Validez y confiabilidad de un cuestionario sobre satisfacción en usuarios de prótesis dentales totales / Validity and Reliability of a Questionnaire on Treatment Satisfaction among Patients Wearing Complete Dentures / Validade e confiabilidade de um questionário de satisfação em usuários de próteses dentárias totais

Introducción: evaluar la satisfacción con los tratamientos requiere cuestionarios específicos y validados que garanticen una prestación del servicio adecuada y que contribuya al bienestar de las personas. El objetivo fue evaluar la validez y la confiabilidad de la versión colombiana de un cuestionario sobre satis-facción en una población de usuarios de prótesis total. Materiales y métodos: se realizó un estudio de evaluación de tecnología diagnóstica con una población de 226 pacientes, a partir de las características sociodemográficas y los diez ítems del instrumento. Se analizó la consistencia interna, la reproducibilidad prueba-reprueba y los límites de acuerdo de Bland y Altman. Así mismo, se analizaron los componentes y se aplicó el modelo de Rasch. Resultados: participaron 158 (69.91 %) mujeres y la mediana de edad fue de 69 años. Se obtuvieron un alfa de Cronbach de 0.90 y un coeficiente de correlación intraclase de 0.91. Se identificaron dos factores, los diez ítems se ajustaron al modelo de Rasch y no se observó un funcionamiento diferencial del ítem. Conclusiones: la versión colombiana del cuestionario presentó excelente confiabilidad y las medidas obtenidas explicaron el 58.60 % de la varianza.

Introduction: Evaluating treatment satisfaction requires a specific and validated questionnaire that can obtain information about adequate service provision and contribute to people's well-being. The objective of this study was to evaluate the validity and reliability of the Colombian version of a questionnaire on satisfaction among complete denture wearers. Materials and methods: This survey evaluated diagnostic technology used among 226 patients. Information on sociodemographic characteristics was obtained and ten items of the instrument were evaluated. Internal consistency, test-retest reproducibility, and Bland-Altman limits of agreement were analyzed. Component analysis was performed and the Rasch model was used. Results: Median age of the participants was 69 (ric: 63-76) years, and 158 (69.91%) were women. Cronbach's alpha and intraclass correlation coefficients were 0.91 and 0.80, respectively. Two factors were identified, all ten items conformed to the Rasch model and no differential item functioning was observed. Conclusions: The Colombian version of the questionnaire showed excellent reliability, and the proportion of variance explained by the measures was deemed satisfactory (58.60%).

Introdução: a avaliação da satisfação com os tratamentos requer questionários específicos e validados, que garantam uma prestação de serviço adequada e contribuam para o bem-estar das pessoas. O obje-tivo é avaliar a validade e confiabilidade da versão colombiana de um questionário de satisfação em uma população de usuários de próteses dentárias totais. Materiais e métodos: foi realizado um estudo de avaliação de tecnologia diagnóstica com uma população de 226 pacientes. Foram avaliadas as carac-terísticas sociodemográficas e os dez itens do instrumento. A consistência interna, a reprodutibilidade teste-reteste e os limites de concordância foram analisados de acordo com Bland e Altman. Foi reali-zada uma análise de componentes e aplicado o modelo Rasch. Resultados: participaram 158 (69,91%) mulheres, a mediana de idade foi de 69 anos. Obteve-se um alfa de Cronbach de 0,90 e um coeficiente de correlação intraclasse de 0,91. Dois fatores foram identificados, os dez itens se ajustaram ao modelo Rasch e nenhum funcionamento diferencial dos itens foi observado. Conclusões: A versão colombiana do questionário apresentou excelente confiabilidade e as medidas obtidas explicaram 58,60% da variância.

