Titanium versus ceramic implants for overdentures: a meta-analysis of prospective studies.

The aim of this study was to compare the use of titanium and ceramic implants for overdentures in terms of their failure rates, surface treatments, and marginal bone loss (MBL). The literature was searched using the PubMed, Scopus, and Cochrane databases up to October 2019. Clinical studies in which ceramic and titanium implants for overdentures were compared in terms of their failure rates, surface treatments, and MBL were included in the meta-analysis. The meta-analysis was performed based on the Mantel-Haenszel and inverse variance methods using a fixed-effects model and 95% confidence intervals. A total of 2747 publications were identified after the exclusion of duplicate articles. Fifteen were selected for full-text reading, and 2 were included in the review. Each of the 2 studies initially enrolled 24 patients, and a total of 38 patients (mean age of 62 years) were evaluated at the 1-year follow-up. A total of 112 titanium implants (success rate of 71.1%) and 146 ceramic implants (success rate of 65.9%) were placed. Twenty titanium implants failed, and an associated MBL of 0.15 mm was observed. For ceramic implants, 42 failures occurred, and an associated MBL of 0.33 mm was observed. Titanium implants provided better clinical results (less MBL and lower failure rate) for the support of overdentures than did ceramic implants.

Alcohol and light-polymerizing glaze effect on the physical and mechanical properties of a bisacrylate composite resin before and after immersion in chlorhexidine gluconate.

STATEMENT OF PROBLEM: The use of 0.12% chlorhexidine gluconate (CHX) may damage bisacrylate composite resin interim restorations, but whether they can be protected with an application of alcohol and/or the use of a glaze is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of applying a 70% alcohol solution on the physical and mechanical properties of a bisacrylate composite resin, with and without the application of a light-polymerizing glaze subjected to 0.12% CHX twice a day for 7 days. MATERIAL AND METHODS: Forty specimens of an autopolymerized bisacrylate composite resin were divided into 4 groups (n=10): Group C (without alcohol, without glaze), Group G (without alcohol, with glaze), Group A (with alcohol, without glaze), and Group AG (with alcohol, with glaze). All specimens were submitted to in vitro treatment with 0.12% CHX for 7 days, and tests of color alteration (ΔE00), microhardness, roughness, and surface were performed initially and after treatment. Data were submitted to analysis of variance (ANOVA) and the Tukey HSD test (α=.05). RESULTS: Group A had the lowest mean value of ΔE00 with a significant statistical difference from Group C. The groups with alcohol presented higher microhardness mean values compared with groups without alcohol in both periods of analysis, except for the groups with glaze in the final period. Group C showed higher mean roughness values in comparison with Group A in both periods. Group AG presented higher mean roughness values than Group G. Surface energy values did not vary significantly among groups, except between Groups C and A in the final period. CONCLUSIONS: The application of alcohol optimized the properties of the autopolymerized bisacrylate composite resin analyzed, with and without the application of glaze. Overall, the use of CHX changed the microhardness and roughness when the glaze was applied.

Antimicrobial and protective effects of non-thermal plasma treatments on the performance of a resinous liner.

OBJECTIVE: Overcoming substantial shortcomings of soft liners as physico-chemical changes and liner-biofilm-related infections remains a challenge in the rehabilitation treatment. In this study, protective non-thermal plasma (NTP) treatments were developed on the soft liner surface to improve its surface and physico-chemical properties and to reduce fungal colonization after biofilm inhibition challenge. METHODS: Resinous liner specimens (Coe-Soft) were prepared and distributed in 3 groups according to the surface treatments: (1) untreated (control); (2) treated with sulfur hexafluoride-based NTP (SF6); and (3) treated with hexamethyldisiloxane-based NTP (HMDSO). To test the NTP stability and their protective and antimicrobial effect on the liner surface over time, the morphology, chemical composition, roughness, water contact angle, shore A hardness, sorption and solubility were evaluated before and after the specimens were exposed to dual-species biofilm of Candida albicans and Streptococcus oralis for 14 days. Colony forming units and biofilm structure were assessed. Data were submitted to ANOVA and Tukey tests (α = 0.05). RESULTS: Both treatments modified the surface morphology, increased hydrophobicity and roughness of the liner, and were effective to reduce C. albicans adhesion without affecting the commensal health-associated S. oralis. HMDSO presented chemical stability and lower hardness in both periods, whereas SF6 exhibited higher initial hardness than control and the highest sorption; contrarily, similar solubility was noted for all groups. CONCLUSION: HMDSO-based film showed improved physico-chemical properties and inhibited C. albicans biofilm. Thus, it has potential for use to control candida-related stomatitis and improve liner's stability even after being exposed to biofilm inhibition challenge.

