Effects of marginal adaptation with different materials on restoring dental wedge-shaped defects / 中国基层医药

Objective To evaluate the effects of marginal adaptation with different materials on restoring dental wedge-shaped defects. Methods From January 2016 to July 2016,80 patients with 172 wedge -shaped defect teeth in Stomatological Hospital of Haishu District were chosen and randomly divided into three groups accord-ing to random number table method,26 patients with 55 defect teeth were treated with Fuji glass ionomer( group A) , 23 patients with 59 defect teeth were treated with Carey charismatic light-cured composite resin( group B) ,and the other 31 patients with 58 defect teeth were treated with beautifil flow plus reinforced polymer F03(group C). Marginal adaptation of three groups of different materials of the teeth were measured. Results The micro -leakage depth among the three groups had statistically significant difference(H=7. 036,P=0. 035). The micro-leakage depth of group A,B and C were (1. 10 ± 0. 05) mm,(0. 96 ± 0. 05) mm,(0. 78 ± 0. 06) mm,respectively. There was statisti-cally significant difference among the three groups(F=22. 371,P=0. 005). Conclusion The marginal adaptation of beautifil flow plus reinforced polymer F03 is superior to FujiⅡglass-ionome and Charisma composite resin,and has benefits for treatment of wedge-shaped defects.

Effect of several repair techniques on the bond strength between composite resin and degraded Y-TZP ceramic / Efeito de várias técnicas de reparo na resistência de união entre resina composta e zircônia degradada

Objective: To evaluate the bond strength of different repair treatments for composite resin to aged Y-TZP ceramics. Material and Methods: Zirconia blocks were cut into smaller specimens, sintered according to manufacturer's recommendations (final dimensions of 4×4×3 mm), and randomly allocated into nine groups (n=15) according to the surface treatment and presence/ absence of aging of the substrate (subjected to lowtemperature degradation - LTD), as follows: without LTD (Control: without treatment; TBS: tribochemical silica coating + silane + adhesive); with LTD (Control-LTD: without treatment; TBS-LTD: TBS with hydrothermal degradation; MoS-LTD: Monobond S + adhesive; MoPLTD: Monobond Plus + adhesive; MZP-LTD: Metal/ Zirconia Primer + adhesive; USB-LTD: Single Bond Universal; AP-LTD: Alloy primer + adhesive). LTD was simulated in an autoclave (134 °C, 2 bar, 5 h). The ceramic blocks were embedded in PVC cylinders with a self-curing acrylic resin; each surface treatment protocol was performed; a composite resin cylinder ( : 3.25 mm and height: 3 mm) was then build-up using split metallic matrices. All the specimens were aged (thermocycling + storage in water for 90 days) and subjected to the shear bond strength test using a universal testing machine (1 mm/min). The failure mode was classified into four types: adhesive, composite resin cohesive fracture, ceramic cohesive fracture, and mixed. The bond strength values were subjected to Mann­Whitney test. Results: Only air-abraded samples (TBS and TBS­LTD) survived thermocycling. More than 80% of the samples of the other groups presented pre-test failures. TBS groups presented higher values of bond strength (3.94) compared to TBSLTD (0.96). The predominant type of failure for the surviving samples were adhesive. Conclusion: Air particle abrasion is mandatory to improve the bond strength of the Y-TZP substrate; an aged substrate presents an even more unfavorable scenario for adhesion. (AU)

Objetivo: Avaliar a resistência de união ao cisalhamento gerada por diferentes técnicas de reparo em resina composta aderida em zircônia envelhecida (sujeita a degradação a baixa temperatura - LTD). Material e Métodos: blocos de zircônia foram seccionados em espécimes, sinterizados de acordo com o fabricante (dimensões finais de 4x4x3 mm), e aleatorizados em nove grupos (n=15) de acordo com o tratamento de superfície e presença/ausência de envelhecimento do substrato (LTD), conforme: sem LTD (Control: sem tratamento; TBS: tribosilicatização + silano + adesivo); com LTD (Control-LTD: Monobond S + adesivo; MoP-LTD: Monobond plus + adesivo; MZPLTD: Meta/Zirconia primer + adesivo). LTD foi simulada em autoclave (134 °C, 2 bar, 5 h). Os blocos de cerâmica foram embutidos em cilindros de PVC com resina acrílica autopolimerizável; cada tratamento de superfície foi realizado; um cilindro de resina composta ( : 3,25 mm 3 mm de altura) foi confeccionado usando matrizes metálicas bipartidas. Todos os espécimes foram envelhecidos (termociclagem + armazenagem em água por 90 dias) e sujeitos ao teste de cisalhamento usando um equipamento de teste universal (1 mm/ min). O modo de falha foi classificado em quatro grupos: adesivo, fratura coesiva em resina composta, fratura coesiva da cerâmica, e mista. Os valores de adesão foram sujeitos ao teste de Mann-Whitney. Resultados: somente as amostras jateadas (TBS e TBSLTD) sobreviveram a termociclagem. Mais que 80% dos espécimes dos outros grupos apresentaram falhas préteste. Os grupos TBS apresentaram os maiores valores de resistência ao cisalhamento (3,94) comparado com TBS-LTD (0,96). Os tipos predominantes de falha para os espécimes sobreviventes foi adesiva. Conclusão: o jateamento é recomendável para aumentar a resistência adesiva à zircônia; um substrato envelhecido apresenta um cenário mais desfavorável de adesão. (AU)

