Influence of plasma-based dry etching on the bond strength of Y-TZP ceramic.

The aim of this study was to evaluate the bond strength between an yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic and a luting agent when submitted to plasma etching surface treatment before and after thermocycling (TC) with 3000 cycles of 5°C-55°C. The null hypothesis was that the surface treatments and thermocycling would not influence the bond strength. A total of 160 Y-TZP ceramic blocks in 2 sizes (10 size 1 and 10 size 2 blocks in each group) were distributed into 8 groups: group C (control), no surface treatment; group C-TC, TC without prior surface treatment; group SAO, sandblasting with aluminum oxide (Al2O3); group SAO-TC, sandblasting with Al2O3 followed by TC; group SAOS, sandblasting with silica-coated Al2O3; group SAOS-TC, sandblasting with silica-coated Al2O3 followed by TC; group PE, plasma etching; and group PE-TC, plasma etching followed by TC. In each group, size 1 blocks were cemented to size 2 blocks to fabricate specimens for microshear bond strength testing (n = 10 per group). Cementation followed surface treatments (except in control groups) and preceded any TC. All specimens were cemented using a luting agent that contained 10-meth-acryloyloxydecyl dihydrogen phosphate (MDP). The specimens were submitted to a microshear bond strength test and the means were analyzed with a 2-factor analysis of variance and Tukey test. Group PE showed the highest bond strength value before thermocycling (17.31 MPa). After thermocycling, the highest value was observed in the SAO-TC group (9.73 MPa), and statistically significant differences were observed between SAOS-TC and SAO-TC (P < 0.05) and PE-TC and SAO-TC (P < 0.05). Plasma etching improved the bond strength values between the Y-TZP ceramic and MDP-containing luting agent before thermocycling. After thermocycling, all groups showed lower bond strength values.

Wear at the Implant-Abutment Interface of Zirconia Abutments Manufactured by Three CAD/CAM Systems.

PURPOSE: To evaluate the changes in the external-hexagon surface of the titanium (Ti) implant before and after mechanical cycling, when coupled with zirconia (Zr) abutments (A) manufactured by three computer-aided design/computer-aided manufacturing (CAD/CAM) systems (Neodent Digital, Zirkonzahn, and AmannGirrbach) and the ZrTi abutment manufactured by Neodent. MATERIALS AND METHODS: Four groups were formed (n = 6): titanium implant with Zr AmannGirrbach abutment (AZrAG), with Zr Zirkonzahn abutment (AZrZ), with Zr Neodent abutment (AZrN), and with Zr abutment with infrastructure in Ti Neodent (AZrTiN). Standardized abutments were made from three identical abutments milled in wax. Images of the surface of each side of the hexagons of the implant were obtained by scanning electron microscopy, before and after mechanical cycling, to evaluate the parameters: (1) scratches in the hexagon face; (2) hexagon superior shoulder kneading; (3) hexagon shoulder wear; (4) alterations on the hexagon base; and (5) scratches on the hexagon top. The abutments were coupled with the implants, and Cr-Co crowns were cemented. The implant/abutment/crown assemblies were submitted to mechanical cycling (400 N, 8.0 Hz) for 1 million cycles. The observed changes were classified as follows: absence (0), mild (1), moderate (2), and severe (3). The results were analyzed using the Mann-Whitney, Kruskal-Wallis, and Dunn tests (P < .05). RESULTS: For parameter 1, a significant difference (P = .008) was observed between AZrZ and AZrAG, with more scratches in AZrZ; and between AZrN and AZrTiN (P = .006), with more scratches in AZrN. For parameter 2, a significant difference (P < .05) was observed between AZrZ and AZrAG and between AZrZ and AZrN, with greater kneading in AZrZ; among AZrN and AZrTiN, there was no significant difference (P = .103). For parameter 3, a significant difference (P < .05) was observed between AZrZ and the other groups of Zr, with more wear in AZrZ; between AZrN and AZrTiN, there was no significant difference (P = .107). For parameter 4, a significant difference (P < .05) was observed between AZrZ and AZrN, with more scratches in AZrZ; a significant difference (P = .002) was also observed between AZrN and AZrTiN, with more scratches in AZrN. For parameter 5, a significant difference (P < .05) was observed between AZrZ and AZrAG and between AZrZ and AZrN, with the fewest scratches in AZrZ; a significant difference (P = .006) was also observed between AZrN and AZrTiN, with more alterations in AZrN. Considering all the alterations, the AZrZ group showed more surface alteration, 1.74 (0.99); followed by AZrN, 1.43 (0.92); AZrAG, 1.32 (0.96); and AZrTiN, 0.88 (0.94). CONCLUSION: Among the Neodent abutments, the AZrN group had shown more surface alterations. Among the Zr groups, AZrZ samples had shown the most altered surfaces, suggesting that alterations on the implant/Zr abutment hexagon surfaces are related to the abutment milled hexagon shape.