Influence of a light-activated glaze on the adhesion of Streptococcus sanguinis to the surface of polymers used in fabrication of interim prostheses.

AIM: This study aimed to investigate the adhesion of Streptococcus sanguinis to the surface of interim prostheses that were treated or not treated with a light-activated glaze, and subjected or not subjected to a thermocycling procedure. METHODS: 36 specimens of each resin were divided into 4 groups: heat-activated acrylic resin; chemically-activated acrylic resin; bis-acryl composite resin (Protemp; 3M ESPE); and bis-GMA (Charisma; Heraeus Kulzer). Half of the specimens underwent application of glaze and the other half underwent mechanical polishing. Specimens were randomly distributed into groups (N = 9) with and without thermocycling (2000 cycles). Surface energy, roughness and microbiological analyses were performed. RESULTS: Groups treated with glaze showed lower roughness when compared with the same groups without glaze treatment, before and after thermocycling, except for the bis-acryl groups after thermocycling. Surface energy values were higher in the groups treated with glaze, except the bis-acryl group before and after thermocycling. After thermocycling, the values of bacterial adhesion decreased numerically, with the exception of the chemically-activated acrylic resin group treated with glaze and the heat-activated acrylic resin group without glaze treatment. CONCLUSION: The application of glaze and the thermocycling do not influence, in a statistically significant manner, the bacterial adhesion on polymer surfaces.

Caracterização superficial e eficácia antibiofilme no uso de digluconato de clorexidina a 0,12% sobre resinas utilizadas na confecção de restaurações provisórias contemporâneas, com e sem a aplicação de glaze fotopolimerizável: estudo in situ / Surface characterization and antibiofilm efficacy in the use of 0,12% chlorhexidine digluconate on resins used in the preparation of contemporary provisional restorations, with and without application of light-curing glaze: in situ study

Durante a reabilitação com próteses fixas, o uso de provisórios é importante para que se alcance o sucesso clínico e a longevidade da prótese definitiva, mantendo a saúde e protegendo os tecidos dentais e periodontais. O objetivo deste estudo foi avaliar a estabilidade de cor, microdureza, rugosidade e energia livre de superfície de resinas de restaurações provisórias, com e sem a aplicação de glaze fotopolimerizável, e avaliar a eficácia antibiofilme do digluconato de clorexidina a 0,12% sobre as mesmas. Para isso, foram confeccionadas amostras de resina de Bis-Acril (Protemp 4, 3M ESPE, São Paulo, Brasil) e de resina acrílica ativada quimicamente (RAAQ) (Dencor, Artigos Odontológicos Clássico LTDA, São Paulo, Brasil), de forma que, apenas metade dessas amostras foi submetida ao polimento químico com glaze fotopolimerizável. Essas amostras foram posicionadas em dispositivos palatinos contendo 4 nichos (1 RAAQ sem glaze, 1 RAAQ com glaze, 1 Bis-Acril sem glaze, 1 Bis-Acril com glaze), utilizados por voluntários (n=20). As fases experimentais foram: Os voluntários usaram o dispositivo contendo as amostras do grupo controle, durante dias, sendo realizada aplicação de sacarose 30% sobre as amostras. Posteriormente, usaram o dispositivo contendo novas amostras do grupo teste, durante mais sete dias, sendo realizado tratamento com digluconato de clorexidina a 0,12% e aplicação de sacarose 30%. A seguir, determinou-se a alteração de cor, microdureza, rugosidade e energia livre de superfície, inicialmente e após o período experimental, de todas as amostras, tendo sido realizada a coleta do biofilme para posterior análise de polissacarídeos extracelulares álcali-solúveis (PEC). Os dados foram submetidos à análise de variância e ao teste Tukey (p<0,05); exceto os valores de PEC, submetidos à análise de variância e ao teste Student-Newman-Keuls (p<0,001). Os grupos teste apresentaram menor alteração de cor que seus respectivos grupos controle, com diferença estatística significante somente entre os grupos Bis-Acril sem glaze. Com relação à microdureza, os valores aumentaram para os grupos teste em relação aos seus respectivos grupos controle, com diferença estatística significante no período final, com exceção do grupo RAAQ e Bis-Acril sem glaze, que mostraram apenas um aumento e diminuição numérica, respectivamente. Comparando-se os grupos teste com seus respectivos grupos controle, os valores de rugosidade aumentaram apenas numericamente entre os grupos RAAQ sem glaze, no período final. Já na análise de energia livre de superfície, os valores aumentaram para os grupos teste em relação ao seu respectivo grupo controle, sem diferença estatística significante. Os grupos teste apresentaram redução estatisticamente significativa da quantidade de PEC formado, em relação aos grupos controle. Pode-se concluir que o enxaguatório à base de digluconato de clorexidina a 0,12% foi satisfatório neste estudo in situ, melhorando significativamente as propriedades de alteração de cor, microdureza e energia livre de superfície e proporcionou uma melhora, no entanto, não significativa para a rugosidade, contribuindo assim, para um melhor desempenho das resinas analisadas. A aplicação do glaze também contribuiu de maneira significativa para a melhora de todas as propriedades analisadas, com exceção da alteração de cor, na qual, foi prejudicial(AU)

