Does airborne-particle abrasion before, rather than after, zirconia sintering lead to higher mechanical strength even under aging challenge?

STATEMENT OF PROBLEM: Information concerning the effect of airborne-particle abrasion before zirconia sintering on its strength after aging is lacking. PURPOSE: The purpose of this in vitro study was to determine the influence of airborne-particle abrasion moment (before or after zirconia sintering), particle size, and aging on the mechanical strength of a yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramic. MATERIAL AND METHODS: Four hundred presintered zirconia disks were allocated to nonabraded (control) and abraded groups with 50 µm or 120 µm Al2O3 particles before (50/BS or 120/BS) or after sintering (50/AS or 120/AS). The disks were aged by storing them in distilled water for 24 hours at 37 °C (24 h) (control); mechanical cycling (MC) (1×106 cycles; 2 Hz; 100 N); hydrothermal aging (HA) (134 °C; 0.2 MPa; 20 hours); or by both methods (MC+HA), totaling 20 groups (n=20). The specimens were subjected to biaxial flexural strength (BFS) testing. Fractographic analysis was performed to identify the fracture origin. Tetragonal to monoclinic transformation was determined by X-ray diffraction. The BFS data (MPa) were analyzed by 2-way ANOVA and the Games-Howell post hoc test (α=.05). Weibull statistics was also applied. RESULTS: The BFS and characteristic strength (σ0) of the 120/AS groups were significantly higher compared with the other abraded groups and statistically similar or higher compared with the respective nonabraded groups. In contrast, the 120/BS/24 h and all the 50/BS groups presented the lowest values. In all groups, the initial defect had its origin on the tensile stress side. Neither airborne-particle abrasion nor aging (except for the 50/AS/MC+HA) reduced the zirconia reliability compared with the respective controls. Abrading the zirconia in its presintered stage or after sintering increased the monoclinic phase content, and the sintering process eliminated this phase. CONCLUSIONS: Airborne-particle abrasion before zirconia sintering yields an inferior performance compared with that after sintering under aging challenges. The BFS and σ0 were strongly determined by the particle size and airborne-particle abrasion moment, while aging mainly acted in the nonabraded zirconia or when this material was abraded before sintering.

Effect of grinding and polishing on the roughness and fracture resistance of cemented CAD-CAM monolithic materials submitted to mechanical aging.

STATEMENT OF PROBLEM: The effect of clinical adjustments on the strength of cemented computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials under aging challenge is unclear. PURPOSE: The purpose of this in vitro study was to assess the surface roughness and fracture resistance (with or without mechanical aging) of cemented CAD-CAM monolithic materials submitted to grinding and polishing procedures. MATERIAL AND METHODS: Disks of Lava Ultimate, Vita Enamic, crystallized Vita Suprinity, and IPS e.max CAD were analyzed for roughness after polishing by using silicon carbide papers (Lava Ultimate and Vita Enamic) or glazing (IPS e.max CAD and Vita Suprinity) (control), after grinding by using 30-µm grit diamond rotary instruments, and after grinding and polishing by using a polishing kit. For fracture resistance, a simplified trilayer model consisting of a restorative disk, an epoxy resin disk, and a steel ring was used. The bonded trilayer disks received the same treatments described for the roughness analysis. Half of the specimens underwent mechanical aging for 1×106 cycles. All specimens were loaded until failure. The Weibull modulus was calculated. RESULTS: The IPS e.max CAD and Vita Suprinity showed the highest roughness after grinding and the lowest at baseline. For the Lava Ultimate and Vita Enamic, polishing provided lower roughness than at baseline. Grinding, followed or not by polishing, and mechanical aging did not adversely affect the fracture resistance or the reliability of the materials. CONCLUSIONS: Polishing did not recover the initial surface roughness of the glass-ceramic materials. Fracture resistance was not affected by grinding, followed or not by polishing, even after mechanical aging.

Marginal Fit of Metal-Ceramic Copings: Effect of Luting Cements and Tooth Preparation Design.

PURPOSE: To evaluate the effect of the triad finish line design, axial wall convergence angle, and luting cement on the marginal fit of metal copings used in metal-ceramic crowns. MATERIALS AND METHODS: Schematic dies and their respective copings were cast in NiCr alloy. The dies exhibited the following finish line/convergence angle combinations: sloping shoulder/6°, sloping shoulder/20°, shoulder/6°, shoulder/20°. Marginal fit was evaluated under a stereomicroscope, before and after cementation. Copings were air-abraded with 50 µm Al2 O3 particles and cemented with Cimento de Zinco, RelyX U100, or Panavia F cements (n = 10/group). Data were square-root transformed and analyzed by 3-way factorial random effect model and Tukey's post hoc test (α = 0.05). RESULTS: Statistical analysis showed significance for the interactions finish line and convergence angle (p < 0.05), convergence angle and time (p < 0.001), and luting cement and time (p < 0.001). Sloping shoulder/20° provided the highest marginal discrepancy when compared to the other finish line/convergence angle combinations, which were statistically similar among each other. For both convergence angles and for all luting cements, the marginal discrepancy was significantly higher after cementation. Before and after cementation, 6° provided better marginal fit than 20°. After cementation, Panavia F provided higher marginal discrepancy than Cimento de Zinco. CONCLUSION: Lower convergence angle combined with shoulder and a low-consistency luting cement is preferable to cement metal copings.

