Oral health self-perception, maximum bite force and masticatory efficiency in patients with overdentures with different attachment systems-A crossover study.

BACKGROUND: The literature is unclear about how the different attachment systems for overdentures impact the maximum bite force, the masticatory efficiency and how this impact in the oral health self-perception in patients. OBJECTIVE: To evaluate the effect of two attachment systems (O-ring and Locator) for mandibular overdenture using single implant on quality of life, maximum bite force (BF) and masticatory efficiency (ME). METHODS: Twenty-eight completely edentulous denture wearers with a mandibular symphysis implant were randomly selected and allocated into two groups in a crossover study, considering O-ring and Locator attachment types. The quality of life and self-perception of oral health were assessed using the Oral Health Impact Profile (OHIP-Edent) and Geriatric Index of Determination of Oral Health (GOHAI) questionnaires, respectively. BF was measured using a gnathodynamometer and ME by chewing silicone cubes and almonds in different numbers of cycles. RESULTS: There was no difference between the attachment systems about self-perceived oral health and impact on quality of life (p > .05). The O-ring-type system obtained a significantly higher BF than the locator-type system (p = .04). Regardless of the food chewed, no statistically significant difference was observed with the type of attachment (p > .05). The ME was directly proportional to the masticatory cycles only for almonds (p < .01). CONCLUSIONS: Locator and O-ring inserts had a similar impact on patients' quality of life, self-perception of oral health and ME. Additionally, the O-ring system exhibited superior properties in the BF.

Implant digital impression accuracy using extraoral scanners: a three-dimensional analysis

Aim: To analyze the accuracy of extraoral systems (Ceramill Map400+, AutoScan-DS200+, and E2) in full implantprosthetic rehabilitation three-dimensionally. Methods: A metallic edentulous maxilla with four implants was digitalized by a contact scanner (MDX-40 - Roland, control) and used as a control image to compare with other images generated by three laboratory scanners (10 samples per group). Letters identified all the four components: A and D angled 45º, and B and C parallel. The BioCAD software exported the images (.STL) to compare and verify deviations of the analogs on the X, Y, and Z axes. The nonparametric Kruskal-Wallis test and the two-way ANOVA on ranks with a post hoc Tukey test analyzed the data with 5% significance. Results: No statistical differences were observed in the accuracy between the extraoral scanners (p=0.0806). However, when analyzing only the components, component D was more accurate when scanned with Ceramill Map400+ compared with AutoScan DS200+ (p<0.001) and with E2 (p=0.002). Conclusions: All extraoral systems assessed showed digitalization accuracy but with more deviations in angled implants. The Ceramill Map400+ scanner showed the best results for the digital impression of a complete arch

A randomised crossover clinical trial of masticatory function in complete denture wearers with conventional and lingualised balanced occlusion.

OBJECTIVES: The purposes of the present study were as follows: (1) to conduct a randomised crossover clinical trial to evaluate masticatory performance in wearers of conventional complete dentures in both arcs with conventional balanced occlusion (CBO) and lingualised balanced occlusion (LBO), using almonds as natural test food chewed for (a) 30 chewing cycles, (b) 40 chewing cycles and (c) until the subject felt ready to swallow and (2) to perform a randomised crossover clinical trial of oral health self-perception through the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. BACKGROUND: During rehabilitation with full dentures, achieving stability and retention is essential for masticatory performance. A factor that can act is the appropriate occlusal scheme to be used, although the literature is full of discussions as to the most suitable occlusal scheme to be used, being CBO and LBO the most used in complete dentures. MATERIALS AND METHODS: The clinical trial was conducted with 30 participants (14 males and 16 females; average age 65.8 years). A base of interchangeable posterior teeth in the lower dentures was used, thereby changing the occlusal schemes without needing to make another complete denture. The masticatory tests and GOHAI application were conducted in two sessions: first with each occlusal scheme, and second only after participants did not report discomfort with dentures. The analysis of variance for the mixed repeated-measures test (ANOVA) was used to verify the results (α = 0.05). RESULTS: The results showed no difference in masticatory performance according to the occlusal scheme (P = .519). The masticatory performance increased with the number of cycles (P < .001) tested, regardless of the type of occlusion scheme, and oral health self-perception was higher after the second masticatory evaluation session (P = .027). CONCLUSION: The masticatory performance was similar between the two occlusal schemes, increasing according to the number of chewing cycles. The adaptive period is relevant, regardless of the occlusion scheme, because the time factor was decisive for the improvements noted in the oral health self-perception of the participants (according to the GOHAI results).