During rehabilitation with ceramic fragments, it is important to use provisional restorations, which are essential to achieve clinical success and longevity of the definitive prosthesis, maintaining the health and protecting dental and periodontal tissues. The aim of this study was to evaluate color stability, microhardness, roughness, and surface free energy of provisional prosthesis samples, with and without the application of light-curing glaze on the surface, and to evaluate the antibiofilm efficacy of 0.12% chlorhexidine digluconate in these samples. For this, resin samples of Bis-Acryl (Protemp, 3M ESPE, Sao Paulo, Brazil) and chemically-activated acrylic resin (CAAR) (Dencor, Artigos Odontológicos Clássico LTDA, Sao Paulo, Brazil) were made. Half of these samples were submitted to chemical polishing with light-curing glaze. These samples were placed in intraoral devices, which contained 4 niches (1 CAAR without glaze, 1 CAAR with glaze, 1 Bis-Acryl without glaze, 1 Bis-Acryl with glaze), used by volunteers (n=20). The experimental pases were: The volunteers initially used the device containing the samples from the control group for seven days, in which 30% sucrose were applied. Then, they used the device containing the samples from the test group for another seven days, in which 0.12% chlorhexidine digluconate and 30% sucrose were applied. Next, the tests of color change, microhardness, roughness and surface energy, initially and after the experimentais phases, of all samples, and the biofilm was collected for later analysis of alkali-soluble extracellular polysaccharides (EPS). Data were submitted to the analysis of variance (ANOVA) and to the Tukey test (p<0.05), except for the EPS values, which were submitted to the ANOVA and Student-Newman Keuls (p<0.001). The test groups had lower color alteration in relation to their respective control groups, and there was a statistically significant difference only between the Bis-Acryl groups without glaze. Regarding the microhardness, the values increased for the test groups in relation to their respective control groups, with a significant statistical difference in the final period, except for the CAAR group without glaze, which had only a numerical increase, and the Bis-Acryl group without glaze, in which values decreased numerically. Comparing the test groups with their respective control groups, the roughness values increased only numerically for the CAAR group without glaze, in the final period. In the surface energy analysis, the values statistically increased for the test groups, when compared to their respective control group. The test groups presented a statistically significant reduction of the biofilm amount in relation to the control groups. It can be concluded that the 0.12% chlorhexidine digluconate base rinse was clinically satisfactory, significantly improving the properties of color change, microhardness, surface energy properties, and provided non-significant improvement of the roughness, thus contributing to a better clinical performance of the resins analyzed. The glaze application also contributed significantly to all the analyzed properties, except for the color change, in which it was deleterious(AU)

Reabilitação oral de paciente submetido à maxilectomia parcial sem comunicação bucossinusal: relato de caso / Oral rehabilitation of patient submitted to partial maxilectomy without bucossinusal communication: case report