Influence of ceramic primers on microshear bond strength to zirconia

This study aimed to investigate the effect of two ceramic primers on the microshear bond strength (µSBS) of yttria-stabilized zirconia (Y-TZP) to two types of self-adhesive resin cement and one BisGMA-based resin cement. Zirconia specimens were sandblasted with 27-µm aluminum oxide and composite cylinders were cemented with resin cement with or without the prior use of ceramic primers. Nine groups (n=12) were randomly distributed according to the cement (self-adhesive RelyX U200/3M ESPE, self-adhesive Maxcem Elite/Kerr, and BisGMA-based dual-cure RelyX ARC/3M ESPE) and ceramic primer (Z-Primer Plus/Bisco and Porcelain Liner M/Sun Medical Co.). After luting, the specimens were stored in distilled water at 37°C for 24 hours and then submitted to the µSBS test. The data were analyzed with two-way ANOVA followed by the Scheffe post hoc test (p<0.05). There were significant differences between RelyX U200 and other groups. There were also significant differences between the RelyX U200 group without ceramic primer and other groups without ceramic primers (p<0.05). Self-adhesive resin cement (RelyX U200 and MaxCem) presented higher microshear bond strength (6.17 and 2.32 MPa) than the conventional resin cement (RelyX ARC) when a porcelain primer was not used (0.43 MPa). When using Porcelain Liner M, the results of RelyX ARC (2.94 MPa) were equivalent to the results of self-adhesive cement (3.93 and 2.11 MPa). When using Z-Prime Plus, the results of MaxCem (5.36 MPa) were lower than those of RelyX U200 (9.59 MPa) but equivalent to those of RelyX ARC (6.07 MPa). When using the RelyX ARC, the use of both ceramic primers improved bond strength to zirconia. When using self-adhesive resin cement, Z-Prime Plus improved microshear bond strength values. It can be concluded that, after 24 hours, the highest µSBS results were obtained when using Z-Prime Plus and RelyX U200 self-adhesive cement.

Immediate precision of the digital osteotomy template in the digital stackable template: a clinical study / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate the immediate accuracy of the digital osteotomy template in the digital stackable template.@*METHODS@#From November 2018 to January 2020, 4 patients with dentition loss were selected from the Prosthodontics Department, West China Stomatological Hospital. All patients met the conditions for immediate planting and immediate restoration. Owing to the lack of vertical target-restoration space, the implantation plan included intraoperative osteotomy. According to the preoperative cone beam CT (CBCT) data, combined with aesthetic digital smile design (DSD) analysis, virtual wax design, and so on, the ideal bone plane design was performed. According to the virtual osteotomy plane, the virtual implantation plan was designed, and then the digital stackable template assuming osteotomy template, implantation guide, and temporary restoration were made and 3D printed. Osteotomy was performed under the guidance of digital osteotomy template during the operation. The preoperative CBCT and postoperative CBCT of all patients overlapped, the deviation between the actual osteotomy and the ideal osteotomy was calculated, and the angle deviation between the postoperative bone plane and the ideal bone plane was measured.@*RESULTS@#The ave-rage volume deviation between the postoperative design and the ideal one was 492.94 mm³, accounting for 21.21% of the preset osteotomy volume. The average deviation between the postoperative osteotomy and the ideal osteotomy in four patients was 0.024 8 mm. The average angle between the postoperative bone plane and the ideal bone plane was 6.03°.@*CONCLUSIONS@#The displacement deviation of virtual osteotomy design and the actual osteotomy one under the guidance of digital osteotomy template in the digital stackable template are highly consistent with the original design. Thus, this clinical technique is worth popularizing, accurate, and quantifiable.

