Judicialization and cancer: quality of life of patients and caregivers in the COVID-19 pandemic.

BACKGROUND: In Brazil, cancer patients and caregivers of cancer patients seek judicial intervention for free access to medications from the public health system. Indeed, the COVID-19 pandemic potentially affected the health-related quality of life of cancer patients and caregivers of cancer patients. This study aimed to describe the sociodemographic profile and assess the health-related quality of life of patients and caregivers in the state of Goias, Brazil, in 2020. METHODS: A cross-sectional study was conducted using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and a sociodemographic questionnaire. RESULTS: A total of 88 (67,7%) patients and 42 (32,3%) caregivers participated in the study, mostly women (55,5%); aged from 18 to 60 (66%) years old; with up to nine years of education (73,1%) and monthly family income lower than the minimum wage (69,2%); married or in a stable union (92,3%); living with multiple people in the same household (73,8%). The quality of life domains with the best scores were mental health for patients and pain for caregivers. The most affected quality of life domain was physical limitation for patients and caregivers. Factors associated with better quality of life were female gender and age between 18 and 60 years in patients, more than 9 years of education, living with multiple people in the same house, and having a monthly family income higher than US$200 for caregivers. CONCLUSION: The study found evidence of physical and emotional vulnerability during the pandemic, highlighting the need to strengthen public policies of assistance support to this population.

Anaerobic adhesives effect on counter-torque of abutment screws on implants with external hexagon and conical connections: An in vitro study.

BACKGROUND: Abutment screw loosening is a common complication of implant supported prostheses, especially for single crowns. In engineering, anaerobic adhesives (AA) are used to provide chemical locking between screw surfaces, but their application in implantology remains unclear. PURPOSE: The purpose of this article is to evaluate, in vitro, the effect of AA on counter-torque of abutment screws for cemented prosthesis on dental implants with external hexagon connection (EHC) and conical connection (CC). MATERIALS AND METHODS: Sample was composed by 60 specimens, 30 dental implants with EHC and 30 with CC. Abutments (transmucosal 3 mm straight universal abutment) were installed without AA (control group) or with application of AA with two different adhesive strength: medium strength (LOCTITE® 242) and high strength (LOCTITE® 277). The specimens were subjected to mechanical cycling at 37°C, with a load setting of 133 N, a 1.3 Hz frequency, and 1 200 000 cycles. The abutments were removed, and the counter-torque values were registered. Screws and implants were inspected using a stereomicroscope to verify the presence of residual adhesive and damage the internal structures. The data were analyzed using descriptive statistics and comparison tests (p < 0.05). RESULTS: Comparing to the torque of installation, the medium strength AA kept the counter-torque values for CC implants and the high strength AA kept the counter-torque for EHC implants and increased for CC implants. In the intergroup comparisons, control group presented significantly lower counter-torque values than other groups, both for EHC and CC implants. High strength AA presented similar results to medium strength AA in the EHC implants, but in the CC implants presented higher counter-torque values. Damage in threads was more frequent in the groups that received high strength AA. CONCLUSION: The use of AA increased the counter-torque of abutment screws, both in implants with EHC and CC.

Expected and perceived burdens in patients receiving mandibular overdentures retained by one or two implants.

PURPOSE: This study aimed to assess patients' expected burdens before treatment and their perceived burdens after the surgical and prosthodontic procedures of mandibular overdenture treatment and to evaluate factors influencing patients' perceptions. METHODS: Data were collected from 47 participants enrolled in a randomized clinical trial comparing mandibular overdentures retained by one or two implants. A 20-item questionnaire measured on a four-point Likert scale covering the surgical and prosthetic treatment procedures was used to assess the patients' perception of the procedural burdens before (expected burdens) and immediately after (experienced burdens) each procedure. Operators' perceptions of intercurrences associated with the procedures were also assessed as an independent variable. RESULTS: Low levels of perceived burdens were observed both before and after treatment. The mean overall scores of 1.65 ± 0.46 and 1.53 ± 0.33 for expected and experienced burdens, respectively, indicated that most items ranged between "not burdensome at all" and "somewhat burdensome." Significant differences between expected and experienced burdens were found for eight items (P < 0.001). Considering the treatment stages, expected burdens scored higher in the pre-surgical, surgical, and prosthetic stages and lower in the post-surgical phase than experienced burdens. Overall, the experienced burdens were significantly affected by the expected burdens (P < 0.001) and operator's perceived burdens(P = 0.045). CONCLUSIONS: Treatments were associated with low levels of perceived burdens related to surgical and prosthodontic procedures and were highly correlated with the expected burdens before treatment. However, patients tend to overestimate the expected burdens before treatment, especially for surgical procedures.

