A new approach to endodontic access in anterior teeth: a pilot study / Uma nova abordagem para acesso endodôntico em dentes anteriores: estudo piloto

Introduction: The coronal opening is essential, during endodontic treatment, for direct access to the root canals. Usually, in the anterior teeth, endodontic access is achieved on the palatal/lingual surface, more specifically in the cingulum region. However, the lack of observation for dental positioning can lead to some accidents and complications, such as buccal perforations, causing esthetic damage and compromising the treatment. Objective: To evaluate the applicability of a new approach for performing coronal opening in anterior teeth, regarding the wear caused on the tooth crown, and to evaluate the ease of performing the new technique to minimize the risk of perforation. Material and method: Ten students (n=10) from the Improvement in Endodontics program participated in the present study. Twenty artificial teeth were used, which were upper, central incisors. Each participant performed two coronal openings. First, with no guidance (Group A - Conventional Technique) and afterward, a new opening, but with guidance with the spherical diamond tip placed parallel to the long axis of the tooth (Group B - Modified Technique). Result: The results showed that 90% of the participants considered the Modified Technique as having lower risk of accidents, as well as being easier for locating the pulp chamber. There was a statistical difference both in the measurement of the total area of wear and in the width, while there was no statistical difference in the height. Conclusion: Preliminary data collected with the survey were satisfactory for the Modified Technique. Statistically, it showed a favorable difference in relation to the area of wear and the width. However, in height there was no statistical difference.

Introdução: A abertura coronária é fundamental durante o tratamento endodôntico para um acesso direto aos canais radiculares. Em geral, em dentes anteriores, o acesso endodôntico é realizado na face palatina/lingual, mais especificamente em região de cíngulo. Entretanto, a falta de observação do posicionamento dentário pode levar a alguns acidentes e complicações, como as perfurações por vestibular, ocasionando dano estético e comprometendo o tratamento. Objetivo: Avaliar a aplicabilidade de uma nova abordagem de realização da abertura coronária em dentes anteriores, quanto ao desgaste ocasionado na coroa dentária, e avaliar a facilidade de execução da nova técnica para minimizar os riscos de perfurações. Material e método: Dez alunos (n=10) do curso de Aperfeiçoamento em Endodontia participaram do estudo. Foram utilizados vinte dentes artificiais, sendo eles incisivos centrais superiores. Cada participante realizou duas aberturas coronárias. Primeiramente sem nenhuma orientação (Grupo A - Técnica Convencional) e após, uma nova abertura, porém com orientação, com a ponta diamantada esférica posicionada paralelamente ao longo eixo do dente (Grupo B - Técnica Modificada). Resultado: Os resultados demonstraram que 90% dos participantes consideraram a Técnica Modificada como a de menor risco de acidentes e, ainda, de mais fácil localização da câmara pulpar. Houve diferença estatística tanto para a medida da área total de desgaste quanto para a largura, enquanto na altura não houve diferença estatística. Conclusão: Os dados preliminares coletados pelo questionário se mostraram satisfatórios para a Técnica Modificada. Estatisticamente, apresentou diferença favorável em relação à área de desgaste e largura, já em altura não houve diferença estatística.

The influence of the retention feature in artificial teeth on its attachment to the thermoplastic resin denture base / Influência da forma de retenção em dentes artificiais de resina acrílica na fixação na base de prótese termoplástica

Objective: Teeth play a crucial role in masticatory efficiency and esthetic harmony making rehabilitation of partially edentulous patients a challenge because of the limitations of conventional removable partial dentures. As a therapeutic alternative, thermoplastic polymers are used in current dental practice either for practical processing purposes or aesthetics. However, it is recognized that the bond between acrylic resin artificial teeth and thermoplastic polymers has no chemical interaction, and depends on retentive features added to the teeth. This study analyzed the efficacy of two retentive forms of features through compressive strength test and as a secondary outcome, fracture and displacement resistance test. Material and Methods: Three groups of samples each with 14 sets of acrylic teeth were compared when two retentive features, single hole and groove retention, and a control group with teeth without any specific form. The experimental unit consisted of six maxillary anterior teeth, positioned in a linear pattern into a polypropylene block, where each tooth was submitted to a static load until its removal, on a universal testing machine. Results: Those specimens with a groove retention presented larger resistance to displacement when compared to the other groups (p <0.05). This was emphasized by the fracture of the tooth tested, with part of the cervical portion remaining embed in the base, and not its displacement as with (or without) the retentive feature. Conclusion: In this study, the type of retention influenced significantly to a better retention considering teeth and thermoplastic polymer base. The data in this study indicates that a groove placed on the artificial tooth offers significantly better retention efficacy to the point where the displacement was only possible after its fracture (AU)