Resistencia a la tracción diametral in vitro de cinco cementos dentales usados como cementantes de puentes y coronas en prótesis fijas / In vitro diametral tensile strength of five dental cements used as bridge and crown cement in fixed prostheses

RESUMEN Objetivo: El propósito de la investigación fue evaluar la resistencia a la tracción diametral in vitro de cinco cementos dentales: BisCem, Duolink, Ketac Cem, Meron, Allcem, cuatro adhesivos convencionales y un autoadhesivo polimerizado químicamente utilizados como cementantes de puentes y coronas en prótesis fijas. Materiales y métodos: Se prepararon 100 especímenes conformados por cementos: BisCem, Duolink, Ketac Cem, Meron, Allcem, los cuales se dividieron aleatoriamente en 5 grupos de 20 especímenes cada grupo sujetas a fotopolimerización y auto polimerización de 8mm de diámetro y 5mm de alto, con 2mm de distancia aproximadamente de la lámpara para la polimerización, se utilizó un formador de probetas de polietileno de alta densidad estandarizado, el tipo de muestreo es no probabilístico. Se sometieron a los especímenes de cada grupo a la prueba de tracción utilizando una máquina de ensayo universal (zwickiLine by Zwick/Roell), hasta lograr el fracaso del cemento, sometidas a una fuerza continua de 500 kg, con una velocidad de desplazamiento fija de 1 cm/min. Resultados: La resistencia promedio a la tracción diametral de probetas del cemento BisCem fue de 38,75 ± 11,56 MPa, del cemento Duolink fue 64,30 MPa, del cemento Meron 57,14 MPa, del cemento Ketac Cem es de 32,23 MPa, del cemento BisCem (38,753 MPa) y el cemento Ketac Cem (39,233 MPa). El cemento dental Duolink es aquel que presenta mayor resistencia a la tracción diametral de probetas en comparación a Meron (57,137 MPa) que es su similar. La tabulación y el análisis han sido sometidos a los test de Shapiro Wilk, análisis de varianza ANOVA y la prueba de Tuckey los valores de cada muestra se distribuyen normalmente existiendo diferencias significativas entre los grupos estudiados. Conclusiones: Las probetas del cemento de resina adhesiva Duolink evidenció una mayor resistencia a la tracción diametral con mejores valores significativos de resistencia a diferencia de los cementos Ketac Cem, Allcem, Meron y BisCem.

SUMMARY Objetive: The purpose of the research was to evaluate the in vitro diametral tensile strength of five dental cements: BisCem, Duolink, Ketac Cem, Meron, Allcem, four conventional adhesives and a chemically polymerized self-adhesive used as bridge cements and crowns in fixed dentures . Materials and methods : 100 specimens consisting of cements were prepared: BisCem, Duolink, Ketac Cem, Meron, Allcem, which were randomly divided into 5 groups of 20 specimens each group subject to photopolymerization and self-polymerization of 8mm in diameter and 5mm high, with an approximate distance of 2mm from the lamp for polymerization, a standardized high density polyethylene specimen was used, the type of sampling is not probabilistic. The specimens of each group were subjected to tensile testing using a universal testing machine (zwickiLine by Zwick / Roell), until the failure of the cement was achieved, subjected to a continuous force of 500 kg, with a fixed displacement speed of 1 cm / min Results: The average tensile strength of diametral tensile specimens of BisCem cement was 38.75 ± 11.56 MPa, Duolink cement was 64.30 MPa, Meron cement 57.14 MPa, Ketac Cem cement was 32.23 MPa, BisCem cement (38.753 MPa ) and Ketac Cem cement (39,233 MPa). Duolink dental cement is the one with the highest tensile strength of diametral specimens compared to Meron (57,137 MPa), which is similar. The tabulation and the analysis have been submitted to the Shapiro Wilk test, ANOVA analysis of variance and the Tuckey test. The values of each sample are normally distributed with significant differences between the studied groups. Conclusions : Duolink adhesive resin cement specimens showed a higher diametral tensile strength with better significant strength values unlike Ketac Cem, Allcem, Meron and BisCem cements.