Wear resistance and abrasiveness of CAD-CAM monolithic materials.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) restorations are in contact with the antagonist tooth, either a natural tooth or a restoration. Therefore, clinicians should be aware of the wear resistance of CAD-CAM materials and the wear behavior of the antagonist. PURPOSE: The purpose of this in vitro study was to evaluate the wear resistance and abrasiveness of CAD-CAM materials. MATERIAL AND METHODS: In a 2-body wear test, the materials IPS e.max CAD (Ivoclar Vivadent AG), Vita Suprinity (Vita Zahnfabrik), Lava Ultimate (3M ESPE), Vita Enamic (Vita Zahnfabrik), and Lava Plus (3M ESPE) acted as abraders and, together with bovine enamel, also as antagonists. Each antagonist wheel ran against each abrader wheel for 200000 cycles, with a spring force of 15 N, and at a rotational speed of 1 Hz in distilled water. The wear rate was determined with a surface profilometer. The surfaces were observed with scanning electron microscopy, and their hardness, coefficient of friction, and roughness were evaluated. RESULTS: Lava Plus and IPS e.max CAD exhibited the highest potential for wear of Lava Ultimate. These 2 materials, together with Vita Suprinity, provided the highest wear of enamel and Vita Enamic. Vita Suprinity and IPS e.max CAD had higher wear than Lava Plus, and the inverse was also true. Vita Enamic and Lava Ultimate were among the materials that caused the lowest wear of enamel and all other evaluated materials. Scanning electron microscopy images revealed that except for Lava Ultimate, all other materials damaged enamel, in which Vita Suprinity and IPS e.max CAD were more aggressive when sliding against the materials. Lava Plus had the greatest hardness, followed by Vita Suprinity and IPS e.max CAD, Vita Enamic, and then Lava Ultimate. The coefficient of friction varied from 0.42 to 0.53. The Vita Enamic and Lava Ultimate showed the highest surface roughness. CONCLUSIONS: The nanofilled composite resin and polymer-infiltrated ceramic were more antagonist-friendly (whether enamel or CAD-CAM material) than glass-ceramics and zirconia. Care should be taken when selecting the material that will contact mainly with glass-ceramics. Hardness should also be considered when selecting a material.

Elastic Properties of Lithium Disilicate Versus Feldspathic Inlays: Effect on the Bonding by 3D Finite Element Analysis.

PURPOSE: To determine the elastic properties of five ceramic systems with different compositions (lithium disilicate vs. feldspathic ceramics) and processing methods and compare the stress distribution in premolars in the interface with inlays made with these systems loaded with the maximum normal bite force (665 N) using 3D finite element analysis (FEA). MATERIALS AND METHODS: The elastic properties of five ceramic restoration materials (IPS e.max Press, IPS e.max CAD, Vita PM9, Vita Mark II, Vita VM7) were obtained using the ultrasonic pulse-echo method. Three-dimensional FEA simplified models of maxillary premolars restored with these ceramic materials were created. The models were loaded with a load at the two nodes on the occlusal surface in the middle of the tooth, 2 mm from the outside of the tooth, simulating a loading ball with a radius of 6 mm. RESULTS: The means values of density (g/cm³), Young's modulus (GPa), and Poison's ratio was 2.6 ± 0.3, 82.3 ± 18.3, and 0.22 ± 0.01 for IPS e.max Press; 2.3 ± 0.1, 83.5 ± 15.0, and 0.21 ± 0.01 for IPS e.max CAD; 2.5 ± 0.1, 44.4 ± 11.5, and 0.26 ± 0.08 for PM9; 2.4 ± 0.1, 70.6 ± 4.9, and 0.22 ± 0.01 for Vitamark II; 2.4 ± 0.1, 63.3 ± 3.9, and 0.23 ± 0.01 for VM7, respectively. The 3D FEA showed the tensile stress at the interface between the tooth and the inlay was dependent on the elastic properties of the materials, since the Vita PM9 and IPS e.max CAD ceramics presented the lowest and the highest stress concentration in the interface, respectively. CONCLUSIONS: The elastic properties of ceramic materials were influenced by composition and processing methods, and these differences influenced the stress concentration at the bonding interface between tooth and restoration. The lower the elastic modulus of inlays, the lower is the stress concentration at the bonding interfaces.

The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses.

OBJECTIVES: This study aimed to investigate the influence of restoration thickness to the fracture resistance of adhesively bonded Lava™ Ultimate CAD/CAM, a Resin Nano Ceramic (RNC), and IPS e.max CAD ceramic. METHODS: Polished Lava™ Ultimate CAD/CAM (Group L), sandblasted Lava™ Ultimate CAD/CAM (Group LS), and sandblasted IPS e.max CAD (Group ES) discs (n=8, Ø=10 mm) with a thickness of respectively 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm, and 3.0 mm were cemented to corresponding epoxy supporting discs, achieving a final thickness of 3.5 mm. All the 120 specimens were loaded with a universal testing machine at a crosshead speed of 1 mm/min. The load (N) at failure was recorded as fracture resistance. The stress distribution for 0.5 mm restorative discs of each group was analyzed by Finite Element Analysis (FEA). The results of facture resistances were analyzed by one-way ANOVA and regression. RESULTS: For the same thickness of testing discs, the fracture resistance of Group L was always significantly lower than the other two groups. The 0.5 mm discs in Group L resulted in the lowest value of 1028 (112) N. There was no significant difference between Group LS and Group ES when the restoration thickness ranged between 1.0 mm and 2.0 mm. There was a linear relation between fracture resistance and restoration thickness in Group L (R=0.621, P<0.001) and in Group ES (R=0.854, P<0.001). FEA showed a compressive permanent damage in all groups. SIGNIFICANCE: The materials tested in this in vitro study with the thickness above 0.5 mm could afford the normal bite force. When Lava Ultimate CAD/CAM is used, sandblasting is suggested to get a better bonding.

