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1.
Braz. j. oral sci ; 21: e225991, jan.-dez. 2022. tab
Article in English | LILACS, BBO | ID: biblio-1354992

ABSTRACT

Aim: A retrospective, cross-sectional study was carried out to evaluate the performance of resin composite restorations placed by undergraduate dental students with 1 to 15 years of placement based on dental records. Methods: Four calibrated operators evaluated 498 restorations (anterior and posterior) of 120 patients according to Ryge's validated criteria (USPHS). Results: The criteria that showed the smallest changes between the types of failures were color matching, marginal discoloration and surface texture. Regarding the longevity, the surface texture showed an increase in the frequency of failures from the second time interval (3.1 to 6 years). Higher prevalence of failure was found in class II and III restorations, with secondary caries being the main reason. No significant differences were found for anatomic form, marginal adaptation, and color matching. Class V restorations showed a higher fracture rate with total displacement of the restoration, with no increase in the frequency of fracture over time. Conclusion: High rate of restoration failure was observed, possibly due to the lack of experience and skills of the students. This outcome highlight the need for continuous revision and improvements of teaching practice regarding the development of clinical competences and skills by dental students


Subject(s)
Humans , Male , Female , Composite Resins , Dental Restoration Failure , Dental Restoration, Permanent
2.
Rev. Asoc. Odontol. Argent ; 109(3): 149-157, dic. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1370323

ABSTRACT

Objetivo: Describir las fallas en diferentes sistemas de implantes al ser sometidos a fuerzas de torsión creciente, de- terminar el torque en el cual aparece un daño medible en el implante o alguno de sus componentes y especificar la falla más frecuente. Materiales y métodos: Se realizó un estudio experi- mental in vitro. Se utilizaron 88 implantes agrupados según diseño y marca comercial (Federa, Rosterdent, Biomet 3i, Tree-Oss, B&W, ML) en 11 grupos de 8 implantes cada uno. Éstos fueron inmovilizados en acrílico y fijados en una pren- sa. Se aplicó una fuerza de torsión creciente con torquímetro de precisión digital hasta la aparición de alguna falla en el implante o sus componentes. Se registró el torque en el que se produjo la falla. Se realizó estadística descriptiva para el análisis de datos. Resultados: El 100% de los implantes o alguno de sus componentes mostraron una falla detectable al ser sometidos a fuerzas de torsión creciente (rango de torque: 83,5 Ncm ­im- plante con conexión cono morse 8 grados­ a 384 Ncm ­implan- te de conexión interna sin montar­). El torque promedio más bajo en el que aparecieron los daños fue 103,75 (±8,08) Ncm para implantes de conexión interna tipo cono morse, mientras que el más alto fue 279,87 (±89,73) Ncm para implantes de conexión interna sin montar. La falla más frecuente (28,4%) fue la fractura del tornillo del portaimplante y falseo del hexá- gono externo simultáneamente. Conclusión: Las fallas detectables a fuerzas de torsión creciente ocurrieron entre 83,5 Ncm y 384 Ncm. La falla rei-terada fue la fractura del tornillo del portaimplante y falseo del hexágono simultáneamente (AU)


Aim: To describe the failures in different implant sys- tems when subjected to increasing torsional forces, deter- mine the torque at which measurable damage occurs to the implant or one of its components, and determine the most frequent failure. Materials and methods: This was an experimental in vitro study. A total 88 implants were used, grouped accord- ing to design and trademark (Federa, Rosterdent, Biomet 3i, Tree-Oss, B&W, ML) into 11 groups of 8 implants each. The implants were immobilized in Duralay acrylic and fixed in a vice. Increasing torsional force was applied with a digital pre- cision torque wrench until the occurrence of any failure in the implants or their components. The torque at which the failure occurred was recorded. Descriptive statistics were performed for data analysis. Results: 100% of the implants or any of their compo- nents showed a detectable failure when subjected to increas- ing torsional forces (force range: 83.5 Ncm in an implant with 8-degree Morse taper connection to 384 Ncm in an implant with unmounted internal connection). The lowest average torque at which damage occurred was 103.75 (±8.08) Ncm for conical implants with Morse internal connection, while the highest was 279.87 (±89.73) Ncm for implant with unmounted internal connection. The most frequent failure (28.4%) was fracture of the implant retaining screw and distortion of the external hexagon simultaneously (AU)


Subject(s)
Tensile Strength , Dental Implants , Torque , Torsion, Mechanical , In Vitro Techniques , Epidemiology, Descriptive , Dental Restoration Failure
3.
Rev. ADM ; 78(5): 283-290, sept.-oct. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1348323

ABSTRACT

Los cambios en la vida, así como también en el campo de la Odontología, deben ser para mejorar siempre en todos los aspectos posibles. Y muchos de los cambios recientes en la Odontología Restauradora están encaminados a la utilización de materiales estéticos para remplazo de restauraciones metálicas previas, sin generar certeza total de ser mejores opciones. Esto ha generado un marcado incremento en la tendencia a practicar, más enfáticamente, el remplazo de restauraciones previas (AU)


Changes in life, as so in the field of Dentistry, should always be for the improvement on most possible aspects. Many of the recent changes in Restorative Dentistry are focus on the use of cosmetic materials to replace previous metallic restorations, without total certainty of being better options. This has generated a marked increase in the tendency to practice, more emphatically, the replacement of previous restorations (AU)


Subject(s)
Humans , Male , Female , Dental Restoration Failure , Dental Caries/therapy , Dental Materials , Dental Restoration, Permanent , Recurrence , Metal Ceramic Alloys , Esthetics, Dental , Conservative Treatment
4.
Medisan ; 25(4)2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1340217

ABSTRACT

Introducción: La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una tasa de éxito superior a 89 % en periodos de observación entre 10-15 años; no obstante, el número de implantes continúa incrementándose y, con ello, la prevalencia de enfermedades perimplantarias. Objetivo: Profundizar los conocimientos sobre la enfermedad perimplantaria y los tratamientos existentes. Desarrollo: Como resultado del avance en la rehabilitación, el uso de implantes dentales ha tomado un gran auge en los últimos años y, en particular, en la provincia de Santiago de Cuba; sin embargo, con el uso de esta técnica también se han incremento las complicaciones y los fracasos por múltiples razones. Conclusiones: La enfermedad perimplantaria representa un problema de salud con incidencia creciente, que requiere de un enfoque multidisciplinario, lo que depende de varios principios biológicos que es preciso respetar, tales como el diagnóstico, el plan terapéutico, la ejecución cuidadosa del proceder, el seguimiento posoperatorio y la carga apropiada del implante, que son factores importantes para lograr el resultado deseado.


