Cirugía preprotésica de torus mandibular bilateral con impedimento del movimiento lingual / Preprosthetic surgery of a bilateral mandibular torus with tongue movement dysfunction

El torus mandibular es un crecimiento exofítico óseo benigno en la parte interna de la mandíbula, generalmente presente en ambos lados. Su etiología se relaciona a diversos factores como la herencia, grado de estrés, factores ambientales, nutricionales y trauma oclusal. Puede causar problemas funcionales y estéticos, como dificultad en la pronunciación, mal aliento, molestias al comer con prótesis mal adaptadas y ulceraciones. En la mayoría de los casos no es necesario el tratamiento, excepto cuando se requiere para mejorar la función protésica o solucionar problemas funcionales. En este artículo presentamos la situación clínica que describe la escisión exitosa del torus mandibular bilateral en un paciente de 57 años para la posterior rehabilitación protésica. La escisión del torus mandibular bilateral es un procedimiento seguro y predecible que ayuda a prevenir complicaciones protésicas y biológicas, mejorando la estabilidad y la función del sistema estomatognático (AU)

The mandibular torus is a benign bony exophytic growth in the inner part of the mandible, usually present on both sides. Its etiology is related to various factors such as heredity, degree of stress, environmental and nutritional factors, and occlusal trauma. It can cause functional and aesthetic problems, such as difficulty in pronunciation, bad breath, discomfort when eating with ill-fitting prostheses, and ulcerations. In most cases, treatment is not necessary, except when it is required to improve prosthetic function or solve functional problems. In this article we present the clinical situation that describes the successful excision of the bilateral mandibular torus in a 57-year-old patient for subsequent prosthetic rehabilitation. Bilateral mandibular torus excision is a safe and predictable procedure that helps prevent prosthetic and biological complications, improving the stability and function of the stomatognathic system (AU)

Effectiveness of commercially available denture adhesives on retention of mandibular complete denture in resorbed mandibular ridge: an in vitro study / Efectividad de los adhesivos disponibles comercialmente sobre la retención de prótesis removibles completas mandibulares en el reborde mandibular reabsorbido: un estudio in vitro

Background: Denture adhesives are alternatives used to improve retention, stability, comfort and satisfaction in patients with complete dentures. Evidence on the effectiveness of denture adhesives on resorbed mandibular ridges is scarce. Among the many commercially available denture adhesives, the ideal material for the severely resorbed mandibular ridge remains in dispute. Objective: The aim of this study was to evaluate the effectiveness of different quantities of four commercially available denture adhesives on the retention of mandibular complete dentures in severely resorbed ridges. Materials and Methods: A resorbed edentulous mandibular ridge model was manufactured in acrylic resin. A denture base was made and three loops were attached to it. Four commercially available denture adhesives (Fixodent, Perlie White, Fiftydent and Polident) were tested in amounts of 0.2 g, 0.4 g, 0.6 g, 0.8 g and 1.0 g. The acrylic resin model was evenly moistened with 1 ml of water and a weighted amount of adhesive material was applied to the denture base. The universal testing machine engaged the loops fixed on the denture base and applied the vertical displacement force. The maximum vertical displacement force values were recorded for each denture adhesive material at different amounts. Statistical calculation was performed using Kruskal Wallis with Bonferroni post hoc correction. Results: Statistically significant differences were observed in the mean values of the vertical displacement force for adhesive amounts of 0.2 g, 0.4 g, 0.6 g and 1.0 g (p<0.05) between the four adhesive materials tested. Statistically significant differences were observed when four denture adhesives were compared to each other in different amounts (p<0.05). Statistically significant differences were observed between different amounts for each of four denture adhesives (p<0.05). Conclusions: Among the four materials tested, Polident showed greater effectiveness at 0.6 g and 0.8 g, Fittydent at 0.6 g, 0.8 g and 1 g, Fixodent at 0.4 g and 0.6 g and Perlie White at 1 g and 0.8g quantity to resist vertical displacement. forces on the severely resorbed mandibular crest. Using an appropriate amount of denture adhesive allows for proper retention of the denture; Replacement of this adhesive is necessary once a day.

