Comparison of the retention of conventional dentures after the use of common adhesive brands on poor denture foundations: an in vitro study / Comparación de la retención de dentaduras convencionales con el uso de marcas comerciales de adhesivos en procesos alveolares deficientes: un estudio in vitro

There is no information about the possible impact in denture retention after the use of common denture adhesives (DAs) when poor denture foundations (PDF) are present. Moreover, there is a lack of information about which current formulation provides greater retention and for how long. Twelve models from edentulous patients with different ridge shape and border height were used and complete dentures were manufactured. Four different formulation brands of DAs were tested after 10 minutes and three, six, nine, and 12 hours of DA application using a universal testing machine. The Fittydent® and Fixodent® adhesives had the highest retention at 12 hours. The PDF group increased on average its retention by 400 %. However, the group presented lower retention compared to the good denture foundation group. In conclusion, DAs significantly increased denture retention. The PDF group were the most benefited with the application of DAs. The Fixodent® paste had the highest retention.

No existe información acerca del posible impacto en la retención de dentaduras después del uso de adhesivos dentales comunes (DAs) cuando existen rebordes alveolares deficientes (PDF). Más aun, existe una falta de información acerca de cuál formula actual provee mayor retención y por cuanto tiempo. Doce modelos de pacientes edentulos con diferentes formas y alturas en sus rebordes alveolares fueron usados, y dentaduras completas les fueron realizadas. Cuatro diferentes fórmulas y marcas de DAs fueron evaluadas después de 10 minutos, tres, seis, nueve y 12 horas de que se aplicó el DA usando una maquina universal de pruebas. Los adhesivos Fittydent® y Fixodent® presentaron la retención más alta a las 12 horas. El grupo con PDF incrementó su retención hasta en un 400 %. Sin embargo, el grupo presentó menor retención cuando se comparó con el grupo que posee adecuados procesos alveolares. Los DAs incrementaron significativamente la retención de las dentaduras. El grupo PDF fue el más beneficiado con la aplicación de DAs. La pasta Fixodent® provee la más alta retención.

Técnica de impresión para rebordes móviles. Parte 1: maxilar / Impression technique of movable fibrous ridge. Part 1: maxilla

RESUMEN: El reborde móvil maxilar producido por reabsorción ósea extrema compromete la estabilidad de la prótesis total, por lo que debe ser registrado en reposo. Se describe una nueva técnica de impresión mucoestática simple y rápida que, junto al esquema oclusal y ordenamiento dentario planificados, optimiza la retención protésica. Se discuten sus resultados y se comparan con otras técnicas de impresión.

ABSTRACT: The movable fibrous ridge caused by extreme maxillary bone resorption compromises the stability of complete dentures, so it must be registered passively. A new, simple and quick mucostatic impression technique along with the occlusal scheme and dental planning system optimizes prosthetic retention. Results are discussed and compared with various impression techniques.

Influence of Inner Circular Sealing Area Impression Method on the Retention of Complete Dentures

The aims of the present study were to describe an impression method of "inner circular sealing area" and to evaluate the effect of the method on retention, aesthetics and comfort of complete dentures, which lack labial base for patients with maxillary protrusions. Three patients were subjected to the experiment, and two sets of complete maxillary dentures were made for each patient; the first set was made without labial base via an inner circular sealing area method (experimental group) and the second had an intact base that was made with conventional methods (control group). Retention force tests were implemented with a tensile strength assessment device to assess the retention and a visual analogue scale (VAS) was used to evaluate the comfort between the two groups. Results showed larger retention force, better aesthetics and more comfort in the experimental group. The improved two-step impression method formed an inner circular sealing area that prevented damage to the peripheral border seal effect of the denture caused by incomplete bases and obtained better denture retention.

O objetivo deste caso foi descrever um método de impressão por "área de selamento circular interno" e avaliar o efeito deste método na retenção, estética e conforto de próteses totais sem base labial para pacientes com protrusão maxilar. Três pacientes foram objeto desta experiência e foram feitas duas próteses maxilares completas para cada um deles; a primeira foi elaborada sem base labial pelo método de área de selamento circular interno (grupo experimental) e a outra teve uma base feita pelo método convencional (grupo controle). Foram realizados testes de retenção com estudo de tensão para avaliar a retenção e para avaliação do conforto dos dois grupos, foi empregada a escala analógica visual (EAV). Os resultados demonstraram que o grupo experimental apresentou força de retenção maior, estética melhor e mais conforto. O método modificado de impressão em duas etapas formou uma área de selamento circular interno que evitou danos ao selamento periférico causados por bases incompletas e obteve melhor retenção da prótese.