Introduction: The use of dental implant as method to replace lost teeth has demonstrated to be a treatment with a success rate higher than 89 % in periods of observation between 10-15 years; nevertheless, the number of implants is still increasing and, with it, the prevalence of peri-implantar diseases. Objective: To deepen the knowledge on the peri-implantar disease and the existing treatments. Development: As a result of the advance in rehabilitation, the use of dental implants has taken a great boom in the last years and, in particular, in the province of Santiago de Cuba; however, with the use of this technique the complications and failures have also increased due to multiple reasons. Conclusions: The peri-implantar disease represents a health problem with growing incidence that requires a multidisciplinary approach, what depends on several biological principles that is necessary to respect, such as the diagnosis, the therapeutic plan, the careful implementation of the procedure, the postoperative follow up and the appropriate load of the implant that are important factors to achieve the result desired.


Subject(s)
Dental Implants/adverse effects , Dental Restoration Failure , Stomatitis
5.
Braz. dent. j ; 32(3): 44-55, May-June 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345505

ABSTRACT

Abstract In the RLT (Rapid Layer Technology), veneering ceramic and framework are fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) and then cemented to obtain the restoration. This study aimed to evaluate the effect of the thickness of veneering ceramic manufactured by the RLT technique on the fracture resistance (FR) of bilayer crowns with zirconia frameworks. Twenty zirconia frameworks and twenty feldspathic posterior crowns with two different veneering ceramic occlusal thicknesses (1mm=TF1; 2mm=TF2) were manufactured using CAD/CAM system. The specimens were luted to an epoxy resin abutment with resin cement and mechanically cycled (200N and 4.5×105 Pa, 37°C, 2×106 cycles, 3Hz). The FR test was performed (10kN, 0.5mm/min), and the specimens were analyzed in a stereomicroscope. For the stress analysis (finite element analysis, FEA), a 10kN load was equal to the in vitro test, and the principal stress was evaluated. The FR data were analyzed by Student's t-test and Weibull's analysis. The thickness influenced the FR of bilayer crowns. The FR was higher in the TF2 than in the TF1 group. The TF2 group presented the highest characteristic strength compared to the group TF1. The predominant type of failure was delamination. The FEA showed higher stress concentrations below the loading application point at the veneering cement interface in the 1-mm-thick model. The bilayer crowns manufactured using the approach of 2mm of veneering ceramic promoted higher FR compared to the group with 1mm veneering ceramic. Also, the FEA showed that the veneer ceramic thickness has an effect on stress distribution in zirconia-based bilayer crowns.


Resumo Na RLT (Rapid Layer Technology), a cerâmica de cobertura e infraestrutura são fabricados pelo Computer-Aided Design / Computer-Aided Manufacturing (CAD / CAM) e cimentados para obter a restauração. Este estudo teve como objetivo avaliar o efeito da espessura da cerâmica de cobertura fabricada pela técnica RLT na resistência à fratura (RF) de coroas bilaminadas com infraestrutura de zircônia. Vinte infraestruturas de zircônia e vinte coroas posteriores feldspáticas com duas espessuras oclusais da cerâmica de cobertura (1mm = TF1; 2mm = TF2) foram fabricadas usando o sistema CAD / CAM. Os espécimes foram cimentados em preparos de resina epóxi com cimento resinoso dual e ciclados mecanicamente (200N e 4,5×105 Pa, 37° C, 2×106 ciclos, 3Hz). O teste de RF foi realizado (10kN, 0,5mm / min) e, posteriormente, os espécimes foram analisados em estereomicroscópio. Para a análise de tensão (análise de elementos finitos, FEA), uma carga de 10kN foi aplicada igual ao teste in vitro, e a tensão principal foi avaliada. Os dados de RF foram analisados pelo teste t de Student e análise de Weibull. A espessura mostrou forte influência na RF das coroas bilaminadas. A RF foi maior em TF2 do que no grupo TF1. O grupo TF2 apresentou a maior resistência característica em relação ao grupo TF1. O tipo de falha predominante foi a delaminação. O FEA mostrou maiores concentrações de tensões abaixo do ponto de aplicação da carga, na interface cimento e cerâmica de cobertura no modelo de coroa de 1 mm de espessura. As coroas de bilaminadas confeccionadas com 2 mm de cerâmica de cobertura promoveram maior RF em comparação ao grupo com cerâmica de cobertura de 1 mm. Além disso, a FEA mostrou que a espessura da cerâmica de cobertura tem um efeito na distribuição de tensões em coroas bilaminadas à base de zircônia.


Subject(s)
Humans , Dental Porcelain , Dental Veneers , Technology , Zirconium , Materials Testing , Ceramics , Computer-Aided Design , Dental Restoration Failure , Crowns , Dental Stress Analysis
6.
São José dos Campos; s.n; 20210000. 71 p. ilus., tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1358876