Introducción: Los adhesivos para prótesis dentales son alternativas utilizadas para mejorar la retención, la estabilidad, la comodidad y la satisfacción en los pacientes con prótesis completas. La evidencia sobre la efectividad de los adhesivos para prótesis dentales en los rebordes mandibulares reabsorbidos es escasa. Entre los muchos adhesivos para prótesis dentales disponibles comercialmente, sigue estando en disputa cuál es el material ideal para el reborde mandibular severamente reabsorbido. Objetivo: El objetivo de este estudio fue evaluar la efectividad de diferentes cantidades de cuatro adhesivos para prótesis dentales disponibles comercialmente sobre la retención de prótesis dentales completas mandibulares en reborde mandibular reabsorbido severamente. Materiales y Métodos: Se fabricó un modelo de reborde mandibular edéntulo reabsorbido en resina acrílica. Se hizo una base para la prótesis y se le colocaron tres bucles. Se probaron cuatro adhesivos para dentaduras postizas disponibles comercialmente (Fixodent, Perlie White, Fiftydent y Polident) en cantidades de 0,2 g, 0,4 g, 0,6 g, 0,8 g y 1,0 g. El modelo de resina acrílica se humedeció uniformemente con 1 ml de agua y se aplicó la cantidad correspondiente de material adhesivo sobre la base de la dentadura. La máquina de prueba universal enganchó los bucles fijados en la base de la dentadura postiza y aplicó la fuerza de desplazamiento vertical. Se registraron los valores máximos de fuerza de desplazamiento vertical para cada material adhesivo para dentaduras postizas en diferentes cantidades. El cálculo estadístico se realizó utilizando Kruskal Wallis con corrección post hoc de Bonferroni. Resultado: Se observaron diferencias estadísticamente significativas en los valores medios de la fuerza de desplazamiento vertical para cantidades de 0,2 g, 0,4 g, 0,6 g y 1,0 g (p<0,05) entre los cuatro materiales adhesivos para prótesis dentales probados. Se observaron diferencias estadísticamente significativas cuando se compararon cuatro adhesivos para prótesis dentales entre sí en diferentes cantidades (p<0,05). Se observaron diferencias estadísticamente significativas entre diferentes cantidades en los cuatro adhesivos para prótesis (p<0,05). Conclusión: De los cuatro materiales probados, Polident mostró mayor efectividad a 0,6 g y 0,8 g, Fittydent a 0,6 g, 0,8 g y 1 g, Fixodent a 0,4 g y 0,6 g y Perlie White a 1 g y 0,8 g para resistir fuerzas de desplazamiento vertical en la cresta mandibular severamente reabsorbida. El uso de una cantidad adecuada de adhesivo para dentaduras postizas permite una retención adecuada de la dentadura postiza; El reemplazo de este adhesivo es necesario una vez al día.

X-linked hypohidrotic ectodermal dysplasia management with removable prosthesis in a pediatric patient: case report / Manejo de displasia ectodérmica hipohidrótica ligada al cromosoma X con prótesis removible en un paciente pediátrico: reporte de caso

Introduction: Ectodermal dysplasia is a rare genetic disorder that affects structures derived from ectoderm such as teeth, hair, nails, and sweat glands. Oligodontia is a common finding that affects the chewing, smiling and self- esteem of these pediatric patients. Case Report: We present a case report of a 7-years-old pediatric patient who consulted with his mother, showing the same condition. The intervention consisted of a removable prosthesis with satisfactory results. Conclusion: The X-linked hypohidrotic ectodermal dysplasia represents a challenge for a pediatric dentist who offers rehabilitation to the patient according to craniofacial development, age, socioeconomic status, and the number of missing teeth.

Introducción: La oligodoncia es un hallazgo común que afecta la masticación, la sonrisa y la autoestima de estos pacientes pediátricos. Case Report: Presentamos un reporte de caso de un paciente pediátrico de 7 años que consultó con su madre presentando la misma condición. La intervención consistió en una prótesis de remoción con resultados satisfactorios. Conclusión: La displasia ectodérmica hipohidrótica ligada al cromosoma X representa un desafío para un odontopediatra que ofrece rehabilitación al paciente de acuerdo con el desarrollo craneofacial, la edad, el nivel socioeconómico y el número de dientes faltantes.

Self-perception of oral health among tertiary-care users: quanti-qualitative analysis with chronic kidney disease patients

Chronic kidney disease (CKD) has become a global public health challenge. The objective of this study was to analyze the relationship between self-perception of oral health and clinical condition among patients with CKD. This isa quanti-qualitative survey conducted in a CKD specialized service. The sample consisted of 60 patients who underwent oral examinations to have their severity of caries (DMFT) and need for dental prosthesis checked. Age, sex, time on dialysis, marital status, skin color, education and pre-existing diseases were also analyzed. Among the kidney patients who agreed to undergo the clinical examinations and showed communication skills, some were selected, and three focus groups were created, with the participation of a moderator and six to 10 kidney patients in each group. Their speeches were processed in the IRAMUTEQ software and analyzed through the similarity analysis and word cloud techniques. As for profile, the patients were aged 60.23 ± 10.87 years old; were male (73.33%); were on dialysis for 41.90 ± 56.57 months; were married (61.67%); were white (76.67%); had incomplete primary education (41.66%); had arterial hypertension (76.67%); had a DMFT index of 22.55 ± 8.39; 43.33% needed an upper complete denture; and 30.00% needed a lower complete denture. The similarity analysis revealed many doubts and uncertainties about current health services, which can be proven by the words 'no' and 'treatment'. The quanti-qualitative analysis showed a high rate of dental loss and the need for complete dentures and suggests inequities in oral health care for chronic kidney disease patients, especially in tertiary care. There was a positive representation regarding oral health, but the lexicographical analyses of the textual corpusconfirmed the self-perception of lack of dental care.

Evaluación de la calidad del servicio de Prótesis Estomatológica, centrada en el liderazgo / Assessment of dental prosthesis quality service focused on leadership

RESUMEN Fundamento: Para lograr la calidad en los servicios estomatológicos se realizan investigaciones sobre su evaluación. Las definiciones entre los autores son variadas en dependencia de la importancia otorgada a diferentes dimensiones. Hasta el momento no se ha encontrado una propuesta que favorezca el protagonismo de los líderes. Objetivo: Diseñar una metodología para la evaluación de la calidad del servicio de Prótesis Estomatológica centrada en el liderazgo en clínicas estomatológicas municipales. Metodología: Se emplearon métodos teóricos y empíricos. Con el análisis de los documentos que rigen el proceso de evaluación de la calidad se identificaron las dimensiones priorizadas y los aspectos que se deben considerar en la elaboración de la propuesta. Resultados: La metodología se estructuró a partir de las siguientes etapas: planificación y organización, recolección de la información y ejecución y control del proceso y para cada una de ellas se establecieron los procedimientos que se deben seguir para realizar una evaluación sistemática y alcanzar la calidad del servicio. Conclusiones: Se diseñó una metodología para la evaluación de la calidad de los servicios de Prótesis Estomatológica centrada en el liderazgo y estructurada en tres etapas.

