG) se evaluó en los siguientes períodos: preoperatorio inmediato y 180 días postoperatorios. El grupo de control tuvo una tasa de éxito de 85 +/- 18 % y el grupo de prueba tuvo una tasa de éxito de 95 +/- 4 %. Las tasas de éxito variables (p = 0,36) no presentaron una diferencia estadísticamente significativa. La CAF aislada o su asociación con SCTG mostraron resultados favorables en los tratamientos de las recesiones gingivales de clase I y II de Miller.

Comportamento da pressão arterial sistêmica em pacientes submetidos a procedimentos cirúrgicos odontológicos / Behavior of systemic blood pressure in patients submitted to dental surgery procedures

Objetivo: realizar uma revisão de literatura sobre a ocorrência de alterações significativas na pressão arte¬rial sistêmica de pacientes submetidos a procedimentos cirúrgicos odontológicos. Materiais e método: esta revisão de literatura foi conduzida por meio das seguintes bases de dados: PubMed, SciELO e Google Scholar. As palavras-chave para a busca textual foram: cirurgia oral (oral surgery), hipertensão (hypertension), ansiedade (anxiety), odontologia (dentistry). Os critérios de inclusão foram: literatura sobre a temática em estudo, literatura dos últimos anos, literatura publicada em inglês ou português, estudos laboratoriais e clínicos e revisão sistemática. Os critérios de exclusão foram: revisão de literatura, carta ao editor, artigo de opinião, literatura duplicada em bases de dados e literatura que não abordasse as variáveis em estudo. Revisão de literatura: durante a prática clínica, o cirurgião-dentista lida rotineiramente com pacientes sistemicamente comprometidos. Entre eles, encontram-se os pacientes hipertensos, que necessitam de uma atenção diferenciada, devido a diversos fatores externos que podem influenciar sua condição sistêmica. Considerações finais: existe uma variação da pressão arterial durante todo procedimento cirúrgico odontológico, e o momento mais evidente dessa alteração é após a anestesia; essas variações, por sua vez, podem ser atribuídas à ansiedade e ao estresse causados pelo ato cirúrgico; a redução do estresse bem como o controle da ansiedade e do medo frente a um tratamento odontológico são benefícios no atendimento de pacientes hipertensos. (AU)

Objective: the objective of this study was to describe through a review of the literature on the occurrence of significant changes in the systemic arterial pressure of patients submitted to dental surgical procedures. Materials and method: this literature review was conducted using the databases: PubMed, SciELO and Google Scholar. The keywords for the literature search were: Oral surgery; Hypertension; Anxiety; Dentistry. The inclusion criteria were: papers that covers the subject under study, papers of the last years, papers in English and Portuguese language, laboratory studies, clinical studies and systematic review. The exclusion criteria were: literature review, letter to the editor, opinion article, papers duplicated in databases and literature that did not address the variables under study. Literature review: in the clinical practice, the dental surgeon routinely treats systemically compromised patients. Among them are the hypertensive patients who need a differentiated attention due to several external factors that can influence their systemic health. Final considerations: there are a variation of the arterial pressure throughout the dental surgical procedure, the moment that this change becomes more evident is after the anesthesia; these variations in turn can be attributed to the anxiety and stress caused by the surgical act; the reduction of surgical stress as well as the control of anxiety and fear of dental treatment are benefits in the care of hypertensive patients. (AU)

A importância da bioética na prática odontológica: considerações atuais da literatura / The importance of bioethics in the dental practice: current considerations from the literature