Clinical effect of minimally invasive painless Carisolv iodide removal technique in the treatment of dental caries / 中国基层医药

Objective To investigate the clinical effect of minimally invasive painless iodide removal technique in the treatment of dental caries.Methods From January 2017 to October 2017,60 patients with dental caries in Xiaogang Hospital of Beilun District were selected and divided into observation group(n=50)and control group(n=50).The patients in the control group were treated by traditional dental drill dehumidification technique,and the patients in the observation group were treated by minimally invasive painless iodide removal technique.The clinical effects of the two groups were compared and analyzed.Results The total effective rate,the severe pain during treatment and the slight pain sensation of the observation group were 94％,0％,14％,respectively,which were better than those of the control group(72％,10％,46％),the differences between the two groups were statistically significant(χ2 =11.254,5.011,9.451,all P<0.05).Conclusion The use of Carisolv iodine can reduce the use of anesthetic,or reduce the necessity of using the needle,which can reduce the pain and discomfort of the patients.There is a choice to remove caries,will not damage the normal dental tissue,can reduce the occurrence of complications,which can prolong the life of teeth and reduce the probability of infection,thus to prevent tissue around the tooth from being damaged.

Application effect of glass fiber pile and cast metal pile in tooth defect repair and its influence on periodontal tissue / 中国基层医药

Objective To analyze the application effect of glass fiber pile and cast metal pile in tooth defect repair and its influence on periodontal tissue.Methods From February 2014 to February 2015,112 patients with dental defect in the Central Hospital of Yiwu were randomly divided into the control group and the research group according to the digital table,with 56 cases in each group.The control group received the casting metal pile repair,the research group was repaired with glass fiber piles.The remediation effect,periodontal tissue status,inflammatory response and adverse reaction were compared between the two groups.Results The success rate of the research group was significantly higher than that of the control group(89.29％vs.66.07％),and there was statistically significant difference(χ2 =8.70,P<0.05).After treatment,the alkaline phosphatase,interleukin-6(IL-6)and interleukin-8(IL-8)levels of the two groups were increased compared with before treatment,which of the research group were obviously lower than those of the control group [(440.75 ±55.75)U/L vs.(491.75 ±62.59)U/L,(18.77 ± 2.21)ng/L vs.(30.65 ±3.97)ng/L,(51.42 ±6.32)μg/L vs.(76.33 ±9.50)μg/L],there were statistically significant differences(t=4.52,19.56,16.33,all P<0.05).After treatment,the periodontal examination depth of the two groups was(2.15 ±0.29)mm and(2.17 ±0.25)mm,respectively,and there was no statistically significant difference(t=0.39,P>0.05).Conclusion The effect of glass fiber pile in tooth defect repair is better than cast metal pile,and its stability and biocompatibility are better,and it is a simple operation,which is worthy of clinical promotion.