ABSTRACT Background: In order to achieve dental quality service, some researches on its evaluation is conducted. Definitions among authors are diverse depending on the importance given to unlike scopes. So far, no proposal has been found that favors the leaders´ protagonism. Objective: To design a methodology for the assessment of dental Prosthesis quality service focused on leadership in municipal dental clinics. Methodology: Theoretical and empirical methods were used. Though the documents´ enquiry that rule the quality evaluation process, highlighted dimensions and aspects to be considered in the proposal production were identified. Results: The methodology was structured on the basis of the following stages: planning and organization, information gathering, execution and process control, also the procedures to be followed to conduct a systematic assessment and achieve quality service were established. Conclusions: A methodology for the evaluation of dental prosthesis quality services focused on leadership and structured in three stages was designed.

Table-Top Lithium Disilicate Ceramic Restoration Thickness Effect on the Stress Distribution in Upper Premolars: 3D Finite Element Analysis / Efecto del Espesor de la Restauración de Cerámica de Disilicato de Litio de Sobremesa en la Distribución de Tensiones en los Premolares Superiores: Análisis de Elementos Finitos 3D

To evaluate the stresses generated in upper premolars rehabilitated with ceramic fragments (table-top) of lithium disilicate on the occlusal surface. An upper premolar was modeled following its anatomical references using computer aided design software (Rhinoceros version 5.0 SR8, USA). The dental tissues were individually designed containing enamel, dentin and periodontal ligament. The main anatomical points were used as parameters for model creation. Ceramic fragments were modeled varying their maximum thicknesses as: 0.5 mm, 1.0 mm and 1.5 mm. Solid geometries were exported to the analysis software (ANSYS 17.2, USA) in STEP format. The materials were considered isotropic, homogeneous and linear, and the values of the elastic modulus of the materials and structures were used to perform a static structural mechanical analysis. The set was submitted to 200 N load. The system fixation was defined on the basis of the three- dimensional model, and the results were obtained in MPa according to the failure criteria of the analyzed materials (tensile stress). Occlusal restoration was not detrimental to mechanical behavior. Stress distribution in the internal region of the restoration was similar between the groups. Thicker fragments presented a lower concentration of tensile stress, therefore suggesting better prognosis in attenuating tensile stresses in the tooth region. More conservative occlusal ceramic fragments presented worse prognosis. However, all evaluated thickness for table-tops support the occlusal rehabilitation of upper premolars when submitted to 200 N loading.

El objetivo fue evaluar las tensiones generadas en los premolares superiores rehabilitados con fragmentos cerámicos (tablero) de disilicato de litio en la superficie oclusal. Se modeló un premolar superior siguiendo sus referencias anatómicas utilizando un software de diseño asistido por computadora (Rhinoceros versión 5.0 SR8, EE. UU.). Los tejidos dentales se moldearon individualmente conteniendo esmalte, dentina y ligamento periodontal. Los principales puntos anatómicos se utilizaron como parámetros para la creación del modelo. Los fragmentos cerámicos se modelaron variando sus espesores máximos como: 0,5 mm, 1,0 mm y 1,5 mm. Las geometrías sólidas se exportaron al software de análisis (ANSYS 17.2, EE. UU.) En formato STEP. Los materiales se consideraron isotrópicos, homogéneos y lineales, y los valores del módulo elástico de los materiales y estructuras se utilizaron para realizar un análisis mecánico estructural estático. El conjunto se sometió a una carga de 200 N. La fijación del sistema se definió a partir del modelo tridimensional, y los resultados se obtuvieron en MPa según los criterios de falla de los materiales analizados (tensión de tracción). La restauración oclusal no perjudica el comportamiento mecánico. La distribución de la tensión en la región interna de la restauración es similar entre los grupos. Los fragmentos más gruesos presentaron una menor concentración de tensión de tracción, lo que sugiere un mejor pronóstico en la atenuación de las tensiones de tracción en la región dentaria. Los fragmentos cerámicos oclusales más conservadores presentaron peor pronóstico. Sin embargo, todos los espesores evaluados para tableros de mesa en disilicato de litio apoyan la rehabilitación oclusal de los premolares superiores cuando se someten a una carga de 200 N.

