Influência de espessuras de fibromucosa e de material reembasador de próteses totais na distribuição de tensões sobre implantes cone morse durante fase de osseointegração: análise pelo método dos elementos finitos - 3D / Influence of fibromucosal thickness and reline material of complete dentures on stress distribution on cone morse implants during osseointegration phase: analysis by the finite element method - 3D

Durante o período de osseointegração de implantes em uma reabilitação oral com prótese do tipo protocolo ou overdenture, uma prótese total convencional provisória poderá ser utilizada e revestida com materiais reembasadores macios, os quais têm por objetivo reduzir o estresse para a interface ossoimplante. A avaliação mecânica de tal situação clínica é de extrema relevância, a fim de se estabelecer protocolos mais seguros durante esta fase inicial da implantodontia. O objetivo deste estudo foi realizar uma análise biomecânica pelo método dos elementos finitos 3D, da distribuição de tensões durante a fase provisória de reabilitação com implantes osseointegrados simulando uma situação clínica de protocolo/overdenture inferior sobre 4 implantes do tipo cone morse, na fase de cicatrização. Para este estudo foram confeccionados 6 modelos 3D, sob carregamento em 2 direções (vertical e oblíquo em relação ao plano oclusal), simulando osso tipo II, variando a altura do tecido gengival (2 mm e 3 mm) e a espessura do material reembasador (0 mm - sem material, 2 mm e 4 mm), sendo utilizado um cicatrizador compatível com a altura + 0,5 mm para cada situação gengival. A posição dos 4 implantes cone morse (UNITITE, UCM 3510N, SIN) foi sempre a mesma, nas posições perdidas dos dentes 46, 43, 33 e 36. Para a altura gengival de 2 mm foi utilizado cicatrizador de 2,5 mm de altura (UNITITE, CIMU 4525, SIN) e para a altura gengival de 3 mm, o cicatrizador de 3,5 mm de altura (UNITITE, CIMU 4535, SIN). Os modelos utilizados foram: (G2C2,5-SR) altura gengival de 2mm, cicatrizador de 2,5mm, sem material reembasador; (G2C2,5-R2) altura gengival de 2mm, cicatrizador de 2,5mm, com soft rreembasador de 2mm; (G2C2,5-R4) altura gengival de 2mm, cicatrizador de 2,5mm, com material reembasador de 4mm; (G3C3,5-SR) altura gengival de 3mm, cicatrizador de 3,5mm, sem material reembasador; (G3C3,5-R2) altura gengival de 3mm, cicatrizador de 3,5mm, e reembasador de 2mm e (G3C3,5-R4) altura gengival de 3mm, cicatrizador de 3,5mm e soft reembasador de 4mm. A metodologia para modelagem se baseou em um escaneamento de superfície de uma prótese total inferior montada, sob um modelo inferior padrão, e de seu modelo de assentamento. As geometrias dos implantes (CM 3,5x10mm) e de seus cicatrizadores foram obtidas por simplificação do desenho dos mesmos no programa SolidWorks e no programa Rhinoceros 3D. O software utilizado para análise foi o ANSYS 17.0. A visualização dos resultados foi qualitativa através de mapas de deslocamento, von Mises e tensão máxima principal. As regiões com maiores deslocamentos foram as dos implantes mais anteriores (#33 e #43), sendo os do modelo 6 submetidos a forças verticais os que apresentaram maiores deslocamentos, próximos a 0,05 mm. A força oblíqua, de forma geral, tendeu a sobrecarregar mais os implantes do lado onde as cargas foram aplicadas. No tecido ósseo foi possível observar que o osso cortical se mostrou com mais concentração de tensão de tração que o osso trabecular. A utilização do material reembasador gerou menores tensões transmitidas para o tecido gengival, concentrando estas tensões principalmente no material reembasador. A não utilização de material reembasador aumenta as concentrações de tensões nos implantes/cicatrizadores, independentemente de sua espessura ou da espessura gengival. Concluiu-se que o uso de reembasador soft diminuiu as tensões nos implantes/cicatrizadores e tecido gengival; o aumento da espessura do material reembasador não influenciou na diminuição das tensões aos tecidos de suporte e tecidos gengivais mais espessos foram favoráveis em diminuir as tensões transmitidas ao tecido ósseo, mas concentram mais tensões nos implantes/cicatrizadores(AU)

