Evaluation of extra-narrow diameter implants in the oral rehabilitation of young patients after oral trauma: A prospective study.

BACKGROUND/AIM: Oral trauma is a common event in young patients and can lead to tooth loss, especially after avulsion of a tooth. The aim of this study was to evaluate the survival, esthetic outcomes, ridge preservation, and patient satisfaction of extra-narrow diameter implants (NDIs) as a temporary rehabilitation treatment for young patients who had lost permanent maxillary incisors after an avulsion. MATERIALS AND METHODS: This study comprised a prospective clinical and experimental study on a case series of 13 patients (age: 10-14 years) with a history of avulsion of one or more maxillary incisors. The patients received 19 mini-drive locks implants (Intralock) with acrylic resin crowns, divided into two evaluation arms: immediate implant placement (n = 10) and delayed implant placement (n = 9). The cases were followed up every 3 months with an initial tomography (T0) before implant placement and after 1 year (T1). The clinical stability of the implant in the bone and the retention of the provisional implant crown were evaluated, and the esthetic index was calculated at each follow-up. Intragroup and intergroup differences in alveolar ridge height and thickness were compared at T0 and T1, and a questionnaire was administered to assess the patient's perception of the treatment. RESULTS: The implant survival rate after 1 year was 78.9%. Alveolar ridge height and thickness increased in all cases at T1 (p < .05). Patients who received immediate implants had greater initial and final alveolar ridge thickness. The esthetic index progressively increased over the investigated time period (p = .001). Only one female patient presented with crown infraocclusion after 1 year. The patients' esthetic perceptions of their smiles significantly improved after treatment (p = .001). CONCLUSIONS: Extra-NDI had good survival rates, were effective at maintaining alveolar bone, and promoted aesthetic recovery and patient satisfaction with treatment during the period studied.

The challenge of managing oral maxillofacial rehabilitation with quality and cost-benefit.

Although orofacial cancer leads to substantial functional, esthetic, and psychosocial deficits for patients, reconstructive plastic surgeries may not be indicated for large facial defects. The high costs of prosthetic oral maxillofacial rehabilitation may hamper such treatment, which commonly involves virtual planning, craniofacial implants, and computer-aided design and computer-aided manufactured prostheses. This report shows the treatment of 2 patients with large facial defects from surgical resection of cancerous tissue who were rehabilitated with implant-supported bar-clip overdentures and facial prostheses fabricated by using low-cost straightforward methods.

Whitening effect of 35% hydrogen peroxide in simulation of tooth with orthodontic bracket.

OBJECTIVE: To evaluate the color change and tooth whitening perception in 2 and 3 mm dental specimens simulating the orthodontic bracket for a 14-day period. MATERIALS AND METHODS: Forty bovine tooth fragments (8 × 7 mm) of 2 mm (G2, n = 20) and 3 mm (G3, n = 20) were divided into Control (C: without bracket simulation and whitening) and Experimental (E: with composite resin simulating orthodontic bracket cementation area). Analyses of color change (ΔE00 ) and perception of tooth whitening (WID ) were performed before (T0 ) and after (T1 ) the first bleaching session; before (T2 ) and after (T3 ) the second bleaching session; and after 7 days of the second bleaching session (T4 ). RESULTS: After 14 days (T4), ΔE00 and WID showed similarity results, except for G2C and G3E. The thickness did not influence the ΔE00 and WID (G2C = G3C and G2E = G3E). The presence of orthodontic bracket did not interfere in the color change or tooth whitening perception after 14 days, except for comparison of G2C and G3E. Additionally, dentin thickness did not influence the color change. CLINICAL SIGNIFICANCE: Teeth with orthodontic brackets showed similar color change and whitening perception to teeth without orthodontic bracket, but it is not influenced by dentin thickness.