Cirurgias de ressecção parcial ou total da maxila em pacientes oncológicos geram comprometimento funcional e estético, alterando a deglutição, mastigação, fonética e aspiração, diminuindo a qualidade de vida do paciente. Assim, o objetivo deste estudo foi descrever a reabilitação oral de um paciente com prótese total maxilar estendida e uma prótese total mandibular convencional. Tal paciente havia sido submetido à uma cirurgia de ressecção parcial do rebordo alveolar maxilar, sem comunicação bucossinusal, por ser portador de Carcinoma espinocelular grau I. Paciente do sexo masculino, 69 anos, procurou atendimento no Centro de Oncologia Bucal da FOA ­ UNESP, para confecção de suas próteses, após dois anos da realização de sua cirurgia. Foi observado declínio do suporte labial no local onde havia sido feita a ressecção cirúrgica gerando comprometimento estético e funcional ao paciente. Desta forma, foi proposta a realização de confecção de prótese total maxilar estendida e prótese inferior convencional, as quais foram instaladas e ajustadas adequadamente. Após 1 ano de acompanhamento, paciente encontra-se satisfeito com o tratamento, o qual devolveu sua estética, função e fonética(AU)

Surgeries of partial or total resection of the maxilla in oncological patients generate functional and aesthetic impairment, altering swallowing, chewing, phonetics and aspiration, reducing the quality of life of the patient. Thus, the objective of this study was to describe the oral rehabilitation of a patient with maxillary total prosthesis and a conventional mandibular total prosthesis. This patient had undergone surgery of partial resection of the maxillary alveolar ridge, without bucosinusal communication, for being a carrier of grade I squamous cell carcinoma. A 69-year-old male patient sought care at the Oral Oncology Center of FOA - UNESP, for denture after two years of surgery. Decreased lip support was observed in the place where surgical resection had been performed, generating aesthetic and functional impairment to the patient. In this way, it was proposed to make a complete maxillary full prosthesis and conventional lower prosthesis, which were installed and adjusted properly. After 1 year of follow-up, the patient was satisfied with the treatment, which returned his aesthetics, function and phonetics(AU)

Instalação de prótese provisória implantossuportada: relato de caso / Installation of implant-supported provisional prosthesis: case report

A busca por restaurações protéticas suportadas por implantes está aumentando cada vez mais na odontologia, e é uma parte importante do tratamento reabilitador, principalmente em regiões estéticas. Desta forma, o objetivo deste estudo foi descrever o caso clínico de um paciente reabilitado com implante e posterior instalação de prótese provisória em região anterior de maxila, reestabelecendo sua estética, fonética e função. Paciente do sexo masculino procurou atendimento devido à fratura do elemento 2.2. Ao exame clínico, foi observada raiz residual desse elemento. Então, foi proposto ao paciente a exodontia da raiz residual, instalação de implante imediato e posterior instalação de prótese provisória. Após seis meses de acompanhamento, o paciente encontra-se satisfeito com a aparência clínica dos tecidos periodontais adjacentes, sendo então iniciado o tratamento reabilitador protético com a prótese definitiva(AU)

The search for implant-supported prosthetic restorations is increasing in dentistry, and is an important topic of the rehabilitation treatment, especially in esthetic regions. Thus, the aim of this study was to describe a clinical case of a patient rehabilitated with implant and later with provisional prosthesis in the maxilla anterior region, reestablishing esthetics, phonetics and function. A male patient sought the Department of Dental Materials and Prosthodontics of the Faculty of Dentistry of Aracatuba/UNESP due to a fracture of the left lateral incisor. During the clinical exam, a residual tooth root was observed. Then, the extraction of the residual root was proposed, followed by the installation of an immediate implant and subsequent installation of provisional prosthesis. After six months of follow-up, the patient was satisfied with the clinical appearance of the adjacent periodontal tissues and started the prosthetic treatment with the definitive prosthesis(AU)

Surface characterization of polymers used in fabrication of interim prostheses after treatment with photopolymerized glaze.