Reabilitação oral com prótese total através do emprego da técnica da zona neutra / Oral rehabilitation with complete dentures using neutral zone technique

A prótese total é um dispositivo mecânico destinado a substituir todos os dentes do arco dental e a parte gengival ausente, a fim de restituir a função, a estética e a saúde dos órgãos mastigatórios. Uma das técnicas de confecção de próteses totais visa localizar, dentro da área chapeável, a posição anteriormente ocupada pelos dentes naturais, chamada de “zona neutra”, em que as forças linguais são neutralizadas pelas forças dos lábios e bochechas. Uma vez que essas forças são desenvolvidas através da contração muscular durante as diversas funções orais, elas variam em magnitude nos diferentes indivíduos. A técnica consiste, basicamente, na colocação de um material de moldagem sobre uma base, normalmente de acrílico, sendo o conjunto levado à cavidade oral do paciente, que deverá realizar movimentos de deglutição e sucção visando uma moldagem da musculatura durante as funções orais. Esta técnica possui uma importante indicação na reabilitação de desdentados completos, principalmente quando se observa uma atrofia significativa do rebordo mandibular, culminando em instabilidade protética. Entretanto, quer seja pelas controvérsias existentes em relação à técnica ou pelo próprio desconhecimento dos profissionais quanto à sua realização, esta técnica permanece pouco utilizada na rotina diária. Desta forma, o objetivo deste estudo foi elaborar uma revisão da literatura sobre a técnica da zona neutra e sua utilização em reabilitações orais

Complete denture is a mechanical device developed to replace all the teeth of the dental arch and the missing gingival portion, in order to restore function, aesthetics and health of the masticatory organs. One of the techniques of complete denture treatment aims at locating within the basal area the position previously occupied by natural teeth, called “neutral zone”, in which tongue forces are neutralized by the forces of the lips and cheeks. Since these forces are developed by muscle contraction during the various oral functions, they vary in magnitude among different individuals. The technique consists of placing the impression material on a base plate, usually made of acrylic, and inserting it into patient’s oral cavity, while the patient performs suction and swallowing movements seeking for an impression of the musculature during oral functions. This technique has an important indication in the rehabilitation of complete edentulous, mainly when there is a significant atrophy of the mandibular ridge, culminating in prosthetic instability. However, due to the controversies regarding this technique or to the lack of knowledge about its performance, this technique is still rarely used in daily routine. Thus, the aim of this study was to present a literature review on the use of the neutral zone technique in oral rehabilitations

Wear of double crown systems: electroplated vs. casted female part

OBJECTIVES: The wear of telescopic crowns is a common problem often reducing the patient's satisfaction with the denture and resulting in a renewal of the denture. The study aims to compare the wear behavior of conical crowns using electroplated copings (group E ) with standard telescopic crowns with cast female parts (group C). MATERIAL AND METHODS: 10 conical crowns were milled for each group of a cast gold alloy. The specimen of group E had a conicity of 2º. The cast secondary crowns of group C had a 0º design. The electroplated coping was established by direct electroforming. An apparatus accomplishing 10,000 wear cycles performed the wear test. The retentive forces and the correlating distance during insertion and separation were measured. The wear test was separated in a start phase, an initial wear phase and the long term wear period. The retention force value and the force-distance integral of the first 0.33 mm of each cycle were calculated. RESULTS: The retentive forces were significantly higher for group E and the integrals were significantly lower for this group except the integral at cycle 10,000. The changes of retention force and integral did not differ significantly between both groups in all phases. The change of the integrals as well as the integral at the particular cycles showed higher interquartile distances for group C. CONCLUSIONS: Within the limitations of this study the tested conical crowns showed clinically acceptable retentive properties. The values reached a range comparable to retentive elements tested in recent literature. The values of group C showed higher ranges. The force measured for group E was significantly higher than for group C but the integrals showed an opposite tendency. The results indicate that an exclusive analysis of the force is not sufficient as the integral is not equivalent to the force although it describes the retentive property of the system in a better way than the force over a distance is described. Both systems seem to be suitable for clinical practice.

