Overdenture sobre raízes: uma alternativa na reabilitação protética de pacientes parcialmente dentados / Root-retained overdentures: prosthodontic rehabilitation alternative to partially dentate patients

O propósito do estudo foi realizar uma revisão de literatura a respeito do aproveitamento de raízes remanescentes para retenção de overdenture, as indicações dessa modalidade protética, sua longevidade e benefícios como alternativa reabilitadora viável. Foram consultadas bases de dados científicas, pesquisas diretas através de buscadores virtuais e em bibliotecas físicas, sem período cronológico estabelecido, tendo como descritores: ôsobredentaduraõ, ômanutenção de raízesõ, ôdentadura retida por dentesõ, ôoverdentureõ, ôroot maintainingõ e ôtooth-retained dentureõ. Baseada na revisão de literatura, concluiu-se que a overdenture retida por dentes remanescentes é mais estável e retentiva quando comparada a próteses removíveis convencionais, leva à manutenção dos estímulos proprioceptores, impede a reabsorção óssea adjacente, proporciona adequada eficiência mastigatória, restabelece o bem-estar social e psíquico do paciente e é um tratamento de baixo custo, fácil manutenção e evita procedimentos extensos e invasivos...

The purpose of the study was to review the literature on using remaining dental roots for overdenture retention, indications for these prosthodontics mode, its longevity and benefits as a viable rehabilitation alternative. For this literature review, scientific databases were perused and direct Internet searches were done, with no time period established, having as descriptors: ôoverdentureõ, ôroot maintainingõ and ôtooth-retained dentureõ. Based on the literature review, it was concluded that overdentures retained by remaining teeth are more stable and retentive when compared to conventional removable prosthesis, it leads to the proprioception maintaining, continued preservation of the bone around the remaining teeth, provides appropriate chewing efficiency, reestablishes the patientÆs social e psychic comfort, and it is a low cost, easy maintenance treatment that avoid extensive procedures...

Influence of different cantilever extensions and glass or polyaramide reinforcement fibers on fracture strength of implant-supported temporary.

In long-term oral rehabilitation treatments, resistance of provisional crowns is a very important factor, especially in cases of an extensive edentulous distal space. The aim of this laboratorial study was to evaluate an acrylic resin cantilever-type prosthesis regarding the flexural strength of its in-balance portion as a function of its extension variation and reinforcement by two types of fibers (glass and polyaramid), considering that literature is not conclusive on this subject. Each specimen was composed by 3 total crowns at its mesial portion, each one attached to an implant component (abutment), while the distal portion (cantilever) had two crowns. Each specimen was constructed by injecting acrylic resin into a two-part silicone matrix placed on a metallic base. In each specimen, the crowns were fabricated with either acrylic resin (control group) or acrylic resin reinforced by glass (Fibrante, Angelus) or polyaramide (Kevlar 49, Du Pont) fibers. Compression load was applied on the cantilever, in a point located 7, 14 or 21 mm from the distal surface of the nearest crown with abutment, to simulate different extensions. The specimen was fixed on the metallic base and the force was applied until fracture in a universal test machine. Each one of the 9 sub-groups was composed by 10 specimens. Flexural strength means (in kgf) for the distances of 7, 14 and 21 mm were, respectively, 28.07, 8.27 and 6.39 for control group, 31.89, 9.18 and 5.16 for Kevlar 49 and 30.90, 9.31 and 6.86 for Fibrante. Data analysis ANOVA showed statistically significant difference (p<0.05) only regarding cantilever extension. Tukey's test detected significantly higher flexural strength for the 7 mm-distance, followed by 14 and 21 mm. Fracture was complete only on specimens of non-reinforced groups.

Influence of different catilever extensions and glass or polyamaramid reinforcement fibers on fracture strength of implant-supported temporary

In long-term oral rehabilitation treatments, resistance of provisional crowns is a very important factor, especially in cases of an extensive edentulous distal space. The aim of this laboratorial study was to evaluate an acrylic resin cantilever-type prosthesis regarding the flexural strength of its in-balance portion as a function of its extension variation and reinforcement by two types of fibers (glass and polyaramid), considering that literature is not conclusive on this subject. Each specimen was composed by 3 total crowns at its mesial portion, each one attached to an implant component (abutment), while the distal portion (cantilever) had two crowns. Each specimen was constructed by injecting acrylic resin into a two-part silicone matrix placed on a metallic base. In each specimen, the crowns were fabricated with either acrylic resin (control group) or acrylic resin reinforced by glass (Fibrante, Angelus) or polyaramide (Kevlar 49, Du Pont) fibers. Compression load was applied on the cantilever, in a point located 7, 14 or 21 mm from the distal surface of the nearest crown with abutment, to simulate different extensions. The specimen was fixed on the metallic base and the force was applied until fracture in a universal test machine. Each one of the 9 sub-groups was composed by 10 specimens. Flexural strength means (in kgf) for the distances of 7, 14 and 21 mm were, respectively, 28.07, 8.27 and 6.39 for control group, 31.89, 9.18 and 5.16 for Kevlar 49 and 30.90, 9.31 and 6.86 for Fibrante. Data analysis ANOVA showed statistically significant difference (p<0.05) only regarding cantilever extension. Tukey's test detected significantly higher flexural strength for the 7 mm-distance, followed by 14 and 21 mm. Fracture was complete only on specimens of non-reinforced groups.