Objetivo: Os dentes são um fator essencial na eficiência mastigatória. A harmonia estética e a reabilitação dos indivíduos parcialmente dentados tornam-se um desafio, frente às limitações das próteses parciais removíveis convencionais. Como uma alternativa terapêutica, os polímeros termoplásticos são utilizados na odontologia contemporânea, tanto para o seu processamento prático como seu apelo estético. Entretanto, pouco se sabe a respeito da união entre a resina acrílica de dentes artificiais e resinas termoplásticas, assim como a influência dos mecanismos de retenção, uma vez que não há interação química entre eles. O objetivo deste estudo foi analisar duas formas de retenção de dentes de resina acrílica a bases de prótese de material termoplástico, por força compressiva e como desfecho secundário, teste de resistência a fratura e deslocamento dos dentes artificiais. Material e Métodos: O presente estudo analisou dois tipos diferentes de retenções: uma cavidade com único ponto e uma canaleta de mesial a distal; e como grupo controle, dentes colocados sem qualquer recurso específico. A unidade experimental consistiu de seis dentes superiores anteriores, posicionados em linha em um bloco de polipropileno. Em cada dente artificial foi aplicada força até a sua remoção, em uma máquina universal de ensaios. Resultados: Os resultados mostraram que a retenção com canaleta apresentou maior força de deslocamento, quando comparado com os outros grupos (p <0,05). Tal fato foi evidenciado pelo teste de fratura e deslocamento, no qual parte da porção cervical do dente artificial permaneceu unida à base, não ocorrendo o deslocamento com (ou sem) a retenção. Conclusão: Neste estudo, o tipo de retenção influenciou de forma significante a retenção de dentes artificiais de resina acrílica a bases de prótese termoplásticas. Os dados deste estudo indicam que a confecção da retenção em canaleta nos dentes artificiais oferece significante aumento na eficiência da retenção, ao ponto em que o deslocamento do dente ocorreu somente após sua fratura (AU).

Avaliação qualitativa de dentes artificiais de resina acrílica após escovação simulada / Qualitative evaluation of artificial acrylic resin teeth after simulated brushing

Introdução: os dentes artificiais de resina acrílica são amplamente utilizados na confecção de próteses, por apresentarem propriedades físicas, mecânicas e biológicas, além de características de fácil manuseio. No entanto, devido sua característica de baixa resistência à abrasão, a escovação pode levar à perda de massa dos dentes artificiais e aumento da rugosidade. Objetivo: avaliar de forma qualitativa a rugosidade superficial e polimento de dentes artificiais das marcas Hereaus Premium; Trilux e Vita, após período de 1 ano de escovação, com fotografias em Lupa Estereoscópica. Metodologia: para a realização deste estudo, serão utilizados 10 dentes artificiais de cada marca comercial (Trilux, Vita e Hereaus Premium). Os dentes serão fixados com resina ortoftálica em tubo de PVC de 15 mm de espessura. Para o teste de abrasão, será usada uma máquina de escovação simulada com escovas de dentes de cerdas macias e solução de pasta de dente. As imagens serão obtidas com câmera digital acoplada a lupa estereoscópica. A rugosidade superficial e o polimento serão analisados antes da escovação simulada e após 12 meses de escovação através das imagens. Resultados: após o teste de abrasão foi observado a presença de um desgaste superficial e/ou ranhuras na superfície dos dentes artificiais em todos os grupos. Porém não houve um padrão similar entre os corpos de prova de um mesmo grupo. Conclusão: Pode-se concluir que a escovação provocou o aumento da rugosidade superficial e alteração no polimento em todos os dentes artificiais utilizados.

Introduction: acrylic resin artificial teeth are widely used in the manufacture of dentures, as they have physical, mechanical and biological properties, in addition to easy handling characteristics. However, due to its characteristic of low abrasion resistance, brushing can lead to loss of mass of artificial teeth and increase in roughness. Objective: qualitatively evaluate the surface roughness and polishing of artificial teeth of Hereaus Premium brands; Trilux and Vita, after a 1-year brushing period, with photographs using a Stereoscopic Magnifying Glass. Methodology: for this study, 10 artificial teeth of each commercial brand will be used (Trilux, Vita and Hereaus Premium). Teeth will be fixed with orthophthalic resin in a 15 mm thick PVC tube. For the abrasion test, a simulated brushing machine with soft bristle toothbrushes and toothpaste solution will be used. Images will be obtained with a digital camera coupled to a stereoscopic magnifying glass. Surface roughness and polishing will be analyzed before simulated brushing and after 12 months of brushing through the images. Results: after the abrasion test, the presence of surface wear and/ or grooves on the surface of the artificial teeth was observed in all groups. However, there was no similar pattern between the specimens of the same group. Conclusion: it can be concluded that brushing caused an increase in surface roughness and change in polishing in all artificial teeth used.