Frecuencia de las retenciones dentarias en radiografías panorámicas: presentación de un estudio en 1000 pacientes / Frequency in deductions dental panaramic radiographs: presentation of a study in 1000 patients

La retención dentaria es una anomalía en la que una vez llegada la época normal de erupción, permanecen los dientes en el interior de los maxilares manteniendo la integridad de su saco pericoronario, pudiendo producir en su intento de erupción accidentes patológicos de variado aspecto e intensidad. Una de las causas se debe a que los maxilares de la especie humana son de menor tamaño que los de nuestros antecesores, y de esta manera no es posible alinear armónicamente los 32 dientes. La radiografía panorámica es de gran utilidad para diagnosticar esta lesión, sin manifestación clínica en algunos casos. Sobre una muestra de 1000 pacientes, desde los 6 hasta los 92 años, se diagnosticaron 334 retenidos; 180 en mujeres y 154 en varones. Las retenciones dentarias halladas fueron: 131 correspondieron a terceros molares inferiores, 70 derechos y 61 izquierdos; 107 correspondieron a los terceros superiores, 58 derechos y 49 izquierdos. Caninos permanentes 52: 43 superiores, y 9 inferiores. Premolares: 28, 20 inferiores y 8 superiores. El análisis de varianza nos indicó que hay diferencias significativas entre edades analizados por décadas pero no se halló diferencias entre sexos.

An impacted tooth is a dental anomaly in which a dental piece remains enclosed into the jaw after the normal eruption age is reached, despite it usually keeps the physiology of the pericoronal sac; but it is known to cause some pathological accidents of varying kind and intensity during the tooth's attempt of eruption. One of the reasons for this anomaly is probably the fact that the jaws of the human species are smaller in size than those of our ancestors, so it is almost impossible for the 32 teeth to be aligned in a harmoniously way. The panoramic radiography is very helpful to diagnose this abnormality, which in many instances may occur with no clinical manifestations. 1000 radiographs, taken from 6- to 92-year-old patients, a total of 334 impacted teeth were found, 180 female and 154 in male; their distributions were as follows: 131 lower third molars, 70 right and 61 left; 107 were upper third molars, 58 right and 49 left; 52 permanent canines were found, 43 upper and 9 lower; 28 premolars, 20 lower and 8 upper.The variance analysis indicated that theres`s a significate difference between the analized ages per decades, but there were no differences found between sexs.

Prótese destacável com sistema “Swivel Loc” – relato de caso clínico / Detachable prosthesis with Swivel Loc system – a clinical case report

A reabilitação total maxilar com próteses implantossuportadas representa em algumas situações clínicas dificuldades quanto a estética, fonética, suporte labial e higienização. As próteses destacáveis implantossuportadas são uma opção de tratamento frente a essa situação, onde o uso de encaixes permite a conexão entre uma prótese removível e uma infraestrutura metálica, sendo estéticos e funcionalmente eficientes. O objetivo deste trabalho foi de apresentar por meio de um caso clínico a confecção de uma protese destacável do sistema “Swivel Loc” como alternativa de aperfeiçoar a previsibilidade dessas reabilitações

The total rehabilitation of maxilla with supported implant prostheses represent in some clinical difficulties regarding aesthetics, phonetics, lip support and hygiene. The detachable implant supported dentures are a treatment option when faced with this situation, the use of attachments allows a connection between a removable prosthesis and a metallic infrastructure, being aesthetic and functionally efficient. The aim of this work was present through a clinical case the making of a detachable prosthesis with Swivel Loc system as an alternative to improve the predictability of these rehabilitations

Tratamiento multidisciplinario de pacientes edéntulo con síndrome de Apert: reporte de un caso clínico / Multidisciplinary treatment of edentulous patients Apert syndrome: report of a case