Initial oral biofilm formation on titanium implants with different surface treatments: An in vivo study.

OBJECTIVE: The aim of this study was to examine in vivo the initial bacterial adhesion on titanium implants with different surface treatments. DESIGN: Ten subjects wore oral splints containing machined pure titanium disks (Ti-M), acid-etched titanium (Ti-AE) and anodized and laser irradiated disks (Ti-AL) for 24h. After this period, disks were removed from the splints and adherent bacteria were quantified by an enzymatic assay to assess total viable bacteria and by Real Time PCR to evaluate total bacteria and Streptococcus oralis levels. Additionally, the initial adherent microorganisms were visualized by scanning electron microscopy (SEM). Titanium surface morphology was verified using SEM, and roughness was evaluated by profilometer analysis. RESULTS: Regarding titanium surface roughness, Ti-AL (1.423±0.397) showed significantly higher Ra values than did Ti-M (0.771±0.182) and Ti-AE (0.735±0.196) (p<0.05, ANOVA - Tahame). Ti-AE and Ti-AL presented roughened micro-structure surfaces characterized by open pores, whereas Ti-M showed long grooves alternating with planed areas. Comparing the Ti-M, Ti-AE and Ti-AL groups for viable bacteria (MTT assay), total bacteria and S. oralis quantification (qPCR), no significant differences were observed among these three groups (p>0.05, ANOVA - Tahame). SEM images showed similar bacterial adhesion on the three titanium surfaces, predominantly characterized by cocci and several bacilli, indicating an initial colonization of the oral biofilm. CONCLUSION: In conclusion, roughness and microtopography did not stimulate initial biofilm formation on titanium surfaces with different surface treatments.

Influence of dental chair backrest inclination on the registration of the mandibular position.

STATEMENT OF PROBLEM: Varying the inclination of the dental chair backrest might alter the distribution of occlusal contact points. PURPOSE: The purpose of this study was to identify the influence of backrest inclination on the registration of the mandibular position. MATERIAL AND METHODS: Ten participants aged between 18 and 30 years with a complete permanent dentition, uncompromised motor function, no tooth mobility, and no temporomandibular disorders were selected. To register interocclusal contacts, an autopolymerizing methylmethacrylate device was adapted to the maxillary anterior teeth and a composite resin increment was added to the mandibular central incisors. Contacts were registered with the following variations in the inclination of the dental chair backrest: 90 degrees, 120 degrees, and 180 degrees. A standardized digital photograph was made of each mark in each backrest position, and the images were superimposed to measure the distances in registration from 90 to 120 and from 90 to 180 degrees. Data were analyzed with the Student paired t test (α=.05). RESULTS: When the chair was inclined from the 90-degree to the 120-degree position, the mandible was repositioned posteriorly by a mean of 0.67 mm, but the difference was not statistically significant. When the chair was inclined from the 90-degree to the 180-degree position, however, the mandible was repositioned posteriorly by a statistically significant mean of 1.41 mm. CONCLUSIONS: Mandibular position is influenced by increasing inclination, and this influence was statistically significant at a 180-degree incline.

Evaluation of castable and premachined metal base abutment/implant interfaces before and after cyclical load.