Presença de Candida sp na saliva de pacientes usuários de prótese total e próteses parciais removíveis atendidos em uma Faculdade de Odontologia de Goiás / Presence of Candida sp in the saliva of patients with complete dentures and partial removable dentures of a Goiás Dental School

Objetivos ­ À vista disso, conhecendo como a principal condição exógena para que ocorra a proliferação de Candida e introdução de Candidose em cavidade oral é a prótese dentária com tempo de uso de mais de 5 anos, propomos nesse estudo avaliar a quantificação de Candida na saliva pacientes usuários de prótese parcial e total removíveis, correlacionando com idade avançada e o fluxo salivar e fatores que possam agir influenciando sua quantificação. As espécies do gênero Candida são normalmente encontradas na microbiota de pacientes saudáveis, sendo a C. Albicans a mais comum. Já a patogenicidade da espécie só ocorre caso haja condições propicias para o seu desenvolvimento, como comprometimento do sistema imune, hiposalivação e uso incorreto de próteses. As próteses totais, em especial, estão associadas ao aumento de UFC e presença de candidose na cavidade oral. Métodos ­ Foram avaliados 121 indivíduos sendo 31 do grupo controle e 90 usuários de próteses dentárias. Foram realizada uma coleta de saliva de cada paciente no momento da primeira consulta odontológica e os pacientes foram classificados quanto ao fluxo salivar em reduzido, normal e aumentados. A análise microbiológica foi realizada com a mesma saliva utilizada na avaliação do fluxo salivar, sendo estas semeadas e a as colônias de Candida foram quantificadas e os pacientes serão categorizados em negativos, portadores e positivos. Resultados ­ Foi possível uma relação forte no que se refere a diminuição do fluxo salivar associado a idade avançada e em decorrência disto, com a quantidade de UFC de Candida na saliva dos pacientes estudados. Conclusão ­ Posto isso, fica comprovado que os pacientes que utilizam próteses removíveis são os com maior quantidade de UFC, seguidos pelos pacientes que utilizam próteses totais

Objectives ­ In view of this, knowing as the main exogenous condition for the occurrence of Candida proliferation and introduction of Candidosis in oral cavity is the dental prosthesis with time of use of more than 5 years, we propose in this study to carry out a evaluation the quantification of the presence of Candida in saliva in patients using partial and total removable prosthesis, correlating at the found with advanced age and the salivar flow and factors that may influence its quantification. Species of the genus Candida are usually found in the microbiota of healthy patients, with C. Albicans being the most universal. The pathogenicity of the species occurs only if there are propitious conditions to its development, such as impairment of the immune system, hyposalivation and incorrect use of prostheses. Total prostheses, in particular, are associated with increased CFU and the presence of candidosis in the oral cavity. Methods ­ A total of 121 individuals were evaluated, 31 from the control group and 90 users of dental prostheses. Saliva collection was performed from each patient at the time of the first dental appointment and the patients were classified as reduced, normal and increased salivary flow. Microbiological analysis was performed with the same saliva used for salivary flow evaluation. These were sown and Candida colonies were quantified and patients were categorized as negative, carrier and positive. Results ­ It was possible to have a strong relationship regarding the decrease in salivary flow associated with advanced age and, as a result, with the amount of Candida CFU in the saliva of the studied patients. Conclusion ­ Thus, it is proven that patients using removable prostheses are the ones with the highest amount of CFU, followed by patients using total prosthesis

Previsibilidade na Instalação Imediata de Implante Cone Morse pelo Planejamento Digital e Provisionalização Imediata: Relato de Caso / Predictability in Immediate Implant Placement of Morse Taper by Digital Planning and Immediate Provisionalization: Case Report

A instalação imediata de implantes em região estética é uma prática frequente, pois reduzir a remodelação óssea e tecidual. Os implantes com interface cone Morse apresentam resultados biológicos e estéticos satisfatórios a longo prazo, pois apresentam gap reduzido entre implante e componente protético e a interface fica distante do tecido ósseo. Este artigo tem como objetivo relatar a reabilitação estética de um incisivo central superior comprometido através da instalação de um implante cone Morse utilizando a técnica da cirurgia guiada com provisionalização imediata. Paciente com 40 anos de idade, do sexo masculino, apresentava incisivo central superior (#21) com tratamento endodôntico prévio, recessão gengival vestibular, escurecimento coronário e mobilidade. O caso clínico apresentado mostrou que, após 12 meses, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes em alvéolos pós-extração e instalação de um dente provisório imediato em regiões estéticas.