During the period of osseointegration of implants in an oral rehabilitation with a protocol or overdenturetype prosthesis, a conventional temporary complete denture can be used and coated with soft reline materials, which aim to reduce the stress to the bone-implant interface. The mechanical assessment of such a clinical situation is extremely relevant in order to establish safer protocols during this initial phase of implantology. The objective of this study was to perform a biomechanical analysis by the 3D finite element method, of the stress distribution during the provisional phase of rehabilitation with osseointegrated implants simulating a clinical situation of protocol/lower overdenture on 4 cone morse implants, in the healing phase. For this study, 6 3D models were made, under loading in 2 directions (vertical and oblique in relation to the occlusal plane), simulating type II bone, varying the height of the gingival tissue (2 mm and 3 mm) and the thickness of the reline material (0 mm - without material, 2 mm and 4 mm), using a healer compatible with the height + 0.5 mm for each gingival situation. The position of the 4 cone morse implants (UNITITE, UCM 3510N, SIN) was always the same, in the missing positions of teeth 46, 43, 33 and 36. For the 2 mm gingival height, a 2.5 mm high healer was used. (UNITITE, CIMU 4525, SIN) and for a gingival height of 3 mm, the healer with a height of 3.5 mm (UNITITE, CIMU 4535, SIN). The models used were: (G2H2,5-WS) 2mm gingival height, 2.5mm healing, without soft material; (G2H2,5-S2) 2mm gingival height, 2.5mm healing, with 2mm reline; (G2H2,5-S4) 2mm gingival height, 2.5mm healing, with 4mm reline; (G3H3,5-WS) gingival height of 3mm, healing of 3.5mm, without soft material; (G3H3,5-S2) 3mm gingival height, 3.5mm healing, and 2mm reline and (G3H3,5-S4) gingival height of 3mm, healing of 3.5mm and reliner of 4mm. The methodology for modeling was based on a surface scan of a complete lower denture assembled, under a standard lower model, and its seating model. The geometries of the implants (CM 3.5x10mm) and their healers were obtained by simplifying their design in the SolidWorks program and in the Rhinoceros 3D program. The software used for analysis was ANSYS 17.0. The visualization of the results was qualitative through displacement maps, von Mises and maximum principal stress. The regions with the greatest displacements were those of the most anterior implants (#33 and #43), and those of model 6 submitted to vertical forces presented the greatest displacements, close to 0.05 mm. The oblique force, in general, tended to place more stress on the implants on the side where the loads were applied. In the bone tissue, it was possible to observe that the cortical bone showed a higher concentration of tensile stress than the trabecular bone. The use of soft material generated lower tensions transmitted to the gingival tissue, concentrating these tensions mainly in the soft material. The non-use of soft material increases stress concentrations on implants/healers, regardless of their thickness or gingival thickness. It was concluded that the use of a soft reliner reduced the stresses on the implants/healers and gingival tissue; the increase in the thickness of the reline material did not influence the reduction of tensions to the supporting tissues and thicker gingival tissues were favorable in reducing the tensions transmitted to the bone tissue, but concentrated more tensions in the implants/healing agentes(AU)

Avaliação in vitro da biocompatibilidade de resinas acrílicas para base de próteses e materiais reembasadores resilientes / In vitro biocompatilibility of denture base acrylic resins and soft reline materials

O objetivo deste estudo foi avaliar a citotoxicidade de 3 resinas acrílicas (RA) para bases de prótese sendo duas polimerizadas por energia de microondas (Vipi Wave-VW e Nature Cryl-NC) e uma fotoativada (Eclipse-E); e a biocompatibilidade de materiais reembasadores resilientes (MRR), sendo 2 à base de silicone (Ufi Gel P e Sofreliner S), 2 à base de resina acrílica (Durabase Soft e Trusoft) e 2 condicionadores de tecidos (Softone e Coe Comfort) por meio de análises do metabolismo celular, da morfologia celular, do padrão de morte celular, da proliferação celular e da expressão do fator de crescimento TGFß 1, da integrina α5ß1 e de citocinas. A análise das RA foi realizada com células L929; para os MRR, as análises foram realizadas utilizando-se células L929, e/ou HaCaT e/ou RAW 264,7. Os resultados obtidos foram submetidos à análise estatística, realizada ao nível de significância de 5%. Todos os materiais quando testados com eluatos não apresentaram efeitos citotóxicos, e quando testados em contato direto (MTT e azul de alamar) alteraram significativamente a viabilidade celular, tendo sido os menores valores observados para o material NC quando comparado ao E. Para os materiais reembasadores o T, S e C. Maior taxa de necrose e apoptose foram observadas para os eluatos de todos os materiais quando avaliados no período de 24 horas; além disso, foi demonstrado que os materiais avaliados podem desencadear a expressão do TGFß 1, da integrina α5ß1 e de proteínas inflamatórias (fator de necrose tumoral - TNF-α, da citocina IL-1ß e de 5 quimiocinas: CCL2, CCL3, CCL5, CXCL2 e CXCL4). Sendo assim, de acordo com as limitações do presente estudo, pode-se concluir que a resina Nature Cryl resultou em menor viabilidade celular que a resina Eclipse e que os materiais Ufi Gel P e Sofreliner S apresentaram, em geral, melhor bicompatibilidade dentre os materiais reembasadores resilientes avaliados