ABSTRACT

Este estudo avaliou influência de diferentes métodos de acabamento de superfície na probabilidade de sobrevivência de restaurações de zircônia translúcida e o potencial de desgaste ao antagonista. Foram utilizados 220 preparos confeccionados em resina epóxi (Nema G10) que receberam restaurações do tipo "table top" de zircônia e dissilicato de lítio (1.0 mm de espessura), 100 em YZ HT, 100 em KATANA UTML e 20 em IPS e.max CAD. Cada grupo de zircônia foi dividido em cinco subgrupos de acordo com o acabamento de superfície: Polimento - borrachas diamantadas com 2 granulações; Glaze - camada de glaze; Polimento e Glaze - polimento e glaze associados; Infiltração com sílica; Infiltração com vidro. As restaurações de dissilicato de lítio receberam uma camada de glaze. Os espécimes foram submetidos à fadiga deslizante em uma máquina de ensaio com carga de 200 N, a uma frequência de 4 Hz, totalizando 1.250.000 ciclos. A cada 416.666 ciclos a máquina foi interrompida e as restaurações foram avaliadas quanto à presença de falhas em estereomicroscópio. O antagonista foi analisado quanto aos parâmetros de desgaste. Foram realizadas análises de rugosidade, microestruturais e fractográfica. Kaplan ­ Meier, Mantel ­ Cox (log-rank) e ANOVA compararam os dados. Não foram observadas diferenças para profundidade de desgaste entre os grupos de zircônia, porém os acabamentos glaze e infiltração de vidro promoveram maior volume de desgaste do que a infiltração de sílica e polimento e glaze. Ambas zircônias promoveram maior profundidade e volume de desgaste ao antagonista do que o dissilicato de lítio. Foi observada diferença na rugosidade entre o tipo de zircônia e os acabamentos de superfície, enquanto que o dissilicato de lítio apresentou rugosidade semelhante as zircônias com glaze. Micrografias (MEV) demonstraram a remoção dos acabamentos de superfície após a fadiga deslizante para todos os grupos. A análise fractográfica demonstrou que as fraturas tiveram início na área de contato oclusal e a análise de cross-section demonstrou que Katana e e.max CAD apresentaram mais defeitos na superfície após a fadiga do que a Vita. A zircônia Vita apresentou maior probabilidade de sobrevivência comparado a Katana e ao dissilicato de lítio. Restaurações de zircônia com os acabamentos polimento+glaze e infiltração de sílica promoveram menor volume de desgaste ao antagonista comparadas as restaurações de zircônia com glaze ou infiltradas com vidro, enquanto o polimento apresentou o mesmo potencial abrasivo de todos os acabamentos. Além disso, a vitrocerâmica apresentou menor potencial de desgaste do antagonista do que ambas as zircônias.


This study evaluated the surface finishes influence on the survival probability of translucent zirconia restorations and also the wear potential against steatite antagonist. 220 epoxy resin (Nema G10) preparations received zirconia and lithium disilicate table top restorations (1.0 mm thickness), 100 milled in YZ HT, 100 in KATANA UTML and 20 in IPS e.max CAD. Each zirconia group was divided into five subgroups according to the surface finish: Polishing (P) 2 granulations diamond rubbers; Glaze (G) glaze layer; Polishing and Glaze (PG) polishing and glaze associated; Silica infiltration (IS); Glass infiltration (IV). The lithium disilicate restorations received a glaze layer (EG). The specimens were submitted to sliding fatigue test in a mechanical machine against steatite sphere. The parameters were: 200 N loads, 4 Hz of frequency, totaling 1,250,000 cycles. Every 416,666 cycles the restorations were evaluated in stereomicroscope for failures presence (cracks, fractures or detachment of the restorations). Roughness, microstructural, fractographic and wear analysis were performed. Kaplan­Meier, Mantel­Cox (log-rank) and ANOVA compared the data. The failure survival was different among the groups. No difference was observed for wear depth among zirconia groups, whereas glaze and glass infiltration promoted greater volume loss than silica infiltration and polishing plus glaze. Both zirconia promoted greater volume loss and wear depth to the antagonist than lithium disilicate. Difference was observed for roughness among the zirconia and surface finishes, while lithium disilicate presented similar roughness compared to both glazed zirconia. Micrographs (SEM) showed the surface finishes removal after sliding fatigue for all groups. Fractographic analysis showed occlusal contact area as fractures origin and the cross-section analysis showed that Katana and e.max CAD presented more surface defects after fatigue than Vita. The Vita restorations presented higher survival probability compared to Katana and lithium disilicate restorations. Zirconia polished+glaze and silica infiltration promoted less antagonist volume loss compared to glazed or glass infiltrated, while polishing had the same wear potential as all finishes. In addition, the glass-ceramic presented less potential to wear the antagonist than both zirconia.


Subject(s)
Ceramics , Dental Prosthesis , Dental Restoration Failure , Dental Restoration Wear , Silica Gel
7.
Braz. dent. j ; 31(6): 650-656, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132343

ABSTRACT

Abstract Patients with a history of cancer are increasingly common in the dental office. Treating cancer patients requires a multidisciplinary team, which should include the dentist, in order to control the complications that occur in the oral cavity and also to recover the patient undergoing treatment in any of its types: surgical, medical, radiotherapeutic, or its possible combinations. Dental implants can be a safe and predictable treatment option for prosthetic rehabilitation. The aim of this paper is to describe in retrospect the success rate of osseointegrated implants in oncology and non-oncology patients placed by the Master of Dentistry in Oncology and Immunocompromised Patients, as well as the Master of Medicine, Surgery and Oral Implantology of the University of Barcelona Dental Hospital, between July 2011 and March 2016. 466 patients were reviewed, with a total of 1405 implants placed, considering the oncological history of the patients and the implant success rate. The total success rate in the concerned period was 96.65%. When comparing cancer patients with healthy ones, the success rate has been 93.02% in the first case, and 97.16% in the latter. According to the literature review, our results encourage implant placement in cancer patients, it is important to recognize that this is an analysis of a complex care pathway with a large number of confounding variables. However, the findings should not be considered as generalizable.