COVID-19 em pessoas com deficiências do desenvolvimento: uma revisão de escopo / COVID-19 en personas con trastornos en el desarrollo: una revisión de alcance / COVID-19 in people with developmental disabilities: a scoping review

Resumo Objetivo Examinar a evidência emergente sobre os tipos e a frequência de deficiências do desenvolvimento na população afetada pela COVID-19, identificando formas de categorização, incidência/prevalência e comorbidades mais frequentes. Métodos Para esta revisão de escopo realizou-se busca por estudos observacionais nas bases de dados Medline (PubMed), Scopus (Elsevier), ISI Web of Science (Clarivate), Lilacs (BVS) e 'literatura cinzenta'. Como critérios de elegibilidade, os estudos deveriam apresentar resultados de ocorrência de deficiência de desenvolvimento em pessoas com COVID-19, permitindo comparação com a população em geral, ou entre os grupos de deficiências. Dois revisores independentes fizeram o mapeamento das informações utilizando um instrumento de extração de dados previamente elaborado. Outros dois pesquisadores verificaram os dados e auxiliaram na elaboração dos quadros de apresentação dos resultados. Resultados Observou-se diversidade de terminologias empregadas para categorizar as DD. As pessoas com DD e com comorbidades que representam maior risco para a COVID-19 necessitaram de internação hospitalar com maior frequência do que a população em geral. De um total de 4930 estudos, 14 foram selecionados para avaliação. Destes, 5 artigos foram estudos longitudinais. Conclusão Em pessoas com DD, a COVID-19 apresentou taxas de morbidade, letalidade e mortalidade mais altas em faixas etárias mais jovens, na população mais pobre, na população institucionalizada e que requer tecnologias de suporte de vida e cuidados especializados. A vulnerabilidade das pessoas com DD à COVID-19 depende do tipo e da gravidade da deficiência e da presença de comorbidades, evidenciando a necessidade de atenção no diagnóstico e nas medidas preventivas, como a vacinação.

Resumen Objetivo Examinar la evidencia emergente sobre los tipos y la frecuencia de trastornos en el desarrollo (TD) en la población afectada por COVID-19 e identificar formas de categorización, incidencia/prevalencia y comorbilidades más frecuentes. Métodos Para esta revisión de alcance se realizó una búsqueda de estudios observacionales en las bases de datos Medline (PubMed), Scopus (Elsevier), ISI Web of Science (Clarivate), Lilacs (BVS) y 'literatura gris'. Como criterio de elegibilidad, los estudios debían presentar resultados de casos de TD en personas con COVID-19 y permitir la comparación con la población general, o entre los grupos de trastornos. Dos revisores independientes realizaron el mapeo de la información con la utilización de un instrumento de extracción de datos previamente elaborado. Otros dos investigadores verificaron los datos y ayudaron a elaborar los cuadros de presentación de resultados. Resultados Se observó diversidad en la terminología empleada para categorizar los TD. Las personas con TD y con comorbilidades que representan mayor riesgo de COVID-19 necesitaron internación hospitalaria con mayor frecuencia que la población general. De un total de 4930 estudios, 14 fueron seleccionados para el análisis, de los cuales 5 artículos fueron estudios longitudinales. Conclusión En personas con TD, el COVID-19 presentó índices de morbilidad, letalidad y mortalidad más altos en rangos de edad más jóvenes, en la población más pobre, en la población institucionalizada y que requiere tecnologías de soporte vital y cuidados especializados. La vulnerabilidad de las personas con TD depende del tipo y gravedad del trastorno y de la presencia de comorbilidades, lo que deja en evidencia la necesidad de atención en el diagnóstico y en las medidas preventivas, como la vacunación.