Facial rehabilitation with implant-retained nasal prosthesis of acrylic resin: a case report / Reabilitação facial com prótese nasal em resina acrílica implanto-retida: relato de caso clínico

ABSTRACT The objective of this study was to report a clinical case of facial rehabilitation with an acrylic implant-retained nasal prosthesis after partial rhinectomy resulting from the resection of a basal cell carcinoma in the patient, a 53-year-old Caucasian, normosystemic, professional cowboy. After clinical examination and in possession of computed tomography images, surgery was performed for the placement of conventional dental implants in the premaxillary region (left side). After the surgery, a three-month period of waiting was observed to allow osseointegration of the implants. Later, the nasal prosthesis was prepared, and at the end of treatment, this presented satisfactory peripheral adaptation, retention and esthetics. The patient has returned for follow-up every 6 months, regarding analysis of the prosthesis color, peri-implant health, hygiene, and exchange of the magnets and relays when necessary. The authors concluded that this therapy may be well indicated in patients with partial and total nasal defects, provided that there is correct planning and execution of the surgical, clinical and laboratory phases.

RESUMO O objetivo deste trabalho é relatar um caso clínico de reabilitação facial com prótese nasal acrílica implanto-retida pós-rinectomia parcial decorrente da ressecção de um carcinoma basocelular em um paciente do sexo masculino, vaqueiro, 53 anos de idade, caucasiano e normossistêmico. Após exame clínico e de posse da tomografia computadorizada, foi realizada a cirurgia de instalação dos implantes dentários convencionais na região da pré-maxila (lado esquerdo). Depois de realizada a cirurgia, esperou-se a osseointegração dos implantes por três meses e, posteriormente, foi realizada a confecção da prótese nasal que, ao final do tratamento, apresentou adaptação periférica, retenção e estética satisfatórias. O paciente tem retornado a cada 6 meses para proservação quanto à análise da cor da prótese, saúde periimplantar, higienização, troca dos magnetos e reembasamentos quando necessários. Os autores concluem que essa terapia pode ser bem indicada em defeitos nasais parciais e totais, desde que haja correto planejamento e execução das fases cirúrgica, clínica e laboratorial.

Esthetics and function: a return to the basic concepts: case report / Estética e função: um retorno aos conceitos básicos: caso clínico

ABSTRACT Immediate esthetic rehabilitation is a common practice in contemporary restorative dentistry. Sometimes without a precise diagnosis and clinical planning, two or three clinical sessions have been sufficient to start and end an extensive all-ceramic oral rehabilitation. It is essential, however, for these treatments to be based on the biological, mechanical, and occlusal principles that have been established for decades, and not only on aesthetic considerations. In this case report, a 26 year-old bruxist patient with functional and aesthetic needs, was rehabilitated with ceramic restorations in the six maxillary anterior teeth, through an interdisciplinary approach. The diagnostic wax-up was essential to predict the outcome; guide the periodontal surgery; serve as a reference for dental preparations, and restore the dynamics of jaw movements. After the adhesive cementation, a protective occlusal splint for use during sleep was introduced. The authors concluded that careful diagnosis and planning was critical to outcome of this case, and that the quality and longevity of restorative treatment depended on the respect for biomechanical, occlusal, and aesthetic concepts.

RESUMO Reabilitações estéticas imediatas são práticas frequentes na Odontologia restauradora atual. Por vezes, sem um diagnóstico e um planejamento clínico preciso, duas ou três sessões clínicas têm sido o bastante para iniciar e finalizar uma reabilitação oral extensa totalmente cerâmica. Contudo é fundamental que esses tratamentos voltem a ser sustentados por princípios biológicos, mecânicos e oclusais básicos, instituídos há décadas, e não apenas por aspectos estéticos. No presente relato de caso, uma paciente de 26 anos, bruxista, com necessidades funcionais e estéticas, foi reabilitada com restaurações cerâmicas nos 6 dentes anteriores superiores, por meio de uma abordagem interdisciplinar. O enceramento diagnóstico realizado foi fundamental para prever o resultado, guiar a cirurgia periodontal, servir de referência para os preparos dentais e restaurar a dinâmica dos movimentos mandibulares. Após a cimentação final das restaurações, a proteção com placa oclusal no período do sono foi instituída. Concluiu-se que um criterioso diagnóstico e planejamento foi fundamental para o desfecho do caso, e que a qualidade e a longevidade desse tratamento restaurador parece depender intimamente do respeito aos conceitos biomecânicos, oclusais e estéticos.