Resumo Pacientes com histórico de câncer são cada vez mais comuns no consultório odontológico. O tratamento de pacientes com câncer requer uma equipe multidisciplinar, que deve incluir o dentista, a fim de controlar as complicações que ocorrem na cavidade oral e também para tratar o paciente com qualquer uma das modalidades de tratamento: cirúrgica, médica, radioterápica ou suas possíveis combinações. Os implantes dentários podem ser uma opção de tratamento segura e previsível para reabilitação protética. O objetivo deste artigo é propor um estudo retrospectivo sobre a taxa de sucesso de implantes osseointegrados em pacientes oncológicos e não oncológicos atendidos no Mestrado em Odontologia em Pacientes Oncológicos e Imunodeprimidos, bem como no Mestrado em Medicina, Cirurgia e Implantodontia Oral do Hospital Odontológico da Universidade de Barcelona, entre julho de 2011 e março de 2016. Foram revisados 466 pacientes, com um total de 1405 implantes instalados, considerando o histórico oncológico dos pacientes e a taxa de sucesso do implante. Resultados: A taxa de sucesso total no período em questão foi de 96,65%. Na comparação entre pacientes com câncer e saudáveis, a taxa de sucesso foi de 93,02% no primeiro caso e 97,16% no segundo. Conclusão: De acordo com a revisão da literatura, nossos resultados encorajam a colocação de implantes em pacientes com câncer, é importante reconhecer que esta é uma análise complexa que requer cuidado devido ao grande número de variáveis. No entanto, os resultados não devem ser considerados de forma generalizada.


Subject(s)
Humans , Dental Implants , Neoplasms , Retrospective Studies , Treatment Outcome , Dental Prosthesis, Implant-Supported , Dental Restoration Failure , Dental Implantation, Endosseous
8.
Rev. cuba. estomatol ; 57(2): e1508, abr.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126504

ABSTRACT

RESUMEN Introducción: La microfiltración coronal causada por los materiales de restauración temporal es considerada una de las causas del fracaso de los tratamientos endodónticos. A raíz de ello, en los últimos años se ha buscado crear un material de restauración temporal que sea capaz de evitar este problema. Objetivo: Comparar in vitro la microfiltración coronal de un cemento experimental y cuatro materiales de restauración temporal usados en endodoncia. Métodos: Se realizaron cavidades clase I en 90 premolares, divididos en 10 grupos (n= 9) y evaluados en dos periodos de tiempo (1 y 2 semanas). Se realizó la elaboración del cemento experimental, posteriormente se llevó a cabo el sellado coronal de las piezas dentales con el cemento experimental, Clip F (VOCO), Eugenato (MOYCO), Ketac™ Molar Easymix 3M (ESPE) y Coltosol® F. Los especímenes fueron sumergidos en tinta china (Pelikan) durante 1 y 2 semanas. Se evaluó la microfiltración en la interfase pared dentinaria-restauración temporal utilizando un esteromicroscopio (Leica Microsystems LAS EZ versión 2.0.0). La medición se realizó en milímetros en el programa LAS EZ versión 2.0.0. Resultados: Se encontró diferencias estadísticamente significativas (p < 0,05) al comparar la microfiltración coronal de los cinco materiales de restauración temporal, según el tiempo de exposición en tinta (1 y 2 semanas). Conclusiones: El cemento experimental presentó menor microfiltración que el Coltosol® F y Ketac™ Molar EasyMix 3M (ESPE); sin embargo, ninguno de los cuatro materiales fue capaz de prevenir la microfiltración en su totalidad(AU)


ABSTRACT Introduction: Coronal microleakage caused by temporary restorative materials is viewed as one of the reasons for endodontic failure. Efforts have been made in recent years to create a temporary restorative material capable of preventing that problem. Objective: Compare in vitro coronal microleakage of an "experimental cement" and four temporary restorative materials used in endodontics. Methods: Class I cavities were made in 90 premolar teeth divided into 10 groups (n= 9) and evaluated at two time periods (1 and 2 weeks). The "experimental cement" was prepared and then coronal sealing of the teeth was performed with the experimental Cement, F (VOCO), Eugenato (MOYCO), Ketac™ Molar Easymix 3M (ESPE) and Coltosol® F. The pieces were submerged in India ink (Pelikan)for 1 and 2 weeks. Microleakage was evaluated on the interface dentin wall / temporary restoration using a stereo microscope (Leica Microsystems LAS EZ version 2.0.0). Measurement was made in millimeters using the software LAS EZ version 2.0.0. Results: Statistically significant differences were found (p < 0.05) when comparing coronal microleakage in the five temporary restorative materials according to exposure time in ink (1 and 2 weeks). Conclusions: The experimental cement had less microleakage than Coltosol® F and Ketac™ Molar EasyMix 3M (ESPE). However, none of the four materials was capable of completely preventing microleakage(AU)


Subject(s)
Humans , Dental Restoration Failure , Dental Leakage/etiology , Endodontics/methods , Dental Cementum
9.
Rev. Asoc. Odontol. Argent ; 108(1): 29-39, ene.-abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1096767

ABSTRACT

El objetivo de este artículo es revisar la evidencia científica existente acerca de los tipos de retención protética fija sobre implantes: atornillada, cementada y cemento-atornillada. Fueron evaluadas sus ventajas y desventajas a fin de facilitar al clínico la elección del sistema de retención en el tratamiento rehabilitador con implantes. Si bien la evidencia científica no es concluyente, la prótesis atornillada presentaría más complicaciones técnicas, y las cementadas, más complicaciones biológicas. Por ello, las prótesis cemento-atornilladas podrían ser en la actualidad una opción de elección, por su versatilidad en la rehabilitación implanto-soportada, combinando las ventajas de cada tipo de retención (AU)


The objective of this article is to review the existing scientific evidence about the different types of retention of fixed prosthetic on implants: screwed, cemented and cement-screwed. The advantages and disadvantages of them were evaluated in order to facilitate the clinician's choice of the retention system in the rehabilitation treatment with implants. Although the scientific evidence is inconclusive, the screwed prosthesis would present more technical complications, while the cemented, more biological complications. Therefore, cement-screwed prostheses could be an option of choice, due to their versatility when rehabilitating an implant, combining the advantages of each type of retention (AU)


Subject(s)
Dental Prosthesis Retention/methods , Dental Prosthesis, Implant-Supported , Crowns , Dental Abutments , Cementation/instrumentation , Dental Prosthesis, Implant-Supported/adverse effects , Dental Restoration Failure , Evidence-Based Dentistry
10.
Rev. ADM ; 77(2): 108-116, mar.-abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1102217