Influence of filling materials on the fracture resistance of resin composite used for sealing screw access hole / Influência dos materiais de preenchimento na resistência a fratura das resinas compostas utilizadas para selamento do orifício de acesso ao parafuso

Introduction: Screw-retained restorations have a screw access hole (SAH) sealed with resin composite aiming at safe-guarding the aesthetic features of the ceramic veneer. The loss or wear of the resin composite applied in sealing the SAH is among the most common complications in implant prosthodontics, as the fracture of ceramic veneer. Objective: Evaluate the influence of sealant materials on the fracture resistance of resin composite applied in sealing screw access hole in screwed (SAH) implants. Material and method: The samples were produced from UCLA abutments in metallic NiCr alloy with subsequent application of ceramic. After asperisation and conditioning ceramic surface, was applied silane and dentin adhesive, before sealing the conduits with resin composites Z100 and P60. Nine groups (n=10) were evaluated: sealing with Z-100 (ZNC) and P-60 (PNC) without obturation of SAH; sealing with Z100 (ZCP) and P-60 (PCP) with absorbent cotton; Z100 (ZPT) and P60 (PPT) with polytetrafluoroethylene; Z100 (ZGP) and P60 (PGP) with gutta-percha and a cemented ceramic crown (ICS). After the fracture resistance test, the data were analyzed using two-way ANOVA and Tukey HSD tests (p<.05). Result: The fracture mode was evaluated by scanning electron microscope. Irrespective of the filling material, the highest mean values of fracture resistance were observed in the sealing with P60 (p=.002). When combined with resins composed of a sealing material, the results obtained were: ZGP: 805.5N/ PGP: 929.5N

Introdução: As próteses parafusadas possuem orifício de acesso ao parafuso (SAH), os quais são selados com resina composta. Sua perda ou desgaste está entre as complicações mais comuns em próteses sobre implantes, associadas a fratura da lâmina cerâmica. Objetivo: Assim, é importante avaliar a influência dos materiais de selamento na resistência à fratura de resina composta aplicada ao SAH no selamento de prótese sobre implantes parafusadas. Material e método: As amostras foram produzidas utilizando pilares UCLA em liga metálica de NiCr com posterior aplicação de cerâmica. Após asperização e condicionamento da superfície cerâmica, foram aplicados silano e adesivo dentinário, antes da selagem dos condutos com as resinas compostas Z100 e P60. Foram avaliados nove grupos (n = 10): selamento com Z-100 (ZNC) e P-60 (PNC) sem selamento do SAH; selamento com Z100 (ZCP) e P-60 (PCP) com algodão absorvente; Z100 (ZPT) e P60 (PPT) com politetrafluoroetileno; Z100 (ZGP) e P60 (PGP) com guta-percha e coroa de cerâmica cimentada (ICS). Após o teste de resistência à fratura, os dados foram analisados usando ANOVA de dois fatores e testes Tukey HSD (p<0,05). O tipo de fratura foi avaliado por microscópio eletrônico de varredura. Resultado Independentemente do material obturador, os maiores valores médios de resistência à fratura foram observados no selamento com P60 (p=0,002). Quando combinados com resinas compostas por um material de selamento, os resultados obtidos foram: ZGP: 805,5N/ PGP: 929,5N

One-year prospective clinical study comparing patient satisfaction and masticatory performance of mandibular overdentures supported by one versus two implants.

OBJECTIVE: There is a lack of clinical evidence on mandibular overdentures (MOD) supported by a single implant. To compare patient satisfaction and masticatory performance in MOD supported by one versus two implants in a two-group parallel randomized clinical trial. MATERIAL AND METHODS: Twenty-one patients wearing new maxillary and mandibular complete dentures (CDs) were randomly divided to receive one (GI, n = 11) or two (GII, n = 10) implants in the mandibular arch. Four months after implant placement, o-ring abutments were installed in the implants, and matrix attachments were placed in the lower complete dentures. Patient satisfaction with their dentures and masticatory performance were compared at baseline, 3, 6, and 12 months after the procedure. Data on patient satisfaction were analyzed using the Friedman test and the Mann-Whitney U test. Data on masticatory performance were analyzed using one-way repeated measures analysis of variance (ANOVA) and Student's t test (α=0.05). RESULTS: Both groups exhibited a significant increase in overall patient satisfaction in all periods evaluated (p<0.05), except for GI after 12 months, which had values similar to baseline (p=0.74). Satisfaction levels of GI and GII were similar at baseline, 3 and 6 months, but GII showed higher satisfaction levels (p=0.01) than GI at 12 months. GI and GII exhibited a significant increase (p<0.05) in masticatory performance for all periods relative to baseline. However, GII had higher masticatory performance with dentures than GI, regardless of the period (p<0.05). CONCLUSION: MOD supported by two implants demonstrated better patient satisfaction in the follow-up at 12 months and better masticatory performance than MOD supported by one implant.