Morphometric evaluation of multirooted artificial teeth used for endodontic training / Avaliação morfométrica de dentes artificiais polirradiculares utilizados para treinamento endodôntico

Introduction Dental practice professionals encounter several urgency cases, mainly related to endodontic problems. To attend to these, professionals need extensive prior preclinical training, being one of the main difficulties the search for models that simulate dental morphology. Aim To compare the external morphometry of multirooted artificial teeth to literature. Material and method The artificial teeth (Upper First Premolar, Upper First Molar and Lower First Molar) were donated by the manufacturers: Fábrica de Sorrisos (FS) and IM do Brasil LTDA (IM), totaling 30 teeth. The total length of the tooth and root, height and buccal-palatal and mesial-distal dimensions of the crown were measured with a digital pachymeter. The data were placed in a spreadsheet and the statistical analysis was performed [ANOVA or Kruskal-Wallis and then, Dunnett's test (α=5%)]. Result The Upper Molar samples of the company Fábrica de Sorrisos presented all variables within the morphometric patterns described in the literature. The other dental groups presented statistically significant differences, maintaining or not a certain proportionality. Conclusion Of all the dental groups analyzed, the upper molar from the company Fábrica de Sorrisos was the only one that presented all the external morphometric aspects according to literature.

Introdução Dentro da prática odontológica, os profissionais podem receber diversos casos de urgência, principalmente relacionados a problemas endodônticos e, para atendê-los, há a necessidade de um extenso treinamento pré-clínico prévio, sendo uma das principais dificuldades a busca por modelos que simulem a morfologia dentária. Objetivo Comparar a morfometria de dentes artificiais polirradiculares à literatura. Material e método Os dentes artificiais (Primeiro Pré-molar Superior, Primeiro Molar Superior e Primeiro Molar Inferior) foram doados pelos fabricantes: Fábrica de Sorrisos (FS) e IM do Brasil Ltda. (IM), totalizando 30 dentes. Foi realizada mensuração do comprimento total do dente e o da raiz, da altura e das dimensões vestíbulo-palatina e mésio-distal da coroa, com paquímetro digital. Os dados foram dispostos em uma planilha de cálculo e realizou-se a análise estatística [ANOVA ou Kruskal-Wallis e, após, teste de Dunnett (α=5%)]. Resultado A amostra de molares superiores da empresa FS apresentou todas as variáveis dentro dos padrões morfométricos descritos na literatura. Os demais grupos dentários apresentaram diferenças estatisticamente significantes, mantendo ou não certa proporcionalidade. Conclusão De todos os grupos dentários pesquisados o molar superior da empresa FS foi o único que apresentou todos os aspectos morfométricos externos de acordo com os dados da literatura.

Avaliação de dentes monorradiculares artificiais utilizados para treinamento endodôntico / Evaluation of artificial monoradicular teeth used for endodontic training

Introdução: É desafio do ensino pré-clínico em Endodontia fornecer aos alunos dentes artificiais que reproduzam a morfologia dos dentes humanos. Objetivo: Comparar a morfologia interna e externa de dentes artificiais monorradiculares com dados da literatura sobre dentes humanos. Material e método: Os dentes artificiais foram doados pelos fabricantes: Fábrica de Sorrisos, empresa A, (n=20), e IM do Brasil Ltda., empresa B, (n=20). Foi realizada mensuração do comprimento total do dente e da raiz, da altura, das dimensões vestibulopalatina e mesiodistal da coroa, com paquímetro digital. A descrição morfológica das raízes, coroas e câmaras pulpares foi realizada. A localização topográfica do forame apical principal foi avaliada após exploração dos canais com instrumento endodôntico tipo K #15 até este atingir visualmente o ápice radicular. Os dados foram dispostos em uma planilha de cálculo e realizou-se a análise estatística [ANOVA e pós-teste de Tukey (α=5%)]. Resultado: A amostra de caninos superiores da empresa B apresentou todas as variáveis dentro dos padrões morfométricos descritos na literatura. Em relação às morfologias interna e externa, a amostra de incisivos laterais superiores da empresa A foi a única a apresentar todas as variáveis dentro dos padrões descritos na literatura. Em relação à localização topográfica foraminal, os dentes da empresa A, assim como o canino inferior da empresa B, apresentaram tendência à posição distalizada e centralizada, vindo ao encontro da literatura. Conclusão: Nenhum dente artificial estudado apresentou total similaridade morfológica e morfométrica com a literatura analisada, diferindo em pelo menos uma das variáveis, sendo indicada aos fabricantes uma revisão dos seus modelos.