Effect of restoration technique on stress distribution in extensively destroyed premolars: a finite element analysis study / Efeito da técnica restauradora na distribuição de tensões em pré-molares extensamente destruídos: uma análise por elementos finitos

ABSTRACT Objective: The objective of this study by the finite element method was to analyze the stress distribution on a single-rooted mandibular premolar tooth restored in two different ways. Methods: Laboratory simulation considered the following situations: 1) premolar restored with gold cast post and ceramic crown; 2) premolar restored with glass fiber post, composite resin core and ceramic crown. For this we used a two-dimensional model of a premolar with load application of 300N in the axial and oblique directions within the ANSYS program for Windows. Results: Under the axial load, a higher concentration of stresses was observed around the cast post (166 MPa). In the oblique load simulation, there was a concentration of stresses on the buccal root wall, internally and externally, in the tooth restored with cast post (222 MPa). In both load directions, the glass fiber post dissipated the stress received with greater uniformity (55 to 111 MPa). Conclusion: These data suggested that from the biomechanical point of view, the use of a glass fiber post and composite resin core could be more advantageous than the cast post technique for a mandibular single-rooted premolar tooth.

RESUMO Objetivo: Analisar, por meio do método dos elementos finitos, a distribuição de tensões em elemento dental pré-molar inferior unirradicular restaurado de duas maneiras distintas. Métodos: A simulação laboratorial considerou as seguintes situações: 1) pré-molar restaurado com núcleo metálico fundido em liga áurea e coroa em cerâmica; 2) pré-molar restaurado com pino de fibra de vidro, núcleo de preenchimento em resina composta e coroa em cerâmica. Para isso foi utilizado um modelo bidimensional de um pré-molar com aplicação de carga de 300N nas direções axial e oblíqua com uso de programa ANSYS para Windows. Resultados: Diante da carga axial, foi observada uma maior concentração de tensões na região do núcleo fundido (166 Mpa). Na simulação de carga oblíqua, observou-se uma concentração de tensões na parede radicular vestibular, interna e externamente, no dente restaurado com núcleo fundido (222 Mpa). Nas duas situações em estudo, o pino de fibra de vidro e núcleo de preenchimento dissipou, com maior uniformidade, a tensão recebida (55 a 111 Mpa). Conclusão: Esses dados sugerem que o uso de pino de fibra pré-fabricado e núcleo de preenchimento em resina composta pode ser mais vantajoso que a indicação de núcleo fundido, sob o ponto-de-vista biomecânico, em dente pré-molar inferior unirradicular.

Reabilitação estética com abutment e coroa de zircônia da agenesia do incisivo lateral superior: relato de caso / Esthetic rehabilitation with abutment and zirconia crown in the maxillary lateral incisor agenesis: case report

A ausência congênita dos incisivos laterais superiores acomete aproximadamente 2% dos indivíduos e pode causar problemas estéticos caso não seja tratada de maneira adequada. O tratamento da ausência de um ou mais dentes na região maxilar anterior é um grande desafio da Implantodontia atual. Uma alternativa é a utilização do pilar protético de zircônia que, juntamente com uma coroa também livre de metal, possibilita a combinação de fatores como resistência, estética e satisfação do paciente. O presente artigo relata um caso clínico envolvendo a agenesia do dente 22 em uma paciente de 35 anos onde o seu respectivo decíduo encontrava-se ainda em função, porém com um grau elevado de reabsorção radicular, inviabilizando assim, sua permanência na arcada dentária. O tratamento reabilitador consistiu na exodontia da unidade 62, colocação do implante e instalação da coroa provisória imediata. Após o período de 4 meses, o tratamento protético definitivo foi realizado com a instalação do abutment de zircônia e confecção de uma coroa em cerâmica pura utilizando o sistemaZirkonzahn™para a confecção do copping. Observamos que a associação do componente e coroa livre de metal permitiu alcançar um resultado estético e funcional bastante satisfatório