Heat treatment following surface silanization in rebonded tribochemical silica-coated ceramic brackets: shear bond strength analysis.

OBJECTIVE: This study aimed to evaluate the effects of heat treatment on the tribochemical silica coating and silane surface conditioning and the bond strength of rebonded alumina monocrystalline brackets. MATERIAL AND METHODS: Sixty alumina monocrystalline brackets were randomly divided according to adhesive base surface treatments (n=20): Gc, no treatment (control); Gt, tribochemical silica coating + silane application; Gh, as per Gt + post-heat treatment (air flux at 100ºC for 60 s). Brackets were bonded to the enamel premolars surface with a light-polymerized resin and stored in distilled water at 37ºC for 100 days. Additionally, half the specimens of each group were thermocycled (6,000 cycles between 5-55ºC) (TC). The specimens were submitted to the shear bond strength (SBS) test using a universal testing machine (1 mm/min). Failure mode was assessed using optical and scanning electron microscopy (SEM), together with the surface roughness (Ra) of the resin cement in the bracket using interference microscopy (IM). 2-way ANOVA and the Tukey test were used to compare the data (p>0.05). RESULTS: The strategies used to treat the bracket surface had an effect on the SBS results (p=0.0), but thermocycling did not (p=0.6974). Considering the SBS results (MPa), Gh-TC and Gc showed the highest values (27.59±6.4 and 27.18±2.9) and Gt-TC showed the lowest (8.45±6.7). For the Ra parameter, ANOVA revealed that the aging method had an effect (p=0.0157) but the surface treatments did not (p=0.458). For the thermocycled and non-thermocycled groups, Ra (µm) was 0.69±0.16 and 1.12±0.52, respectively. The most frequent failure mode exhibited was mixed failure involving the enamel-resin-bracket interfaces. CONCLUSION: Regardless of the aging method, Gh promoted similar SBS results to Gc, suggesting that rebonded ceramic brackets are a more effective strategy.

Heat treatment following surface silanization in rebonded tribochemical silica-coated ceramic brackets: shear bond strength analysis

OBJECTIVE: This study aimed to evaluate the effects of heat treatment on the tribochemical silica coating and silane surface conditioning and the bond strength of rebonded alumina monocrystalline brackets. MATERIAL AND METHODS: Sixty alumina monocrystalline brackets were randomly divided according to adhesive base surface treatments (n=20): Gc, no treatment (control); Gt, tribochemical silica coating + silane application; Gh, as per Gt + post-heat treatment (air flux at 100ºC for 60 s). Brackets were bonded to the enamel premolars surface with a light-polymerized resin and stored in distilled water at 37ºC for 100 days. Additionally, half the specimens of each group were thermocycled (6,000 cycles between 5-55ºC) (TC). The specimens were submitted to the shear bond strength (SBS) test using a universal testing machine (1 mm/min). Failure mode was assessed using optical and scanning electron microscopy (SEM), together with the surface roughness (Ra) of the resin cement in the bracket using interference microscopy (IM). 2-way ANOVA and the Tukey test were used to compare the data (p>0.05). RESULTS: The strategies used to treat the bracket surface had an effect on the SBS results (p=0.0), but thermocycling did not (p=0.6974). Considering the SBS results (MPa), Gh-TC and Gc showed the highest values (27.59±6.4 and 27.18±2.9) and Gt-TC showed the lowest (8.45±6.7). For the Ra parameter, ANOVA revealed that the aging method had an effect (p=0.0157) but the surface treatments did not (p=0.458). For the thermocycled and non-thermocycled groups, Ra (µm) was 0.69±0.16 and 1.12±0.52, respectively. The most frequent failure mode exhibited was mixed failure involving the enamel-resin-bracket interfaces. CONCLUSION: Regardless of the aging method, Gh promoted similar SBS results to Gc, suggesting that rebonded ceramic brackets are ...

Toxicity of photodynamic therapy with LED associated to Photogem®: an in vivo study.

The aims of this study were to evaluate the effects of Photogem®-mediated photosensitization on rat palatal mucosa and the biodistribution of the photosensitizer in this tissue. A solution of Photogem® (500 or 1000 mg/l) was applied to the palatal mucosa for 30 min and the exposure time to blue LED (460 nm) was 20 min (144 J/cm(2)). At 0, 1, 3, and 7 days, palatal mucosa was photographed for macroscopic analysis. After killing, the palate was removed for microscopic analysis. Thermal mapping evaluated temperature change in the tissue during irradiation. All experimental groups revealed intact mucosa in the macroscopic analysis. Tissue alterations were observed microscopically for only four out of 80 animals subjected to PDT. Fluorescence emitted by Photogem® was identified and was limited to the epithelial layer. A temperature increase from 35 to 41°C was recorded. Photogem®- mediated PDT was not toxic to the rat palatal mucosa.