Introduction: It is a challenge of pre-clinical teaching in Endodontics to provide students with artificial teeth that reproduce the internal and external morphology of human teeth. Objective: To compare the internal and external morphology of single-rooted artificial teeth with data from the literature on human teeth. Material and method: The artificial teeth were donated from two companies: Fábrica de Sorrisos, company A, (n=20) and IM do Brasil Ltda, company B (n=20). Measurement of total tooth length, root, height, buccal-palatal and mesio-distal crown dimensions with digital caliper was performed. The morphological description of the roots, crown and pulp chamber was performed, the last one only after access. The topographic location of the main apical foramen was evaluated after canal exploration with a K #15 endodontic instrument until it visually reached the root apex. The data were arranged in a spreadsheet and statistical analysis was performed (ANOVA, followed by the Tukey post-test (α=5%)). Result: Regarding the morphometric parameters, the upper canine sample from company B presented all variables within the standards described in the literature. Regarding internal and external morphology, the sample of upper lateral incisors from Company A was the only one to present all variables within the standards described in the literature. Regarding the foraminal topographic location, the teeth of Company A, as well as the lower canine of company B, showed a tendency to the distalized and centralized position, in line with the literature. Conclusion: none of the artificial teeth studied showed total morphological and morphometric similarity with the control, differing in at least one of the variables, and a review of their models is indicated to the manufacturers.

In Vitro Effect of Acidic Challenges on the Physical Properties of Dental Prosthesis Artificial Teeth

Abstract Objective: To evaluate the effect of immersion and acid challenge with cola drink on color change (ΔE), Vickers hardness (VHN) and surface roughness (Ra) of artificial acrylic resin teeth. Material and Methods: The artificial teeth were divided into 6 groups (n= 8): TC (Trilux/Control), BC (Biotone/Control), TAC (Trilux/Acid challenge), BAC (Biotone/Acid challenge), TI (Trilux/Immersion) and BI (Biotone/Immersion). The teeth were embedded in acrylic resin and the labial side was serially polished to provide appropriate flat surface. The samples of TC, BC, TI, BI groups were immersed in artificial saliva and cola drink (coke) for 7 days, respectively. The acid challenge was performed with immersion of samples in coke for 5 min, and subsequently immersion in artificial saliva for 2h. This cycle was repeated at 4 times/day, during 7 days. The tests of VHN, ΔE and Ra were analyzed before and after the challenge and immersion groups. Data was analyzed by ANOVA, Tukey and T test (α = 0.05). Results: There was no difference in Ra values between groups after treatments. However, there was a decrease in VHN for all groups. BI (19.2 ± 0.3) presented significantly lower hardness than BAC (19.5 ± 0.9) and BC (20.2 ± 0.5). Groups BI (2.18 ± 0.41) and TI (1.50 ± 0.43) had statistically higher ΔE compared to the other groups. Conclusion: The hardness of resin teeth decreased after acid challenges, but the roughness surface was not affected. The color was more affected by the times of exposure in cola beverage and remineralization in artificial saliva, which were associated to the material degradation (AU).

The treatment of an edentulous patient with conventional complete denture and CAD/CAM complete denture / 대한치과보철학회지

In patients with fully edentulous jaw, treatment of complete dentures should be carried out in many stages when following the conventional methods. Therefore there were disadvantages such as multiple visits to dental clinic is inevitable. In addition, errors caused by polymerization shrinkage, which happens during the fabrication of denture, and difficulties in reproduction of damaged or lost denture were considered as disadvantages. But nowadays, computer-aided design and computer-aided manufacturing (CAD/CAM) system is widely used in dentistry and it has begun to expand its spectrum in manufacturing complete dentures. Using CAD/CAM system to fabricate complete dentures can reduce the number of patient's visit and clinical chair time, since taking impression, recording jaw relation, and selection of artificial teeth are performed at the same time during the first visit, and delivering of dentures during the second visit is possible. In addition, because 3D-Printing technology is used, errors by polymerization shrinkage can be reduced. Among the companies that fabricate complete dentures using CAD/CAM system, DENTCA CAD/CAM denture (DENTCA Inc., Los Angeles, CA, USA) is the most commercialized company. In this case, we treated patients of complete dentures using conventional complete denture method and DENTCA CAD/CAM denture system in the same patient. We would like to report this case because we have achieved good results not only in functional aspects of pronunciation, chewing, and swallowing but also in aesthetic aspects.

Color Stability of Acrylic Resin Teeth After Immersion in Staining Solutions / Análisis del Cambio de Color de Dientes Artificiales Tras Inmersión en Soluciones Colorantes

ABSTRACT: The objective of this study was to evaluate the color alteration of four brands of artificial teeth (Art Plus, Trilux, Bionote and Biolux), after immersion in color solutions of coffee, red wine and urucum. We used 80 artificial teeth, which were standardized with 2 mm thickness. Then, they were subjected to finishing and polishing, and divided into 4 groups (n = 05), which were immersed in one of the 3 types of dye, plus distilled water (control). The samples were immersed daily for 4 hours, then they were removed, washed in tap water, dried with absorbent paper and immersed in distilled water for the subsequent hours in a biological glasshouse at 37 ºC, for 21 days. The evaluation of the color change was made in the periods of 0, 7, 14 and 21 days, by means of the tristimulus colorimeter. The data were subjected to the ANOVA and Tukey test with a 5 % significance. The results showed that the urucum was the substance that caused the greatest staining while the coffee and the wine did not show statistical difference. Regarding trademarks, Trilux presented a statistical difference compared to the other commercial brands, revealing colorimetric alteration only in the 14-day period. It was concluded that the composition of the artificial teeth, the type of pigmenting agent and the immersion time determine the color change.