ABSTRACT

La frecuencia de las cirugías relacionadas con implantes dentales que involucran procedimientos de aumento de tejido blando y hueso han aumentado significativamente. Los sustitutos óseos derivados de bovinos han sido, por mucho, los xenoinjertos más utilizados en odontología. Aunque la literatura está repleta de estudios clínicos a favor de los materiales de injerto derivados de bovinos, los estudios que reportan los riesgos y las complicaciones clínicas son escasos. La impresión clínica y la preocupación por la seguridad del paciente llevaron al informe que hemos proporcionado. El objetivo de esta presentación de una serie de casos es crear conciencia sobre los riesgos a largo plazo y las complicaciones clínicas tardías de los materiales de injerto derivados de bovinos. Los pacientes fueron referidos a un consultorio privado debido a complicaciones asociadas con los procedimientos de injerto óseo. Reportamos los datos demográficos, hallazgos médicos y dentales significativos. Las complicaciones incluyeron: sinusitis y patologías del hueso maxilar, desplazamiento de los materiales del injerto, falla del implante, reacción de cuerpo extraño, encapsulación del material, inflamación crónica, fenestraciones de tejidos blandos y quistes asociados. Los materiales de injerto derivados de bovino no fueron biodegradables. La preocupación de los autores es que la morbilidad del paciente puede no reducirse con los xenoinjertos, debido a los riesgos inherentes y a las complicaciones asociadas. La resolución de las lesiones y los síntomas asociados se logró después de la eliminación/ remoción de los materiales del injerto óseo. La extracción quirúrgica de los materiales de xenoinjerto puede requerir habilidades clínicas avanzadas, debido a las diferentes configuraciones que los cirujanos pueden encontrar en las partículas no resorbidas y migradas. Los médicos que buscan proporcionar resultados funcionales y estéticos deben ser conscientes de las complicaciones de los materiales de injerto derivados de bovinos. La seguridad a largo plazo de los xenoinjertos y su posible asociación con la transmisión de enfermedades son preocupaciones válidas (AU)


The frequency of dental implant related surgeries that involve soft and bone augmentation procedures has increased significantly. Bovinederived substitutes have been by far the most commonly used xenografts in dentistry. Albeit literature is replete with clinical studies in favor of bovine-derived graft materials, bibliographical data reporting on risks and clinical complications is scarce. Clinical impression and concern for patients' safety led to the report we have provided. The aim of the present case series was to raise awareness on the long-term risks and late clinical complications of bovine-derived graft materials. Patients were referred to a private practice due to bone augmentation complications. Demographics, significant medical and dental findings are reported. The present report was conceived with the safety of patients in mind. Complications included sinus and maxillary bone pathoses, displacement of the graft materials, oro-antral and oro-nasal communications, paresthesia, implant failure, foreign body reactions, encapsulation, chronic inflammation, soft tissue fenestrations and associated cyst. Bovine-derived graft materials were not biodegradable. Resolution of the associated lesions and symptoms was achieved after the removal of the bone graft materials. Clinicians seeking to provide functional and esthetic outcomes should be aware of the complications of the bovine-derived graft materials. The long-term safety of xenografts and their potential association with disease are valid concerns (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Postoperative Complications , Cattle , Risk Factors , Bone Transplantation , Bone Substitutes , Dental Implantation, Endosseous , Dental Restoration Failure , Oral Surgical Procedures , Maxillary Sinus/pathology
12.
Article in Chinese | WPRIM | ID: wpr-878388

ABSTRACT

OBJECTIVE@#This study aimed to investigate the effect of occlusal thickness design on fracture resistance of endocrowns restored with lithium disilicate ceramic and zirconia.@*METHODS@#A total of 24 artificial first mandibular molars were randomly divided into four groups with six teeth in each group as follows: group lithium disilicate ceramic-2 mm (lithium disilicate ceramic, with an occlusal thickness of 2 mm and a retainer length of 4 mm); group lithium disilicate ceramic-4 mm (lithium disilicate ceramic, with an occlusal thickness of 4 mm and a retainer length of 2 mm); group zirconia-2 mm (zirconia, with an occlusal thickness of 2 mm and a retainer length of 4 mm); and group zirconia-4 mm (zirconia, with an occlusal thickness of 4 mm and a retainer length of 2 mm). After adhesive cementation (RelyX Ultimate Clicker), all specimens were subjected to thermocycling (10 000 cycles). The specimens were subjected to fracture resistance testing at a 135° angle to the teeth at a crosshead speed of 0.5 mm·min⁻¹ in a universal testing machine. Data were analyzed with ANOVA and Tukey's HSD test by SPSS 15.0. The failure modes were classified.@*RESULTS@#The fracture resistances of groups lithium disilicate ceramic-
2 mm, lithium disilicate ceramic-4 mm, zirconia-2 mm, and zirconia-4 mm were (890.54±83.41), (2 320.87±728.57), 
(2 258.05±557.66), and (3 847.70±495.99) N respectively. Group zirconia-4 mm had the highest fracture resistance, whereas group lithium disilicate ceramic-2 mm had the lowest.@*CONCLUSIONS@#The fracture resistance of molar endocrown with zirconia is higher than that with lithium disilicate ceramic. Increasing the occlusal thickness can improve the fracture resistance but increase the risk of fracture of abutment.