Durante el abordaje terapéutico odontológico de los pacientes parcialmente edéntulos, resulta indispensable la obtención de una adecuada estabilidad esquelética, una buena dimensión vertical y una adecuada rehabilitación protésica; a tal fin, es necesaria una programación terapéutica así como la cooperación de las distintas especialidades odontológicas: prótesis, ortodoncia y cirugía. El presente artículo resume la programación y principales fases terapéuticas durante el abordaje de una paciente parcialmente edéntula, diagnosticada con Síndrome de Apert, quien fue sometida a un tratamiento ortodóntico-quirúrgico, además de realizársele una rehabilitación protésica con adecuada dimensión vertical, logrando un equilibrio neuromuscular y una estabilidad oclusal y esqueletal a largo plazo

A case of Apert´s Syndrome is reported as a contribution of better understanding of this disease. A literature review is done concluding that this disease has an important genetic component and belongs to those ones that present craneofacial deformities. The most important characteristics of this syndrome are the associated craneofacial and limb deformities. It´s treatment requires a team aproach with participation of diverses specialities of dentists, in order to give the patient a better treatment from the functional, esthetic and social standpoint

Prótesis fija metal cerámica con anclajes simplificados / Metal-ceramic fixed-prosthesis with simplified anchorages

Se propone la reposición fija de una o dos piezas dentarias del sector posterior de boca, mediante la utilización de prótesis metal cerámica pero con anclajes simplificados. Si bien el o los pónticos de la misma son convencionales clásicos de metal-cerámica, encambio los retenedores son inlays simplificados, con elementos de retención en profundidad tipo ®undercuts, aunque sin anatomía en oclusal. Dicha cara oclusal recibirá como tratamiento previo al cementado, simplemente una cobertura opacificadora del metal, y se recubrirán directamente con resina compuesta estratificada de forma convencional luego del cementado. Son prótesis fijas estéticas, de menor costo relativo dada la simplicidad de los procedimientos requeridos, y especialmente indicadas cuando las piezas dentarias pilares están sanas o con muy poca pérdida de estructuras duras.

A metal-ceramic fixed-partial-prosthesis with simplified anchorage is proposed for the replacement of one or two posterior teeth. Although their pontics are metal-ceramic custom ones, retainers are simplified metal inlays with undercuts as retention forms, but lacking anatomy in their occlusal surface. This occlusal surface is treated, prior to cementation of the prosthesis, with a metal opaque coating, and will be subsequently covered with a stratified composite resin after adhesive cementation procedure. They are aesthetic fixed partial prosthesis, of lesser cost due to the simplicity of the procedures involved, and especially indicated when the pillars are sound or have suffered minor structure loss.

Clinical and histopathological analysis of intramucosal zirconia inserts used for improving maxillary denture retention

Intramucosal inserts made of zirconia ceramic have been used for the rehabilitation of edentulous patients. This study aimed to follow up on patients with complete dentures having intramucosal zirconia inserts and to perform a histological analysis of biopsies of the epithelium surrounding the inserts. Twelve 31-66-year-old subjects of both genders received complete denture treatment having the intramucosal inserts in place. Detailed clinical, prosthetic and surgical procedures were described. Clinical exams were done on postoperative days 3, 7, 15, 120 and 360. One year after denture placement, the subjects received local anesthesia and the tissues surrounding the insertion sites in the alveolar ridge were removed using a scalpel blade. Biopsies were fixed for up to 48 h in 10 percent phosphate-buffered formaldehyde and 5-µm-thick sections were cut and stained with hematoxylin and eosin and Gomori Trichrome. Immunohistochemistry was used to identify endothelium (anti-CD3) and T lymphocytes (anti-CD31). Removing and reinserting the denture was painful until day 15, but all patients reported a marked increase in the retention and stability of the complete denture with little or no discomfort after 30 days. The histopathological analysis showed that zirconia inserts were well tolerated by the oral mucosa, with the presence of collagen fibers in the tissue around the insert, with mild inflammatory response and allowing reepithelialization, expressed by parakeratosis, epithelial hyperplasia and presenting granular layer. In conclusion, intramucosal zirconia inserts did not affect the health of oral mucosa and provide adequate retention and stability of the complete denture and comfort to the patients.