Influence of Cusp Inclination and Type of Retention on Fracture Load of Implant-Supported Crowns

Abstract There are few informations about the influence of cusp inclination on the fracture strength of implant-supported crowns. The study aimed to evaluate the influence of cusp inclination and retention type on fracture load in implant-supported metal-ceramic single crowns. Sixty crowns were made, classified as cemented and screw-retained with screw access hole (SAH) sealed or not. Standard (33°) and reduced (20°) cusp inclinations were tested for each group (n=10). To support crowns of a mandibular second molar, analogs of external hexagon implants 5.0 were used. The fracture load was measured in a universal testing machine EMIC DL2000 (10 kN load cell; 0.5 mm/min). Two-way ANOVA (retention and cusp inclination) followed by post hoc Tukey’s honest significant difference test was used for the statistical analyses (a=0.05). Crowns with reduced cusp inclination exhibited significantly higher fracture load (p<0.01) than crowns with standard cusp inclination. Cemented crowns showed significantly higher fracture load (p<0.01) than screw-retained crowns. The interaction among these factors was not significant (p>0.05) for the fracture load. The sealing of SAH did not influence the fracture load of screw-retained crowns (p>0.05). In conclusion, fracture load of implant-supported metal-ceramic crowns was influenced by retention and cusp inclination, and there was no influence of the sealing of SAH.

Resumo Existem poucas informações sobre a influência da inclinação de cúspide na resistência à fratura de coroas implantossuportadas. O objetivo do estudo foi avaliar a influência da inclinação de cúspide e do tipo de retenção na carga de fratura de coroas unitárias metalocerâmicas implantossuportadas. Sessenta coroas foram confeccionadas, classificadas como cimentadas e parafusadas com orifício de acesso ao parafuso selado ou não. Cúspides com inclinação padrão (33°) e reduzida (20°) foram testadas para cada grupo (n=10). Para suportar as coroas de um segundo molar inferior, análogos de implante hexágono externo 5.0 foram utilizados. A carga de fratura foi mensurada em máquina de ensaios universais EMIC DL2000 (célula de carga de 10 kN; 0,5 mm/min). ANOVA dois fatores (retenção e inclinação da cúspide) seguido do pós-teste de Tukey da diferença honestamente significativa foi utilizada para análise estatística (a=0,05). Coroas com inclinação de cúspide reduzida exibiram carga de fratura significativamente maior (p>0,05) que coroas com cúspides de inclinação padrão. Coroas cimentadas apresentaram carga de fratura significativamente maior (p<0,01) que coroas parafusadas. A interação entre os dois fatores não foi significante (p>0,05) para a carga de fratura. O selamento do orifício de acesso ao parafuso não influenciou a carga de fratura das coroas parafusadas (p>0,05). Concluindo, a carga de fratura de coroas metalocerâmicas implantossuportadas foi influenciada pelo tipo de retenção e inclinação da cúspide, e não houve influência do selamento do orifício de acesso ao parafuso

Influence of Liquid Lubrication on the Screw-Joint Stability of Y-TZP Implant Abutment Systems.

PURPOSE: To evaluate the effectiveness of abutment screws coated with liquid Vaseline on the screw-joint stability of yttria-stabilized tetragonal zirconia (Y-TZP) abutment systems. MATERIALS AND METHODS: Forty Y-TZP prefabricated abutments, 20 Neodent and 20 Bionnovation, were tightened to 20 Ncm on their respective external hexagon implants, and divided into four groups (n = 10) according to the screws: coated with Vaseline or uncoated. The removal torque (RT) value of the abutment screw was measured before and after loading. A cyclic loading (0.5 × 106 cycles; 15 Hz) between 11 and 211 N was applied. Means were compared using a repeated-measures ANOVA (α = 0.05). RESULTS: There was no significant difference between coated and uncoated screws (p = 0.822). Significant differences were found between the abutment systems (p < 0.001). There was a significant effect of cyclic loading (p < 0.001). CONCLUSIONS: Coated and uncoated screws presented similar effectiveness in maintaining preload. CLINICAL RELEVANCE: The liquid lubricant used in this study does not influence the stability of Y-TZP single-implant restorations.