Abstract Objective To examine the emerging evidence on developmental disability type and frequency in the population affected by COVID-19, identifying more frequent forms of categorization, incidence/prevalence and comorbidities. Methods For this scoping review, we searched for observational studies in the MEDLINE (PubMed), Scopus (Elsevier), ISI Web of Science (Clarivate), LILACS (VHL) and grey literature databases. As eligibility criteria, studies should present results of developmental disability (DD) occurrence in people with COVID-19, allowing comparison with the general population, or between groups of disabilities. Two independent reviewers mapped the information using a previously elaborated data extraction instrument. Two other researchers verified the data and assisted in table elaboration to present the results. Results There was a diversity of terminologies used to categorize DD. People with DD and comorbidities that represent a higher risk for COVID-19 required hospitalization more frequently than the general population. Out of a total of 4930 studies, 14 were selected for assessment. Of these, 5 articles were longitudinal studies. Conclusion In people with DD, COVID-19 had higher morbidity, lethality and mortality rates in younger age groups, in the poorest population, in the institutionalized population, requiring life support technologies and specialized care. The vulnerability of people with DD to COVID-19 depends on disease type and severity and the presence of comorbidities, highlighting the need for attention in diagnosis and preventive measures, such as vaccination.

Grafting biomaterials associated to topical glucocorticoid: effects on pre-osteoblastic cells (MC3T3-E1).

The topical glucocorticoid budesonide has been prescribed before and after sinus lift surgery as adjuvant drug treatment for maxillary sinus membrane inflammation. However, there is no study on the effects of budesonide on the regenerative process of bone grafting biomaterials. We investigated the effect of the association of budesonide with some biomaterials on the growth and differentiation capacity of pre-osteoblastic cells (MC3T3-E1 subclone 4). Xenogeneic (Bio-Oss and Bio-Gen) and synthetic hydroxyapatites (Osteogen, Bonesynth, and HAP-91) were tested in conditioned medium (1% w/v). The conditioned medium was then supplemented with budesonide (0.5% v/v). Cell viability was assessed using the MTT assay (48, 96, and 144 h), and mineralized nodules were quantified after 14 days of culture using the Alizarin Red Staining. Alkaline phosphatase activity was assessed through the release of thymolphthalein at day seven. All biomaterials showed little or no cytotoxicity. The Bio-Gen allowed significantly less growth than the control group regardless of the experimental time. Regarding differentiation potential of MC3T3-E1, the HAP-91-conditioned medium showed remarkable osteoinductive properties. In osteodifferentiation, the addition of budesonide favored the formation of mineral nodules when cells were cultured in medium conditioned with synthetic materials, whereas it weakened the mineralization potential of cells cultured in xenogeneic medium. Regardless of whether budesonide was added or not, Osteogen and Bio-Oss showed higher alkaline phosphatase activity than the other groups. Budesonide may improve bone formation when associated with synthetic biomaterials. Conversely, the presence of this glucocorticoid weakens the mineralization potential of pre-osteoblastic cells cultured with xenogeneic hydroxyapatites.

Grafting biomaterials associated to topical glucocorticoid: effects on pre-osteoblastic cells (MC3T3-E1)

Abstract The topical glucocorticoid budesonide has been prescribed before and after sinus lift surgery as adjuvant drug treatment for maxillary sinus membrane inflammation. However, there is no study on the effects of budesonide on the regenerative process of bone grafting biomaterials. We investigated the effect of the association of budesonide with some biomaterials on the growth and differentiation capacity of pre-osteoblastic cells (MC3T3-E1 subclone 4). Xenogeneic (Bio-Oss and Bio-Gen) and synthetic hydroxyapatites (Osteogen, Bonesynth, and HAP-91) were tested in conditioned medium (1% w/v). The conditioned medium was then supplemented with budesonide (0.5% v/v). Cell viability was assessed using the MTT assay (48, 96, and 144 h), and mineralized nodules were quantified after 14 days of culture using the Alizarin Red Staining. Alkaline phosphatase activity was assessed through the release of thymolphthalein at day seven. All biomaterials showed little or no cytotoxicity. The Bio-Gen allowed significantly less growth than the control group regardless of the experimental time. Regarding differentiation potential of MC3T3-E1, the HAP-91-conditioned medium showed remarkable osteoinductive properties. In osteodifferentiation, the addition of budesonide favored the formation of mineral nodules when cells were cultured in medium conditioned with synthetic materials, whereas it weakened the mineralization potential of cells cultured in xenogeneic medium. Regardless of whether budesonide was added or not, Osteogen and Bio-Oss showed higher alkaline phosphatase activity than the other groups. Budesonide may improve bone formation when associated with synthetic biomaterials. Conversely, the presence of this glucocorticoid weakens the mineralization potential of pre-osteoblastic cells cultured with xenogeneic hydroxyapatites.