Congenital absence of upper lateral incisors affects approximately 2% of individuals and can cause cosmetic problems if not treated properly. The treatment of absence of one or more teeth in the maxillary anterior region is a major challenge of current Implantology. An alternative is to use a zirconia prosthetic abutment, combined to an also metal free crown, which enables the combination of factors such as strength, aesthetics and patient satisfaction. This article reports a case involving agenesis of tooth 22 in a 35 years old patient which the respective deciduous was still in function, but with a high degree of root resorption, and therefore could not be maintained. The rehabilitation treatment consisted on extractionof the 62, implant placement and immediate installation of the temporary crown. After a period of 4 months, the final prosthetic treatment was carried out with the installation of zirconia abutment and manufacture of a ceramic crown using Zirkonzahn™ system for the copping construction. We observed that the association of the component and metal free crown permitted the achievement of an aesthetic and functional result quite satisfactory

Surgical and prosthetic considerations to rehabilitate an ocular defect using extraoral implants: a clinical report.

This clinical report shows the use of extraoral implants to rehabilitate an ocular defect, focusing the surgical and prosthetic procedures. Using local anesthesia and a surgical template obtained from the diagnostic wax ocular pattern, two cylinder dental implants were strategically placed in the lateral aspect of the right infraorbital region. Four months later, an acrylic framework including two spherical magnets was made using plastic UCLA abutments. After casting laboratory steps, a customized silicon prosthetic appliance was fabricated from the diagnostic wax ocular pattern and attached to the Co-Cr framework, observing its profile and seating aspects. The patient was satisfied with the treatment result, due to the retention, esthetics, and adhesive-free method to anchor his ocular prostheses.

Perfil das reabilitações sobreimplantes confeccionadas no ceará / Profile of implant rehabilitations made in Ceará (Brazil)

Esse estudo avaliou o perfil das reabilitações protéticas sobreimplantes osseointegrados confeccionadas no Estado do Ceará (Brasil), a partir da observação dos trabalhos protéticos enviados aos laboratórios de prótese. Foi aplicado um questionário aos técnicos em prótese dentária (TPD) inscritos no Conselho Regional de Odontologia – Ceará. Os principais resultados mostraram que: a) o articulador semiajustável não era usado rotineiramente pela maioria dos cirurgiões-dentistas (70,3%); b) o implante de hexágono externo (78,4%) e os componentes Ucla calcináveis (50%) compreenderam as maiores indicações clínicas; c) as maiores falhas técnicas foram erros na posição tridimensional do implante (45,2%) e na transferência ou moldagem dos implantes (41,9%). Verificou-se que o perfil das reabilitações sobreimplantes era bastante tradicional e baseado em algumas seleções inapropriadas de materiais e técnicas. Concluiu-se a importância de uma constante atualização técnica e científica, bem como maior integração entre os profissionais da área (implantodontista, protesista e técnico), no intuito de oferecer melhores reabilitações protéticas aos pacientes.

This study evaluated the profile of implant-retained dental prosthesis made in the State of Ceará (Brazil), from the observation of the works sent to the dental laboratories. A questionnaire was given to dental technicians (TPD) registered in the Regional Council of Dentistry – Ceará. The main results showed that: 1) the semi-adjustable articulator was not routinely used by most dentists (70.3%); 2) the implant external hexagon (78.4%) and cast Ucla abutments (50%) comprised the major clinical indications; 3) the main technical failures were errors in three-dimensional position of the implant (45.2%) and implant transfer impressions (41.9%). It was verified that the profile of oral rehabilitation was quite traditional and based on some inappropriate selections of materials and techniques (for example: cast Ucla). It was concluded the importance of constantly technical and scientific updating as well as greater integration among the professionals (surgeon, prosthodontist, and dental technician) in order to provide better prosthetic rehabilitation for patients.

