ABSTRACT
As coroas de cerâmica pura estão ganhando força na odontologia uma vez que as exigências estéticas e mecânicas são cada vez mais evidentes, uma vez que as próteses metal free do tipo bicamada, não raramente, apresentam lascamento da cerâmica de cobertura como a principal falha a longo prazo, então iniciou-se o uso de próteses monolíticas. Paralelamente é crescente a busca e o uso de implantes osseointegráveis para suportar as reabilitações parciais, sendo a primeira opção para as reabilitações orais de áreas edêntulas. Logo, o objetivo deste estudo clínico prospectivo, randomizado de boca dividida é avaliar o desempenho clínico e a previsibilidade, caracterizando o número e o tipo de complicações e falhas precoces como desgaste do antagonista, perda óssea, inflamação gengival e falhas mecânicas que possam ocorrer em PPFs de três elementos implantossuportadas com retenção mista em região posterior de mandíbula em zircônia monolítica e infraestrutura de zircônia com cerâmica de cobertura, além de avaliar a percepção estética e satisfação do paciente com cada uma delas. Os pacientes selecionados (N=2) passarão por procedimentos cirúrgicos para instalação de dois implantes na região posterior de mandíbula, sendo dois de cada lado. Após três a quatro meses os cicatrizadores serão instalados e a moldagem será realizada para confecção das próteses seguindo a aleatorização do lado da mandíbula. Serão avaliados desgaste das próteses e dos antagonistas por meio de microscopia eletrônica de varredura; perda óssea periimplantar utilizando radiografias periapicais em três períodos, imediatamente após a instalação das próteses, uma semana após e três meses depois, percepção estética e alteração de cor utilizando o método de escala visual analógica pelo paciente. As hipóteses deste estudo são resistência à fratura e lascamento será semelhante nos grupos avaliados, todos os grupos serão esticamente aceitáveis, o desgaste do antagonista e das próteses será semelhante entre os grupos e a manutenção periodontal e nível de perda óssea será semelhante para os grupos(AU)
The pure ceramic crowns have been gaining strength in dentistry since the aesthetic and mechanical requirements are increasingly evident. Since free metal dentures of the bilayer type, not infrequently, show sputtering of the ceramic cover as the main long-term failure, the use of monolithic prostheses was started. At the same time, the search for and use of osseointegratable implants to support partial rehabilitation is increasing, being the first option for oral rehabilitation of edentulous areas. Therefore, the purpose of this prospective, randomized, split-mouth clinical study is to assess clinical performance and predictability, characterizing the number and type of early complications and failures such as antagonist wear, bone loss, gingival inflammation, and mechanical failures that may occur in PPFs of three implant - supported elements with mixed retention in posterior region of mandible in monolithic zirconia, zirconia infrastructure with covering ceramics and metaloceramics, besides evaluating aesthetic perception and patient satisfaction with each one. Patients selected (n = 8) will undergo surgical procedures to install two implants in the posterior mandible, two on each side. After three to four months the healing will be installed and the molding will be performed to make the prosthesis following the randomization of both the patients and the side of the jaw. Wear of prostheses and antagonists will be assessed by scanning electron microscopy and profilometry; bone loss peri-implant using periapical radiographs in seven periods, immediately after the implant installation, 7 days after surgery, before the installation of the healers, at the installation of the prosthesis, 21 days after, six and twelve months later, aesthetic perception and color change using the method of visual analog scale by the patient and an intraoral spectophotometer. The hypotheses of this study are resistance to fracture and chipping will be similar in the evaluated groups, all groups will be ethically acceptable, the wear of the antagonist and the prostheses will be similar between groups and the periodontal maintenance and level of bone loss will be similar for the groups(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Ceramics , Dental Prosthesis, Implant-Supported , Tooth Crown , Denture, Partial, Fixed , Dental Implants , Dental Restoration FailureABSTRACT
PURPOSE: To determine wear amount of single molar crowns, made from four different restoratives, and opposing natural teeth through computerized fabrication techniques using 3D image alignment. MATERIALS AND METHODS: A total of 24 single crowns (N = 24 patients, age range: 18 – 50) were made from lithium disilicate (IPS E-max CAD), lithium silicate and zirconia based (Vita Suprinity CAD), resin matrix ceramic material (Cerasmart, GC), and dual matrix (Vita Enamic CAD) blocks. After digital impressions (Cerec 3D Bluecam, DentsplySirona), the crowns were designed and manufactured (Cerec 3, DentsplySirona). A dual-curing resin cement was used for cementation (Variolink Esthetic DC, Ivoclar). Then, measurement and recording of crowns and the opposing enamel surfaces with the intraoral scanner were made as well as at the third and sixth month follow-ups. All measurements were superimposed with a software (David-Laserscanner, V3.10.4). Volume loss due to wear was calculated from baseline to follow-up periods with Siemens Unigraphics NX 10 software. Statistical analysis was accomplished by Repeated Measures for ANOVA (SPSS 21) at = .05 significance level. RESULTS: After 6 months, insignificant differences of the glass matrix and resin matrix materials for restoration/enamel wear were observed (P>.05). While there were no significant differences between the glass matrix groups (P>.05), significant differences between the resin matrix group materials (P<.05) were obtained. Although Cerasmart and Enamic were both resin matrix based, they exhibited different wear characteristics. CONCLUSION: Glass matrix materials showed less wear both on their own and opposing enamel surfaces than resin matrix ceramic materials.
Subject(s)
Humans , Cementation , Ceramics , Crowns , Dental Enamel , Follow-Up Studies , Glass , Lithium , Molar , Resin Cements , Silicates , ToothABSTRACT
PURPOSE: The aim of this study was to identify the effects of three aesthetic restorative materials on the wear between tooth and restoration by a pin-on-disk manner. MATERIALS AND METHODS: Six aesthetic restorative materials were used to prepare disk specimens for wear test, which were Lava Zirconia as zirconia group, Vintage MP and Cerabien ZR as veneering porcelain group, Gradia Direct microhybrid composite containing prepolymerized fillers, Filtek Z250 microhybrid composite containing zirconia glass and colloidal silica particles, and Filtek Z350 nanocomposite as composite resin group. Vertical loss of the worn cusp, change of the surface roughness of the restoration materials, and the surface topography were investigated after wear test under 9.8-N contact load. RESULTS: The porcelain groups (Vintage MP and Cerabien ZR) caused the largest vertical loss of teeth when compared with those of the composite resin and zirconia groups, and Filtek Z250 microhybrid composite results in the second-largest vertical loss of teeth. The surface of Filtek Z350 nanocomposite was deeply worn out, but visible wear on the surface of the zirconia and Gradia Direct microhybrid composite was not observed. When the zirconia surface was roughened by sand-blasting, vertical loss of teeth considerably increased when compared with that in the case of fine polished zirconia. CONCLUSION: It was identified that microhybrid composite resin containing a prepolymerized filler and zirconia with reduced surface roughness by polishing were the most desirable restorative materials among the tested materials to prevent the two-body wear between aesthetic restorative material and tooth.