Efeito da ciclagem mecânica em pré-molares restaurados com inlays confeccionados com diferentes materiais cerâmicos na resistência de união dentina-restauração / Effect of mechanical cycling on bond strength of five different ceramics inlays to dentin

Tendo em vista os diversos materiais presentes no mercado, e que ainterface adesiva é a principal responsável pela durabilidade de restaurações estéticas, é importante avaliarmos que material apresenta melhor desempenho na cavidade bucal, promovendo sucesso no emprego de restaurações estéticas. Dessa forma, esse estudo teve como objetivo avaliar a resistência de união entre cinco diferentes tipos de restaurações cerâmicas, em cavidades do tipo inlay, e o substrato dentário (pré-molares superiores) antes e após ciclagem mecânica. Para isso, 100 pré-molares superiores íntegros receberam preparos MOD e restaurações inlays foram confeccionadas. Os espécimes foram, então, divididos em 10 grupos (n=10), de acordo com 2 fatores de estudo (fatorial 5 x 2): fator estratégia restauradora (5 diferentes tipos de restauração cerâmica com diferentes composição, microestrutura e forma de processamento: e.Max Press, e.Max CAD,Vita PM9, Vita Mark II e Vita VM7); fator ciclagem mecânica (com ciclagem [100 N, 2 Hz, 1,2 x106 ciclos] e sem ciclagem). Em seguida, todos os espécimes foram seccionados no sentido x e y, para se obter espécimes em forma de barras (non-trimming approach) compostos de dentina vestibular – restauração – dentina lingual, para então serem submetidos a teste de microtração. A superfície de fratura foianalisada com auxílio de um estereo microscópio e o modo de falha determinado. Além disso, uma análise de elementos finitos para avaliação da distribuição de tensões nas restaurações foi empregada. Os dados obtidos foram analisados estatisticamente de acordo com sua distribuição. A ciclagem teve significante efeito (p= 0,0087 < 0,05) no grupo da cerâmica e.Max Press (G1 e G2), enquanto a resistência de união não foi afetada pela ciclagem nas demais cerâmicas. O teste de Tukey indicou que a resistência de união do grupo Vitamark II teve o mais alto valor médio de resistência de união em ambas as condições, com ciclagem e sem ciclagem...

Nowadays, a great variety of ceramics are available in the market. The knowledge about the technique that provides better durability to restoration is important. Moreover, because of the adhesive interface is the main responsible for the durability of aesthetic restorations, it is important to evaluate which material presents the best long-term clinical performance to ceramic inlays and provides success in the aesthetic restorations. The purpose of the present study is to evaluate the bond strength of five different ceramics inlays to the tooth structure (upper pre-molar) after mechanical cycling. Then, 100 upper pre-molar received inlays ceramics with different compositions and manufacturing processes and were divided into 10 groups (n=10), in accordance to 2 factors of study: types of ceramic (5 different types of ceramic restorations with compositions, microstructures and manufacturing processes: e.Max Press, e.Max CAD, Vita PM9, Vita Mark II and Vita VM7); and mechanical cycling factor (with mechanical cycling [100N, 2Hz, 1,2 x 106 cycles] and without mechanical cycling). After that, all the specimens was cuted in x and y axis, (non-trimming approach). These bars were composed by dentine - restoration - lingual dentine. The bond strength of the bars was measured by microtensile bond strength test. The fractured ceramic surfaces were examined under a stereo microscope and the failure mode was classified. Additionally, a 3-dimensional (3-D) finite element analysis was performed to evaluate the distribution of stress 13 on the restorations. The mechanical cycling had a significant effect (p = 0.0087 <0.05) on the ceramic e.max Press (G1 and G2), while the bond strength was not affected by cycling the other ceramics. The Tukey test indicated that the bond strength of Vitamark group II hadthe highest average bond strength in both conditions, with and without cycling cycling. The mode of failure in interface adhesive/cement and ceramics was that which...

Efeito da ciclagem mecânica em pré-molares restaurados com inlays confeccionados com diferentes materiais cerâmicos na resistência de união dentina-restauração / Effect of mechanical cycling on bond strength of five different ceramics inlays to dentin