Influence of different cantilever extensions and glass or polyaramid reinforcement fibers on fracture strength of implant-supported temporary fixed prosthesis

In long-term oral rehabilitation treatments, resistance of provisional crowns is a very important factor, especially in cases of an extensive edentulous distal space. The aim of this laboratorial study was to evaluate an acrylic resin cantilever-type prosthesis regarding the flexural strength of its in-balance portion as a function of its extension variation and reinforcement by two types of fibers (glass and polyaramid), considering that literature is not conclusive on this subject. Each specimen was composed by 3 total crowns at its mesial portion, each one attached to an implant component (abutment), while the distal portion (cantilever) had two crowns. Each specimen was constructed by injecting acrylic resin into a two-part silicone matrix placed on a metallic base. In each specimen, the crowns were fabricated with either acrylic resin (control group) or acrylic resin reinforced by glass (Fibrante, Angelus) or polyaramide (Kevlar 49, Du Pont) fibers. Compression load was applied on the cantilever, in a point located 7, 14 or 21 mm from the distal surface of the nearest crown with abutment, to simulate different extensions. The specimen was fixed on the metallic base and the force was applied until fracture in a universal test machine. Each one of the 9 sub-groups was composed by 10 specimens. Flexural strength means (in kgf) for the distances of 7, 14 and 21 mm were, respectively, 28.07, 8.27 and 6.39 for control group, 31.89, 9.18 and 5.16 for Kevlar 49 and 30.90, 9.31 and 6.86 for Fibrante. Data analysis ANOVA showed statistically significant difference (p<0.05) only regarding cantilever extension. Tukey’s test detected significantly higher flexural strength for the 7 mm-distance, followed by 14 and 21 mm. Fracture was complete only on specimens of non-reinforced groups.

Fidelidade de troquéis de gesso obtidos do mesmo molde de uma silicona de condensação / Accuracy of stone dies consecutively constructed at the same by-condensation silicone mold

Não existem dados na literatura confirmando que seja adequado o uso de um mesmo molde para confeccionar mais de um troquel de gesso. Nesta pesquisa, o objetivo foi verificar a precisão de três troquéis de gesso, obtidos de um mesmo molde. A estrutura original moldada (troquel-padrão) consistia num tronco de cone, confeccionado em aço inoxidável, a qual simulava um dente preparado para receber uma coroa total e na qual um anel também confeccionado em aço inoxidável (coroa-padrão) podia ser adequadamente adaptado. Com uma silicona de condensação, através da técnica do casquete, foram confeccionados 10 moldes. Em cada molde, um primeiro troquel de gesso era imediatamente confeccionado, seguido por dois outros. A citada coroa-padrão era então encaixada em cada troquel de gesso obtido, para avaliar, com o auxílio de um microscópio de profundidade, o grau de fidelidade. O tratamento estatístico dos valores detectados permitiu concluir que todos os trquéis de gesso apresentaam dimensões significantemente maiores do que as do troquel-padrão e que houve uma piora progressiva da adaptação da coroa-padrão, desde o primeiro troquel de cada grupo até o terceiro.

Avaliação da resistência à fratura de dentes endodonticamente tratados, reconstruídos com pinos intra-radiculares, quando submetidos à ciclagem dinâmica / Evaluation of the fracture strength of endodontically treated teeth, reconstructed with post and cores, when submitted to the dynamic loading