Objetivo: revisar a literatura sobre os meios pelos quais o cirurgião-dentista deve orientar sua conduta, tornando- se ciente daquilo que lhe é exigido em relação à sua profissão. Materiais e método: esta revisão de literatura foi conduzida pelos principais bancos de dados de saúde: PubMed, SciELO e Google Scholar. As palavras-chave para a busca textual foram: ética profissional (ethics, professional); educação em odontologia (education, dental); odontologia (dentistry). Os critérios de inclusão foram: literatura que aborde a temática em estudo, literatura dos últimos anos, idiomas inglês e português, estudos laboratoriais e clínicos e revisão sistemática. Os critérios de exclusão foram: revisão de literatura, carta ao editor, artigo de opinião, literatura duplicada em bases de dados e literatura que não abordasse as variáveis em estudo. Revisão de literatura: a bioética baseia-se em quatro princípios básicos que estabelecem uma metodologia para analisar os casos concretos e os problemas éticos que ocorrem na prática da assistência à saúde, sendo eles: não maleficência, beneficência, respeito à autonomia e justiça. Sendo esses princípios fundamentais para o desenvolvimento da bioética, com isso, abordando uma forma peculiar de definir e manejar os valores envolvidos nas relações dos profissionais de saúde e seus pacientes. Considerações finais: a bioética deve nortear os avanços dentro do respeito ao ser humano e à sua individualidade, sem que ocorram possíveis infrações. Todavia, são necessários maiores estudos para uma maior compreensão sobre o tema e as melhores medidas para cada caso em particular. (AU)

Objective: to review the literature on the means by which dentists should guide their behavior, becoming aware of the requirements concerning their profession. Materials and method: this literature review was performed by the main health databases of PubMed, Sci- ELO, and Google Scholar. The keywords for the text search were ethics, professional; education, dental; dentistry. The inclusion criteria were the literature addressing the subject studied, the recent literature, English and Portuguese languages, laboratory and clinical studies, and systematic reviews. The exclusion criteria were literature reviews, letters to the editor, opinion articles, the literature duplicated in databases, and the literature that did not address the variables studied. Literature review: bioethics is based on four basic principles that establish a methodology for analyzing the concrete cases and ethical problems occurring in the health care practice, as follows: non-maleficence, beneficence, respect for autonomy, and justice. These are fundamental principles for the development of bioethics, hence addressing a particular way of defining and managing the values involved in the relationships between health professionals and their patients. Final considerations: bioethics should guide the advances regarding human beings and their individuality, without the occurrence of potential infractions. However, further studies are required for a better understanding of the subject and for the best measures for each particular case. (AU)

Abordagem quanto ao diagnóstico e ao tratamento da avulsão dentária: uma revisão de literatura / Approach to diagnosis and treatment of dental avulsion: a literature review

Objetivo: descrever uma revisão da literatura que apresente as principais consequências que podem ocorrer quando o dente avulsionado é reimplantado de forma tardia, proporcionando um prognóstico desfavorável. Revisão de literatura: a avulsão dental é uma lesão traumática que se caracteriza pelo completo deslocamento do dente de seu alvéolo, acarretando danos tanto às estruturas de suporte do elemento dental quanto às estruturas pulpares. A permanência extraoral do elemento dental avulsionado por períodos longos ou em meios de armazenamento inadequados pode provocar danos adicionais. Considerações finais: as lesões de inserções são as principais consequências da pós-avulsão dentária, isso devido a uma ruptura do ligamento periodontal, com uma secagem excessiva antes do reimplante, danificando as células do ligamento periodontal, o que, por sua vez, provoca uma resposta inflamatória exacerbada em uma ampla área da superfície radicular. (AU)

Objective: to describe a literature review, which presents the main consequences of late reimplantation of the avulsed tooth, providing an unfavorable prognosis. Literature review: tooth avulsion is a traumatic lesion characterized by the complete displacement of the tooth from the socket, causing damage to the support structures of the dental element as well as to pulp structures. The long extraoral time of the avulsed tooth or the time in inadequate storage may cause additional trauma. Final considerations: insertion lesions are the main consequences of tooth post-avulsion due to a rupture in the periodontal ligament, with an excessive drying prior to reimplantation, which damages the periodontal ligament cells and causes an exacerbated inflammatory response in a large root surface area. (AU)

Evaluation of the Fluorescence of Composite Resins Under an Ultraviolet Light Source / Evaluación de la Fluorescencia de Resinas Compuestas Bajo una Fuente de Luz Ultravioleta