The immediate placement of implant in fresh sockets in the aesthetic area is a frequent practice as it reduces bone and tissue remodeling. Morse taper implants present satisfactory biological and aesthetic results in the long term, since they present a reduced gap between implant and prosthetic component and this interface is distant from bone. This article aims to report the aesthetic restoration of a compromised central upper incisor with the placement of a Morse taper implant using guided surgery with immediate provision. A 40-year-old male patient had a central upper incisor (#21) with previous endodontic treatment, vestibular gingival recession, coronary browning, and mobility. The clinical case presented showed that, after 12 months, precise and aesthetic results are possible to achieve with the placement of implants in post-extracting alveolus and installation of an immediate provisional tooth in esthetic regions.

Prótese dento-gengival sobre implantes: relato de caso / Dentogengival prosthesis on implant: case report

A perda de tecido ósseo e gengival na região anterior é um desafio para o clínico devido as exigências estéticas do sorriso, essa perda de tecido de sustentação cria uma relação desarmônica entre as coroas clínicas e ameias interdentais. O objetivo deste estudo é relatar o caso clínico de uma reabilitação maxilar anterior através de uma prótese dentogengival sobre implantes (PDGI). O tratamento realizado após o diagnóstico clínico consistiu na realização de moldagens de estudo, fotografias para o planejamento digital (DSD), confecção dos provisórios, abertura dos implantes, escolha dos pilares protéticos, colocação dos provisórios sobre os implantes, remodelação gengival com provisórios, moldagem de trabalho, ajustes e prova da porcelana, parafusamento da prótese sobre implante e preservação do paciente. Essa reabilitação pode ser uma alterativa viável para substituição de tecido gengival e ósseo perdido, quando a regeneração não tiver um prognóstico favorável ou em pacientes que não desejam ou não podem submeter-se a procedimentos regenerativos. Concluímos que a PDGI melhorou de maneira significativa tanto os requisitos estéticos como funcionais do paciente(AU)

The loss of the bone and gingival tissue in the frontal zone is a challenge to the clinician due to the smiling aesthetic requirements. The loss of the teeth sustentation tissue creates an inharmonic relation between the clinical crowns and the interdental niches. The purpose of this study is to report a clinical case of aesthetic rehabilitation of the anterior maxillary through dentogingival prosthesis on implants. The treatment accomplished after the clinical diagnosis consisted in molding study, taking pictures for digital planning (DSD), confection of the provisional ones, opening the dental implant, assorting of the prosthetic abutments, placing the dental abutment on the dental implant, gingival remodeling with provisional ones, molding work, adjusting and testing the porcelain crown, screw driving the prosthesis on the implant and preserving the patient. This rehabilitation may be a viable alternative to replacing both the gingival and bone tissue when regeneration does not have a favorable prognosis, or in patients whom do not wish or cannot undergo regenerative procedures. We conclude that dentogingival prosthesis on implant has significantly improved both the functional and aesthetic requirements of the patient(AU)

A prospective study on the application of 6-mm-long implants in the upper and lower posterior edentulous regions / 中华口腔医学杂志