Subject(s)
Ceramics , Crowns , Dental Porcelain , Dental Restoration Failure , Dental Stress Analysis , Materials Testing , Zirconium
13.
Article in English | LILACS, BBO | ID: biblio-1135480

ABSTRACT

Abstract Objective: To evaluate the influence of cavosurface vestibular bevel (CSVB) application on the clinical success (CS) of class IV restorations of traumatized permanent teeth, the influence of the number of fracture angles and dental trauma recurrence (DTR) on the restorations retention rate (RRR) and incidence of pulp necrosis (PN). Material and Methods: Fifty-seven children and adolescents with enamel and dentin fractures requiring C-IV restorations were randomly allocated in groups with CSVB and without CSVB. The primary outcomes were the CS of restorations, evaluated using modified USPHS criteria, and the incidence of PN after a 6-months follow-up. As secondary outcomes, the influence of the number of fractured angles and the DTR on the RRR and on the incidence of PN were evaluated (p>0.05). Results: Of 57 children and adolescents, 74 teeth were restored, and 71 completed the six-month follow-up analysis. Teeth restored with and without CSVB displayed similar CS as well as the same incidence of PN (p>0.05). The number of fractured angles did not influence the RRR and DTR was not associated with PN (p>0.05). DTR was associated with a lower RRR (p<0.001). Conclusion: Cavosurface vestibular bevel did not influence the clinical success of Class IV restorations or incidence of PN after 6-months follow-up. DTR did not influence the incidence of pulp necrosis, but did negatively influence the restorations retention rate. The number of fracture angles did not influenced in the restorations retention rate.


Subject(s)
Humans , Male , Female , Child , Adolescent , Tooth Fractures/diagnostic imaging , Randomized Controlled Trial , Composite Resins/chemistry , Dental Restoration Failure , Dental Restoration, Permanent , Brazil/epidemiology , Chi-Square Distribution , Dental Pulp Necrosis , Dental Enamel
14.
Article in English | LILACS, BBO | ID: biblio-1101281

ABSTRACT

Abstract Objective: To assess the reproducibility of two clinical criteria for the evaluation of restorations in primary teeth and the impact on treatment decision. Material and Methods: A cross-sectional study was performed selecting 71 resin-based composite restorations placed in primary molars of children who had sought dental treatment at a dental school. Two trained examiners evaluated independently the restorations using modified FDI and USPHS criteria. All restorations were assessed separately with each system in random order to avoid memory bias. Kappa statistics were used to determine inter-examiner reliability considering each parameter of both criteria and score final about treatment decision. McNemar test was used to compare the treatment decision with two criteria. The significance level was set at 5%. Results: Kappa values ranged from 0.28 to 0.93 with USPHS and 0.28 to 0.88 with FDI, considering each parameter separately. Inter-examiner agreement for treatment decision was excellent for both criteria (Kappa: 0.85-0.90). For clinical decision-making, no difference between criteria was found, irrespective of examiner. Conclusion: Low inter-examiner agreement for evaluation of each parameter of USPHS and FDI criteria does not reflect on reproducibility for treatment decision. Both criteria may be suitable for evaluation of composite restorations in primary teeth.


Subject(s)
Humans , Male , Female , Child , Tooth, Deciduous , Dental Care/psychology , Dental Restoration Failure , Clinical Decision-Making , Molar , Schools, Dental , Brazil/epidemiology , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Composite Resins/therapeutic use
15.
Rev. ABENO ; 20(1): 68-79, 2020. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1284606

ABSTRACT

This study investigated the teaching of direct resin composite restoration repair in primary teeth in undergraduate dental programs within Brazil. A questionnaire relating to this topic was developed and e-mailed to 205undergraduate dental schools between May and September 2019.Data obtained were analyzed descriptively. Theresponse rate was 43.4% and out of those responding schools, 82% included this topic within theircurriculum. Two of the most commonly reported reasons for teaching repair of resin composite restorations were dental structure preservation (95.9%), and reduction in the risk of pulp complications (71.2%). With regard to protocol for repair, few schools (24.7%) taught mechanical roughening of the resin portion to be repaired with diamond burs. Conversely, phosphoric acid etching was recommended by 87.7% of schools and 76.7% indicated adhesive application into prepared surface.The most commonly taught material for repair was conventional resin composite.The teaching the repair of failed resin composite restorations has been established within the curriculum of undergraduate dental programs in Brazil. However, there is no consensus for the clinical protocol for repair (AU).


Este estudo investigou o ensino do reparo de restauração direta de resina composta em dentes decíduos nos cursos de graduação em Odontologia no Brasil. Um questionário referente a este tópico foi desenvolvido e enviado por e-mail para 205 cursos de Odontologia entre maio e setembro de 2019. Os dados obtidos foram analisados descritivamente. A taxa de resposta foi de 43,4% e dos cursos respondentes, 82% incluíram esse tópico em seu currículo. As duas razões mais comumente relatadas para o ensino do reparo de restaurações de resina composta foram preservação da estrutura dentária (95,9%) e redução do risco de complicações pulpares (71,2%). No que diz respeito ao protocolo para reparo, poucos instituições(24,7%) ensinaram o desgaste mecânico da porção da resina a ser reparada com pontas diamantadas. Por outro lado, o condicionamento com ácido fosfórico da superfície preparada foi recomendado por 87,7% das instituições e 76,7% indicaram aplicação de adesivo na superfície preparada. O material mais comumente ensinado para reparo foi resina composta convencional. O ensino do reparo de restaurações de resina composta com falhas foi estabelecido dentro do currículo dos cursos de graduação em Odontologia no Brasil. No entanto, não há consenso sobre o protocolo clínico para reparo (AU).


Subject(s)
Students, Dental , Brazil/epidemiology , Composite Resins , Dental Restoration Failure , Education, Dental , Tooth, Deciduous , Clinical Protocols , Surveys and Questionnaires , Pediatric Dentistry , Curriculum/standards , Dentistry
16.
Braz. oral res. (Online) ; 34(supl.2): e073, 2020. tab
Article in English | LILACS, BBO | ID: biblio-1132731

ABSTRACT

Abstract The impact of clinical trials on patient care depends on the outcomes that they evaluate. In Dentistry, many trials use outcomes that are important to clinicians, but not to the patients. Thus, the aim of the present manuscript is to present an overview of the limitations, challenges, and proposals on the use of clinically relevant outcomes (CRO) in dental trials. Clinically relevant outcomes are variables that directly measure how the patient feels, functions, or survives. Some CROs, such as tooth loss, implant failure, and restorations failure require many years to occur and the number of events is low. The adoption of these variables as primary outcomes results in challenges for the researchers, such as use of large sample sizes and long follow-up periods. Surrogate outcomes, such as biomarkers, radiographic measurements and indexes, are frequently used to replace CROs. However, they present many limitations, since the effect of the treatment on a surrogate does not necessarily reflect a change in the clinical outcome. Some proposals for the adoption of CROs are presented, such as the development of core outcome sets within each dental specialties and the organization of multi-center clinical trials.