Autopercepción y condición de salud bucal en el anciano / Self-perception of oral health in the elderly and oral health condition

Introducción: Debido al aumento en la esperanza de vida y, en consecuencia, al aumento en el número de personas mayores, la asociación entre los estados de salud se vuelve relevante en términos de salud pública, ya que además de los años vividos, la calidad de vida de estos pacientes es importante. Objetivo: Evaluar la autopercepción y el estado de salud bucal en personas mayores. Métodos: Estudio observacional, de corte transversal (enero-julio del 2019) en el que se realizaron cuestionarios GOHAI (índice de evaluación de la salud oral geriátrica) y el cuestionario sobre el tipo, el tiempo de uso y la limpieza de las prótesis dentales, el cáncer oral y los datos socioeconómicos. La presencia de posibles lesiones orales también se evaluó mediante examen clínico. Los sujetos incluidos en la muestra eran ancianos (60 años o más) que asistían a las unidades de salud de Aracaju. Resultados: Participaron 55 mujeres y ocho hombres. Al evaluar el índice de evaluación de la salud oral geriátrica, se verificó que el 47,6 por ciento de la muestra tenía una mala percepción de la salud oral. Se encontraron asociaciones entre el índice de evaluación de la salud oral geriátrica entre la última visita al dentista, la adaptación de la prótesis dental y las heridas bucales (p < 0,05). Las lesiones orales más prevalentes fueron mucosa rojiza o irritada (35,7 por ciento) y eritroplasia (14,2 por ciento) y se detectó que el 76 por ciento de las prótesis tenían grietas o suciedad. El 77,7 por ciento de los participantes en el estudio solo utilizaban dentífrico como material de limpieza de la prótesis. Conclusión: La salud bucal autopercibida y las condiciones de salud bucal de los ancianos evaluados se consideraron deficientes, se observa la presencia de prótesis mal adaptadas y agrietadas, además de mucositis(AU)

Introduction: due to the increase in life expectancy and, consequently, to the increase in the number of elderly people, the association between health states becomes relevant in terms of public health, since in addition to the lived years the quality of life of these patients is important. Objective: evaluate the self-perception of oral health and check the oral health condition of the elderly. Methods: observational cross-sectional study (January to July / 2019) in which questionnaires were the GOHAI (Geriatric Oral Health Assessment Index) questionnaire and questionnaire about type, time of use and cleaning of dental prostheses, oral cancer and socioeconomic data. The presence of possible oral lesions was also assessed by clinical examination. The subjects included in the sample were elderly (60 years or older) attending the Aracaju Health Units. Results: fifty-five were female and eight male. When evaluating the Geriatric Oral Health Assessment Index, it is verified that 47.6 percent of the sample has poor self-perception of oral health. Associations were found between GOHAI Index for last visit to the dentist, dental prosthesis adaptation and mouth wound (p < 0.05). The most prevalent oral lesions were reddish or irritated mucosa (35.7 percent), followed by erythroplakia (14.2 percent), 76 percent of the prostheses had cracks or dirt. About the cleaning of the protests, 77.7 percent use only dentifrice as cleaning material. Conclusion: self-perceived oral health and oral health conditions of the elderly evaluated were considered poor, in the presence of poorly adapted and cracked prostheses, in addition to mucositis(AU)

Traditional versus simplified impression methods for complete dentures: critical appraisal of evidence / Método tradicional versus simplificado en impresiones para prótesis total removible: evaluación crítica de la evidencia Método tradicional versus simplificado

Abstract Introduction: Inspite of the great advances in dentistry, aging populations imply that there are still significant numbers of edentulous people worldwide. In most cases, implant-assisted prosthetic rehabilitation is the best solution. However, economic issues constrain access to this therapeutic approach, meaning that conventional removable prosthetics continue to be the most frequent treatment. In the removable denture making process, the so-called traditional method has been widely taught and used. It involves taking two impressions: a preliminary one followed by a definitive one (or functional). The simplified method constructs the prosthesis directly from the first impression obtained with a stock tray, without the need of a second impression. Purpose: To review the scientific evidence comparing both methods in terms of patient satisfaction, clinical quality, and masticatory performance and capacity. Results: No advantages have been found in favor of the traditional method regarding the four variables selected. Conclusions: According to the available information, the traditional method of taking impressions for complete removable dental prostheses does not provide significantly superior clinical results when compared to those obtained using the simplified method in terms of clinical quality, patient satisfaction, performance and masticatory capacity.

Resumen Introducción: Pese a los avances de la odontología, el fenómeno del envejecimiento de la población ha generado que la cantidad de personas desdentadas totales aún represente una cifra significativa. Los artificios protésicos implanto-asistidos constituyen, en la mayoría de los casos, la mejor alternativa rehabilitadora. Sin embargo, la variable económica surge como el principal impedimento para que los pacientes accedan a este recurso, y por este motivo, mantienen la prótesis total removible como una opción terapéutica. Para su confección, el método tradicional indica la necesidad de tomar dos impresiones: una preliminar y una definitiva o funcional. El método simplificado, confecciona la prótesis a partir de la primera impresión, obtenida con cubeta de stock. Objetivo: Revisar evidencia científica que compara ambos métodos en cuanto a las variables de: satisfacción del paciente, calidad clínica, rendimiento y capacidad masticatoria. Resultados: No se verifican ventajas a favor del método tradicional en relación a las variables estudiadas. Conclusiones: En concordancia con la información recabada, los resultados clínicos obtenidos mediante el método tradicional de toma de impresiones para prótesis totales no son significativamente superiores a los del método simplificado en relación a calidad clínica, satisfacción del paciente, rendimiento y capacidad masticatoria.