Caracterización de los pacientes con reparaciones de prótesis estomatológica / Characterization of the patients with repairs of stomatological prosthesis

Fundamento: las prótesis dentales por su función en la boca, el tipo de material con que es confeccionada, por el uso y cuidado por parte del paciente sufre con mucha frecuencia roturas y deterioro que son resueltos en la clínica por medio de reparaciones. Objetivo: caracterizar los pacientes con reparaciones de prótesis estomatológica en el Policlínico Julio Antonio Mella. Métodos: se realizó un estudio observacional, descriptivo transversal en el año 2015, en pacientes atendidos en el departamento de prótesis estomatológica del Policlínico Universitario Julio Antonio Mella. El universo lo constituyeron 590 pacientes mayores de 20 años de edad de ambos sexos, en busca de atención por urgencia de prótesis con problemas de su aparato protésico. La selección de la muestra fue no probabilística y quedó constituida por 567 pacientes que presentaron urgencia de prótesis por reparación de su aparato protésico. Resultados: entre los 567 pacientes predominó el sexo femenino y los grupos de edades que más incidió fueron el de 40 a 59 años seguido del 60 a 79 años. Del total de individuos que solicitaron urgencias por reparación de prótesis usaban prótesis parcial removible 319 y 248 prótesis totales. El mayor motivo de reparaciones perteneció a la caída de dientes de manera esencial en las prótesis parciales, seguida de las fracturas completas con predominio en las prótesis totales. Conclusiones: las reparaciones simples fueron más abundantes sin diferencia notable entre las prótesis totales y las parciales. Hubo más incidencia de caída de dientes en las prótesis parciales y de fractura completas en las prótesis totales.

Background: for their function in the mouth, the type of material out of which is manufactured, the use and care on behalf of the patient, dental prostheses suffer breakings and deterioration very frequently that are solved in the clinic with repair. Objective: to characterize patients with repairs of stomatological prosthesis in Julio Antonio Mella clinic. Methods: an observational, descriptive and cross-sectional study was conducted from in 2015, in patients who were assisted in Julio Antonio Mella clinic. The universe was composed of 590 patients over 20 years old from both sexes, in search of attention for urgency of prosthesis with problems of their prosthetic appliance. The selection of the sample was non probabilistic and it was made up of 567 patients who presented urgency for repair of their prosthesis. Results: among the 567 patients females prevailed. The age groups that predominated were the ones from 40 to 59 years followed by the 60 to 79 years. From the total of individuals that requested urgencies for repair of prosthesis 319 people used removable partial denture and 248 total prostheses. The major reason for reappearances was due to the fall of teeth in partial dentures, followed by the total fractures with predominance in the full dentures. Conclusions: the simple repairs were more abundant without notable difference between the full and the partial dentures. There was more incidence of fall of teeth in partial prostheses and complete fractures in the full dentures.

Effect of Metal Primers on Bond Strength of a Composite Resin to Nickel-Chrome Metal Alloy

Abstract This study evaluated the effects of three metal primers and one multi-mode adhesive system on the shear bond strength (SBS) of a flowable composite resin to nickel-chrome metal alloy (Ni-Cr). Ninety plates were cast from Ni-Cr and divided in nine groups (n=10). The surfaces were sandblasted with Al2O3 and primed with three adhesive primers: Alloy Primer (AP), Universal Primer (TP) and RelyX Ceramic Primer (CP), and a multi-mode adhesive (Scotchbond Universal, SU). The Adper Single Bond Plus (SB) and SU adhesives were also combined with adhesive primers. Control group did not have any surface treatment. The groups were: AP, AP+SB, AP+SU, TP+SB, TP+SU, CP+SB, CP+SU and SU. Composite cylinders were built on alloy surface. After 24 h, half the specimens were subjected to SBS and the other half to thermal cycling before testing. Data were analyzed by two-way ANOVA and Tukey’s test (a=0.05). Failure modes were assessed by SEM observation. Higher SBS were obtained with AP and TP combined with adhesives at 24 h and the lowest one for control group. Thermocycling reduced SBS for AP, CP+SU and SU. Combination between TP and SU resulted in the highest SBS after the thermocycling. TP groups showed all types of failures and high incidence of mixed failures. The use of AP and UP metal primers before application of SU and SB adhesive systems increased the SBS of composite to Ni-Cr. These combinations between metal primers and adhesives had the highest SBS after thermocycling.