ABSTRACT: The aim of this research is to compare the fluorescence of different trademarks of composite resins under ultraviolet light, indicating through the optical characteristics the restorative materials that best mimic the properties of dental fluorescence. In this study, nine composite resin trademarks of EA2 color were evaluated, and ten test samples were prepared for each material, totalizing ninety specimens. The specimens were produced from a bipartite aluminium matrix (10x2 mm), and then stored for 24 h in tubes of radiographic films, immersed in distilled water and after 48 h it were polished. A blind-type study (four evaluators) was used and the samples were analyzed in a dark wooden chamber where it was coupled two black lamps. In the data collection phase, the Kolmogorov-Smirnov normality test, ANOVA and Post Hoc of Tukey were used (adopting a significance level of 0.05). It was noted that the composite resin of the trademark Ultrafill was more fluorescent and Luna was statistically less fluorescent than all other materials, while Opallis and Tetric were superior to Glacier. There was no significant statistical difference among the composite resins Premissa, Point 4, Llis and Premium.

RESUMEN: El objetivo de esta investigación es comparar la fluorescencia de diferentes marcas registradas de resinas compuestas bajo luz ultravioleta, indicando a través de las características ópticas los materiales de restauración que mejor imitan las propiedades de la fluorescencia dental. En este estudio, se evaluaron nueve marcas registradas de resina de color EA2, y se prepararon diez muestras de prueba para cada material, totalizando noventa especímenes. Las muestras se produjeron a partir de una matriz de aluminio bipartita (10x2 mm), y luego se almacenaron durante 24 h en tubos de películas radiográficas, se sumergieron en agua destilada y después de 48 h se pulieron. Se utilizó un estudio de tipo ciego (cuatro evaluadores) y las muestras se analizaron en una cámara de madera oscura donde se acoplaron dos lámparas negras. En la fase de recolección de datos, se utilizaron las pruebas de normalidad KolmogorovSmirnov, ANOVA y Post Hoc de Tukey (adoptaron un nivel de significancia de 0,05). Se observó que la resina compuesta de la marca registrada Ultrafill era más fluorescente y la marca Luna fue estadísticamente menos fluorescente que todos los demás materiales, mientras que Opallis y Tetric eran superiores a Glacier. No hubo diferencias estadísticamente significativas entre las resinas compuestas Premissa, Point 4, Llis y Premium.

Etiología de las Pérdidas Dentales en Pacientes Rehabilitados con Prótesis sobre Implantes / Etiology of Tooth Loss in Patients Rehabilitated with Dental Implants

RESUMEN: El objetivo de esta investigación fue analizar la etiología de las pérdidas dentales en pacientes rehabilitados con prótesis sobre implantes. Se realizó un estudio transversal con informaciones de 93 pacientes de una clínica privada que recibieron tratamiento con implantes en el período de 2000 a 2009. Los datos fueron recolectados a través de las fichas clínicas, documentaciones radiográficas y fotografías de los casos clínicos. Se levantaron datos sobre género, edad, nivel de escolaridad, hábito de fumar, tipo de diente extraído y razón de la extracción. Los resultados mostraron que la razón periodontal fue el principal motivo de las pérdidas dentales, representando el 24,7 %, seguida por las fracturas radiculares con pines metálicos (23,7 %) y caries secundarias (15,1 %). En los pacientes menores de 40 años, los traumatismos dentales y las fracturas radiculares con pino fueron responsables de la mayoría de las pérdidas. Las razones de las pérdidas dentales mostraron significancia estadística con la variable edad (p<0,05). El género, el hábito de fumar y el grado de escolaridad no mostraron asociación significativa (p>0,05) con las razones de las pérdidas dentales.

ABSTRACT: The aim of this study was to analyze the etiology of tooth loss in patients rehabilitated with dental implants. Was conducted a cross-sectional study with data from 93 patients from a private clinic who were treated with implants from the year 2000 until 2009. Data were collected through medical records, radiographic documentation and photographs of clinical cases. Data on sex, age, education level, smoking habits, teeth loss localization and extraction ratio were analyzed. The results showed that periodontal disease was the main reason for tooth loss, accounting for 24.7 %, followed by root fractures with posts (23.7 %) and secondary caries (15.1 %). In patients below 40 years, dental trauma and root fractures were responsible for most of the losses. The reasons for tooth loss showed statistical significance with the age (p<0.05). Sex, smoking habits and education showed no significant association (p>0.05) with the reasons of the tooth loss.