Planejamento, execução clínica e manutenção deprotocolo all-on-four bimaxilar – relato de caso clínico / Planning, clinical execution, and maintenance of bimaxillary all-on-four protocol – case report

O número, a posição e a disposição dos implantes emum arco desdentado sempre foi motivo de discussãodiante de reabilitações orais fixas. O conceito all-onfourrepresenta uma modalidade de reabilitação detodo um arco edêntulo suportada sobre 04 implantesposicionados estrategicamente, tendo como principaisvantagens a eliminação de enxertos no seiomaxilar, o aumento da área de ancoragem protéticae a redução de tempo e custo do tratamento. Estetrabalho descreve a terapia cirúrgica e protética deuma paciente que utilizava uma reabilitação fixa conjugadaa próteses removíveis com grandes prejuízosbiológicos, funcionais e estéticos. Devido à péssimacondição clínica de todos os dentes remanescentes,optou-se pela exodontia e indicação de um protocoloall-on-four bimaxilar. Reportou-se à literatura científicano sentido de verificar a viabilidade clínica desseprocedimento em longo prazo. Os autores concluíramque o protocolo all-on-four recuperou satisfatoriamenteas funções orais e estéticas da pacienteapós o acompanhamento de 02 anos. Contudo, umcorreto planejamento, execução e manutenção dotratamento são condições imprescindíveis para o sucessodessa modalidade terapêutica.

The number, position, and arrangementof implants (used to rehabilitate) archeshave been discussed in fixed dental prosthesisliterature. The all-on-four protocolrepresents an option to treat entireedentulous arch, and consists on the useof four implants strategically placed tosupport a full arch prosthesis. The mainadvantages are the elimination of the necessityof maxillary sinus grafting, increasedprosthetic anchorage area and time -cost reducing. This paper shows a clinicalcase using the “All-on-Four” technique,describing the surgical and prostheticphases of the therapy. The remaing teethwere extracted due to poor clinical prognosis,and bimaxillary all-on-four protocolwas installed. In the case described,after 2 years of follow-up, the all-on-fourprotocol therapy showed good results,improving the oral functions and aesthetic.Correct planning, execution, andmaintenance are essential conditions forthe long term success.

Dimensional stability of distances between teeth in complete dentures comparing microwave polymerization and conventional cycles

Aim: This study investigated the tooth movement of complete dentures processed by micro wave activation and conventional processing method in water bath. Methods: Twenty maxillary complete dentures were fabricated and randomly assigned to 4 groups (n=5): Group I: Classico convention alheat-curing acrylic resin processed by microwave polymerization; Group II: Classico resinprocessed in water bath at 74°C for 9 h (control-group); Group III: QC-20 fast heat-curing acrylic resin processed in boiling water for 20 min; Group IV: Onda-Cryl microwave acrylic resin processed at the same conditions of Group 1. Metallic referential pins were placed on the incisal border of the central incisors, buccal cusp of the first premolars, and the mesiobuccal cusp of the second molars.Transversal and anteroposterior distances were measured before and after the complete dentures processing with a linear optical microscope (Olympus Optical Co., Tokyo, Japan) accurate to0.0005 mm. Data were subjected to A NOVA and Tukey’s test at 5% significance levels. Results:Inside each group, dentures showed some tooth movement but without statistical difference before and after the polymerization. Conclusions: Dentures processed by microwave energy presented similar performance to those subjected to conventional cycles in water bath for most of distances evaluated.

Protocolo all-on-four em maxila - Discutindo aspectos clínicos e biomecânicos / All-on-four protocol in maxillary arch - Discussion on clinical and biomechanical aspects

Este trabalho tem o objetivo reportar a reabilitação oral de uma paciente com grandes necessidades funcionais e estéticas. Devido à péssima condição clínica de todos os dentes remanescentes, optou-se pela exodontia e indicação de um protocolo all-on-four (tudo sobre quatro) na maxila e um protocolo convencional na mandíbula suportada sobre cinco implantes. O conceito all-on-four consiste em uma modalidade de reabilitação suportada sobre quatro implantes, sendo dois implantes anteriores posicionados axialmente e dois implantes posteriores inclinados. Nesse trabalho, dados da literatura científica referentes aos aspectos clínicos e biomecânicos foram confrontados e discutidos em relação ao caso clínico apresentado. Os autores concluíram que o protocolo all-on-four recuperou satisfatoriamente a função e a estética da paciente, evitando a necessidade de levantamento de seio maxilar. Essa abordagem terapêutica pode ser de grande indicação na clínica, com relativa facilidades cirúrgica e protética, apesar da reduzida evidenciação científica sobre a manutenção de estruturas biológicas e mecânicas em longo prazo quando utilizado em maxila edêntula.