Análise do comportamento das próteses implanto-suportadas e dos componentes pela técnica do cilindro cimentado com diferentes marcas de cimentos resinosos / The behavior of implant-supported dentures and abutments using thecemented cylinder technique with different resinous cements

Objetivo: Avaliar o comportamento das próteses implanto-suportadas confeccionadas pela técnica do cilindro cimentado utilizando três marcas comerciais de cimentos resinosos. Métodos: Foram avaliados 53 pacientes, sendo 26 do sexo feminino e 27 do sexo masculino, com idades entre 25 a 82 anos. Resultados: Reabilitações parciais (54,43%) e totais (45,57%) sobre implantes do tipo hexágono externo, interno ou cone morse (Neodent ®, Curitiba, Brasil), totalizando 237 fixações. Os cimentos utilizados foram Panavia® (21,94%), EnForce® (58,23%) e Rely X® (19,83%). O tempo em uso das reabilitações variou de 1 a 5 anos. Considerando todas as reabilitações, foram observados 5 cilindros (2,1%) soltos; 2 implantes (0,48%) foram perdidos após o primeiro ano em carga, 16 parafusos de retenção (6,75%) da prótese estavam soltos e 31 parafusos do pilar (13,08%) desapertados. Conclusão: As prováveis causas relacionadas as falhas foram falta de retenção interna na estrutura metálica, padrão oclusal, técnica de cimentação e condição de carga. A técnica do cilindro cimentado apresentou ser efetiva quando empregada em reabilitações parciais e totais implanto-suportadas, mantendo a estabilidade protética dos componentes envolvidos, independente do cimento utilizado, porém, mais estudos clínicos devem ser realizados.

Objective: Evaluate the behavior of implant-supported dentures and their components, made by cemented cylinder technique, using three types of resin cements. Methods: Fifty three patients, of whom 26 were women and 27 men, aged between 25 and 82 years. Results: With partial (54.43%) and total (45.57%) implant-supported dentures, of the Cone Morse, external and internal hexagon types (Neodent®, Curitiba, Brazil), totaling 237 fixations, were analyzed. The resin cements used were Panavia® (21.94%), EnForce® (58.23%) and Rely X® (19.83%) and the components were used in accordance with the Laboratory Immediate Loading - Neodent® sequence. The period of time of denture use ranged between 1 and 5 years. The results reported that 5(2.1%) cylinders were loosened from metal structure (both belonging to Rely X group), 2(0.48%) implants were lost after the first year of use, 16(6.75%) denture retention screws were loosened and 31(13.08%) abutment screws were unloosened. Conclusion: The reasons for these failures probably are: metal structure internal retention failure, occlusal pattern, cementation technique and loading conditions. The cemented cylinder technique was effective when used in partial and total implant-supported rehabilitations, keeping prosthetic components stable, despite the resin cement utilized. However, further clinical studies must be conducted.

Treatment of severely mutilated incisors: a challenge to the pedodontist.

Dental caries is the single most common chronic childhood disease. In early childhood caries, there is early carious involvement and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue habits and subsequent malocclusion and psychological problems if esthetics are compromised. The restoration of severely decayed primary incisors is often a difficult procedure that presents a special challenge to pediatric dentists. This case report documents the restoration of severely mutilated lateral incisors in a patient with early childhood caries.

Sobredentadura inferior implanto-suportada: relaçäo entre número de implantes e grau de satisfaçäo do paciente / Implant supported mandibular overdenture: relationship between the number of implants and patient satisfaction

O objetivo deste artigo foi avaliar e comparar o grau de satisfaçäo de 43 pacientes que usavam próteses totais inferiores e que receberam sobredentaduras implanto-suportadas após a instalaçäo de dois, três, quatro e cinco implantes osseointegrados. Através de questionários, aspectos como funçäo, estética, conforto e higiene foram analisados e correlacionados ao número de implantes instalados

Moldagem de borda com silicone zetalabor / Border molding with silicone zetalabor

Os autores mostraram uma técnica de moldagem de borda utilizando um tipo de silicone por condensaçäo (Zetalabor Titanium), considerando sua fácil manipulaçäo, ótima dureza, após a polimerizaçäo e fidelidade de reproduçäo, consumindo menor tempo de trabalho e näo requerendo aparelhagem específica