The aim of this study was to evaluate the cytotoxicity of 3 denture base acrylic resins with different polymerization methods (Eclipse, Vipi Wave and Nature Cryl) and the biocompatibility of soft lining materials, 2 silicone-based (Ufi Gel P and Sofreliner S), 2 acrylic-based (Durabase Soft and Trusoft) and 2 tissue conditioners (Softone and Coe Comfort), by analysing cell metabolism, cell morphology, pattern of cell death, cell proliferation and expression of growth factor TGFß 1, integrin α5ß1 and cytokines. For the acrylic resins, analyses were made with L929 cells, while for the resilient lining materials, analyzes were performed using L929, and/or HaCaT and/or RAW 264.7 cells. Results were statistically analyzed, at a significance level of 5%. The 24 and 48-h eluates from all materials were not cytotoxic to the cells. For the direct contact tests (MTT and Alamar Blue), a significant effect on cell viability was found, with the lowest values observed for materials NC when compared with E and between the reliners Trusoft, Softone and Coe Comfort. For all materials, increased rate of necrosis and apoptosis were observed for the 24 hs eluates. It was also demonstrated that all materials tested can trigger the expression of TGFß 1, α5ß1 integrin and inflammatory proteins (tumor necrosis factor -TNFα, cytokine IL-1ß and 5 chemokines- CCL2, CCL3, CCL5, CXCL2 and CXCL4). Thus, within the limitations of this study, it can be concluded that the denture base acrylic resin Nature Cryl resulted in lower cell viability compared to the Eclipse resin and that the materials Ufi Gel P and Sofreliner S showed better biocompatibility among the soft liner materials evaluated

The color stability of direct denture reline resins / 대한치과보철학회지

STATEMENT OF PROBLEM: Direct denture reline resins tend to discolor during service in the oral environment by intrinsic and extrinsic factor. PURPOSE: This study was designed to evaluate the color stability of direct denture reline resins. MATERIAL AND METHODS: Mild Rebaron(GC Corp., Japan), Meta Base M(Sun medical Co., Japan), Mild Rebaron LC(GC Corp., Japan) and as a control group, Vertex SC(Dentimex Zeist, Holland) were chosen for this study. Ten specimens of each direct denture reline resins were fabricated. Treatment methods designed for this study were the coffee staining test(7days) and the accelerated aging test(100hours). The color changes before and after treatment were measured by Tristimulous colorimeter(Yasuda seiki seisakusho, Ltd. Japan) and analyzed. RESULTS: All the direct denture reline resins subjected to the coffee staining test and the accelerated aging test showed noticible difference in color change. After coffee staining test, Meta Base M showed the highest color change followed by Vertex SC, Mild Rebaron LC and Mild Rebaron. There were no statistical differences between Meta Base M and Vertex SC and between Mild Rebaron LC and Mild Rebaron(p>0.05). After accelerated aging test, Mild Rebaron LC showed the highest color change followed by Vertex SC, Meta Base M and Mild Rebaron. There were no statistical differences only between Mild Rebaron and Mata Base M(p>0.05) but among the others, there were statistical differences(p<0.05). CONCLUSION: Within the limitation of this study, all the direct denture reline resins subjected to the extrinsic and intrinsic factors showed noticible difference in color change, and there were differences among manufacturers.

A Study on the Bond Strength of Reline Resin to Pressure Injection Type Thermoplastic Denture Base Resin / 대한치과보철학회지

The purpose of this study was to evaluate the bond strength of reline resin to pressure injection type thermoplastic denture base resin.The denture base resins used in this study were Hipolycarbonate(High Dental Co.,Japan),Acetal dental(Pressingdental s.r.l.,Repubblica di San Marino)of thermoplastic resin and Acron MC(GC Dental Industrial Co.,Japan)of heatcured resin.The reline resins used were Lucitone 199(Dentsply international Inc.,USA),Tokuso rebase(Tokuyama Corp.,Japan),and Lightdon-U(Dreve-Dentamid-Gmbh,Germany).The reline resins are representative of heat-cured,self-cured,and light-cured resin respectively.Bond strength was examined by use of a three-point transverse flexural strength test. The results were as follows: 1.The bond strength of Lucitone 199 to Acron MC was the highest. 2.The bond strengths of Lucitone 199 and Tokuso rebase to Hi-polycarbonate resulted in a value of approximately one half that of Lucitone 199 to Acron MC,and there were no significant differences between these and the bond strength of Tokuso rebase to Acron MC(p<0.05). 3.The bond strengths of reline resins to Acetal dental were lower than those of reline resins to Hi-polycarbonate. 4.For all base resins Lightdon-U showed lower bond strength than the other reline resins.