PURPOSE: The purpose of this study was to compare the vertical fit of the castable abutment/implant and premachined base metal abutment/implant interface, before and after cyclic loading. MATERIALS AND METHODS: Ten UCLA abutments were distributed in 2 groups: castable and premachined with a cobalt-chromium metal base. The abutments were cast in cobalt-chromium alloy and were screwed onto implants (3.75 × 13 mm, external hexagon) with a 32 N·cm torque. The vertical gap (in micrometers) at the interface abutment/implant was evaluated by linear microscope 2 times: after torque and after cyclic load (1 million cycles, 400 N). RESULTS: The mean values of the vertical gap at the castable abutment/implant and premachined abutment/implant interfaces before and after cyclic load were 5.33 to 6.64 µm and 7.36 to 8.16 µm, respectively. The mean values of the vertical gap were statistically analyzed (ANOVA and t test, P ≤ 0.05). Vertical gap values of the castable abutment/implant interface were not significantly different from those of the premachined abutment/implant interface, before (P = 0.154) and after (P = 0.471) cyclical loading. CONCLUSION: Castable and premachined base metal abutments showed similar gaps at the implant/abutment interface, both after applying torque and after cyclic loading.

Stability of external and internal implant connections after a fatigue test.

OBJECTIVE: The objective of this study was to compare the torque and detorque values of screw intermediates of external hexagon, internal hexagon, and Morse taper implants in single restorations before and after mechanical cycling. MATERIALS AND METHODS: The study sample was divided into three groups (n = 10) as follows: group EH - external hexagon implant, group IH - internal hexagon implant, and group MT - Morse taper implant. Universal abutments were screwed on the implants, and metal crowns were cemented onto the abutment. The samples were submitted to a mechanical testing of 1 million cycles, with a frequency of 8 cycles per second under a 400 N load. The application and registration of the screw torque (T0) and detorque (T1) values of the intermediate were performed before and after the test. The results were statistically evaluated by analysis of variance (ANOVA) and Tukey's test (α = 0.05). RESULTS: There was no difference between the values of T0 and T1 in the intra-group samples. However, the inter-group difference in T0 between the EH (12.8 N cm) and MT (18.6 N cm) groups and in T1 between the EH (10.4 N cm) and IH (13.8 N cm), EH and MT (19.4 N cm), and MT and IH (P = 0.001) groups were significant. The MT group showed a lower variation of T0 and T1. CONCLUSION: The internal implants, particularly MT, showed better stability in these cases when used for single restorations.

Urinary levels of catecholamines among individuals with and without sleep bruxism.

INTRODUCTION: Sleep bruxism (SB) is characterized by repetitive and coordinated mandible movements and non-functional teeth contacts during sleep time. Although the etiology of SB is controversial, the literature converges on its multifactorial origin. Occlusal factors, smoking, alcoholism, drug usage, stress, and anxiety have been described as SB trigger factors. Recent studies on this topic discussed the role of neurotransmitters on the development of SB. OBJECTIVE: Thus, the purpose of this study was to detect and quantify the urinary levels of catecholamines, specifically of adrenaline, noradrenaline and dopamine, in subjects with SB and in control individuals. MATERIALS AND METHODS: Urine from individuals with SB (n = 20) and without SB (n = 20) was subjected to liquid chromatography. The catecholamine data were compared by Mann-Whitney's test (p

Limiar de dor à pressão em pacientes com cefaléia tensional e disfunção temporomandibular / Pressure pain thereshold in patients with tension type headache and temporomandibular dysfunction

O objetivo deste estudo foi avaliar a evolução do limiar de dor muscular, através da algometria de pressão (LDP) e palpação manual (PM), dos músculos masseter e temporal em 20 pacientes portadores de disfunção temporomandibular (DTM). Todos participantes apresentavam queixa de cefaléia por mais de 6 meses, com características de cefaléia tensional e foram avaliados antes e dois meses após receberem como terapêutica, uma placa oclusal. A intensidade da cefaléia foi avaliada pela escala analógica visual (EAV) e a freqüência, pelo relato do número de episódios de dor por semana. Os resultados evidenciaram redução estatisticamente signifi cante (p<0,05) para intensidade e freqüência das dores de cabeça. Houve elevação do limiar de dor a pressão (LDP) dos músculos temporal direito (p = 0,027), temporal esquerdo (p=0.004) e masseter esquerdo (p= 0,025). Não foi encontrada diferença estatisticamente signifi cante para palpação manual dos quatro músculos avaliados. A análise dos dados permitiu concluir que apesar da redução considerável da intensidade e freqüência dos episódios de cefaléia após utilização de placas oclusais, foram encontrados resultados diferentes quando avaliado o limiar de dor dos músculos masseter e temporal com a algometria de pressão e com palpação manual.