RESUMEN: El objetivo de este estudio fue evaluar la alteración de color de cuatro marcas de dientes artificiales (Art Plus, Trilux, Bionote y Biolux), después de inmersión en soluciones colorantes de café, vino tinto y urucum. Se utilizaron 80 dientes artificiales, los cuales fueron estandarizados con 2 mm de espesor. En seguida, los mismos fueron sometidos al acabado y pulido, y divididos en 4 grupos (n = 5), los cuales fueron inmersos en uno de los 3 tipos de colorante, más agua destilada (control). Las muestras permanecieron inmersas diariamente durante 4 horas, luego fueron retiradas, lavadas en agua corriente, secas con papel absorbente e inmersas en agua destilada por las horas subsiguientes en invernadero biológico a 37 ºC, por 21 días. La evaluación del cambio de color se realizó en los períodos de 0, 7, 14 y 21 días, por medio del colorímetro tristimulo. Los datos fueron sometidos a la prueba ANOVA y Tukey con un 5 % de significancia. Los resultados demostraron que el urucum fue la sustancia que provocó mayor manchado mientras que el café y el vino no presentaron diferencia estadística. En cuanto a las marcas comerciales, el Trilux presentó una diferencia estadística en comparación con las otras marcas comerciales, revelando alteración colorimétrica sólo en el período de 14 días. Se concluyó que la composición de los dientes artificiales, el tipo de agente pigmentante y el tiempo de inmersión determinan el cambio de color.

Interalveolar ridge crest relation analysis and rehabilitation of edentulous patient using dental CAD software: A case report / 대한치과보철학회지

As the number of elderly population increases, the proportion of edentulous patients is increasing, and the demand for traditional dentures will also increase. Arranging the artificial teeth according to the relationship and shape of the upper and lower alveolar ridge is an important factor increasing the stability of the denture. This case is a 79 year old female patient who wishes to make denture covered by national health insurance for psychological and economical reasons. With the alveolar bone severely atrophic, the dental CAD software was used for accurate diagnosis and the posterior teeth were arranged in a cross bite according to the interalveolar crest line angle by the program. After completion, the denture showed adequate stability and maintenance in periodic examinations and treatment, and the patient also expressed high satisfaction.

Radiopacidade de dentes artificiais para treinamento pré-clínico de endodontia / Artificial tooth radiopacity for preclinical endodontic training

Resumo Introdução Dentes artificiais têm sido utilizados para a prática odontológica e, segundo seus fabricantes, apresentam muita similaridade aos dentes humanos para treinamento. Objetivo Avaliar a radiopacidade de dentes endodônticos artificiais para uso em atividades de ensino e saber a percepção de docentes quanto à análise radiográfica. Material e método Trinta réplicas de incisivos centrais superiores de três marcas comerciais (Fábrica de Sorrisos, IM do Brasil e Real Dent) e um incisivo humano foram utilizados. Foram dispostos sobre um sensor radiográfico o dente humano e um dente artificial de cada empresa. As análises de radiopacidade foram feitas no programa Photoshop® em triplicata em quatro regiões distintas: porção central da coroa e nos terços cervical, médio e apical do canal. A percepção quanto à utilização dos dentes como instrumento prático de ensino foi avaliada por meio de um questionário aplicado a oito professores de endodontia. Para análise estatística dos valores de radiopacidade, foi utilizada a ANOVA, seguida do teste de Tukey. Foi empregado um nível de significância de 5%. Para análise do questionário, foram empregados métodos descritivos e por porcentagem de dados no que se refere à frequência das respostas. Resultado Houve diferença de radiopacidade entre os diferentes dentes testados em cada região analisada (p > 0,05). Na percepção dos professores com relação à utilização dos dentes no ensino, eles colocaram em ordem crescente os seguintes dentes para uso: IM do Brasil, Fábrica de Sorrisos, Real Dent e humano. Conclusão A radiopacidade dos dentes artificiais foi diferente do humano. O dente artificial da Fábrica de Sorrisos apresentou os maiores valores de radiopacidade. Contudo, os professores consideraram ideais para utilização no ensino apenas o dente humano e o dente da Real Dent.