Influence of Sealing of the Screw Access Hole on the Fracture Resistance of Implant-Supported Restorations.

The purpose of this study was to assess the influence of sealing of the screw access hole (SAH) on the fracture resistance of metal-ceramic implant-supported restorations. UCLA abutments were used to make 30 implant-retained mandibular molar restorations and divide equally into three groups: Group SRS: screw-retained restorations with SAH sealed; Group SRNS: screw-retained restorations with SAH not sealed; Group CR: cement-retained restorations. The following protocol was adopted to restore the SAH: the ceramic surface of the SAH was air-abraded with aluminum oxide; etched with 10% hydrofluoric acid; a silane coupling agent and a bonding agent were applied; cotton pellets were used as filling material and P-60 resin composite as restoring material. The cement-retained restorations were cemented with Rely-X U100. A metal rod with a spherical tip of 6.0 mm diameter was used to apply a vertical static load, simultaneously on the buccal and lingual incline cusps, at a crosshead speed of 0.5 mm/min until the fracture of the specimens. Data were analyzed using one-way ANOVA and Dunnet test (p<0.05) for multiples comparisons. The mode of failure was evaluated by a scanning electron microscopy (SEM). No significant difference between screw-retained restorations was found. The highest mean fracture resistance values were observed with CR group. Therefore, it was shown that SAH sealing did not influence the fracture resistance of the screw-retained restorations.

Influence of Sealing of the Screw Access Hole on the Fracture Resistance of Implant-Supported Restorations

Abstract The purpose of this study was to assess the influence of sealing of the screw access hole (SAH) on the fracture resistance of metal-ceramic implant-supported restorations. UCLA abutments were used to make 30 implant-retained mandibular molar restorations and divide equally into three groups: Group SRS: screw-retained restorations with SAH sealed; Group SRNS: screw-retained restorations with SAH not sealed; Group CR: cement-retained restorations. The following protocol was adopted to restore the SAH: the ceramic surface of the SAH was air-abraded with aluminum oxide; etched with 10% hydrofluoric acid; a silane coupling agent and a bonding agent were applied; cotton pellets were used as filling material and P-60 resin composite as restoring material. The cement-retained restorations were cemented with Rely-X U100. A metal rod with a spherical tip of 6.0 mm diameter was used to apply a vertical static load, simultaneously on the buccal and lingual incline cusps, at a crosshead speed of 0.5 mm/min until the fracture of the specimens. Data were analyzed using one-way ANOVA and Dunnet test (p<0.05) for multiples comparisons. The mode of failure was evaluated by a scanning electron microscopy (SEM). No significant difference between screw-retained restorations was found. The highest mean fracture resistance values were observed with CR group. Therefore, it was shown that SAH sealing did not influence the fracture resistance of the screw-retained restorations.

Resumo O objetivo deste estudo foi avaliar a influência do selamento do orifício de acesso ao parafuso (OAP) na resistência à fratura de coroas metalocerâmicas implantossuportadas aparafusadas. Pilares UCLA foram utilizados para fazer 30 molares inferiores implantossuportados e divididos igualmente em três grupos: Grupo AS: coroas aparafusadas com o OAP selado; Grupo ANS: coroas aparafusadas com o OAP não selado; Grupo CC: coroas cimentadas. O seguinte protocolo foi utilizado para selar o OAP: a superfície de cerâmica do OAP foi jateada com óxido de alumínio; condicionada com ácido fluorídrico a 10%; um agente silano e um adesivo dentinário foram aplicados; bolinhas de algodão foram utilizadas como material de preenchimento e a resina composta P-60 como material de restauração. As coroas cimentadas foram cimentadas com Rely-X U100. Uma haste de metal com uma ponta esférica de 6.0 mm de diâmetro foi usada para aplicar uma carga estática vertical, simultaneamente nas vertentes triturantes das cúspides linguais e vestibulares, com 0,5 mm/min velocidade do atuador até a fratura das coroas. Os dados foram analisados através de ANOVA um fator e teste de Dunnett (p<0,05) para as comparações múltiplas. O modo de falha foi avaliado por um microscópio eletrônico de varredura (MEV). Não houve diferença significativa entre restaurações aparafusadas. Os maiores valores médios de resistência à fratura foram observados com o Grupo CC. Portanto, observou-se que o selamento do OAP não influenciou a resistência à fratura das coroas aparafusadas.

Reestablishment of Occlusal Vertical Dimension in Complete Denture Wearing in Two Stages.