Resumo Este estudo avaliou os efeitos de três primers para metais e um sistema adesivo multi-mode na resistência da união por cisalhamento (SBS) de um compósito resinoso de baixa viscosidade a uma liga niquel-cromo (Ni-Cr). Noventa placas Ni-Cr foram divididas em 9 grupos (n=10). As superfícies foram jateadas com Al2O3 e condicionadas com três primers adesivos: Alloy Primer (AP), Universal Primer (TP) e Rely X Ceramic Primer (CP) e um adesivo multi-mode (Scotchbond Universal, SU). Os adesivos Adper Single Bond Plus (SB) e SU foram combinados com os primers para metais. O grupo controle não recebeu nenhum tipo de tratamento superficial. Os grupos foram: AP, AP+SB, AP+SU, TP+SB, TP+SU, CP+SB, CP+SU e SU. Cilindros de resina foram construídos na superfície da liga. Após 24 h, metade dos espécimes foi submetido ao SBS, a outra metade foi termociclada previamente. Os dados foram analisados pelos testes ANOVA dois fatores e Tukey (a=0.05). Os tipos de fraturas foram determinados utilizando microscopia eletrônica de varredura (MEV). Os maiores valores de SBS foram obtidos com AP e TP combinados com adesivos após 24 h e o menor valor foi obtido no grupo controle. A ciclagem térmica reduziu a SBS para AP, CP+SU e SU. Combinação entre TP e SU resultou em altos valores de SBS após termociclagem. Os grupos TP apresentaram todos os modos de fratura e alta incidência de fraturas mistas. O uso dos primers AP e UP para metais antes da aplicação dos sistemas adesivos SU e SB aumentou a SBS entre o Ni-Cr e a resina composta. Essa combinação entre primers e adesivos mostrou os maiores valores de SBS após a termociclagem.

Reparaciones protésicas: salud bucal y estado prostodóncico de los solicitantes / Denture Repairs: oral health and prosthodontics state the applicants'

Fundamento: la solicitud de reparaciones protésicas no constituye una urgencia en estomatología, pero ello origina una oportunidad de revisión de la cavidad bucal. Objetivo: establecer los aspectos de la salud bucal y el estado prostodóncico de los pacientes solicitantes de algún tipo de reparación protésica. Métodos: se realizó un estudio cuantitativo, longitudinal y descriptivo, de series de casos en 482 pacientes que solicitaron algún tipo de reparación protésica en consulta especializada de la Clínica Estomatológica Municipal “Manuel Sánchez”, Manzanillo, Granma, en el primer semestre del año 2016. Resultados: el mayor por ciento de los pacientes, que solicitaron algún tipo de reparación protésica, eran del sexo femenino. La media de edad se encontró en un rango de 28-86 años. La solicitud de reparaciones protésicas fue mayor en prótesis totales y superiores, fueron las fracturas completas el principal motivo de solicitud. Las revisiones de la cavidad bucal fueron en disminución con el tiempo de uso de las prótesis. El factor de riesgo más referido fue la frecuencia y métodos incorrectos de higiene bucal mientras que la estomatitis subprótesis fue la lesión bucal más constatada. Conclusiones: las solicitudes de reparación protésica se deben, en su mayoría, a fracturas completas y estas son hechas por pacientes que tienen una frecuencia y métodos incorrectos de higiene bucal, lo que determinó que la estomatitis subprótesis fuera la lesión más encontrada.

Background: the requesting denture repairs doesn't constitute an urgency in stomatology but this originates an opportunity of revision of the buccal cavity. Objective: to establish the health buccal aspects and the prosthodontics state of the patient applicants of some type of denture repairs. Methods: a quantitative, longitudinal and descriptive study of cases series in 482 patients requesting some type of denture repairs in specialized consults, in the Manuel Sánchez Municipal Stomatolgical Clinic, Manzanillo, Granma, in the first semester of the year 2016. Results: the 56,85 % of the patients that requested some type of denture repairs, was of the female sex. The age stocking was of 63,27 years in a 28-86 year-old range. The application of denture repairs was bigger in total denture (55,81 %) superiors (53,94 %) being the complete fractures (38,59 %) the main application reason. The revisions of the buccal cavity were diminishing with the time of use of the denture. The risk factor of more referred was the frequency and incorrect methods of buccal hygiene (83,2 %) while the denture stomatitis was the verified buccal lesion (21,16 %). Conclusions: the applications of denture repairs owe you, in their majority, to complete fractures and these they are made by patients that have a frequency and incorrect methods of buccal hygiene what determined that the denture stomatitis was the most opposing lesion.