Prevalence of comorbid substance use disorders with anxiety disorders or post-traumatic stress disorder in people seeking treatment for substance abuse: a systematic review protocol.

OBJECTIVE: This systematic review will aim to assess evidence of the prevalence of comorbid substance use disorders with anxiety disorders or post-traumatic stress disorder in people seeking treatment for substance use. INTRODUCTION: Research shows that anxiety disorders and post-traumatic stress disorder are highly prevalent in people with substance use disorders and can worsen the treatment outcomes, increasing the risk of relapse and poor adherence. However, evidence from systematic reviews on the prevalence of these comorbidities in substance use treatment settings is limited. INCLUSION CRITERIA: Participants will be people seeking treatment for substance use. Studies will be included if they have investigated the prevalence of the comorbid substance use disorders with anxiety disorders or post-traumatic stress disorder in treatment settings. METHODS: Primary studies will be screened from the databases MEDLINE, PsycINFO, CINAHL, and Embase, and from searches to source gray literature. Eligible cross-sectional and cohort studies published after 1994 with no language limits will be retrieved, and their methodological quality will be assessed. Data extraction will include study details, methods, and outcomes. Results will be described by narrative summary or, if studies are sufficiently similar, a meta-analysis will be performed. Prevalence data will be pooled for meta-analysis by a random effects model. The results will be presented graphically in a forest plot. Data heterogeneity will be statistically tested using χ2 and I2 tests. If substantial heterogeneity is detected, sources of heterogeneity will be explored by subgroup analysis and meta-regression, and results will be presented by a narrative summary. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020149956.

Patient satisfaction with ball and Equator attachments for single-implant mandibular overdentures: A short-term randomised crossover clinical trial.

BACKGROUND: Retention and stabilisation of a single-implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. PURPOSE: To compare clinical and patient-reported outcomes following the use of two retention systems, a ball and a stud-type Equator attachment used for SIMO. MATERIAL AND METHODS: Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A-B and B-A) and outcomes were assessed after the 1 week (initial) and 3 months (final) periods. In the final assessment, patients were also asked about their preferred retention system. RESULTS: Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P = .330) and final (P = .08) periods. The multilevel mixed-model analysis revealed that the patients' satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. CONCLUSION: The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients' preference for the second treatment suggested a learning effect in this study.

Perceptions and experiences of patients following treatment with single-implant mandibular overdentures: A qualitative study.

OBJECTIVE: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO). METHODS: Thirteen participants, mean age 65.7 years, 69.2% women, who had had their treatment completed for at least 1 year, were invited and included in the study. Focus groups including four to five participants each were conducted, audio and video recorded and transcribed verbatim. Subsequently, the transcripts were analysed according to the principles of thematic analysis. RESULTS: Four major themes emerged as follows: before decision to undergo treatment with SIMO, implant surgery experience, perception of treatment outcomes and impressions about the care received. Lack of information, cost, comorbidities, older age and fear were initial barriers to the decision for treatment. Dissatisfaction with previous treatment and a sense of opportunity motivated the decision. There were ambivalent reports of absence of pain during surgery and discomfort during anaesthesia. Post-surgical recovery exceeded the pre-surgical negative expectations in most cases. There was a tendency for a positive impact of SIMO on the patients' quality of life, comprising improved ability to chew and communicate, dietary diversification, greater comfort and safety, increased self-confidence and social interaction. Few minor inconveniences were reported such as the feeling of insecurity after an episode of denture fracture and the need to use adhesive paste. Satisfaction with the care received and the trust in the dentist and dental team were evident. CONCLUSION: In general, participants presented positive perceptions and rewarding experiences after rehabilitation with SIMO.