Objective@#To assess clinical and radiographic outcomes of short implants (length six mm) in the posterior region and early-loading with splinted fixed dental prostheses.@*Methods@#Forty-five patients were recruited at 3 centers and 2-3 implants (diameter 4 mm, length 6 mm) were implanted in each case. Totally, ninty-five implants were placed, using one-stage surgery protocol and loaded with a screw-retained splinted fixed prosthesis 6 weeks later. Clinical and radiographic examinations were performed preoperatively, post-surgery, at loading, and 6, 12 and 24 months after prosthesis placement.@*Results@#Four implants were removed before loading. A total of 36 patients with 76 implants completed the whole treatment and 2 year follow-up according to the research design. No implant was lost after loading, and the 2-year survival rate of the implant was 100%(76/76). In all cases, the response of swelling and pain after operation was mild, and the bone resorption around the implants was not obvious at 6 months [(0.04±0.29) mm], 1 year [(-0.11±0.44) mm], and 2 years [(0.00±0.53) mm] after loading. Bone loss less than 1.00 mm was found only in 26% (18/69) implants after 2 years of loading, and the height of the alveolar bone around 17% (12/69) of the implant increased. During 2-year follow-up, the probing depth of the implants increased by nearly 0.50 mm, but there was no clinical significance (P>0.05).@*Conclusions@#The 2-year results of this study showed that the 6-mm-long implants can be a predictable procedure, especially in situations with limited bone height in posterior edentulous regions.

Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework), allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

Abordagem clínica e terapêutica da mucosite oral induzida por radioterapia e quimioterapia em pacientes com câncer / Clinical and therapeutic approach of radiotherapy and chemotherapy induced oral mucositis in cancer patients

O câncer é uma patologia grave e o seu tratamento pode ser feito através de quimioterapia, radioterapia ou uma terapia combinada. O diagnóstico, o pré-tratamento e o tratamento são extremamente importantes para a prevenção das sequelas e para a qualidade de vida dos pacientes. A mucosite oral é um dos efeitos colaterais mais significativos da terapia contra o câncer. O risco para o desenvolvimento dessa condição, a sua gravidade e a duração dependem do tipo de tratamento realizado, idade, predisposição genética, saúde e higiene oral, a função secretora salivar, a alimentação, o uso de tabaco e álcool entre outros. Os sintomas podem variar de leve desconforto até uma dor intensa. O uso simultâneo da quimioterapia e da radioterapia resulta em um quadro de mucosite mais severo e prolongado. O objetivo desse estudo é informar sobre a mucosite oral, os seus fatores de risco, os seus sintomas e os possíveis tratamentos para essa condição.

Cancer is a severe pathology and its treatment generally includes radiotherapy, chemotherapy, surgery or a combination of them. The diagnosis, pre-treatment and treatment are extremely important to prevent the aftereffects and to provide better life quality to these patients. Oral mucositis is one of the most significant side effects in the therapy against cancer. The risk of developing this condition, its severity and duration depends on the type of the treatment performed, age, genetic predisposition, general health, oral hygiene, salivary secretory function, nutrition, smoking habit, alcohol abuse and other. Symptoms can range from mild discomfort to severe pain. Concurrent use of chemotherapy and radiotherapy results in more severe and prolonged mucositis. The aim of this study is to describe the mechanisms of oral mucositis, its risk factors, symptoms and possible treatments.

Reabilitação estética-funcional com ajuste prévio da oclusão em relação cêntrica / Aesthetic and functional rehabilitation with prior adjustment of the occlusion in centric relation