Cuidados en los servicios de Prótesis frente a la pandemia por covid-19 / Cares in the Prosthetic services toward COVID-19 pandemic

RESUMEN La covid-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2, y es capaz de provocar un cuadro clínico variable. Los individuos que están en contacto estrecho con pacientes positivos de esta enfermedad, tienen un mayor riesgo de infección. Así les sucede a los trabajadores de la salud que atienden directamente a pacientes. Al igual que otros servicios de salud, la atención estomatológica requiere del contacto estrecho entre el profesional y el paciente. El objetivo de este trabajo fue describir las principales recomendaciones para la prevención y control de infecciones por SARS-CoV-2 en los servicios de Prótesis. En la práctica dental, la prevención, el control y la reducción de la transmisión de infecciones se realiza a través del uso del equipo de protección personal y de un conjunto de procedimientos de descontaminación, desinfección y esterilización en cualquier superficie o instrumento. La constante actualización científica y la adopción de medidas de protección antes, durante y después de la atención estomatológica, podrán garantizar el éxito de la atención médica con el mínimo riesgo de contagio (AU).

ABSTRACT COVID-19 is an infectious diseases caused by SARS-CoV-2 virus, and it is able to provoke variable clinical characteristics. The individuals that are in close contact with this disease positive patients are at higher infection risk. That is the case of the heath care workers directly caring for patients. As in any health service, dentistry care requires the narrow contact between the professional and the patient. The aim of this paper was describing the main recommendations for preventing and control SARS-CoV-2 in Prosthetic services. In the dental practice, the prevention, control and reduction of infection transmission is achieved using the personal protection equipment and a whole of decontamination, disinfection and sterilization procedures in any surface or device. The constant scientific updating and adopting protection measures before, during and after the dentistry care can ensure the success of health care with the minimal risk of contagion (AU).

Previsibilidade de reabilitações de maxilas edêntulas com a técnica all-on-four: revisão de literatura / Previsibility of edental jaw rehabilitations with the all-on-four technique: literature review

Objetivo: avaliar a previsibilidade das reabilitações de maxilas edêntulas através da técnica all-on-four, mensurada pelas tensões sobre implantes em estudos laboratoriais e sobrevida de próteses, perda óssea marginal e sucesso dos implantes em estudos clínicos. Revisão de literatura: foi executada uma busca na literatura nas bases de dados Lilacs, SciELO e PubMed/Medline, utilizando termos relacionados ao tema, sem restrição temporal e adaptados para cada base. As buscas foram realizadas por um único examinador no período de setembro a novembro de 2019. Após a leitura crítica dos 21 artigos selecionados, constata-se que existem vários estudos com muitos delineamentos que avaliaram a previsibilidade mensurada de várias formas. Considerações finais: diante das evidências científicas encontradas, a reabilitação de maxilas edêntulas com a técnica all-on-four demonstra ser previsível e estável. Estudos retrospectivos, prospectivos e revisões sistemáticas relatam altos índices de sucesso, baixa perda óssea marginal, embasando o uso da técnica all-on-four na odontologia.(AU)

Objective: to assess the predictability of edentulous maxillary rehabilitation using the all-on-four technique, measured by tensions over implants in laboratory studies and prosthetic survival, marginal bone loss and implant success in clinical studies. Literature Review: A literature search was performed in the Lilacs, SciELO and PubMed/ Medline databases, using terms related to the theme, without time restriction and adapted for each base. The searches were carried out by a single examiner from September to November 2019. After a critical reading of the 21 selected articles, it appears that there are several studies with many designs that evaluated the predictability measured in various ways. Final considerations: In view of the scientific evidence found, the rehabilitation of edentulous jaws with the all-on-four technique proves to be predictable and stable. Retrospective, prospective studies and systematic reviews report high success rates, low marginal bone loss, basing the use of the all-on-four technique in dentistry.(AU)

Evaluating the effect of different combination of impression and pouring materials on marginal and internal adaptation of zirconia crowns / Evaluación del efecto de diferentes combinaciones de materiales de impresión y vertido en la adaptación marginal e interna de las coronas de circonio

Purpose: Two important factors in dental prosthesis are making an accurate impression and producing a suitable cast which represents the exact relationship between prepared tooth and oral structures. This study, aimed to investigate the effects of different combinations of impression and pouring materials on marginal and internal adaptation of premolar zirconia crowns. Material and Methods: Forty maxillary premolars were prepared considering round shoulder finish line. The impressions were made either by additional (Panasil) or condensation (Speedex) silicon, and poured by two different types of gypsum materials (Siladent or GC gypsum) (N=10). Zirconia crowns were fabricated using a CAD-CAM system. The crowns were cemented, and the samples were cut in bucco-lingual direction. Marginal and internal gaps were measured by stereomicroscope (×25). Results: The mean marginal gaps for Pansil-Siladent, Panasil-GC, Speedex-Siladent, and Speedex-GC were 141 µm, 143 µm, 131 µm, and 137 µm respectively. The internal gaps were 334 µm, 292 µm, 278 µm, and 257 µm respectively. The independent T-Student test showed no significant differences in average marginal or internal gap among various impression and gypsum materials or their interactions (p>0.05). Two-way ANOVA test showed no significant differences in maximum marginal or internal gap among various impression and gypsum materials and their interactions (p>0.05). Conclusion: The present study revealed no statistically significant difference in marginal/internal gap among crowns prepared using different combinations of impression-pouring materials evaluated.