Influência dos ciclos de polimarizaçäo sobre a adaptaçäo das bases de prótese total confeccionadas com resina acrílica QC-20 / Influence of the polimerization cycles on the total prosthesis bases adaptation made with QC-20 acrylic resin

O objetivo deste estudo foi avaliar as alterações de adaptação em bases de prótese total, confeccionadas com resina acrílica de rápida polimerização (QC-20) em função de três técnicas de polimerização, foram confeccionados 15 modelos em gesso pedra e sobre elas bases de prótese com espessura uniforme de 1,5 mm, divididas aleatoriamente nos grupos: 1 - ciclo convencional (polimerização em água fervente a 74 graus Centígrados por 9 horas); 2- ciclo rápido (polimerização em água fervente em 20 minutos); e 3- por energia de micoondas (polimerização em forno de microondas a 500W por 3 minutos), O conjunto na base de prótese-modelo foi selecionado em três secções látero-laterais e a leitura da desadaptação verificada em um microscópio comparador. Os resultados obtidos foram submetidos à análise estatística e ao teste de Tukey em nível de significância de 5 por cento. A resina acrílica QC-20, quando polimerizada pelos ciclos de 9 horas e de 20 minutos, apresentou estatisticamente melhor adaptação quando comparada ao ciclo por microondas. A maior média de desadaptação ocorreu na linha média da região posterior.

Prótesis parcial removible semirrígida: evaluación clínica de cinco años de uso / Semirigid removable partial denture: a five-year clinical evaluation

Se evalúan los resultados obtenidos con el uso de prótesis parcial removible semirrígida, con retenedores directos DPA, realizadas en forma sistemática durante un período de 5 años en la Clínica de Prótesis II de la Facultad de Odontología de Montevideo. De 462 prótesis clase I de Kennedy resueltas (82 por ciento del total) se tomó una muestra de 3 por ciento, para analizar mediante un cuestionario y un examen clínico específicos, la repercusión ecológica de los retenedores DPA, referidos a incidencia de caries y enfermedad periodontal; a nivel del terreno protético se buscaron signos de trauma periodontal, cambios óseos y mucosos, se valoró la opinión de los pacientes sobre eficacia y confort del tratamiento protético

Efectos del termociclado y las cargas cíclicas sobre dos adhesivos dentinarios SB-2 y SBMP: estudio in vitro / Effects of termocycling and cyclic loads over 2 dentin adhesives: SB-2 and SBMP: in vitro study

In vitro study was carry out in order to compare the microleakage of two different dentin adhesives SB-2 and SBMP in class V. One hundred class V cavities were designed in the enamel-dentin joint. After restorations they were thermocycled, loaded, stained and sectionated before the microlekage were observed. All the groups showed microleakege. The enamel walls presented better beahvior than roots walls. In roots areas were found significative higher microleakage than enamel walls. Enamel walls of Silux Plus, showed les leakage with SB2, white Z 100 worked better in roots walls with SBMP. Enamel areas of ceramic inlays were less leakage with SB2, and composites restoration always showed better sealed than ceramic inlays with both, SB2 and SBMP

Colagem de "Ilhas de esmalte": para determinar retenção de próteses parciais removíveis / \"Enamel islands\" to create undercuts for removable partial dentures

Este trabalho apresenta uma técnica clínica para criar retenção à prótese parcial removível, em locais onde o dente natural não apresenta estas condições. Foram realizadas restaurações com resinas compostas, com "ilhas de esmalte" inseridas nas áreas centrais destas restaurações. Foram realizadas com o propósito de oferecer as condições citadas de retenção e torná-las resistentes a longo prazo à abrasão exercida pela ação dos grampos

Patología, diagnóstico y pronóstico del diente subprotético / Pathology, diagnosis and prognosis of the subprosthetic tooth

La interacción entre las especialidades odontológicas se estudia en las fronteras entre dos de ellas. En este artículo se repasan las interioridades de la relación endodonticoprotética, las implicaciones para cada especialista y las consecuencias para el paciente, de la actidud de cada uno; se hace énfasis en el carácter preventivo que significa la conducta del protesista al hacer el diagnóstico del estado de la pulpa de todos los dientes que van a ser utilizados como base de restauraciones protéticas fijas, así como su actitud al manipular los tejidos que servirán de soporte a la misma