Tendo em vista os diversos materiais presentes no mercado, e que ainterface adesiva é a principal responsável pela durabilidade de restaurações estéticas, é importante avaliarmos que material apresenta melhor desempenho na cavidade bucal, promovendo sucesso no emprego de restaurações estéticas. Dessa forma, esse estudo teve como objetivo avaliar a resistência de união entre cinco diferentes tipos de restaurações cerâmicas, em cavidades do tipo inlay, e o substrato dentário (pré-molares superiores) antes e após ciclagem mecânica. Para isso, 100 pré-molares superiores íntegros receberam preparos MOD e restaurações inlays foram confeccionadas. Os espécimes foram, então, divididos em 10 grupos (n=10), de acordo com 2 fatores de estudo (fatorial 5 x 2): fator estratégia restauradora (5 diferentes tipos de restauração cerâmica com diferentes composição, microestrutura e forma de processamento: e.Max Press, e.Max CAD,Vita PM9, Vita Mark II e Vita VM7); fator ciclagem mecânica (com ciclagem [100 N, 2 Hz, 1,2 x106 ciclos] e sem ciclagem). Em seguida, todos os espécimes foram seccionados no sentido x e y, para se obter espécimes em forma de barras (non-trimming approach) compostos de dentina vestibular – restauração – dentina lingual, para então serem submetidos a teste de microtração. A superfície de fratura foianalisada com auxílio de um estereo microscópio e o modo de falha determinado. Além disso, uma análise de elementos finitos para avaliação da distribuição de tensões nas restaurações foi empregada. Os dados obtidos foram analisados estatisticamente de acordo com sua distribuição. A ciclagem teve significante efeito (p= 0,0087 < 0,05) no grupo da cerâmica e.Max Press (G1 e G2), enquanto a resistência de união não foi afetada pela ciclagem nas demais cerâmicas. O teste de Tukey indicou que a resistência de união do grupo Vitamark II teve o mais alto valor médio de resistência de união em ambas as condições, com ciclagem e sem ciclagem. A falha do tipo..(AU)

Nowadays, a great variety of ceramics are available in the market. The knowledge about the technique that provides better durability to restoration is important. Moreover, because of the adhesive interface is the main responsible for the durability of aesthetic restorations, it is important to evaluate which material presents the best long-term clinical performance to ceramic inlays and provides success in the aesthetic restorations. The purpose of the present study is to evaluate the bond strength of five different ceramics inlays to the tooth structure (upper pre-molar) after mechanical cycling. Then, 100 upper pre-molar received inlays ceramics with different compositions and manufacturing processes and were divided into 10 groups (n=10), in accordance to 2 factors of study: types of ceramic (5 different types of ceramic restorations with compositions, microstructures and manufacturing processes: e.Max Press, e.Max CAD, Vita PM9, Vita Mark II and Vita VM7); and mechanical cycling factor (with mechanical cycling [100N, 2Hz, 1,2 x 106 cycles] and without mechanical cycling). After that, all the specimens was cuted in x and y axis, (non-trimming approach). These bars were composed by dentine - restoration - lingual dentine. The bond strength of the bars was measured by microtensile bond strength test. The fractured ceramic surfaces were examined under a stereo microscope and the failure mode was classified. Additionally, a 3-dimensional (3-D) finite element analysis was performed to evaluate the distribution of stress 13 on the restorations. The mechanical cycling had a significant effect (p = 0.0087 <0.05) on the ceramic e.max Press (G1 and G2), while the bond strength was not affected by cycling the other ceramics. The Tukey test indicated that the bond strength of Vitamark group II hadthe highest average bond strength in both conditions, with and without cycling cycling. The mode of failure in interface adhesive/cement and ceramics was that which ...

Extensometria – cargas axiais e não axiais sobre coroa unitária implantossuportada / Strain gauge analysis – axial and non-axial loads on the single-tooth implant-supported crown

Este estudo avaliou, in vitro, por meio da extensometria, as diferentes deformações ao redor de um implante de hexágono externo após a aplicação de carga em três pontos distintos sobre coroas unitárias, fixado em um bloco de poliuretano. Quatro extensômetros foram colados, diametralmente opostos e tangentes ao implante, na superfície do bloco para quantificar a microdeformação peri-implantar no momento da aplicação da carga. Um pilar protético esteticone foi conectado ao implante com torque de 20 Ncm. Sobre o pilar foi parafusado, a cada sessão de teste, um padrão fundido em liga de Co-Cr (n = 10) com torque de 10 Ncm, que recebeu o carregamento. A carga de 30 kg foi aplicada sobre três pontos predeterminados e os dados de microdeformação registrados com auxílio de um condicionador de sinais elétricos e do software Strain-Smart. Os resultados obtidos foram submetidos à análise estatística utilizando a Análise de Variância (Anova) e o teste de comparação múltipla de Tukey (5%). Os valores médios da microdeformação para as cargas foram: ponto A = 307,6 ponto B = 302,3 e ponto C = 669,5. Pôde-se concluir que os fatores de deslocamento centrífugo do ponto de aplicação de carga interferem significativamente na microdeformação gerada ao redor do implante.

This in vitro study evaluated microstrain levels around a single-tooth, external hexagon dental implant crown. An Estheticone abutment was connected to the implant with 20 Ncm torque, and a single crown cast in Co-Cr alloy (n=10) delivered with 10Ncm. Four strain gauges were bonded, diametrically opposed and tangential to the implant, on the surface of the polyurethane block. After, a 30Kg-load was applied at three different points (A, B, and C). Microstrain (µε) values were recorded with the aid of an electric signal conditioner and the Strain-Smart software. Statistical analyses were performed with Anova and multiple comparison Tukey´s test (5% significance level). Mean deformation values were: point A = 307.6 µε, point B = 302.3 µε, and point C = 669.5 µε. It was concluded that centrifugal displacement of the loading application point interferes significantly with microstrain levels around the dental implant.