Introducción: Dos factores importantes en la prótesis dental son hacer una impresión precisa y la producción de un modelo adecuado que represente la relación exacta entre el diente preparado y las estructuras orales. Este estudio, tuvo como objetivo investigar los efectos de diferentes combinaciones de materiales de impresión y vertido sobre la adaptación marginal e interna de coronas de zirconio premolar. Material y Métodos: Se prepararon cuarenta premolares maxilares considerando la línea de meta del hombro redondo. Las impresiones se realizaron con silicio adicional (Panasil) o de condensación (Speedex) y se vertieron con dos tipos diferentes de materiales de yeso (yeso Siladent o GC) (N = 10). Las coronas de zirconio se fabricaron utilizando el sistema CAD-CAM. Las coronas se cementaron y las muestras se cortaron en dirección buco-lingual. La brecha marginal e interna se midió con estereomicroscopio (×25). Resultados: Las brechas marginales medias para Pansil-Siladent, Panasil-GC, Speedex-Siladent y Speedex-GC fueron de 141µm, 143µm, 131µm y 137µm, respectivamente. Las brechas internas fueron 334µm, 292µm, 278µm y 257µm, respectivamente. La prueba de T-Student independiente no mostró diferencias significativas en la brecha marginal o interna promedio entre varios materiales de impresión y yeso o sus interacciones (p>0.05). La prueba ANOVA bidireccional no mostró diferencias significativas en el espacio marginal o interno máximo entre varios materiales de yeso y de impresión y sus interacciones (p>0.05). Conclusión: El presente estudio no reveló diferencias estadísticamente significativas en la brecha marginal/interna entre las coronas preparadas con diferentes combinaciones de materiales de impresión y vertido evaluados.

Utilización de biomateriales e injertos óseos autólogos en pacientes con atrofia alveolar / Bibliographic update on the use of biomaterials and autologous bone grafts in patients with alveolar atrophy

RESUMEN El material de elección para el reemplazo del hueso perdido por traumatismos, procesos patológicos congénitos o adquiridos y atrofia, son los injertos óseos autógenos o autólogos (hueso del propio paciente). A partir de la introducción del concepto de osteointegración por Branemark, los implantes dentales son parte de la terapéutica diaria para rehabilitar áreas edéntulas. La atrofia alveolar es quizás una de las condiciones bucales más incapacitantes; la razón reside en que es crónica, progresiva, acumulativa e irreversible, altera las relaciones maxilomandibulares, reduce la cantidad de hueso del área dentosoportada y la profundidad del surco. El material de injerto óseo ideal no debería ser sólo un sustituto óseo, sino un material de regeneración que se reabsorba completamente de modo simultáneo a la formación de hueso nuevo. Evaluar el éxito y fracaso de una terapia permite tomar decisiones para un mejoramiento continuo de la práctica clínica. El objetivo de la investigación fue demostrar la importancia de la utilización de biomateriales e injertos óseos autólogos en pacientes con atrofia alveolar (AU).

SUMMARY The elective material for replacing the bone lost by trauma, congenital or acquired pathological processes and atrophy are the autogenic or autologous bone grafts (the patient´s own bones). From the introduction of the concept of osseointegration by Branemark on, dental implants are part of the daily therapeutic for rehabilitating edentulous areas. Alveolar atrophy is perhaps one of the most disabling oral conditions, because it is chronic, progressive, cumulative and irreversible. It alters maxilla-mandibular relations, reduces the bone quality of the dentosupported area and the depth of the sulcus. The ideal bone graft material should not be only a bone substitute, by a regenerative material that could be completely reabsorbed simultaneously with the new bone formation. To assess the success and failure of a therapy allows taking decisions for the continuous improvement of the clinical practice. The aim of the research was to prove the importance of using biomaterials or autologous bone grafts in patients with alveolar atrophy (AU).

Restablecimiento oclusal mediante procedimientos multidisciplinarios / Occlusal restoration by multidisciplinary procedures

RESUMEN Introducción: El edentulismo es la pérdida total o parcial de dientes, ocasionado principalmente por la caries y la enfermedad periodontal; es un proceso gradual que está comúnmente asociado al aumento de edad. Actualmente es considerado una discapacidad debido a la limitación funcional que ocasiona en quien lo presenta. Objetivo: Exponer el tratamiento rehabilitador multidisciplinario, funcional y estético en un paciente con desarmonías oclusales. Presentación del caso: Paciente masculino de 74 años, diagnosticado con edentulismo parcial bimaxilar, mediante examen clínico y radiológico. Se sometió a terapia periodontal generalizada, cirugía preprotésica, restauración de plano oclusal de forma directa e indirecta y rehabilitación bucal con prótesis removibles total superior y parcial inferior; lo cual le permitió recuperar funcionalidad, estética y autoestima. Conclusiones: El edentulismo desencadena alteración en el estado funcional y emocional del paciente. Un diagnóstico integral y plan de tratamiento multidisciplinario y ordenado desencadenó éxito en el presente caso(AU)