Abstract Introduction Artificial teeth have been used for dental practice which, acoording to their manufactures, bear much similarity to human teeth for training. Objective To evaluate radiopacity of artificial endodontic teeth for use in teaching activities and to know the perception of teachers regarding radiographic analysis. Material and method Thirty replicates of upper central incisors of three trade marks (Fábrica de Sorrisos, IM do Brasil and Real Dent) and a human incisor were used. On a radiographic sensor, human tooth and one artificial tooth of each marks were arranged. Radiopacity analyzes were performed using Photoshop® in triplicate in four distinct regions: central portion of the crown and in the cervical, middle and apical thirds of the canal. The perception about the use of teeth as a practical teaching instrument was evaluated through a questionnaire applied to eight teachers of Endodontics. For statistical analysis of the radiopacity values ​​ANOVA was used, followed by the Tukey test. Significance level of 5%. For the analysis of the questionnaire were used descriptive methods and percentage of data regarding the frequency of responses. Result There was a difference in radiopacity between the different teeth tested, in each region analyzed (P > 0.05). In the teachers' perception regarding the use of teeth in teaching, the teachers placed the following teeth for use: IM do Brasil, Fábrica de Sorrisos, Real Dent and human. Conclusion The radiopacity of the artificial teeth was different from the human teeth. The artificial tooth of the Fábrica de Sorrisos presented the highest values ​​of radiopacity. The teachers considered ideal for use in teaching only the human teeth and the prototype Real Dent.

Efeito de diferentes soluções irrigadoras na microdureza superficial Knoop de dentes artificiais / Effect of different irrigation solutions on the Knoop surface microhardness of artificial teeth

Resumo Introdução Dentes artificiais têm sido empregados para a prática de ensino pré-clínico. Porém, não se sabe o comportamento dos mesmos frente aos diferentes procedimentos realizados durante um tratamento endodôntico simulado. Objetivo Avaliar a microdureza de réplicas de dentes humanos, frente a diferentes soluções irrigadoras. Material e método Quarenta e cinco incisivos centrais superiores artificiais de três marcas comerciais nacionais (dentes "A", "B" e "C") e 15 incisivos humanos foram utilizados. As amostras foram seccionadas a 5 mm do ápice dentário. Os fragmentos radiculares foram fixados em resina para posterior teste de microdureza. Os ensaios da microdureza Knoop foram realizados em dois momentos: momento 1 - microdureza inicial; momento 2 - microdureza final, que foi feita após o uso das soluções irrigadoras (Cloreto de Sódio a 0,9%, Hipoclorito de Sódio a 2,5% e Gluconato de Clorexidina a 2%). As endentações deixadas na superfície da amostra foram mensuradas. O valor obtido para microdureza de cada amostra foi feita com base na média de três endentações. Para análise estatística, foram utilizados os testes ANOVA e Teste t pareado, com nível de significância de 5%. Resultado Os dentes artificiais "A" e "C" apresentaram valores inferiores de microdureza quando comparados ao dente humano (P = 0,05). Não houve diferença estatística entre os dentes artificiais "B" e o dente humano (P = 0,2428). Quanto ao uso das diferentes soluções irrigadoras, também não houve diferença na microdureza das peças dentárias. Conclusão Embora a solução irrigadora não tenha influenciado a microdureza, os dentes artificiais apresentaram valores de dureza inferiores aos do dente humano.

Abstract Introduction Artificial teeth have been used for preclinical teaching practice. However, the behavior of the same is not known in relation to the different procedures performed during a simulated endodontic treatment. Objective To evaluate the microhardness of replicates of human teeth, in front of different irrigating solutions. Material and method Forty-five artificial upper central incisors of three national trade marks (teeth "A", "B" and "C") and fifteen human incisors were used. Samples were sectioned 5 mm from the apex. The root fragments were fixed in resin for later microhardness test. The Knoop microhardness tests were performed in two moments: moment 1 - initial microhardness; moment 2 - final microhardness, which was done after the use of the irrigating solutions (0.9% sodium chloride, 2.5% sodium hypochlorite and 2% chlorhexidine gluconate). The indentations left on the sample surface were measured. The obtained value for microhardness of each sample was made based on the average of three indentations. ANOVA and Paired t-test were used for statistical analysis. Significance level of 5%. Result Artificial teeth "A" and "C" presented lower values ​​of microhardness when compared to human teeth (P = 0.05). There was no statistical difference between the artificial teeth "B" for the human (P = 0.2428). Regarding the use of different irrigation solutions, there was also no difference in the microhardness of dental pieces. Conclusion Although the irrigating solution did not influence the microhardness, the artificial teeth presented values ​​of hardness inferior to the human tooth.

Rehabilitation with implant-supported fixed dental prostheses using digital duplication technique on customized artificial tooth, interim denture and implant surgical template: A case report / 대한치과보철학회지

Bone and soft tissue conditions are important for successful implant treatment. But, the placement itself is also very important. Implants which is installed in the wrong position result in the biological, esthetical and mechanical problems. In order to place an implant in the correct position, the final restoration and diagnostic wax-up should be considered prior to the surgery. If the artificial teeth for the interim denture are directly transferred from the diagnostic wax-up, the operator can try the form of diagnostic wax-up in the mouth. If the surgical template is produced by duplicating the interim denture, the implant can be placed in the planned position. In this case, the polymethyl methacrylate (PMMA) artificial tooth was precisely milled by the digital duplication of diagnostic wax-up. And interim denture was fabricated by using these milled teeth. After the patient adapted for a sufficient period, the implant was placed at the planned position with surgical template produced by duplicating the interim denture. After confirming sufficient osseointegration, the final prostheses were made to reflect the shape of diagnostic wax-up. Through this procedure, the satisfactory functional and esthetic outcome could be acquired.