Neste estudo, foi avaliada a resistência à fratura de dentes que, já tratados endodonticamente, foram reconstruídos proteticamente com uma coroa de liga de NiCr (Verabond II), a qual era apoiada sobre núcleos compostos por diferentes materiais, obtidos por diferentes técnicas, cimentados no remanescente radicular com o ionômero de vidro Rely X Lutting 2, o qual é acrescido de resina composta. Esses núcleos eram do tipo metálico fundido, no grupo NMF; no grupo ANATO, a resina composta Filtek Z250 (3M ESPE, St. Paul-MN, USA) constituía o núcleo, contendo um pino de fibra de vidro (Reforpost Fibra de Vidro RX, Ângelus Indústria de Produtos Odontológicos Ltda.,Londrina-PR); este mesmo tipo de pino era utilizado no grupo PFFV, sendo diretamente cimentado, sem acréscimo de resina; finalmente, no grupo PFM, um pino metálico (no 064, FKG Dentaire S. A., La Chaux-de-Fonds, Swiss) era cimentado da mesma maneira descrita para o grupo anterior. Os remanescentes radiculares eram provenientes de dentes caninos superiores humanos, distribuídos aleatoriamente, compondo assim os quatro grupos, cada um com 10 espécimes: Os espécimes, após 24 horas da cimentação, foram submetidos a esforços cíclicos, em uma Máquina Eletro-Mecânica de Fadiga, aplicados no sentido do longo eixo dental, com carga de 20 N, na freqüência de 2,0 Hz, assim perfazendo um total de 250.000 ciclos. Excetuando-se 2 corpos-de-prova cujos núcleos soltaram-se da raiz, durante a carga cíclica, todos os demais foram submetidos a uma carga de compressão, numa máquina universal de ensaios (Kratos - Dinamômetros Ltda. São Paulo-SP), regulada na velocidade de 0,5 mm/min, com a força aplicada na face palatina da coroa, num ângulo de 45º em relação ao longo eixo dental, até a ocorrência da fratura radicular. Os valores de resistência encontrados foram os seguintes, em ordem decrescente: 47,677 kgf para o grupo NMF, 34,921 kgf para o PFM, 31,354 kgf para o PFFV e, 27,172 kgf para o ANATO.

A análise de variância aplicada aos valores originais apontou diferença entre os grupos estudados e um subseqüente teste de Tukey (p < 0,05) permitiu verificar semelhanças entre todos eles, com diferença significante apenas entre os grupos NMF e ANATO.

In this study, was evaluated the strength of endodontically treated teeth, had been reconstructed with a crown of NiCr alloy (Verabond II), which was supported by a post and core for different materials, gotten for different techniques, cemented in the root with the glass ionomer Rely X Lutting 2, which is increased of composed resin. These diferents post and cores were of the casting metallic type, in group NMF; in group ANATO, the composed resin Filtek Z250 (3M ESPE, St. Paul-MN, USA) was the core, contend a glass fiber post (Reforpost Fibra de Vidro RX, Ângelus Indústria de Produtos Odontológicos Ltda., Londrina - PR); this exactly type of post was used in group PFFV, being directly cemented, without resin addition on the core; finally, in group PFM, a metallic post (064, FKG Dentaire S. , La Chaux-of-Fonds, Swiss) were cemented in the same way described for the previous group. All the roots were proceeding from maxillary human canines, randomly distributed, thus composing the four groups, each one with 10 specimens: The specimens, after 24 hours of the cimentation, had been submitted the cyclical efforts, in an Electromechanical Machine of Fatigue, applied in the direction of the long dental axle, with load of 20 N, in the frequency of 2 Hz, thus occuring a total of 250.000 cycles. Excepting 2 body-of-test whose post and cores had been freed of the root, during the cyclical load, all excessively had been submitted to a compression load, in a universal machine of assays (Kratos - Ltda. Dinamômetros. São Paulo - SP), regulated in the speed of 0,5 mm/min, with the force applied in the lingual face of the crown, in an angle of 45º in relation to the long dental axle, until the occurrence of the any root fracture. The joined values of resistance had been following, orderly the decreasing one: 47,677 kgf for group NMF, 34.921 kgf for the PFM, 31,354 kgf for the PFFV and, 27,172 kgf for the ANATO.

The analysis of variance applied to the original values pointed difference between the studied groups and a subsequent Tukey test (p < 0,05) it allowed to verify similarities between all they, with significant difference only between groups NMF and ANATO.

Avaliaçäo da dureza Rockwell (30T) de 29 resinas compostas / Rockwell hardness (30T) of 20 composite resins

A dureza é um dos importantes fatores a ser observado dentre as características dos materiais, sendo provavelmente indicativa de algumas outras propriedades mecânicas, inclusive para as resinas compostas. Foi analisada a dureza Rockwell 30T de 29 compósitos, confeccionando-se 3 corpos-de-prova para cada material. Após fotopolimerizaçäo por 80 segundos, aguardava-se mais 5 minutos e determinava-se a dureza (inicial); os espécimes eram entäo armazenados em água desionizada, a 37§C, durante 168 horas, quando nova leitura da dureza (final) era realizada. Estatisticamente, todas as resinas mostraram aumento de dureza, da mediçäo imediata para a com 168 horas; a resina Filtek Z-100 isoladamente apresentou o maior valor de dureza inicial; quando da dureza final, ela também apresentou o maior valor, agora acompanhada pela Filtek P-60; a de pior desempenho foi a Helioprogress, em ambas as idades