ABSTRACT Introduction: Edentulism is total or partial tooth loss mainly caused by dental caries and periodontal disease. It is a gradual process often associated to aging. At present edentulism is considered to be a disability, due to the functional limitations undergone by sufferers. Objective: Describe the multidisciplinary, functional and esthetic rehabilitation treatment provided to a patient with occlusal disharmony. Case presentation: A 74-year-old male patient was diagnosed with bimaxillary partial edentulism based on clinical and radiographic examination. The patient underwent generalized periodontal therapy, pre-prosthetic surgery, direct and indirect occlusal plane restoration, and oral rehabilitation with total upper and partial lower removable prostheses, as a result of which he recovered his functionality, esthetic appearance and self-esteem. Conclusions: Edentulism triggers changes in the functional and emotional state of patients. Comprehensive diagnosis and orderly multidisciplinary treatment led to success in the case herein presented(AU)

Reabilitação com coroas metal free em dentes anteriores traumatizados e com rizogênese incompleta: relato de caso / Rehabilitation with metal free crowns in traumatized anterior teeth with incomplete rhizogenesis: case report

Objetivo: rizogênese incompleta refere-se a dentes permanentes em que não houve a formação completa do ápice radicular, ocasionando perda da vitalidade pulpar e, consequentemente, incapacidade da bainha epitelial de Hertwig para induzir a formação completa da raiz. Devido ao traumatismo e escurecimento dental, se faz necessário em certos casos a confecção de coroas em porcelana pura para reabilitar a paciente em estética e função. O presente trabalho tem como objetivo demonstrar um caso de reabilitação estética e funcional em dente com rizogênese incompleta, onde se consideraram as perdas estruturais e alteração de cor, para que seja possível estabelecer o tratamento mais adequado. Relato de caso: paciente de 16 anos, gênero feminino, atendida na Clínica de Odontologia de uma instituição privada, insatisfeita com a estética do seu dente devido ao escurecimento do elemento 21, pois quando tinha 5 anos o dente foi traumatizado juntamente com o elemento 11. O plano de tratamento adotado para ambos os elementos foi a confecção de peças protéticas em porcelana e cimentação. Considerações finais: esse caso demonstrou que a confecção de coroas estéticas em porcelana é considerada uma boa conduta na rotina clínica em casos de escurecimento dental, devolvendo estética e função para o paciente.(AU)

Objective: incomplete rhizogenesis refers to permanent teeth with incomplete formation of the root apex, causing loss of pulp vitality and the consequent inability of the Hertwig epithelial sheath to induce complete root formation. Due to dental trauma and darkening, some cases require the production of pure porcelain crowns to rehabilitate the aesthetics and function of patients. The present study aims to show a case of aesthetic and functional rehabilitation in a tooth with incomplete rhizogenesis, in which structural losses and color change were considered to establish the most appropriate treatment. Case report: a 16-year-old female patient treated at the Dental Clinic of a private institution. The patient was not satisfied with the aesthetics of her tooth due to the darkening of element 21, because at 5 years old the tooth was traumatized along with element 11. The treatment used for both elements was the production of prosthetic porcelain crowns and cementation. Final considerations: this case showed that the production of aesthetic porcelain crowns is considered a good conduct in the clinical routine in cases of tooth darkening, returning aesthetics and function to the patient.(AU)

La désinfection des empreintes dentaires au laboratoire de prothèse : évaluation de la pratique des prothésistes dentaires ivoiriens

Le prothésiste dentaire est exposé à un risque élevé de transmission infectieuse par la manipulation des empreintes dentaires souillées par la salive et le sang. En effet, lors d'une prise d'empreinte au cabinet dentaire, le matériau entre en contact direct avec les mucosités et sérosités de la cavité buccale, abritant de nombreux germes. Ainsi la décontamination des empreintes, pour prévenir la contamination croisée. Cette étude a eu pour objectif d'évaluer les attitudes et pratiques des prothésistes dentaires dans la ville d'Abidjan, en matière de décontamination des empreintes. Il s'agit d'une étude transversale descriptive qui s'est déroulée sur une période de trois (03) mois. Elle a concerné 35 prothésistes dentaires exerçant tant dans les secteurs privés et publics. Plus de 97% des prothésistes dentaires interrogés, sont conscients de l'existence du risque infectieux liés aux empreintes dentaires. Aucune des empreintes reçues par les prothésistes, n'était accompagnée de fiche mentionnant son état de décontamination. 85,71% des prothésistes, affirment rincer systématiquement toutes les empreintes dès leur réception et près de 32% ne les décontaminent pas

Reabilitação oral de paciente com fissura palatina e ausência de pré-maxila / Oral rehabilitation of a cleft palate patient without premaxillary bone ­ a clinical report

As fissuras labiopalatais são malformações faciais com sequelas funcionais e estéticas que causam grande impacto na qualidade de vida dos pacientes. O tratamento desses indivíduos requer uma abordagem multidisciplinar, incluindo tratamento plástico cirúrgico, fonoaudiológico e psicológico, além das intervenções odontológicas, ortodônticas e protéticas. Este relato de caso apresentou a reabilitação protética de uma paciente de 57 anos com fissura palatina anterior, com remoção da pré-maxila. Após vários tratamentos, a paciente ainda não havia sido reabilitada, apresentando deformidades provenientes dos tratamentos anteriores incompletos. Uma prótese parcial removível retida por dentes e implantes osseointegrados foi executada, promovendo a melhora na aparência facial, na função mastigatória, na fala e, consequentemente, na qualidade de vida da paciente.