Functional impression technique using temporary denture for rehabilitation of severely atrophic maxillary and mandibular ridges / 대한치과보철학회지

Soft liner is used to functional impression technique when dental stone is immediately poured after taking impression because of viscoelasticity. In this case, a 78-year-old male visited for new dentures. Due to severe resorption of mandibular edentulous ridge, functional impression taking by closed mouth technique was planned. First of all, making maxillary and mandibular provisional dentures was done, and lined by soft liner to rehabilitate pressured maxillary and mandibular edentulous ridge. After this, Functional impression was taken by closed mouth technique using provisional dentures which are transformed to healed maxillary and mandibular edentulous ridge, and final denture were fabricated using maxillary provisional denture as a reference of artificial teeth arrangement. Consequently, restoring a complete edentulous patient with taking functional impression using provisional dentures resulted in recovering satisfying retention and function.

Use of digital scan data for evaluation of edentulous ridge relationship: A case report for removable prosthesis with unilateral cross bite / 대한치과보철학회지

After the teeth were extracted, maxillary and mandibular alveolar ridges show the opposite resorption pattern and as a result, the mandibular arch is enlarged than maxillary arch relatively. In this situation, we should evaluate both alveolar ridge relationship and arrange the artificial teeth properly for stability of removable prosthesis. This case is a 77 years old male patient who wishes to make removable prosthesis and has atrophic alveolar ridge. By use of model scanner and CAD software, the angle between interalveolar crest line and occlusal plane was easily measured. Depending on the measurement, the artificial teeth are arranged in unilateral cross bite and after completion, patient was satisfied with the denture which showed proper stability, retention, support.

Comparative analysis of stress distribution in different prosthetic solutions for Kennedy class I bilateral posterior edentulous arches / Análise comparativa da distribuição de tensão em diferentes soluções protéticas para desdentado posterior bilateral "classe I de Kennedy"

One of greatest challenges of dentists is the rehabilitation of free-end Kennedy class I and class II patients due to the improper occurrence of stress around the supporting structures of conventional removable dentures during mastication. This work aimed to compare the stress distribution in different prosthetic solutions. For this analysis, four photoelastic models (PM) were produced simulating a Kennedy class I arch with the remaining teeth 34 through 44. In all models, teeth 33, 34, 43, and 44 received metal crowns. In addition to the crowns, the A model (PMA) received a conventional removable partial denture (RPD), the B model (PMB) received a RPD associated with a semi-rigid attachment, the C model (PMC) received a RPD associated with a rigid attachment, and the D model (PMD) received a RPD associated with implant and rigid attachment. Evenly distributed loads were applied on the last artificial tooth of the prostheses. Based on the results of the distributed load, the conventional prosthesis presented the best results for all regions (averages ranging from 25.70 to 17.80), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment, and lastly, the prosthesis associated with the semi-rigid attachment. The same result can be observed in the localized load, where the conventional prosthesis presented superior results in all regions (averages ranging from 47.35 to 8.30), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment and, with the prosthesis associated with the semi-rigid attachment. Based on the data obtained, it may be concluded that the conventional RPD presented a balanced stress distribution in the three regions analyzed, and when associated with the semi-rigid attachment, it presented a more favorable behavior than that associated with the rigid attachment.

Um dos maiores desafios para os cirurgiões-dentistas consiste na reabilitação de pacientes com extremidade livre classe I e classe II de Kennedy, devido à ocorrência inadequada de tensão em torno das estruturas de suporte das próteses removíveis convencionais durante o processo da mastigação. O objetivo deste trabalho foi analisar comparativamente a distribuição de tensão em diferentes soluções protéticas. Para essa análise, foram confeccionados quatro Modelos Fotoelásticos (MF) simulando um arco classe I de Kennedy, e tendo como dentes remanescentes do dente 34 ao 44. Em todos os modelos, os dentes 33, 34, 43 e 44 receberam coroas metálicas. Além das coroas, o modelo A (MFA) recebeu uma Prótese Parcial Removível (PPR) convencional, o modelo B (MFB) recebeu uma PPR associada a encaixe semirrígido, o modelo C (MFC) recebeu uma PPR associada a encaixe rígido e o modelo D (MFD) recebeu uma PPR associada a implante e encaixe rígido. Foram aplicadas cargas uniformemente distribuídas e localizadas no último dente artificial das próteses. Baseado nos resultados da carga distribuída, a prótese convencional apresentou os melhores resultados para todas as regiões (médias variando entre 25,70 e 17,80), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. O mesmo resultado pode ser observado na carga localizada, onde a prótese convencional apresentou resultados superiores em todas as regiões (médias variando entre 47,35 e 8,30), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. Baseado nos dados obtidos pôde-se concluir que a PPR convencional apresentou uma distribuição equilibrada de tensões nas três regiões analisadas e, quando associado à fixação semi-rígida, apresentou um comportamento mais favorável do que aquele associado à fixação rígida.