Pilar de zircônia em implante unitário imediato anterior / Zirconia abutment for single-tooth immediate implant restoration: a case report

Com a crescente busca pela estética, uma integração final invisível entre tecido, implante e coroa tem sido um dos principais desafios da Implantodontia atual. Uma alternativa recente é a utilização do pilar protético de zircônia, que permite ao cirurgião-dentista realizar reabilitações protéticas totalmente cerâmicas, pilar protético e coroa, combinando fatores como resistência, excelente estética e satisfação do paciente. Este artigo relata um caso clínico na região anterossuperior, envolvendo o dente 22, no qual uma fratura radicular inviabilizou a manutenção do dente na arcada dentária. O tratamento reabilitador consistiu na realização da cirurgia de extração do dente 22 e de colocação de implante imediato, seguido de instalação de coroa provisória imediata na região. Em seguida, o tratamento protético foi realizado por meio da confecção de coroa unitária implantossuportada sobre pilar de zircônia, utilizando-se o sistema In-ceram Alumina. Clinicamente, observou-se que o uso do pilar de zircônia associado a coroa também livre de metal permitiu ao cirurgião-dentista alcançar o resultado estético e funcional desejado, com perfeita integração entre tecido gengival e coroa, além de adequada performance mecânica. Além disso, pode-se constatar que em condições clínicas favoráveis a instalação de implante imediato, seguida de instalação de coroa provisória imediata, representa uma opção de tratamento viável.

With the increasing quest for aesthetics, a perfect integration between tissue, dental implant, and restorations have been the challenge of current Implant Dentistry. An alternative is the use of high-strength ceramic abutments, such as zirconia, which combines factors such as resistance and aesthetics. This article reports a clinical case in where an anterior tooth loss was reestablished with an immediate implant, followed by immediate temporary implant-supported zirconia abutment, using the In-Ceram alumina system. The authors observed that treatment with zirconia abutment provided the desired functional and aesthetic outcomes.

Photodynamic therapy associating Photogem and blue LED on L929 and MDPC-23 cell culture.

To evaluate the cytotoxicity of PDT (photodynamic therapy) with Photogem associated to blue LED (light-emitting diode) on L929 and MDPC-23 cell cultures, 30000 cells/cm2 were seeded in 24-well plates for 48 h, incubated with Photogem (10, 25 or 50 mg/l) and irradiated with an LED source (460+/-3 nm; 22 mW/cm2) at two energy densities (25.5 or 37.5 J/cm2). Cell metabolism was evaluated by the MTT (methyltetrazolium) assay (Dunnet's post hoc tests) and cell morphology by SEM (scanning electron microscopy). Flow cytometry analysed the type of PDT-induced cell death as well and estimated intracellular production of ROS (reactive oxygen species). There was a statistically significant decrease of mitochondrial activity (90% to 97%) for all Photogem concentrations associated to blue LED, regardless of irradiation time. It was also demonstrated that the mitochondrial activity was not recovered after 12 or 24 h, characterizing irreversible cell damage. PDT-treated cells presented an altered morphology with ill-defined limits. In both cell lines, there was a predominance of necrotic cell death and the presence of Photogem or irradiation increased the intracellular levels of ROS. PDT caused severe toxic effects in normal cell culture, characterized by the reduction of the mitochondrial activity, morphological alterations and induction of necrotic cell death.

Colocação e carregamento imediato do implante com coroas provisórias na zona estética: relato de caso com um sistema cerâmico / Immediate implant placement and occlusal loading with provisional crowns in the esthetic zone: case report with an all-ceramic system

A crescente exigência estética tem levado ao constante desenvolvimento dos pilares protéticos na Implantodontia. O pilar protético de Zircônia permite ao cirurgião-dentista indicar ao paciente reabilitações protéticas totalmente cerâmicas, pilar protético e coroa, o que pode propiciar ótimo resultado estético e alto nível de satisfação do paciente. Este artigo relata uma abordagem multidisciplinar para o tratamento de um caso clínico na região ântero-superior, envolvendo os dentes 11, 12, 13, 14 e 15, no qual houve perdas dentárias dos elementos 11 e 14 em consequência de um trauma. O tratamento restaurador consistiu na realização de cirurgia de implante imediato seguido de coroa provisória imediata na região do dente 11, enquanto que o tratamento protético foi realizado por meio da confecção de coroa unitária implantossuportada sobre pilar de zircônia, confecção de coroa unitária no dente 12 e prótese parcial fixa de três elementos dos dentes 13 ao 15, utilizando-se o sistema In-Ceram Zircônia. Observou-se clinicamente que o uso do pilar de Zircônia e de próteses livres de metal permitiu alcançar excelente resultado estético e adequada performance mecânica. Verificou-se também que quando as condições clínicas são favoráveis, a estratégia de instalação de implante imediato, seguido de coroa provisória imediata, é uma opção viável.

The increase of aesthetic requirements has led to the constant development of new abutments on Implantology. The zirconia abutment allows clinicians to provide patients with an all-ceramic restorative system (abutment and crown) which can generate excellent aesthetic results and high level of patient satisfaction. This article reports a multidisciplinary approach to the treatment of a clinical case in the anterior maxillary region involving teeth 11, 12, 13, 14, and 15, where elements 11 and 14 were lost due to trauma. The restorative treatment consisted of immediate implant placement and immediate temporary crown in the region of tooth 11, while the prosthetic treatment was performed through the construction of single crown on implant-supported zirconia abutment, a single crown on tooth 12 and a 3-element fixed partial denture on teeth 13 to 15, using the In-Ceram Zirconia system. It was clinically observed that the use of zirconia abutment and all-ceramic prostheses achieved excellent aesthetic result and adequate mechanical performance. Also, it was verified that in cases where clinical conditions are favorable, the strategy of immediate implant placement and provisionalization is a viable option.

