ABSTRACT
El objetivofue determinar la asociación correlacional que pudiera presentarse entre las complicaciones técnicas, biológicas y estéticas y el nivel de satisfacción de los tratamientos realizados en la Cátedra de Prótesis de Coronas y Puentes II de la Facultad de Odontología de la UNA en el 2019. Este fue un estudio observacional descriptivo, analítico, de corte transverso. Se incluyeron pacientes que recibieron tratamientos del 2016 al 2018. Acudieron 59 pacientes para la evaluación clínica y aplicación del cuestionario. Se analizaron los datos según número de tratamientos encontrados en cada sujeto, por lo que se calcularon los resultados según 119 tratamientos. Las complicaciones biológicas pulpares fueron la sensibilidad o molestia al frio o al calor en los pilares en un 20.1%. Se encontró asociación muy significativa de las complicaciones biológicas pulpares (p>001) con estado civil, complicaciones biológicas periodontales, complicaciones estéticas cervicales. Las complicaciones biológicas periodontales fueron en mayor frecuencia la gingivitis alrededor de la restauración en un 40,4%. El nivel de satisfacción con el tratamiento recibido se presentó favorable en un 89,1% y asociación muy significativa (p>001) con grado de instrucción y significativa (p>005) con estado civil.Se encontró asociación muy significativa de las complicaciones estéticas cervicales, las complicaciones estéticas de forma y significativa de las complicaciones biológicas periodontales con el nivel de satisfacción.
The objective was to determine the correlational association that could occur between technical, biological and esthetic complications and level of satisfaction in the treatments performed in the Department of Crown and Bridge Prosthodontics II of the Faculty of Dentistry of the National University of Asuncion in 2019. This was a descriptive, analytical, cross-sectional, observational study. Patients who received treatments from 2016 to 2018 were included. Fifty-nine patients attended for clinical evaluation and application of the questionnaire. The data were analyzed according to the number of treatments found in each subject, by which the results were calculated according to 119 treatments. Pulpal biological complications were sensitivity or discomfort to cold or heat in 20.1% of the abutments. A highly significant association was found between pulpal biological complications (p>001) and marital status, periodontal biological complications and cervical esthetic complications. The most frequent periodontal biological complications were gingivitis around the restoration (40.4%). The level of satisfaction with the treatment received was favorable in 89.1% and there was a very significant association (p>001) with educational level and significant (p>005) with marital status. A highly significant association was found between cervical esthetic complications, esthetic complications of shape and periodontal biological complications and the level of satisfaction.
ABSTRACT
A doença periodontal é uma doença inflamatória crônica que resulta na destruição dos tecidos de suporte com consequente perda dental. A substituição dos dentes perdidos por restaurações implantossuportadas tem demonstrado ser um método de tratamento altamente previsível com bom prognóstico em longo prazo. Contudo, algumas sequelas da perda dentária inviabilizam a instalação de implantes osseointegrados em posição ideal, sendo, neste caso, necessários procedimentos regenerativos para tornar possível este tipo de reabilitação. Procedimentos menos invasivos, como próteses convencionais, surgem como uma opção terapêutica para reabilitação de casos em que não há estrutura óssea suficiente para implantes e não há aceitação de procedimentos invasivos por parte dos pacientes. Sendo assim, este trabalho teve como objetivo apresentar a resolução de uma reabilitação por meio de tratamento não invasivo e multidisciplinar. A paciente, gênero feminino, compareceu a clínica da faculdade apresentando próteses fixas mandibulares mal adaptadas bilateralmente, lesões endodônticas, recessão gengival nos dentes pilares e sensibilidade dentinária. Para a adequada resolução deste caso foi proposto à associação de implantes osseointegrados, prótese parcial fixa, exodontia e procedimentos periodontais estéticos, com a utilização de enxerto de tecido conjuntivo subepitelial. Após dois anos de pós-operatório, a paciente mostrou satisfação estética e mastigatória. Com base no caso apresentado, este trabalho discutiu os diversos fatores que podem afetar a escolha de uma determinada modalidade de tratamento, para a reabilitação de espaços edêntulos unitários.
Periodontitis is a chronic inflammatory disease that results in the destruction of teeth and their supporting tissues with subsequent tooth loss. The replacement of missing teeth for implant-supported restorations has proven to be a highly predictable treatment method with good long-term prognosis. However, some consequences of tooth loss prevents dental implant placement in an ideal position, where regenerative procedures are necessary for this type of rehabilitation. Less invasive procedures such as conventional prosthesis emerge as a therapeutic option in cases where there is enough bone structure for implants and patient´s non-acceptance for invasive procedures. Thus, this paper aims to present the resolution of rehabilitation through a noninvasive and multidisciplinary treatment. One female patient referred to the clinic presented maladaptive bilateral mandibular fixed prostheses, endodontic lesions, gingival recession, and root sensitivity. For proper resolution of this case, an association among osseointegrated implants, fixed partial prosthesis, tooth extraction, and aesthetic periodontal procedures with the use of subepithelial connective tissue graft was proposed. After two years, the patient shows excellent aesthetics and chewing. Within the limits of this scenario, this paper discusses the various factors that may affect the choice of a particular treatment modality for the rehabilitation of edentulous single spaces.