The assessment and reestablishment of the occlusal vertical dimension (OVD) are considered important factors in the treatment of complete denture wearers. The long-time use of a complete denture can result in jaw displacement due to abrasion of the artificial teeth and residual ridge resorption, causing esthetic complications. Most patients with old dentures and incorrect OVD accept reestablishment of the OVD with new complete dentures, even if they were used to their old dentures. The present clinical report describes a method of gradual reestablishment of OVD using a diagnostic acrylic splint on artificial teeth in old complete dentures before the manufacture of new complete dentures. Clinical Significance. The use of a reversible treatment for reestablishment of the OVD in old complete dentures with a diagnostic occlusal acrylic splint allows for the reestablishment of the intermaxillary relationship, providing physiological conditions of masticatory performance associated with the recovery of facial esthetics in edentulous patients.

Split-Framework in Mandibular Implant-Supported Prosthesis.

During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient's discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

Prótese metalocerâmica associada à prótese metaloplástica implantossuportada em paciente desdentado total / Full maxillary, metal-ceramic implant-supported prosthesis against a complete, mandibular, acrylic implant-supported prosthesis: a case report

A utilização de diferentes métodos e materiais deve ser considerada durante o planejamento de próteses implantossuportadas. Complicações, como fraturas da base de resina acrílica, desgaste e fratura dos dentes, podem ocorrer com frequência, gerando a necessidade de um planejamento cuidadoso para cada paciente, o que pode tornar a seleção do tipo de tratamento mais complexa. Diante disso, este artigo descreve a reabilitação oral de um paciente totalmente edêntulo, portador de prótese tipo protocolo bimaxilar, que apresentava queixa estética, perda de dimensão vertical e fratura em dentes de resina acrílica do arco superior. Após o restabelecimento da dimensão vertical, realizou-se a substituição de suas próteses antigas por uma nova prótese tipo protocolo bimaxilar, sendo que a cerâmica foi utilizada como material de cobertura para o arco superior, e resina como material de cobertura para o arco inferior. Ao final do tratamento, o paciente recebeu placas oclusais lisas bimaxilares para proteger os dentes e implantes de possíveis hábitos parafuncionais. A forma como o tratamento foi conduzido permitiu uma resolução rápida e eficaz, com resultado estético e funcional muito favorável para o paciente.

The use of different methods and materials should be considered during the planning of implant-supported prostheses. Complications such as fractures of the acrylic resin base, wear and fracture of teeth can occur frequently, creating the need for careful planning for each patient, which can make the selection of the type of treatment more complex. Thus, this article describes the oral rehabilitation of a completely edentulous patient with bimaxillary fixed implant-supported prosthesis, with complaints on aesthetics, loss of vertical dimension and fracture of acrylic resin teeth of the upper arch. After the restoration of vertical dimension, his dentures were replaced with new bimaxillary implant-supported fixed prostheses, ceramic and acrylic resin were used as veneering material for maxilla and mandible, respectively. At the end of the treatment, the patient received bimaxillary flat occlusal splints to protect the teeth and implants of possible parafunctional habits. The approach for the treatment allowed a quick and effective resolution, with aesthetic and functional outcomes very favorable for the patient.

Influence of three types of abutments on preload values before and after cyclic loading with structural analysis by scanning electron microscopy.

PURPOSE: To evaluate the effectiveness of three types of abutments in the maintenance of screw joint preload before and after cyclic loading as well as to observe possible microdamage in the structure of the components using a scanning electron microscope (SEM). MATERIALS AND METHODS: Forty-five external-hex implants were embedded in epoxy resin, received their respective abutments, and were randomly divided into three experimental groups (n = 15): (1) machined titanium (Ti) abutments; (2) pre-machined gold (Au) abutments; and (3) machined zirconia (ZrO(2)) abutments. The abutment screws were tightened according to the manufacturer's recommended torque. Initially, a static bending test was performed using five specimens of each group to determine the load applied in the cyclic loading test. Thus, 10 specimens of each group were used to measure the reverse torque value (preload) of the abutment screw before and after loading. A cyclic loading (0.5 × 10(6) cycles; 15 Hz) between 11 and 211 N was applied at an angle of 30 degrees to the long axis of the implants. The group means were compared using analysis of variance and the Tukey test (α = .05). RESULTS: The reverse torque analysis before cyclic loading showed no significant difference among the groups (P > .05). After cyclic loading, all preload means decreased significantly. The lowest decrease in preload was observed in the Ti group, whereas the highest decrease was observed in the ZrO(2) group, with a significant difference noted between them (P = .010). The Au group presented an intermediate decrease, with no significant difference compared to the other groups (P > .05). SEM images showed structural changes in the mating surfaces of the abutments after cyclic loading. CONCLUSION: The load application reduced the preload means significantly in all groups, and more significantly in the ZrO(2) group.