Association between severity of illicit drug dependence and quality of life in a psychosocial care center in BRAZIL: cross-sectional study.

BACKGROUND: Quality of life must be one of the main purposes for the treatment of drug users, requiring a better understanding of the association between the quality of life and the severity of dependency. This study aimed to investigate the correlation between severity of substance use in various areas of human functioning and quality of life of illicit drug users in a psychosocial care center for alcohol and drugs. METHODS: This cross-sectional study included 60 participants - illicit drug users - treated at a psychosocial care center for alcohol and drugs. Participants were evaluated with the short version of World Health Organization Quality of Life (WHOQOL-Bref) instrument to measure the quality of life, the 6th version of Addiction Severity Index (ASI-6) to assess the severity of dependence in several areas and the Mini International Neuropsychiatric Interview (MINI) to identify the presence of psychiatric disorders. Pearson and Spearman correlation tests and linear regression were applied to verify the association between the severity of dependence and the quality of life, and Student's t-test to compare the mean quality of life between individuals with and without psychiatric comorbidities. RESULTS: Negative correlation was found between the severity of dependence on the drugs dimensions: alcohol, psychiatric, medical, legal, family/social support and family/social problems of ASI-6, and the quality of life domains measured by the WHOQOL-Bref. The evidence was strongest in the psychiatric and medical dimensions. There was a significant difference in the quality of life mean among participants presenting or not presenting psychiatric comorbidities, for the psychological domain in anxiety disorders, and for the physical and psychological domains in mood disorders. CONCLUSION: The quality of life decreased as the severity of dependence increased, with different results in the various areas of the participant's life. This result emphasizes the need for training the professional team which works in the substance use disorders area for more comprehensive diagnostic evaluations and more appropriate therapeutic interventions for each area. The associations were more evident in the medical and psychiatric fields, indicating the need for greater attention to be paid in relation to medical and psychiatric comorbidities.

Marginal bone level changes and implant stability after loading are not influenced by baseline microstructural bone characteristics: 1-year follow-up.

OBJECTIVE: The aim of this study was to investigate the influence of different bone tissue characteristics of implant sites on changes in marginal bone level and implant stability over time. MATERIAL AND METHODS: One hundred and one implants were inserted in 41 patients. Cortical bone thickness of the alveolar ridge was measured on computed tomography (CT) images. Histomorphometric and microtomographic analyses (microCT) were performed in bone specimens obtained by using a trephine bur, at first drilling. Implant stability quotient (ISQ) measured by resonance frequency analysis (RFA) was registered at implant insertion. Implant stability quotient was measured also at the stages of uncovering, loading and at the 1-year follow-up, when standardized periapical radiographs were taken to measure the marginal bone level (MBL). Descriptive statistics, Spearman's rho correlation and multiple linear regression were used for data analysis (P < 0.05). RESULTS: Comparison between groups of higher and lower values of ISQ changes and between groups of higher and lower values of MBL changes revealed no differences in histomorphometric and microtomographic parameters, according to non-parametric comparison tests, (P > 0.05). Bivariate correlation also showed no association among these microstructural parameters and the outcomes evaluated. There was no correlation between cortical thickness and MBL changes (r = -0.029; P = 0.832) and between cortical thickness and ISQ changes (r = 0.145; P = 0.292). CONCLUSION: Microstructural bone characteristics of implant sites have no effect on changes in marginal bone level and implant stability as measured by RFA. Bone morphology cannot predict implant treatment success over time.

Agreement between Histomorphometry and Microcomputed Tomography to Assess Bone Microarchitecture of Dental Implant Sites.