Subject(s)
Humans , Female , Middle Aged , Dental Implantation , Denture, Partial, FixedABSTRACT
Introducción: el propósito de este estudio fue analizar la distribución de los esfuerzos entre tres alternativas deretención de una prótesis dental parcial fija de tres unidades, utilizando el método de elementos finitos (MEF). Métodos: se realizaron tres modelos tridimensionales en elementos finitos del tramo dental anterior superior, restaurando uno con postes colados, otro con postes prefabricados y el tercero con implantes. Los modelos del tramo restaurado fueron modelados con hueso esponjoso, hueso cortical, ligamento periodontal, encía, raíz, gutapercha, cemento resinoso, poste, muñón de resina (modelos postes prefabricados), cofia metálica y corona cerámica. El material de los postes considerado para el análisis fue una aleación de metal noble (postes colados) y fibra de vidrio (postes prefabricados). Los postes fueron cementados con cemento resinoso. Se hizo un análisis lineal y se consideró las no linealidades asociadas a la geometría del modelo. Las variables incluidas en el modelado fueron el módulo de elasticidad y la razón de Poisson. Se aplicó una carga monótamente creciente de 1N en la superficie lingual de la corona con una inclinación de 45º. Los esfuerzos de von Mises fueron determinados. Resultados: el análisis de elementos finitos indicó que la distribución de los esfuerzos generados en el diente modelado con los postes disminuyó significativamente,de acuerdo con una relación inversamente proporcional al módulo de elasticidad del material. En el modelo con implante, los esfuerzos se concentraron en la zona cervical y en el implante mismo. Conclusiones: con las limitantes de este estudio, se encontróque existen variaciones marcadas con respecto a la distribución de los esfuerzos en las tres alternativas de retención, donde un sistema con varios componentes de diferente rigidez es cargado, el elemento más rígido resiste los mayores esfuerzos sin distorsión.
Introduction: the purpose of this study was to analyze the stress distribution among three retention alternativesused in a three unit fixed partial prosthesis, using the Finite Element Analysis (FEA). Methods: three tridimensional FEA modelsof the upper anterior area, restored with a cast post, another with a prefabricated post and the third one with an implant, were prepared. The models of the restored area consisted of trabecular bone, cortical bone, periodontal ligament, gingival, root, gutta-percha, resin luting cement, post, composite resin core (for prefabricated posts), metallic core and metal ceramic crown.The post materials considered for analysis were a noble casting alloy and fiber glass. The posts were cemented with resin luting cement. A lineal analysis was carried out and the nonlinearities associated with the geometry of the model, were considered. The variables included in the model were the modulus of elasticity and Poisson´s ratio. An increasing load of 1N was applied on the lingual surface of the crown with an inclination of 45°. Von Mises stress were then calculated. Results: the Finite Element Analysisshowed that the distribution of stresses generated on the tooth modeled with posts, decreased significantly, in accordance with an inverse proportional relation with the modulus of elasticity of the material. In the implant model, the stresses concentrated on the cervical area and on the implant itself. Conclusions: within the limitations of this study, it was found that that there were marked differences in relation with the stress distribution among the three retention alternatives, where the system with different rigidity components is loaded, the most rigid element is capable of resisting the highest stress without distortion.
Subject(s)
Finite Element Analysis , Dental ImplantsABSTRACT
La electrodeposición es un proceso químico por el cual se realiza una deposición galvánica de oro del 99% de pureza con el fin de obtener infraestructuras en prótesis metal-cerámicas. Las infraestructuras presentan, en promedio, un espesor de 0,2 mm y un desajuste marginal inferior la 20 µm, posibilitando la utilización de un mayor espesor de cerámica si la comparamos a técnicas convencionales. Esta técnica posibilita la disminución de la citotoxicidad, de las reacciones alérgicas y de la corrosión, determinando una mayor duración de las restauraciones. La coloración dorada del material permite al ceramista conseguir una estética más depurada, favoreciendo las tonalidades en la cerámica aplicada. Sin embargo, la necesidad de mano de obra calificada y de equipos modernos y de alto costo son factores que todavía hacen inviable la utilización de la electrodeposición de oro puro como práctica clínica habitual. El objetivo de este estudio es contribuir, a través de una revisión de la literatura, a la comparación en los siguientes factores: calidad del asentamiento marginal, durabilidad, biocompatibilidad, estética de las restauraciones cuyas estructuras hayan sido obtenidos por la técnica de electrodepoisición frente a restauraciones realizadas con técnicas metal-cerámicas convencionales y sistemas cerámicos
Electrodeposition is the galvanic deposition of 99% pure gold to obtain the framework for metal-ceramic prostheses. The framework is 0.2 mm thick, on average, with marginal maladjustment of less than 20 µm, enabling the use of greater ceramic thickness than that of conventional techniques. This new technique reduces cytotoxicity, allergic reactions and corrosion, resulting in longer restoration longevity. The golden coloration of the material allows the ceramist to develop a more evolved esthetic, favoring the tonality of the ceramic applied. However, the need for qualified labor and modern high-cost equipment are factors that hinder the use of electrodeposited pure gold in everyday clinical practice. The aim of this study is to perform a literature review to compare the quality of the marginal fit, longevity, biocompatibility, and esthetic of restorations whose copings were obtained by the electrodeposition technique using conventional metal-ceramics and ceramic systems