Reparación intraoral de una prótesis parcial fija metal-cerámica de seis unidades con resina compuesta: relato del caso / Repair of a six-unit fixed partial denture metal-ceramics with composite resin: case report

Múltiples son los factores que pueden desencadenar fracturas de porcelana en una prótesis parcial fija metal-cerámica, aunque esta situación no siempre determina un reemplazo. La reparación de porcelana mediante el uso de resina compuesta es una alternativa con ventajas de una fácil manipulación y bajo costo. El objetivo del presente artículo es presentar a la resina compuesta como una opción con resultados considerables en la reparación de prótesis metal-cerámicas fracturadas, con alto compromiso estético. Se presenta un caso clínico de reparación intraoral de una prótesis fija metal-cerámica de seis unidades en el sector anterior superior. El tratamiento realizado incluyó fresado de la superficie de porcelana, aislamiento absoluto, grabado ácido con fluoruro de fosfato acidulado, microarenado con óxido de aluminio, silanización, aplicación del adhesivo convencional y tres tipos de resinas compuestas, resina opaca, microhíbrida y resina de nanorelleno. A los 8 meses se evaluó la adaptación de la reparación mediante un explorador e inspección visual, secando con una jeringa triple donde no se observó signos de percolación alguna. Basado en los resultados se puede considerar a esta combinación de resinas compuestas como una alternativa útil en la reparación de porcelana fracturada.

There are multiple factors that can trigger a fracture of porcelain in a metal-ceramic fixed partial denture, although a replacement is not always required. The porcelain repair using composite resin is an alternative with advantages such as easy handling and low cost. The aim of this paper is to present the composite as an option with significant results in the repair of fractured metal-ceramic prostheses, with a high aesthetic commitment. We report a case of intraoral repair of a six-unit metal-ceramic fixed prosthesis in the anterior superior sector. The treatment provided included milling of the surface of porcelain, absolute isolation, acid etching with acidulated phosphate fluoride, aluminium oxide sandblasting, silanization, conventional adhesive application and three types of composite resins: opaque resin, micro-hybrid resin and nanofilled resin. After 8 months we assessed the adaptation of the repair using a surface explorer and visual inspection, drying with a triple syringe. No signs of seepage were observed. Based on the results, this combination of composite resins can be considered as a useful alternative in the repair of broken porcelain.

Avaliação da resistência ao cisalhamento e da durabilidade de união entre sistemas para reparo em metalocerâmicas e titânio / Evaluation of shear bond strength and bond durability of metal-ceramic repair systems and titanium

O reparo de restaurações metalocerâmicas fraturadas é uma opção de tratamento que possibilita o aumento da longevidade da restauração, preservando a estrutura dental, além de ser uma alternativa rápida e de menor custo. Entretanto, o estabelecimento de uma união forte e estável entre material reparador e substrato da restauração fraturada é essencial para o sucesso do reparo. Levando-se em consideração a grande utilidade dos reparos quando corretamente indicados e a possibilidade de um aprimoramento dos mesmos com esses novos sistemas, conforme prometem os fabricantes, foi propósito deste estudo avaliar, em titânio comercialmente puro, a resistência ao cisalhamento de quatro sistemas comerciais de reparo para metalocerâmicas e da variação de um destes, bem como a durabilidade de união após armazenamento em água. Foram confeccionados discos (9 × 3 mm) em titânio comercialmente puro. Estes foram incluídos em anel de PVC com resina acrílica e suas superfícies regularizadas com lixas de carbeto de silício de diferentes granulações (120, 220 e 320) em politriz. Os espécimes receberam um dos seguintes tratamentos (n=10): 1) Epricord, 2) Bistite II DC, 3) Cojet, 4) Scotchbond Multi Uso Plus (grupo Controle), e 5) uma variação do grupo Controle, na qual foram empregadas partículas de sílica do sistema Cojet Sand em substituição às de óxido de alumínio. Os espécimes foram armazenados em água destilada a 37ºC por 24 horas, termociclados (5.000 ciclos - 5º e 55ºC) e, então, armazenados nas mesmas condições descritas anteriormente, por um período adicional de 24 horas ou 6 meses. O ensaio de cisalhamento foi realizado em máquina de ensaios Material Test System 810 com velocidade de 0,5 mm/minuto. O modo da fratura foi avaliado em lupa estereoscópica (30x). Às 24 horas, as médias de resistência (MPa) dos grupos de 1 a 5 foram respectivamente: 13,00 + 2,04c, 8,10 + 1,16d, 18,34 + 2,16b, 13,41 + 1,42c, e 22,73 + 1,42a . Aos 6 meses, foram: 11,20 + 1,26b , 4,79 + 0,38c , 7,36 + 1,91a, 10,11 + 1,29b, e 18,55 + 1,22a . O armazenamento em água afetou significativamente a resistência de união dos grupos 2, 4 e 5, reduzindo suas resistências. Às 24 horas, a resistência ao cisalhamento da combinação Scotchbond Multi Uso/Cojet Sand foi significativamente maior em relação aos demais grupos. Aos 6 meses, o sistema Cojet e a combinação Cojet Sand/ Scotchbond Multi Uso Plus foram estatisticamente superiores aos demais grupos e iguais entre si