Subject(s)
Humans , Clinical Trials as Topic , Stomatognathic Diseases , Treatment Outcome , Dental Restoration Failure
17.
Braz. dent. sci ; 23(2): 1-10, 2020. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1095374

ABSTRACT

Background and aim: Endoscopic sinus surgery owing to its satisfactory prognosis and low complication is considered as the first line of surgical procedure. Implant failure is often reported despite efforts in recent years. The purpose of this study was to review the factors leading to side effects in dental implantation of the maxillary sinus. Material and Methods: The systematic search was performed on electronic databases of MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar to find corresponding articles regarding dental literature during 2010 to 2019. Electronic title management was carried out by Endnote X9 software. Searches were based on the keywords of "dental implants", "Implants"," dental"," maxilla", "sinusitis". Results: The searched potentially relevant titles and abstracts were related to 294 articles, 104 of which were excluded due to lack of study inclusion criteria. At last, 11 articles were included into the final analysis. Postoperative sinusitis was found in 78 patients within 9 articles among 1195 patients. The implant failure was reported in 136 cases and the sinus membrane perforation in 185 sinuses within 11 articles among 1372 sinus lift procedures. Conclusion: The findings showed that the risk factors of sinusitis after implant surgery were Schneiderian membrane rupture and preoperative sinusitis, as well as smoking and residual bone height were the parameters elevating the dental implant failure risk. (AU)


Justificativa e objetivo: A cirurgia endoscópica do seio maxilar, devido ao seu prognóstico satisfatório e baixa complicação, é considerada a primeira opção cirúrgica. A falha do implante é frequentemente relatada, apesar dos esforços realizados nos últimos anos. O objetivo deste estudo foi revisar os fatores que levaram a efeitos colaterais no implante dentário do seio maxilar. Material e Métodos: A busca sistemática foi realizada nas bases de dados eletrônicas do MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google Scholar para encontrar artigos correspondentes sobre literatura odontológica no período de 2010 a 2019. O gerenciamento eletrônico de títulos foi realizado pelo software Endnote X9. As pesquisas foram baseadas nas palavras-chave "implantes dentários", "implantes", "dentário", "maxila", "sinusite". Resultados: Os títulos e resumos potencialmente relevantes pesquisados foram relacionados a 294 artigos, 104 dos quais foram excluídos por falta de critérios de inclusão no estudo. Por fim, 11 artigos foram incluídos na análise final. Sinusite pós-operatória foi encontrada em 78 pacientes em 9 artigos entre 1195 pacientes. A falha do implante foi relatada em 136 casos e a perfuração da membrana sinusal em 185 seios, em 11 artigos, entre 1372 procedimentos de elevação sinusal. Conclusão: Os achados mostraram que os fatores de risco para sinusite após cirurgia de implante foram ruptura da membrana Schneideriana e sinusite pré-operatória, assim como tabagismo e altura óssea residual, os quais foram considerados parâmetros que elevaram o risco de falha do implante dentário. (AU)


Subject(s)
Sinusitis , Dental Implants , Dental Restoration Failure
18.
Rev. cuba. estomatol ; 56(4): e2107, oct.-dez. 2019.
Article in Spanish | LILACS | ID: biblio-1093253

ABSTRACT

RESUMEN Introducción: Existen numerosos tipos de fracaso en las restauraciones cerámicas en base de circonio, cerámicas sobre base o núcleo de circonio siendo el agrietamiento uno de los más frecuentes. Objetivo: Describir las asociaciones de los fracasos en las prótesis con núcleo de circonio y laminadas con cerámicas de recubrimiento. Métodos: Se realizó una revisión bibliográfica sobre los fracasos de la cerámica de restauraciones de circonio y sus mecanismos en MEDLINE, PubMed y SciELO. La búsqueda se orientó a artículos publicados fundamentalmente en los últimos 5 años sin hacer distinciones de idioma. Los tópicos consultados en la revisión estuvieron referidos a estudios experimentales en humanos, animales e in vitro que incluyeran los tópicos de fracaso, longevidad de restauraciones, mecanismos de fracaso, fracturas y tipos de ellas. Análisis e integración de la información: Se profundiza en el tema de los fracasos de la cerámica de restauraciones de circonio. La causa de fracaso más prevalente es el agrietamiento, en sus distintos grados que alcanzan hasta tasas de 16 por ciento a los 5 años, lo que representa una causa de fracaso relevante. No existe evidencia de unión química entre el núcleo de circonio y la cerámica de revestimiento, esto explicaría la génesis de las fracturas. Conclusiones: Las complicaciones más comunes encontradas en restauraciones de núcleo de circonio recubiertas con porcelana están asociadas con el agrietamiento de la porcelana de recubrimiento, a las fracturas del núcleo de circonio que se asocian fundamentalmente a traumas y hábitos parfuncionales; la pérdida de retención y problemas endodónticos(AU)


ABSTRACT Introduction: There are numerous types of failure in zirconia-based ceramic restorations, i.e. ceramic restorations on a zirconia base or core, cracking being one of the most common. Objective: Describe the association between failure in zirconia-core and ceramic-veneered prostheses. Methods: A bibliographic review was conducted about failure in zirconia-based ceramic restorations and its mechanisms in the databases MEDLINE, PubMed and SciELO. The search was aimed at papers published in any language mainly in the last five years. Papers were searched for which referred to experimental studies in humans, animals and in vitro, and dealt with the topics of failure, longevity of restorations, failure mechanisms, fractures and their types. Data analysis and integration: The topic of failure in zirconia-based ceramic restorations was studied in depth. The leading cause of failure is cracking in its various degrees, which reaches rates of up to 16 percent at five years, a relevant failure level. No evidence was found of chemical bonding between the zirconia core and the veneering ceramic, which would otherwise explain the genesis of fractures. Conclusions: The most common complications found in zirconia-core restorations covered with porcelain are associated to cracking of the veneering porcelain, fractures in the zirconia core mainly caused by traumas and parafunctional habits, retention loss and endodontic problems(AU)