Considerações clínicas sobre pilares estéticos / Clinical considerations on ceramic esthetic abutments

A exigência estética em Odontologia tem levado ao desenvolvimento de novos materiais. Os pilares cerâmicos surgem como uma alternativa viável nas reabilitações protéticas em regiões onde a estética é primordial. Este artigo tem por finalidade revisar considerações relevantes na propriedades mecânicas e biológicas dos pilares cerâmicos.

Aesthetic demands in dentistry have turned into the development of newer materials. Ceramic abutments appear as a viable alternative for prosthetic rehabilitations in esthetic regions where this is the primary concern. The objective of this article is to review some relevant aspects about ceramic abutment´s mechanical and biological properties.

Indirect cytotoxicity of a 35% hydrogen peroxide bleaching gel on cultured odontoblast-like cells.

The aim of this study was to evaluate the trans-enamel and trans-dentinal effects of a 35% hydrogen peroxide (H2O2) bleaching gel on odontoblast-like cells. Enamel/dentin discs obtained from bovine incisors were mounted in artificial pulp chambers (APCs). Three groups were formed: G1- 35% H2O2; G2- 35% H2O2 + halogen light application; G3- control. The treatments were repeated 5 times and the APCs were incubated for 12 h. Then, the extract was collected and applied for 24 h on the cells. Cell metabolism, total protein dosage and cell morphology were evaluated. Cell metabolism decreased by 62.09% and 61.83% in G1 and G2, respectively. The depression of cell metabolism was statistically significant when G1 and G2 were compared to G3. Total protein dosage decreased by 93.13% and 91.80% in G1 and G2, respectively. The cells in G1 and G2 exhibited significant morphological alterations after contact with the extracts. Regardless of halogen light application, the extracts caused significantly more intense cytopathic effects compared to the control group. After 5 consecutive applications of a 35% H2O2 bleaching agent, either catalyzed or not by halogen light, products of gel degradation were capable to diffuse through enamel and dentin causing toxic effects to the cells.

Indirect cytotoxicity of a 35 percent hydrogen peroxide bleaching gel on cultured odontoblast-like cells

The aim of this study was to evaluate the trans-enamel and trans-dentinal effects of a 35 percent hydrogen peroxide (H2O2) bleaching gel on odontoblast-like cells. Enamel/dentin discs obtained from bovine incisors were mounted in artificial pulp chambers (APCs). Three groups were formed: G1- 35 percent H2O2; G2- 35 percent H2O2 + halogen light application; G3- control. The treatments were repeated 5 times and the APCs were incubated for 12 h. Then, the extract was collected and applied for 24 h on the cells. Cell metabolism, total protein dosage and cell morphology were evaluated. Cell metabolism decreased by 62.09 percent and 61.83 percent in G1 and G2, respectively. The depression of cell metabolism was statistically significant when G1 and G2 were compared to G3. Total protein dosage decreased by 93.13 percent and 91.80 percent in G1 and G2, respectively. The cells in G1 and G2 exhibited significant morphological alterations after contact with the extracts. Regardless of halogen light application, the extracts caused significantly more intense cytopathic effects compared to the control group. After 5 consecutive applications of a 35 percent H2O2 bleaching agent, either catalyzed or not by halogen light, products of gel degradation were capable to diffuse through enamel and dentin causing toxic effects to the cells.

O objetivo deste estudo foi avaliar os efeitos citotóxicos de um agente clareador com 35 por cento de peróxido de hidrogênio (H2O2) sobre células da linhagem odontoblástica. Foram confeccionados discos de esmalte/dentina obtidos de incisivos bovinos, os quais foram posicionados em câmaras pulpares artificiais (CPAs). Três grupos foram formados: G1: gel clareador; G2: gel clareador + luz halógena e G3: controle. Após 5 aplicações consecutivas do gel clareador sobre o esmalte, os extratos foram obtidos e aplicados por 24 h sobre as células. Foram realizadas avaliações do metabolismo celular, morfologia das células e expressão total de proteína. O metabolismo celular para G1 e G2 reduziu em 62,09 por cento e 61,83 por cento, respectivamente. A redução do metabolismo celular foi estatisticamente significante quando se comparou G1 e G2 com G3. A expressão de proteína total reduziu em 93,13 por cento e 91,80 por cento para G1 e G2, respectivamente. As células em G1 e G2 apresentaram importantes alterações morfológicas após contato com os extratos. Foi possível concluir que independente da catalização ou não do gel clareador por luz halógena, os componentes que se difundiram através dos tecidos duros do dente após sua quinta aplicação sobre o esmalte, causaram intensos efeitos citotóxicos para as células.