O presente artigo teve o objetivo de relatar um caso clínico de reabilitação estética e funcional de paciente com perda das guias anteriores causada por hábitos parafuncionais. Paciente DMS, 33 anos, gênero masculino, procurou a Faculdade de Odontologia da Universidade Federal de Goiás com queixa estética devido ao tamanho dos dentes anteriores. Ao exame clínico foi observado desgaste do terço incisal dos dentes anteriores, superiores e inferiores, provocado por hábitos parafuncionais (bruxismo do sono), e ausência dos dentes 18, 28, 35, 36, 38, 46 e 48. Na análise oclusal notou-se não haver espaço funcional para o restabelecimento da forma anatômica dos dentes na posição de máxima intercuspidação habitual. Foi proposto o ajuste oclusal em relação cêntrica, que uma vez posicionada a mandíbula mais posteriormente possibilitou a obtenção de espaço para reconstituição dos dentes anteriores desgastados. Após três sessões de ajuste foi confeccionada uma prótese parcial removível para reposição dos dentes inferiores ausentes (35, 36 e 46). Previamente à reanatomização dos dentes desgastados com resina composta direta, foi realizada a técnica de mock-up, permitindo a avaliação estética e aprovação do paciente. Concluídos os procedimentos restauradores por meio de guias de matriz de silicona, novos modelos foram obtidos e montados em articulador semiajustável para confecção de placa oclusal miorrelaxante em resina acrílica. Na entrega da placa e ajustes posteriores o paciente foi orientado quanto ao uso e cuidados para manutenção dos resultados alcançados.

The objetive of this article was report a case of cosmetic and functional rehabilitation of patients with loss theiranterior guides caused by parafunctional habits. DMD patient, 33 years, male, sought the Faculty of Dentistry of Federal University of Goiás with esthetic complain due the size of her anterior teeth. In the clinical examination was seen: incisal wear of anterior teeth, upper and lower, caused by deleterious habits (sleep bruxism) and absence of teeth 18, 28, 35, 36, 38, 46 and 48. In occlusal analysis noted that there was no space for the restoration of functional anatomic shape of teeth in the habitual intercuspal position. Occlusal adjustment was proposed in centric relation, once the jaw positioned subsequently had more space for restoration with direct composite of worn anterior teeth. After three sessions the adjustment was made a removable partial denture for replacement of the lower teeth missing (35, 36 and 46). The mock-up technique was performed before the teeth restoration with direct composite resin, allowing the aesthetic evaluation and patient approval. On completion of the restoration procedures using silicone matrix guides, new models were obtained and mounted on semi-adjustable articulator for fabrication of occlusal splints relaxant in acrylic resin. After delivery of the occlusal splints relaxant and subsequent adjustments the patient was instructed on the use and care for maintenance all results.

Próteses fixas implanto-suportadas de 3 elementos: zircônia versus metalocerâmica / Three-unit implant-supported fixed parcial dentures: zirconia versus metal-ceramic

A falha coesiva na porcelana de revestimento de próteses com infraestruturas de policristais de zircônia tetragonal estabilizada por ítrio (PZT-I) tem causado elevadas taxas clínicas de fracassos. No presente estudo avaliou-se a confiabilidade e modos de fratura de próteses fixas implanto-suportadas confeccionadas em uma liga de paládio-prata (PdAg) e em PZT-I, submetidas à fadiga acelerada progressiva. Embebeu-se análogos de implantes em uma resina acrílica. Infraestruturas em PZT-I e PdAg (n = 21/grupo) foram fabricadas, revestidas com porcelana, cimentadas e submetidas a uma carga estática (n = 3/grupo) para obtenção dos valores de resistência à fratura. Em seguida, 18 espécimes de cada grupo foram distribuídos ao longo de 3 perfis de estresse progressivo e submetidos à fadiga em água com a carga aplicada na cúspide vestibular do pôntico. Encontrou-se no grupo PdAg um modo de fratura incluindo trincas flexurais na área do conector competindo com a falha coesiva da porcelana, enquanto que as próteses em PZT-I apresentaram falha coesiva na porcelana de revestimento. O cálculo da confiabilidade (Alta Pro, Relia Soft, intervalo de confiança de 90%, bilateral) revelou confiabilidade significativamente inferior para o grupo PZT-I na finalização de uma missão de 100.000 ciclos a 300 N quando comparada ao grupo PdAg. Concluiu-se que para uma missão de 100.000 ciclos a 300 N a confiabilidade é mais alta para a prótese metalocerâmica quando comparada à em PZT-I. Os modos de fratura diferiram entre os grupos.