Effectiveness of screw surface coating on the stability of zirconia abutments after cyclic loading.

PURPOSE: Different surface treatments have been developed in attempts to prevent the loosening of abutment screws. The aim of the current study was to compare the effectiveness of titanium alloy screws with tungsten-doped diamond-like carbon (W-DLC) coating and uncoated screws in providing stability to zirconia (ZrO2) ceramic abutments after cyclic loading. MATERIALS AND METHODS: Twenty prefabricated ZrO2 ceramic abutments on their respective external-hex implants were divided into two groups of equal size according to the type of screw used: uncoated titanium alloy screw (Ti) or titanium alloy screw with W-DLC coating (W-DLC/Ti). The removal torque value (preload) of the abutment screw was measured before and after loading. Cyclic loading between 11 and 211 N was applied at an angle of 30 degrees to the long axis of the implants at a frequency of 15 Hz. A target of 0.5 X 106 cycles was defined. Group means were calculated and compared using analysis of variance and the F test (α = .05). RESULTS: Before cyclic loading, the preload for Ti screws was significantly higher than that for W-DLC/Ti screws (P = .021). After cyclic loading, there was no significant difference between them (P = .499). CONCLUSIONS: Under the studied conditions, it can be concluded that, after cyclic loading, both abutment screws presented a significant reduction in the mean retained preload and similar effectiveness in maintaining preload.

Antimicrobial activity of disinfectant agents incorporated into type IV dental stone.

PURPOSE: This study evaluated the antimicrobial activity of two disinfectant agents, 2% chlorhexidine digluconate solution (CHX) and 98% chlorhexidine hydrochloride powder (HYD), incorporated into type IV dental stone at the time of mixing. MATERIAL AND METHODS: Agar diffusion test was used for the following microorganisms: Escherichia coli, Staphylococcus aureus, Bacillus subtilis and Candida albicans. The specimens were grouped in: (1) dental stone mixed with sterile distilled water; (2) paper disc soaked with CHX; (3) dental stone mixed with CHX; and (4) dental stone with incorporation of HYD, in 1% proportion of the dental stone mass and mixed with sterile distilled water. The culture medium was inoculated with microbial suspensions 1 and 24 h after pouring of the dental stone. The antimicrobial activity was evaluated by the average diameter of microbial growth inhibition zones. The data were analysed with a nested anova (p < 0.05) and Tukey test for specific comparisons. RESULTS: The disinfectant agents demonstrated antimicrobial activity against all microorganisms, with the exception of C. albicans, against which the CHX was ineffective in two periods of analysis. Significant differences between disinfectants were found with all microorganisms. CONCLUSION: The disinfectant agents analysed were effective against most of the microorganisms tested, except C. albicans.

Influence of surface treatments on the flexural strength of denture base repair.

OBJECTIVE: The purpose of this study was to evaluate the flexural strength of repairs made with autopolymerising acrylic resin after different treatments of joint surfaces. MATERIAL AND METHODS: Fifty rectangular specimens were made with heat-polymerised acrylic resin and 40 were repaired with autopolymerising acrylic resin following joint surface treatments: group 1 (intact specimens), group 2 (chemical treatment: wetting with methyl-methacrylate for 180 s), group 3 (abraded with silicon carbide paper), group 4 (abraded and wetting with methyl-methacrylate for 180 s) and group 5 (without surface treatment). The flexural strength was measured by a three-point bending test using a universal testing machine with a 100 Kgf load cell in the centre of repair at 5 mm/min cross-head speed. All data were analysed using one-way anova and Tukey HSD test for multiple comparisons (p < 0.05). RESULTS: Among repaired specimens, groups 2 and 4 had 66.53 ± 3.4 and 69.38 ± 1.8 MPa mean values and were similar. These groups had superior flexural strength than groups 3 and 5 that were similar and had 54.11 ± 3.4 and 51.24 ± 2.8 MPa mean values, respectively. Group 1 had a mean value of 108.30 ± 2.8 MPa being the highest result. CONCLUSION: It can be concluded that the treatment of the joint surfaces with methyl-methacrylate increases the flexural strength of denture base repairs, although the strength is still lower than that observed for the intact denture base resin. Abrasion with sandpaper was not able to influence the flexural strength of repaired denture bases.