Cleft lip and palate, which is a facial malformation with both functional and aesthetic characteristics, may have a large impact on the lives of those affected. Its correction requires an interdisciplinary approach, which includes surgical, orthodontic and prosthetic treatments. This clinical report presents the prosthetic rehabilitation of a 57-year-old woman with an anterior cleft palate defect that had not been closed completely with surgical repair. In this way, an implant-supported, retained removable partial prosthesis was delivered to improve the patient's facial aspect, masticatory function, speech, and her quality of life.

Prótese unitária metalocerâmica para implantes colocados em nível ósseo: a estratégia para o pilar Gold / Single-tooth implant-supported metalloceramic crowns for bone level implants: the Gold abutment strategy

O planejamento protético sobre os atuais sistemas de implantes dentais tipo cone-morse junto à prótese parafusada procura obter uma versatilidade protética, facilidade de elaboração, boa resposta biológica, reversibilidade e estética, apresentando-se como um pilar protético com cilindro de plástico que permite fabricação diretamente para a fixação no implante, envolvendo o mecanismo antirrotacional, e sendo uma alternativa no tratamento de reabilitação em casos de requerimento estético em implantes instalados no nível ósseo (Bone level, Straumann). Este relato de caso descreveu o procedimento de exodontia atraumática, seguida da instalação de implante imediato com preenchimento de gap, e subsequente sequência clínica da reabilitação sobre implante cone-morse com componente protético com cilindro de plástico (Gold abutment, Straumann), que promove maior previsibilidade estética na reabilitação em implantes instalados no nível ósseo, apresentando um prognóstico satisfatório e equilíbrio mecânico/funcional que envolve mecanismo antirrotacional.

The prosthetic design on the current cone morse dental implant systems, together with the screwed prosthesis, seeks prosthetic versatility, ease of preparation, good biological response, retrievability and aesthetics, presenting a prosthetic abutment with a plastic burnout cylinder for direct connection to the implant with an antirrotational mechanism for esthetic situations involving a bone level implant (Straumann). This case report describes the atraumatic extraction procedure, followed by the installation of an immediate gap filling implant, and a subsequent clinical sequence using the Gold abutment (Straumann) plastic prosthetic component, which promotes greater aesthetic predictability in the rehabilitation of implants installed at the bone level, presenting a satisfactory prognosis and mechanical/functional balance involving antirotation mechanism.

Agenesis of maxillary lateral incisor in an Angle Class II, Division 1 malocclusion patient

The present case report describes the orthodontic treatment of a patient with agenesis of maxillary left lateral incisor and Angle Class II, Division 1 malocclusion. The patient also presented with maxillary midline deviation and inclination of the occlusal plane in the anterior region. Treatment objectives were: correction of sagittal relationship between the maxilla and the mandible; correction of midline deviation, so as to cause maxillary and mandibular midlines to coincide; correction of overbite and leveling of the occlusal plane, so as to create ideal conditions for esthetic rehabilitation of anterior teeth. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

O presente caso clínico relata o tratamento ortodôntico de um paciente portador de agenesia do incisivo lateral superior esquerdo e má oclusão de Classe II 1a divisão de Angle. Apresentava, ainda, desvio da linha média superior e inclinação do plano oclusal na região anterior. Os objetivos do tratamento foram adequar a relação sagital entre as arcadas, proporcionar a coincidência entre as linhas médias superior e inferior, corrigir a sobremordida e nivelar o plano oclusal, criando condições apropriadas para a reabilitação estética dos dentes anteriores. Este caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Bandeira de broadrick para o restabelecimento do plano oclusal com utilização de prótese Overlay / Rehabilitation with Broadrick flag for restoring occlusal plane and use of type Overlay prosthesis

O correto restabelecimento da dimensão vertical de oclusão (DVO), do posicionamento mandibular e do nivelamento do plano oclusal devem ser requisitos básicos nas reabilitações onde houve um colapso oclusal. Porém, em muitos casos essas soluções requerem tratamentos complexos e de alto custo para a maioria da população. O presente trabalho teve como objetivo revisar os princípios envolvidos, indicação clínica, planejamento e execução, com o objetivo de discutir a viabilidade clínica e efetividade de próteses parciais removíveis (PPR) provisórias tipo Overlay e do nivelamento oclusal com o auxílio do dispositivo de Broadrick, identificando suas indicações, vantagens e desvantagens através da apresentação de um caso clínico. Concluiu-se que a PPR tipo Overlay pode ser indicada como alternativa de tratamento para pacientes com necessidade do nivelamento oclusal e do restabelecimento da DVO, podendo ser empregada como tratamento temporário ou definitivo; e o método de Broadrick pode ser útil na orientação da determinação da curva de Spee em pacientes com plano oclusal desequilibrado.

The correct restoration of vertical dimension of occlusion, the mandible positioning and leveling of the occlusal plane should be basic requirements in rehabilitation where there was a collapse occlusal. But in many cases these solutions require complex treatments and expensive for the vast majority of the population. This study aimed to review the principals involved, clinical indication, planning, in order to discuss the feasibility and clinical effectiveness of prosthesis type overlay and leveling the occlusal technique Broadrick, identifying their indications, advantages and disadvantages through the presentation of a clinical case. It was concluded that the overlay PPR may be an alternative treatment for patients in need of restoring the vertical dimension may be used as temporary or permanent treatment, and the method Broadlick may be useful in determining the orientation of the curve of Spee in patients with occlusal plane incorrect.