The aim of this study is to report a prosthetic treatment of a functionally and esthetically compromised patient. Due to a difficult clinical situation, all teeth were extracted and the all-on-four protocol was planned for the maxillary arch, with a conventional protocol in the mandibular arch supported by five implants. The all-on-four concept consists of a prostheses supported by four implants, in which two anterior implants are axially placed and two posterior implants are mesially inclined. In this study, data from the literature related to clinical and biomechanical aspects were discussed, considering the clinical case presented. The authors concluded that the all-on-four protocol can rehabilitate the functional and aesthetical aspects avoiding the sinus lift procedure. This therapeutic approach may be indicated as a surgically and prosthetically excellent planning; however, there is little scientific evidence on long-term maintenance of biological and mechanical components when it is used for edentulous maxillary arches.

The role of polymerization cycle and post-pressing time on tooth movement in complete dentures.

This study analyzed the influence of polymerization cycle and post-pressing time on tooth movement in complete dentures. Forty maxillary complete dentures were fabricated and randomly assigned to 8 groups (n = 5); the polymerization cycle (conventional long cycle in water bath, fast cycle in boiling water, and by microwave energy) and the post-pressing time (immediate and 6 hours) were varied. Metal reference pins were placed on the incisal border of the central incisors (RI and LI), on the buccal cusp of the first premolars (RP and LP), and on the mesiobuccal cusp of the second molars (RM and LM). Two transverse and 2 anteroposterior distances were measured with a linear optical microscope (Olympus Optical Co., Tokyo, Japan) with an accuracy of .0005 mm, before and after processing the complete dentures. The data collected were submitted to analysis of variance (ANOVA) and the Tukey Test at a significance level of 5%. When Clássico, a conventional heat-polymerizable acrylic resin, was polymerized by microwave energy, tooth movement was statistically significant for 2 distances, with the highest value being observed for the 6-hour post-pressing time. Onda-Cryl microwave acrylic resin processed by microwave energy presented the lowest tooth movement for 2 distances, considering the 6-hour post-pressing time. QC-20 acrylic resin presented no statistically significant change considering both post-pressing times in each distance evaluated. Tooth movement showed an asymmetric behavior, so the mastering of the processing method is essential to the precise execution of all laboratory steps, irrespective of the polymerization cycle and post-pressing time used.

The role of polymerization cycle and post-pressing time on tooth movement in complete dentures

This study analyzed the influence of polymerization cycle and post-pressing time on tooth movement in complete dentures. Forty maxillary complete dentures were fabricated and randomly assigned to 8 groups (n = 5); the polymerization cycle (conventional long cycle in water bath, fast cycle in boiling water, and by microwave energy) and the post-pressing time (immediate and 6 hours) were varied. Metal reference pins were placed on the incisal border of the central incisors (RI and LI), on the buccal cusp of the first premolars (RP and LP), and on the mesiobuccal cusp of the second molars (RM and LM). Two transverse and 2 anteroposterior distances were measured with a linear optical microscope (Olympus Optical Co., Tokyo, Japan) with an accuracy of .0005 mm, before and after processing the complete dentures. The data collected were submitted to analysis of variance (ANOVA) and the Tukey Test at a significance level of 5 percent. When Clássico, a conventional heat-polymerizable acrylic resin, was polymerized by microwave energy, tooth movement was statistically significant for 2 distances, with the highest value being observed for the 6-hour post-pressing time. Onda-Cryl microwave acrylic resin processed by microwave energy presented the lowest tooth movement for 2 distances, considering the 6-hour post-pressing time. QC-20 acrylic resin presented no statistically significant change considering both post-pressing times in each distance evaluated. Tooth movement showed an asymmetric behavior, so the mastering of the processing method is essential to the precise execution of all laboratory steps, irrespective of the polymerization cycle and post-pressing time used.