The material used for interim prostheses fabrication must present excellent physical properties for greater longevity in the face of environmental conditions, which can occur in the oral cavity. The purpose of this study was to evaluate the effect of a photopolymerized glaze on the physical and mechanical properties of polymers used for the fabrication of interim prostheses, before and after thermocycling and immersion in staining solutions. One hundred samples of composite and acrylic resins were fabricated: Dencor chemically activated acrylic resin (CAAR) (n=20) and heat-polymerized acrylic resin (HPAR) (n=20), Charisma (n=20), Structur (n=20), and Protemp (n=20). A mechanical polishing was performed on half of the samples, and a chemical polishing was performed on the remaining samples. Subsequently, all samples were submitted to thermocycling and immersion in coffee staining solution for 21days. Analysis of color and microhardness, as well as atomic force microscopy (AFM), scanning electron microscopy (SEM), and energy dispersive x-ray spectrometry (EDS) were performed. The data were submitted to repeated-measures analysis of variance (ANOVA), followed by the Tukey test (α=0.05) and the Student t-test (α=0.05). It was verified that the glaze decreased the chromatic alteration values, and increased the microhardness values of the samples, with the exception of the Charisma resin. The samples that did not receive chemical polishing had the greatest number of surface irregularities. This study concluded that the groups with glaze presented less color alteration. In addition, Charisma and Structur resins exhibited the greatest chromatic stability. As to the microhardness, the values were greater when the samples were treated with the glaze, with the exception of the Charisma group.

Planejamento e instalação de restaurações cerâmicas: relato de caso / Planning and restoration ceramic installation: case report

Nos dias atuais, a cerâmica tem se tornado o material de escolha nas reabilitações estéticas, apresentando muitas vantagens em relação à resina composta. Portando, é de grande importância que o profissional tenha conhecimento sobre sua correta indicação, sabendo avaliar adequadamente fatores como substrato dental, tecidos gengivais, condições endodônticas e anseios do paciente, e saiba aplicar a técnica de forma correta, garantindo o sucesso clínico e longevidade da restauração. Desta forma o objetivo deste estudo foi descrever a técnica operatória de substituição de laminados cerâmicos para a reabilitação estética e funcional do sorriso, bem como suas indicações

Nowadays, the pottery has become the material of choice in aesthetic restorations, with many advantages over the composite. Porting is of great importance that the trader is aware of the correct indication, knowing properly assess factors such as dental substrate, gingival tissues, endodontic conditions and wishes of the patient, and learn to apply the technique correctly, ensuring the clinical success and longevity restoration. Thus the aim of this study was to describe the surgical technique of substitution of ceramic laminates for the aesthetic and functional rehabilitation of the smile, and his instructions

A influência da radioterapia e da quimioterapia sobre próteses obturadoras retidas por implante: revisão de literatura / The influence of radiotherapy and chemotherapy on obturator prosthesis retained by implants: literature review

A prótese obturadora é uma alternativa para a reabilitação funcional e estética de pacientes que se submeteram a ressecção cirúrgica total ou parcial da maxila. Para a obtenção de maior estabilidade e retenção desta prótese, faz-se necessário a associação de implantes osseointegrados para a maioria dos pacientes. Porém, quando se trata de pacientes com história de câncer de cabeça e pescoço, ainda não há consenso na literatura quanto a essa associação, devido ao envolvimento da radioterapia e/ou quimioterapia durante o tratamento, as quais possuem efeitos secundários como: xerostomia, diminuição do suprimento vascular, dificuldade na abertura de boca e deglutição, e a dificuldade em tolerar a prótese. Contudo, a oxigenoterapia hiperbárica tem sido utilizada como um recurso para melhorar a osseointegração dos implantes, aumentando a oxigenação dos tecidos irradiados. Pode-se verificar que a associação da prótese obturadora com implantes osseointegrados, conjuntamente com a radioterapia e/ou quimioterapia, resultaram em melhora na qualidade de vida da maioria dos pacientes estudados

The obturator prosthesis is an alternative for functional and esthetic rehabilitation of patients who have been submitted total or partial surgical resection of the jaw. To obtain increased stability and retention of this prosthesis, osseointegrated implants are due for most patients. However, when dealing with patients with head and neck cancer history, there is no consensus in the literature about this association due to the involvement of radiotherapy and / or chemotherapy during treatment, which have side effects such as: dry mouth, decreased vascular supply, difficulty of mouth opening and swallowing, and difficulty tolerating the prosthesis. Although, the hyperbaric oxygen therapy has been used as a resource to improve osseointegration of the implants, increasing the oxygenation of the irradiated tissues. It was shown that the combination of obturator prosthesis with osseointegrated implants in conjunction with radiotherapy and / or chemotherapy, resulted in improved quality of life for most patients