Rahabilitación oral sobre implantes instalados por medio de la técnica sin colgajo (flapless) y carga inmediata / Oral rehabilitation with flapless surgical technique and immediate implant loading

La rehabilitación oral con implantes osteointegrados es un tratamiento que está bien documentado y con un alto porcentaje de éxito. Sin embargo, exigencias relacionadas al tiempo de tratamiento y a la técnica quirúrgica fueron surgiendo. En ese contexto, el procedimiento de carga inmediata, en el cual la prótesis dental es instalada inmediatamente después del procedimiento quirúrgico se tornó una práctica constante. A pesar de que la carga inmediata ha sido un importante avance, procedimientos mínimamente invasivos, como la instalación de implantes con la técnica directa, sin desplazamiento del colgajo mucoperiostio (flapless) vienen siendo cada vez más realizados. La asociación de la carga inmediata con la técnica directa o de flapless mejora la aceptación de los pacientes y profesionales, pues no hay necesidad de sutura, además de reducir el edema, la hemorragia durante y después de la cirugía, el dolor post-operatorio, el tiempo quirúrgico, la incomodidad y hematoma, reduciendo también la necesidad de medicación post-operatoria. Esas características facilitan las etapas de rehabilitación inmediatamente después de la colocación de los implantes, colaborando con el trabajo del técnico protésico. De esa forma, la propuesta de este trabajo es presentar un caso clínico de rehabilitación oral con implantes osteointegrados y prótesis fijas en ambas arcadas, donde se realizó la técnica directa seguida por carga inmediata, relatando el diagnóstico, planificación, procedimientos quirúrgico/protésicos y seguimiento de 20 meses

The oral rehabilitation with osseointegrated implants is a well-documented treatment with high rate of success. Nevertheless, demands related to treatment time and surgical technique began to appear. In this context, the procedure of immediate loading in which the dental prosthesis is placed right after implant surgery has become a constant practice. Although immediate loading has been an important advance, minimally invasive procedures, such as implant placement without raising a mucoperiosteal flap (flapless) are increasingly being performed. Association of immediate loading with the flapless technique improves acceptance by patients and professionals, because no suturing is required. Moreover, it reduces swelling, bleeding during and after surgery, postoperative pain, surgery time, discomfort and hematoma, as well as the need for postoperative medication. These characteristics ease the stages of rehabilitation soon after implant placement, cooperating with prosthodontist's work. Thus, the proposal of this study is to present a clinical case of oral rehabilitation with osseointegrated implants and fixed prosthesis in both arches, in which the flapless technique was applied, followed by immediate loading. It will discuss the diagnosis, prosthetic planning, surgical/prosthodontic procedures and follow-up for 20 months

Flexural strength of acrylic resin repairs processed by different methods: water bath, microwave energy and chemical polymerization.

UNLABELLED: Denture fractures are common in daily practice, causing inconvenience to the patient and to the dentists. Denture repairs should have adequate strength, dimensional stability and color match, and should be easily and quickly performed as well as relatively inexpensive. OBJECTIVE: The aim of this study was to evaluate the flexural strength of acrylic resin repairs processed by different methods: warm water-bath, microwave energy, and chemical polymerization. MATERIAL AND METHODS: Sixty rectangular specimens (31x10x2.5 mm) were made with warm water-bath acrylic resin (Lucitone 550) and grouped (15 specimens per group) according to the resin type used to make repair procedure: 1) specimens of warm water-bath resin (Lucitone 550) without repair (control group); 2) specimens of warm water-bath resin repaired with warm water-bath; 3) specimens of warm water-bath resin repaired with microwave resin (Acron MC); 4) specimens of warm water-bath resin repaired with autopolymerized acrylic resin (Simplex). Flexural strength was measured with the three-point bending in a universal testing machine (MTS 810 Material Test System) with load cell of 100 kgf under constant speed of 5 mm/min. Data were analyzed statistically by Kruskal-Wallis test (p<0.05). RESULTS: The control group showed the best result (156.04±1.82 MPa). Significant differences were found among repaired specimens and the results were decreasing as follows: group 3 (43.02±2.25 MPa), group 2 (36.21±1.20 MPa) and group 4 (6.74±0.85 MPa). CONCLUSION: All repaired specimens demonstrated lower flexural strength than the control group. Repairs with autopolymerized acrylic resin showed the lowest flexural strength.