Statement of problem: chipping within veneering porcelain has resulted in high clinical failure rates for implant-supported zirconia (Y-TZP) bridges. This study evaluated the reliability and failure modes of mouth-motion step-stress fatigued implant-supported Y-TZP versus Palladium-Silver alloy (PdAg) three-unit bridges. Methods: Implant-abutment replicas wereembedded in polymethylmethacrylate resin. Y-TZP and PdAg frameworks, of similar design (n = 21 each), were fabricated, veneered, cemented (n = 3 each), and Hertzian contact tested to obtain ultimate failure load. In each framework group eighteen specimens were distributed across 3 stepstress profiles and mouth-motion cyclically loaded according to the profile on the lingual slope of the buccal cusp of the pontic. Results: PdAg failures included competing flexural cracking at abutment and/or connector area and chipping, whereas Y-TZP presented predominantly cohesive failure within veneering porcelain. Including all failure modes, the reliability (2-sided at 90% confidence intervals) for a “mission” of 100,000 cycles at 300 N load was determined (Alta Pro, Reliasoft). Reliability remained unchanged for a mission of 100,000 for PdAg, but significantly decreased for Y-TZP. Conclusion: Higher reliability was found for PdAg for a mission of 100,000 cycles at 300N. Failure modes differed between materials.

Medio de enseñanza sobre prótesis inmediata para alumnos de cuarto año de estomatología / Teaching aids for students enrolled in 4th academic of dentistry about immediate dental prosthesis

Los medios de enseñanza reducen considerablemente el tiempo dedicado al aprendizaje, el trabajo con estos estimula la auto-actividad creadora. La simulación obliga al alumno a demostrar lo aprendido. La pérdida de dientes existe desde tiempos remotos por lo que se han buscado procedimientos, como la prótesis inmediata, para reponerlos y restablecer la estética y la función. Por ello y con la intención de lograr prótesis inmediatas estéticas y con una adecuada adaptación sobre la cirugía recién realizada en el paciente, nos propusimos como objetivo lograr el desarrollo de conocimientos y habilidades en los estudiantes de cuarto año de Estomatología con la confección en el laboratorio de los diferentes pasos de la prótesis inmediata, haciendo énfasis en la preparación de los alvéolos artificiales en yeso. Los estudiantes tuvieron una gran participación, utilizando variado instrumental y materiales. Para ello se tomó de forma aleatoria una población de 40 alumnos de cuarto año y de ellos una muestra de 11 alumnos. Se incluyeron alumnos de ambos sexos, la muestra fue escogida de las clínicas estomatológicas de San Juan y Martínez "Hermanos Saíz" y "Antonio Briones Montoto" de Pinar del Río. Se logró que los estudiantes, durante la conferencia, se apropiaran de los conocimientos teóricos con mayor facilidad a través del medio de enseñanza y sirvió además de guía para la obtención de habilidades necesarias no sólo en esta edad académica, sino en su formación como futuros profesionales que tributan a la atención primaria de salud.

Teaching aids reduce considerably time dedicated to teaching activities, working with them auto-creative activity is stimulated. The simulation compels students to demonstrate what they have learned. Loss of teeth has always existed , thus procedures such as the immediate dental protheses to replace and re-establish their esthetic and function are followed. Aimed at developing knowledge, skills and training of the students enrolled in 4th academic year of dentistry specialty, in laboratories where immediate prostheses are made and putting emphasis on the preparation of artificial alveolus in plaster Students participated in these activities using varied tools and materials. To carry out this work 11 students of both sexes were selected at random out of 40 enrolled in 4th academic year at " Hermanos Saiz" Clinic in San Juan y Martinez municipality and at " Antonio Briones Montoto" Clinic respectively. By means of the lectures taught and the teaching aids made , students achieved theoretical knowledge easily using them as a guide to obtain the necessary skills not only for this academic age but also in the formation of future professionals that will work in primary health care.