Oclusão lingualizada para reabilitação final de paciente com disfunção temporomandibular: relato de caso / Complete dentures with lingualized occlusion for rehabilitation of patient with temporomandibular disorder: case report

Há mais de duzentos anos, diversas filosofias e técnicas de confecção das próteses totais vêm sendo discutidas,baseadas sobretudo em diferentes tipos de esquema oclusal e relacionamento dentário. A oclusãolingualizada é um tipo especial de padrão oclusal, caracterizado pelo contato de dentes anatômicos naarcada superior e dentes não-anatômicos na arcada inferior. Tal esquema pode representar um padrão decontatos oclusais que permitam menor quantidade de interferências oclusais, menor reabsorção óssea e,principalmente, maior liberdade de movimentação mandibular, sem travamento, condição esta favorávelaos pacientes com sinais e sintomas temporomandibulares. O presente trabalho descreve a reabilitação oralde uma paciente por meio de próteses totais equilibradas com oclusão lingualizada. A paciente havia sidosubmetida à terapia com pistas deslizantes para tratamento de disfunção temporomandibular do tipo muscular.Os autores concluem que esse padrão oclusal pode ser bem indicado para pacientes disfuncionadospor permitir adequada estabilidade da prótese pela redução das interferências e uma maior liberdade paramovimentos funcionais da mandíbula

Over the past of two hundred years, many philosophies and techniques of manufacturing the completedentures have been discussed, based on different occlusal schemes and dental relationship. Lingualizedocclusion is a special occlusal pattern characterized by contacts of anatomic teeth in the upper arch withnon-anatomic teeth in the lower arch of the dentures. That scheme may present few occlusal interferencesthat promote a little bone resorption and freedom in the mandibular movement, and those conditions arefavorable to patients with temporomandibular disorders. This paper reports a patient?s mouth rehabilitationthrough double complete denture balanced by lingualized occlusion. The patient had been submittedto a slide plates therapy to treat a muscular disorder. The authors conclude that lingualized occlusion seemsto be a well indicated occlusal pattern for patients with muscular disorders because it allows a satisfactoryocclusal stability for reducing the occlusal interferences and freedom for the functional mandibular motion

Prótese parcial removível destacável com sistemas MK1: descrição de técnica laboratorial / Dettachable removable partial denture with MK1 system: description of laboratory technique

A reabilitação oral através de próteses parciais removíveis ainda é uma constante na clínica odontológica apesar do grande avanço técnico-científico da Odontologia Restauradora. Dentro da reabilitação com próteses parciais removíveis, os attachments merecem especial destaque, e o sistema MK1 representa um tipo de attachment de precisão do tipo trava e com funcionamento rígido, que pode ser utilizado sobre dentes, raízes e implantes. Na reabilitação de desdentados parciais, esse sistema pode ser empregado conjugado a próteses fixas convencionais, servindo-se de retenção para próteses parciais removíveis. Em virtude da pouca visibilidade do sistema MK1 perante os protesistas e os técnicos em prótese dental e das dificuldades de execução da técnica laboratorial, esse trabalho tem o objetivo de retratar os mais relevantes aspectos relacionados à execução laboratorial desse sistema. Os autores concluem que a utilização do sistema MK1 constitui-se uma alternativa protética satisfatória, apesar de exigir experiência e uma rigorosa execução dos procedimentos laboratoriais.

Oral rehabilitation removable partial denture has been a very common clinical treatment although it may be seen a great technical and scientific increasing of restorative dentistry. Considering the use of removable partialenture, attachments are in ividence, and MK1 system reoresents a precision locked attachment with rigid working, and it may be used over teeth, roots and implants. That system can be used together fixed partial dentures, offering retention for removable partial dentures in the partially edentulous patients. Because of the little use of MK1 system by prosthodontists and dental technicians, and the difficulties that characterizes its laboratory technique, this work has an aim to present the more important aspects about the MK1 technique. Authors conclude the use of MK1 attachment together removable partial denture represents a satisfactory prosthetic options, although that technique requires experience and a meticulous execution of the laboratory procedures.