Flexural strength of acrylic resin repairs processed by different methods: water bath, microwave energy and chemical polymerization

Denture fractures are common in daily practice, causing inconvenience to the patient and to the dentists. Denture repairs should have adequate strength, dimensional stability and color match, and should be easily and quickly performed as well as relatively inexpensive. OBJECTIVE: The aim of this study was to evaluate the flexural strength of acrylic resin repairs processed by different methods: warm water-bath, microwave energy, and chemical polymerization. MATERIAL AND METHODS: Sixty rectangular specimens (31x10x2.5 mm) were made with warm water-bath acrylic resin (Lucitone 550) and grouped (15 specimens per group) according to the resin type used to make repair procedure: 1) specimens of warm water-bath resin (Lucitone 550) without repair (control group); 2) specimens of warm water-bath resin repaired with warm water-bath; 3) specimens of warm water-bath resin repaired with microwave resin (Acron MC); 4) specimens of warm water-bath resin repaired with autopolymerized acrylic resin (Simplex). Flexural strength was measured with the three-point bending in a universal testing machine (MTS 810 Material Test System) with load cell of 100 kgf under constant speed of 5 mm/min. Data were analyzed statistically by Kruskal-Wallis test (p<0.05). RESULTS: The control group showed the best result (156.04±1.82 MPa). Significant differences were found among repaired specimens and the results were decreasing as follows: group 3 (43.02±2.25 MPa), group 2 (36.21±1.20 MPa) and group 4 (6.74±0.85 MPa). CONCLUSION: All repaired specimens demonstrated lower flexural strength than the control group. Repairs with autopolymerized acrylic resin showed the lowest flexural strength.

Avaliação das condutas de biossegurança em laboratórios de prótese dentária de João Pessoa, PB, Brasil / Evaluation of the biosecurity measures adopted in dental prosthesis laboratories of the city of João Pessoa, PB, Brazil

Objetivo: Avaliar as condutas de biossegurança aplicadas nos laboratórios de prótese dentária da cidade de João Pessoa/PB, tendo em vista os trabalhos enviados por cirurgiões-dentistas. Método: Foram avaliados 25 técnicos em prótese dentária (TPD) da cidade de João Pessoa/PB por meio de um questionário, contendo perguntas referentes ao conhecimento dos princípios de biossegurança pelos protéticos, desinfecção de moldes e outros itens protéticos e uso de equipamentos de proteção individual (EPI). Resultados: 92% dos entrevistados acreditavam na possibilidade de ocorrer infecção cruzada entre os laboratórios de prótese e os consultórios odontológicos, entretanto 64% declararam não realizar nenhum procedimento de desinfecção nos trabalhos recebidos. Para a realização da desinfecção de moldes e modelos, as substâncias não são utilizadas da maneira proposta pelo fabricante ou são inócuas aos microorganismos. Quanto à utilização de EPI, observou-se que 60% dos técnicos utilizam máscara, porém 4% utilizam o gorro. Quanto aos procedimentos tomados em relação aos moldes recebidos, observou-se que 56% dos entrevistados realizam apenas a lavagem em água corrente e, 56% dos modelos de gesso que chegam ao laboratório não recebem tratamento algum para desinfecção. Conclusão: Há a necessidade de maior motivação e instrução aos técnicos para a prevenção de contaminação cruzada durante o envio e o recebimento de trabalhos protéticos entre o laboratório de prótese e o consultório odontológico, pois parte dos TPD avaliados mostraram-se negligentes com relação aos procedimentos de desinfecção.

Objective: To evaluate the biosecurity measures adopted in dental prosthesis laboratories of the city of JoÆo Pessoa, PB, Brazil with respect to prosthetic works sent by dentists. Method: Twenty-five dental prosthesis technicians (DPT) of the city of JoÆo Pessoa, PB, filled out a questionnaire referring to their knowledge of the biosecurity principles, disinfection of impressions and other prosthetic items, and the use of individual protection equipment (IPE). Results: Although 92% of the interviewees believed in the possible occurrence of cross-infection between dental prosthesis laboratories and dental offices, 64% declared that the prosthetic works received in their laboratories do not undergo any disinfection procedure. It was also observed that, for disinfection of impressions and stone casts, the chemical substances are not used as recommended by the manufacturers or are innocuous to microorganisms. Regarding the use of IPE, 60% of the DPT used mask, but only 4% used gowns. With respect to the measures taken regarding the impressions received from dental offices, 56% of the interviewees only wash them in running tap water, and 56% of the stone casts that arrive at the laboratory are not disinfected in any way. Conclusion: There is a need for more motivation and instructions to DPT regarding the prevention of cross-contamination during sending and receiving of prosthetic works between dental prosthesis laboratories and dental offices because the DPT evaluated in this study were found negligent with respect to disinfection procedures.