Repair is a good alternative treatment that can increase clinical longevity of the failed restoration, preserving tooth structure, with the advantages of less chair time and lower cost. However, the clinical success of repair depends on establishing a strong and longterm durable bond between the repair material and the metal surface of the failed restoration. Considering the great benefit of intra-oral repairs and the possibility of improvement with the use of new available repair systems, the purpose of the present study was to evaluate shear bond strength of different repair systems to commercially pure titanium (CP Ti) and bond durability after long-term water storage. One-hundred disk specimens of cast CP Ti (9 × 3 mm) were embedded in a PVC ring and their bonding surfaces were smoothed with silicon carbide papers (120, 220, and 320 grit) using a polisher. Specimens were divided into 5 groups of 20, which received one of the following repair systems: 1) Epricord, 2) Bistite II DC 3) Cojet, 4) Scotchbond Multipurpose Plus (control Group), and 5) Cojet Sand plus Scotchbond Multipurpose Plus (variation of the control Group). The specimens were stored in distilled water for 24 hours at 37ºC, thermal cycled (5,000 cycles ­ 5º to 55ºC) and then stored in distilled water at 37o C for either 24 hours or 6 months. Shear bond tests were performed in a mechanical testing machine with a crosshead speed of 0.5 mm/minute. Each specimen was examined under a stereoscopic lens with ×30 magnification. At 24 hours, the mean values (MPa) for the groups 1 to 5 were respectively 13,00 + 2,04c , 8,10 + 1,16d, 18,34 +2,16b, 13,41 + 1,42c, e 22,73 + 1,42a. After 6 months, the mean (MPa) of each group was respectively 11,20 + 1,26b , 4,79 + 0,38c, 17,36 + 1,91a , 10,11 + 1,29b e 18,55 + 1,22a. Long-term water storage significantly affected groups 2, 4, 5, which showed a significant decrease of shear bond strength. At 24 hours, Cojet Sand/Scotchbond Multipurpose Plus showed the highest shear bond strength when compared to the other four groups. After 6 months, Cojet Sand/Scotchbond Multipurpose Plus and Cojet systems were not statistically different and were statistically superior to the other groups

Reparo intraoral de próteses metalo-cerâmicas : um relato de caso clínico / Intraoral repair in metal-ceramic prostheses: a clinical report

Repairing fractured metal-ceramic prosthesis is a treatment alternative that can increase the restoration longevity, preserve dental structure, and/or the integrity of implant components, besides being a simple, low-cost technique. However, clinicians often see restoration repair as a challenge because of the many doubts regarding the procedures required to obtain satisfactory results. Therefore, the motivation to write this article is the need to provide instructions for clinicians dealing with a situation involving fractured porcelain, presenting an intraoral repair technique that can be used in cases of a fractured ceramic veneer of a fixed partial prosthesis. The technique consisted in treating the remaining ceramic surface and applying a microhybrid composite resin following the steps of a protocol that, according to scientific evidence, has promoted high bond strength to porcelain, in addition to being cost effective.

O reparo de próteses metaloceramicas, quando a cerâmica encontra-se fraturada, e um tratamento alternativo que pode aumentar a longevidade dessas restaurações, preservar a estrutura dental ou a integridade de componentes protéticos sobre implantes, alem de ser uma técnica simples e de baixo custo. No entanto, essa técnica, geralmente, e vista como um desafio pelos cirurgiões-dentistas uma vez que não ha um protocolo clinico bem estabelecido para a obtenção de resultados satisfatórios. Assim sendo, o objetivo deste artigo e prover instruções para os clínicos lidarem com situações de fratura da cerâmica por meio da apresentação de um caso clinico, no qual uma técnica de reparo intra-oral indicada para essa situação foi empregada. Essa técnica consiste em tratar a superfície da cerâmica remanescente e aplicar uma resina composta microhibrida, seguindo os passos de um protocolo que, de acordo com evidencias cientificas, tem promovido alta resistência de união, alem de apresentar um baixo custo.

Ceramic restoration repair: report of two cases

The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.