Técnicas simplificada de moldagem de implantes e tecidos peri-implantares simultaneamente / Simplifyed simultaneous impression techniqhe for implants and peri-implant tissues

O presente artigo descreve um método alternativo de moldagem de transferência na qual possibilita copiar os implantes bem como o contorno dos tecidos peri-implantares de forma simultânea. Para isso, utiliza-se resina composta fluída fotopolimerizável com o intuito de se reproduzir os tecidos gengivais no modelo funconal. Esta técnica tem como vantagem, a reprodução do perfil de emergência, fundamental na estética final da restauração.

The present article described an alternative impression technique for tranfer that is possible to simultaneous copy implants and gingival contours. For that, it used a flow composite resin, with the purpose to reestablish the gingival tissues to functional cast. The advantages to this technique is correctly replayed the emergency contour, considered very important in the final esthetic of the prosthetic restoration.

Effect of the flask contention method on the displacement of maxillary denture teeth

Keeping the flask closed may reduce the stress released by the resin dough after the pressing step, preserving the tooth relationship pattern. The aim of this study was to analyze the influence of the flask contention method on tooth displacement in acrylic resin complete dentures. Twenty identical maxillary complete dentures were made using the heat-cured acrylic resins Classico and QC-20, polymerized by long and fast polymerization cycles respectively, and randomly assigned to 4 test groups according to the conventional packing method and RS tension system. Transversal and anteroposterior distances between specific teeth were measured with a linear optical microscope before and after denture processing. Analysis of variance (ANOVA) and Tukey test were used to compare the groups (p<.05). Results showed that tooth movement was significantly greater for the distance RI-LI in comparison with the others, and the tooth movement was not significantly influenced by the packing method. Within the limitations of this study, the RS tension system presented a similar performance in reducing the tooth movement, when compared with the conventional packing method. The anterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted.

A importância da terapia interdisciplinar na otimização da estética / The importance of interdisciplinary therapy on the esthetic dentistry. A case report

Como reflexo da influência do sorriso na estética facial, o tratamento odontológico deve proporcionar, além do restabelecimento funcional, adequada estética aos pacientes, garantindo seu conforto psiquicossocial. Para que tais objetivos sejam atingidos, é necessário que haja uma visão interdisciplinar do tratamento, garantindo um planejamento integrado capaz de associar todos os requisitos para a obtenção de bom resultado. O objetivo deste relato de caso é demonstrar como a integração entre as áreas da Odontologia pode favorecer o sucesso de um tratamento. Por meio de uma abordagem clínica multidisciplinar que visa a estética, o presente relato de caso descreve a realização de restabelecimento do espaço biológico por meio de extrusão ortodôntica com fibrotomia e ressalta a importância de um adequado planejamento restaurador para obtenção de sucesso.

Terapia cognativa para as disfunções temporomandibulares: aspectos de relevância clínica / Cognitive therapy for temporomadibular disorders: aspects of clinical relevance

As disfunções temporomandibulares (DTM) compreendem um largo espectro de distúrbios articulares e/o musculares na região orofacial, com caráter etiológico multifatorial e de ocorrência cíclica. Reconhecem-se atualmente muitas formas de diagnóstico e de tratamento, o que exige, muitas vezes, uma intervenção multidisciplinar. Diante de um paciente com DTM é possível se ter controle da sintomatologia dolorosa e melhora na limitação dos movimentos mandibulares apenas através de medidas informativas e de autocuidados. Neste trabalho são apresentadas orientações de aconselhamento que têm se mostrado efetivas na prevenção, controle e tratamento de pacientes com DTM. Os autores concluem que a intervenção cognitiva, por ser verdadeiramente uma modalidade terapêutica, é imprescindível como tratamento de todos os casos de disfunção temporomandibular.

Temporomandibular disorders (TMD) may be of both from muscle or joint nature and recent studies have proved its multifactorial and ciclic character. Many ways of diagnosing and treating them have been used and a multidisciplinary staff may be required sometimes. Based only on rational and self-care measures it is possible to controI the symptoms and improve the limitation of mandibular movements. This paper proposes a series of orientations which have been effectively used on prevention, controI and treatment of TMD-patient. The authors conclude that the cognitive intervention must be understood as the very therapy and it is so much important to treat every cases of TMD.