Subject(s)
Humans , Zirconium/administration & dosage , Metal Ceramic Alloys/adverse effects , Dental Restoration Failure , Review Literature as Topic , Databases, Bibliographic
19.
Rev. ADM ; 76(3): 162-168, mayo-jun. 2019.
Article in Spanish | LILACS | ID: biblio-1022153

ABSTRACT

Objetivo: Analizar la evidencia disponible sobre los componentes de los adhesivos dentinarios, las causas de la falla de la interface dentinaadhesivo, las alternativas para disminuir este fenómeno y aumentar el tiempo de vida de las restauraciones adhesivas. Material y métodos: Se realizó una revisión de la literatura de tipo descriptiva, la búsqueda de artículos se llevó a cabo en diferentes bases de datos, bibliotecas electrónicas, buscadores académicos y búsqueda manual en revistas. Se revisaron 118 artículos, de los cuales se seleccionaron 68. Conclusiones: La adhesión dentinaria sufre degradación hidrolítica y degradación proteolítica; el acondicionado ácido de la dentina promueve la liberación de metaloproteinasas y con ello el inicio de la degradación de la interface dentino-adhesivo, por el momento los adhesivos con MDP brindan la mejor opción ya que presentan los mejores resultados para contrarrestar la degradación, además de encontrarse comercialmente al alcance de los profesionistas. Los sistemas que presentan una simplificación de la técnica en ocasiones pueden ir en detrimento de los resultados. Aún es necesario realizar investigación que conduzca a reducir la falla de la interface adhesiva a largo plazo y obtener restauraciones óptimas, duraderas y libres de microfiltraciones (AU)


Objective: Analyze the available evidence on the components of dentin adhesives, the causes of failure of the dentin-adhesive interface, the alternatives to reduce this phenomenon and increase the lifetime of adhesive restorations. Material and methods: A review of the descriptive literature was made, the search of articles was carried out in different databases, electronic libraries, academic search engines and manual search in journals. 118 articles were reviewed, of which 68 were selected. Conclusions: Dentin adhesion suffers from hydrolytic and proteolytic degradation; the acid conditioning of dentine promotes the release of metalloproteinases and with it the beginning of the degradation of the dentin-adhesive interface, for the moment the adhesives with MDP offer the best option since they present the best results to counteract the degradation besides being commercially available to professionals. Simpli file Systems less can sometimes be detrimental to the results. It is still necessary to carry out investigations that leads to a reduction on the failure of the long-term adhesive interface and obtain optimal, durable and microfiltration-free restorations (AU)


Subject(s)
Acid Etching, Dental , Dentin-Bonding Agents , Metalloproteases , Epidemiology, Descriptive , Dental Restoration Failure , Dental Leakage
20.
Braz. dent. j ; 30(3): 244-251, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011551

ABSTRACT

Abstract Severely resorbed mandibles with only cortical bone remaining can fracture during or after implant placement. This case series presents a technique to reduce the risk or the consequences of mandibular fracture. Seven patients with only cortical mandibular bone remaining were treated with the fixation of a titanium plate in the frontal surface previously to implant placement, during the same surgical procedure. Immediate complete-arch implant supported prosthesis were installed. Patient's systemic and local conditions that could influence implant survival were registered previously to surgery and during the follow up period. Biological and biomechanical complications were recorded. The condition of peri-implant tissues was evaluated. The follow-ups ranged from 12 to 84 months. Twenty-nine implants were placed and no implant failure or other biological complication was observed. The peri-implant tissue evaluation demonstrated most implants was surrounded by keratinized tissue (89.5%). No marginal recession (implant platform cervical to gingival margin) was observed. Probing depth was normal, ranging from 0 to 3 mm. Low scores of plaque index or bleeding on probing were recorded. Biomechanical complications evolved loosening of 4 prosthetic screws and 1 fractured. The use of a titanium plate for the fixation of severely resorbed mandibles with only cortical bone remaining was a safe treatment procedure, avoiding biological and major biomechanical complications in the treatment with immediate complete-arch implant-supported prosthesis.


Resumo Mandíbulas severamente reabsorvidas com apenas osso cortical remanescente podem fraturar durante ou após a colocação de implantes. O presente relato de casos apresenta uma técnica para reduzir o risco ou as consequências da fratura mandibular. Pacientes com apenas osso cortical remanescente foram tratados com a fixação de placa de titânio na superfície frontal, previamente a colocação dos implantes, no mesmo procedimento cirúrgico. Próteses totais implanto-suportadas foram instaladas com carga imediata. Condições locais e sistêmicas dos pacientes que poderiam influenciar a sobrevivência dos implantes foram registradas previamente a cirurgia e durante o período de acompanhamento. Complicações biológicas e biomecânicas foram registradas. A condição dos tecidos peri-implante foi avaliada. Sete pacientes completaram o período de acompanhamento, variando entre 12 e 84 meses. Vinte e nove implantes foram colocados e nenhuma falha ou complicação biológica foi observada. A avaliação do tecido peri-implante demonstrou que a maioria dos implantes possuía tecido queratinizado (89,5%). Nenhuma recessão marginal (plataforma do implante cervical à margem gengival) foi observada. Profundidade de sondagem mostrou-se normal, variando entre 0 e 3 mm. Baixos escores de índice de placa ou sangramento à sondagem foram observados. Complicações biomecânicas envolveram perda de 4 e 1 fratura de parafusos protéticos. O uso da placa de titânio para fixação de mandíbulas severamente reabsorvidas com apenas osso cortical remanescente pode ser considerado tratamento seguro, evitando alterações biológicas e maiores complicações biomecânicas no tratamento com próteses totais imediatas implanto-suportadas.


Subject(s)
Humans , Dental Implants , Alveolar Bone Loss , Titanium , Follow-Up Studies , Treatment Outcome , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Dental Restoration Failure , Mandible
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