BACKGROUND: Histomorphometry and microcomputed tomography (microCT) have been used in implant studies but need better understanding before being used as equivalent methods. PURPOSE: The purpose of this study was to investigate the agreement between 2D (histomorphometry) and 3D (microCT) reference methods for assessing jawbone microarchitecture in vivo. MATERIAL AND METHODS: Forty-four bone specimens from 32 patients were obtained during implant placement and examined by microCT, followed by hematoxylin-eosin staining and histomorphometric analysis. The morphometric parameters included bone volume density (BV/TV), bone surface fraction (BS/TV), bone surface density, trabecular thickness, trabecular number, and trabecular separation (Tb.Sp). Bland-Altman plots were used for pairwise agreement analysis between the equivalent 3D and 2D parameters, and complemented with Mountain plots. The association between the two methods was tested using Pearson's correlation followed by Passing-Bablok regression. RESULTS: Systematic bias was observed in all Bland-Altman and Mountain plots, including constant bias for BV/TV and Tb.Sp, and proportional bias for all other parameters. Significant correlation was found for BV/TV (r = 0.80; p < .001) and BS/TV (r = 0.44; p = .003), and the Passing-Bablok regression showed constant bias for BV/TV and proportional bias for BS/TV. CONCLUSION: Because of the poor agreement between measures obtained by histomorphometry and microCT, these methods should not be used interchangeably for jawbones.

Bone tissue microarchitectural characteristics at dental implant sites part 2: correlation with bone classification and primary stability.

OBJECTIVE: To investigate in vivo the correlation between the bone microarchitecture of implant bone sites, bone tissue classification subjectively assessed in radiographs and primary implant stability. MATERIAL AND METHODS: Periapical and panoramic radiographs were obtained from 32 partially edentulous patients. Three surgeons classified bone quality at implant sites using two different methods: assessments in periapical and panoramic radiographs (PP) and according to the classification proposed by Lekholm and Zarb (L&Z). During the implant insertion, bone biopsies were taken, and three-dimensional parameters were measured by microcomputed tomography (microCT). Insertion torque value (ITV) and initial implant stability quotient (ISQ) were recorded at the moment of the implantation. ISQ was also recorded at the uncovering stage of a traditional implant protocol. RESULTS: Bone types 2 and 3 were the most prevalent classifications according to PP (54.3%) and L&Z (58.7%). The mean and standard deviation values of primary stability variables were 38.7(16.7) for ITV, 75.3 (7.7) for initial ISQ and 79.3 (6.8) for uncovering ISQ. Several microCT original and factor variables were found to correlate with bone tissue classifications and primary stability variables. L&Z correlated with architecture (r = 0.31; P < 0.05), density (r = -0.43; P < 0.01) and bulk (r = -0.35; P < 0.05), whereas ITV correlated with architecture (r = -0.40; P < 0.01) and density (r = 0.51; P < 0.01). Multiple linear regression analysis revealed that density and bulk explained 32% of the variability of L&Z bone classification, while density and architecture explained 42% of the variability of ITV. CONCLUSIONS: This study demonstrates the first step in validating L&Z classification. MicroCT provides objective and detailed quantitative data on bone microarchitecture. Intraosseous implant stability is mainly determined by the density of the bone. ITVs could be a good indicator of primary implant stability, whereas ISQs measurements have some limitations and should not be used alone.

Alternativa atual e viável para próteses metalocerâmicas sobre implantes com infraestrutura de cobalto-cromo / Current and viable alternative to prosthesis metaloceramic on implant with infrastructure of cobalt-chromium

As pesquisas atuais e melhoramentos tecnológicos tem tornado viável a aplicação do Co-Cr nas próteses fixas e próteses sobre implantes metalo-cerâmicas. O trabalho desenvolvido tem sugerido esta liga como alternativa para solucionar problemas com a possível toxidade contendo NIBE e o alto custo das ligas nobres. A partir de uma revisão da literatura, este trabalho se propôs a discutir os aspectos clínicos relacionados à confecção de uma prótese fixa sobre implante com infraestrutura em Co-Cr, por meio de relato de caso clínico. Diante do resultado obtido neste caso clínico, pode-se concluir que o uso de infraestrutura em Co-Cr, apresentou um interessante resultado clínico e estético como uma alternativa viável com baixo custo para o cirurgião dentista.

Current research and technological improvements have made possible the application of Co-Cr in fixed prostheses on implants and prostheses PFM. The work has suggested this league as an alternative to troubleshoot the possible toxicity containing NI-BE and the high cost of noble alloys. From a review of the literature, this paper aims to discuss the clinical aspects related to the construction of a fixed prosthesis on implant infrastructure in Co-Cr, through clinical case report. Given the results obtained in this clinical case, we can conclude that the use of infrastructure in Co-Cr, presented an interesting clinical outcome and aesthetic as a viable alternative to low-cost dental surgeon.