Avaliação do efeito citotóxico da terapia fotodinâmica associada ao LED e ao Photogem® sobre a mucosa bucal de rato / Toxicity of the photodynamics therapy with LED associated to Photogem®: an in vivo study

A utilização da PDT para tratamento de diferentes tipos de infecções, tal como a candidose bucal, tem sido estudada. Entretanto, poucos são os dados científicos que relatam os possíveis efeitos tóxicos dessa terapia. Dessa forma, o objetivo deste estudo foi avaliar os efeitos da irradiação na mucosa bucal de ratos com LED azul (de 460 nm e potência de 200 mW/cm2) em presença do fotossensibilizador (FS) Photogem®, em duas diferentes concentrações (500 mg/L e 1000 mg/L). Para isso, foram utilizados 101 ratos (Rattus Norvegicus Albinus Holtzman) distribuídos em 6 grupos, de acordo com os seguintes tratamentos: Grupo 1 ­ controle; Grupo 2 ­ aplicação do FS (500 mg/L); Grupo 3 ­ aplicação do FS (500 mg/L) e irradiação com LED; Grupo 4 - aplicação do FS (1000 mg/L); Grupo 5 ­ aplicação do FS (1000 mg/L) e irradiação com LED; e Grupo 6 ­ irradiação com LED. O FS foi aplicado por 30 minutos (tempo de pré-incubação) e o tempo de irradiação da mucosa foi de 20 minutos (dose de 144 J/cm2 ). Decorridos os 4 períodos de avaliação propostos (0 dia, 1dia, 3 dias e 7 dias), os animais tiveram a mucosa palatina fotografada para análise macroscópica, sendo então imediatamente sacrificados para remoção cirúrgica do palato e posterior análise em microscopia de luz e de fluorescência. Um mapeamento térmico foi realizado a fim de avaliar a variação de temperatura ocorrida no tecido durante a irradiação com LED. Macroscopicamente, em todos os grupos experimentais e para todos os períodos de avaliação propostos na presente pesquisa, observou-se que a mucosa apresentava-se intacta, com aspecto de normalidade semelhante ao do Grupo 1 (controle). Microscopicamente, alterações teciduais, caracterizadas especialmente por discreta inflamação, puderam ser observadas na mucosa palatina de apenas 4 de um total de 80 animais submetidos a PDT. A penetração do fotossensibilizador na mucosa tratada pôde ser observada por meio da emissão de fluorescência do Photogem® , tendo este FS se mantido presente apenas no tecido epitelial. O mapeamento térmico revelou que a temperatura aumentou de 35ºC para 41ºC durante 20 minutos de irradiação. Dentro das condições experimentais avaliadas, foi possível concluir que a PDT, utilizando Photogem® nas concentrações de 500 mg/L e 1000 mg/L associado ou não à irradiação com LED (dose de 144 J/cm2), não foi tóxica para a mucosa palatina de ratos

The use of PDT has been investigated for the treatment of different types of infection, like oral candidosis. There are, however, few research-based data that report the possible toxic effects of this therapy. Therefore, this study evaluated the effects of irradiating the palatal mucosa of rats with blue LED (460 nm; 200 mW/cm²) in the presence of the photosensitizer Photogem® at two concentrations (500 and 1000 mg/L). Then, 101 rats (Rattus norvegicus albinus Holtzman) were randomly distributed in six groups, according to the treatment performed on the palatal mucosa: Group 1: control; Group 2: Photogem® (500 mg/L); Group 3: Photogem® (500 mg/L) + blue LED; Group 4 - Photogem® (1000 mg/L); Group 5: (1000 mg/L) + blue LED; and Group 6: blue LED. The exposure times to the photosensitizing agent and to the light source were 30 min (pre-incubation time) and 20 min (144 J/cm2 energy density), respectively. At 0, 1, 3 and 7 days posttreatment, the animals had their palatal mucosa photographed for macroscopic analysis and were immediately sacrificed. The palate was removed for further analysis by light and fluorescence microscopy. Thermal mapping was made to evaluate the temperature change occurred in the tissue during LED irradiation. In all experimental groups and periods, the macroscopic analysis revealed intact mucosa with normal aspect similar to that of Group 1 (control). Tissue alterations, characterized primarily by a mild inflammation, were observed microscopically on the mucosa of only 4 out of 80 animals subjected to PDT. Photosensitizer penetration into the treated mucosa was identified by the fluorescence emitted by Photogem® and was limited to the epithelial layer. The thermal mapping revealed a temperature increase from 35 to 41ºC during the 20-min irradiation. In conclusion, under the tested conditions, PDT using Photogem® at 500 and 1000 mg/L concentrations associated or not to LED irradiation (144 J/cm2) was not toxic to the rat palatal mucosa

Estudo da anatomia do sistema de canais radiculares de incisivos laterais superiores, utilizando cortes macroscópicos e da diafanização / Lateral upper incisor radicular canal system study, using macroscopic cuts and clarifying technique

Cento e cinco incisivos laterais superiores extraídos foram utilizados na presente pesquisa, que analisou os aspectos da cavidade pulpar por meio de cortes macroscópicos e de diafanização. Verificou-se que 1,9 por cento das amostras apresentqu dois canais e 98,1 por cento, um canal radicular. A permeabilidade dentinária estava presente em 87,2 por cento das amostras, os canais secundários em 15 por cento, os canais laterais em 7,8 por cento e os deltas apicais em 2,8 por cento