A case of removable dentures using digital method / 대한치과보철학회지

Generally dentures are manufactured by conventional method, however the frequency of fabricating denture using digital method is increasing due to the recent development of digital technology in dentistry. The digital method of manufacturing denture is classified into two systems; 3D scan of the impression to arrange the artificial teeth on the CAD (Computer-aided design) and 3D printing to produce the resin-based complete denture, or 3D scan of the model to design of the framework using CAD, resin pattern formation by 3D printing and casting of metal framework of complete denture or removable partial denture. In this case report, electronic surveying and design the metal framework of the dentures were performed using CAD program, and plastic resin patterns fabricated by 3D printing were casted for upper full denture and lower removable partial denture. During follow-up periods, dentures using digital method have provided satisfactory results esthetically and functionally.

Complete denture artificial teeth arrangement deformation in wax denture after festooning: deformation over time

PURPOSE: The purpose of this study was to evaluate the deformation of the complete denture artificial teeth arrangement after festooning over time. MATERIALS AND METHODS: 10 wax dentures of equal teeth arrangement and equal gingival contour were used in this study. Festooning of the wax dentures were conducted and 3D model scans were conducted every 10 minutes for 120 minutes. Interdental transverse distances were measured with the scanned images. Statistical analyses were performed with SPSS Ver. 22. 0. RESULTS: Interdental transverse distance between teeth varied from 0.0999 mm to 0.1787 mm. Mean rate of deformation showed statistically significant change between the 40 – 50 minute interval and 50 – 60 minute interval and between the 50 – 60 minute interval and 60 – 70 minute interval. No statistically significant change of the mean rate of deformation was observed later on. CONCLUSION: Monitoring of the interdental transverse distance for 120 minute after festooning have shown the deformation and displacment of the artificial teeth arrangement. From after the 60 – 70 minute interval after festooning, the mean deformation showed no statistically significant change of the mean rate of deformation was observed. Within the limitations of this in vitro study results suggest that the final occlusal adjustment in wax denture before complete denture curing should be proceeded at least 60 minutes later after festooning.

Neutral zone approach and external impression for rehabilitation of severely atrophic maxillary and mandibular ridges: a case report

In order to produce a stable denture for severe alveolar bone loss area, it is not only important that .0a suitable occlusion is established but also to consider compatibility with the surrounding muscle to form a suitable polished surfaces. Neutral zone is defined as a potential area where the neuromuscular system of the tongue, cheeks and lips is balanced can be determined through the neutral zone impression technique. And if artificial teeth are aligned within the neutral zone and the polished surface follows the anatomical form of the dynamic muscle, higher stability and retention of the denture may be obtained through coordination with the surrounding muscle tissue. This case is being reported since the concept of the neutral zone was applied to a patient with severely atrophic residual alveolar ridge and the result was clinically satisfactory in both function and aesthetics.

Neutral zone approach and external impression for rehabilitation of macroglossia: a case report

Macroglossia is an obstacle in regard to general prosthodontic restoration. Not only is it difficult to obtain support and stability from dentures manufactured from normal protocol, obtaining efficacy from basic mastication is also difficult. In such cases, realizing harmony between the occlusion and surrounding muscle structures may be important with regard to manufacture of stable full dentures, and it is necessary to form the appropriate polished surface for this case. The neutral zone is defined as the potential area resulting from the neuromuscular function that results in equilibrium between the outward force exerted by the tongue and the inward force exerted by the lips and cheeks. The artificial teeth of the full denture lies in this area, and if the polished zone follows the anatomic form of the dynamic muscles, the movement of the muscles simply acts as an element of stabilizing the dentures improving the esthetics through facial support.

Implant hybrid prosthetic treatment in Down syndrome patient: a case report

Down syndrome patients generally have poor oral hygiene due to lack of awareness and ability to perform oral care, and there is a high risk of tooth loss. Also, they are characterized by small and irregular teeth and oligodontia, which makes it difficult to do prosthetic treatment. This article reports a case of implant hybrid prosthesis treatment of maxillary edentulous area in Down syndrome patient. The external shape of the final prosthesis was determined by using the mandibular artificial teeth to reflect the oligodontia of the mandible and the pontic areas were adjusted to facilitate oral hygiene care. As a result, aesthetically and functionally satisfactory results were obtained.