Influência do tratamento de superfície em diferentes substratos na resistência de união à cimento resinoso autoadesivo / The influence of surface treatment on different substrates on bond strength to self-adhesive resin cement

As reabilitações orais com próteses fixas na Odontologia passaram por grande evolução ao serem estabelecidos e firmados os conceitos de adesão química. A alta demanda estética desses tratamentos faz com que as cerâmicas que são materiais altamente biocompatíveis e com ótimas propriedades mecânicas, sejam amplamente utilizadas nas reabilitações orais. Nas próteses sobre implantes, o processo de cimentação de restaurações cerâmicas acontece sobre conexões metálicas em titânio (Ti), cobalto-cromo (CoCr) ou infra-estruturas personalizadas em zircônia (Zr). O processo de cimentação necessita de algumas etapas para promover o tratamento de superfície das restaurações indiretas e variam de acordo com a especificidade de cada substrato. O objetivo deste estudo foi avaliar a influência do tratamento de superfície em diferentes substratos de conexões protéticas utilizando primer e sistema adesivo universal contento o monômero funcional 10-MDP na resistência de união à cimento resinoso autoadesivo, por meio de teste mecânico de cisalhamento. Foram confeccionadas 120 amostras (n= 40 de Ti, CoCr e Zr) as quais foram incluidas em blocos de resina acrílica. As amostras foram subdivididas em 12 grupos (n=10), 3 grupos representam o controle e não tiveram a superfície tratada, os demais grupos tiveram a superfície tratada com primer monocomponente ou sistema adesivo universal contendo 10-MDP. Em seguida foi confeccionado um cilíndro de cimento resinoso (2mm de altura X 2,37mm de diâmetro) com o auxílio de um dispositivo de teflon para mensurar as dimensões exatas. Após 24 horas da confecção dos cilíndros, as amostras foram submetidas ao teste mecânico de cisalhamento em máquina de ensaio universal, a uma velocidade de 0,5mm/min, célula de carga de 100 kgf, até a fratura. Os resultados obtidos foram submetidos a ANOVA e teste Tukey, e demonstraram de uma maneira geral que a aplicação do monômero funcional 10-MDP (10-metacriloiloxidecil dihidrogenio fosfato) presente em primer e adesivo universal testados influenciou positivamente o tratamento de superfície de diferentes substratos utilizados em conexões protéticas, promovendo maior resistência de união ao cimento resinoso autoadesivo em todos os substratos(AU)

Oral rehabilitations with fixed prostheses in Dentistry had grown with great evolution when the concepts of chemical adhesion were established and signed. The high aesthetic demand of these treatments makes Ceramics, that are highly biocompatible materials and with good mechanical properties, widely used in oral rehabilitation. In implant prostheses, the process of cementation happens between ceramic restorations on metallic connections in titanium (Ti) and / or cobalt chromium (CoCr) or custom zirconia (Zr) infrastructures. During the cementing process of ceramic restorations some surface treatment steps are required, these steps varying according to the type of specific ceramics. The aim of this study was to evaluate the influence of surface treatment on different substrates of prosthetic connections using primer and universal adhesive system containing 10-MDP functional monomer on bond strength to self-adhesive resin cement by mechanical shear test. One hundred and twenty samples (n = 40 Ti, CoCr and Zr) were made and included in blocks of acrylic resin. The samples were subdivided into 12 groups (n = 10), 3 groups represent the control and did not have the surface treated, the other groups had the surface treated with single component primer or universal adhesive system containing 10-MDP. Then a resin cement cylinder (2mm height X 2,37mm diameter) was made with the aid of a teflon device to measure the exact dimensions. Twenty four hours after the cylinders were made, the samples were subjected to mechanical shear testing in a universal testing machine at a speed of 0.5mm/min, load cell 100kgf, until fracture. The results were submitted to ANOVA and Tukey test, and showed in general that the application of the 10-MDP functional monomer (10- methacryloyloxydecyl dihydrogen phosphate) present in primer and universal adhesive tested positively influenced the surface treatment of different substrates used in prosthetic connections, promoting greater bond strength to self-adhesive resin cement on all substrates(AU)

Evaluación estética de seis tipos de coronas para dientes primarios / Avaliação estética de seis tipos de coroas para dentes decíduos / Aesthetic evaluation of six types of crowns for primary teeth

Objetivo: Evaluar las preferencias estéticas en relación con el color y la forma de coronas primarias utilizadas para dientes incisivos superiores primarios, mediante la realización de una encuesta a miembros de la Academia Mexicana de Odontología Pediatrica (AMOP). Material y Métodos: Se establecieron seis grupos de estudio con seis coronas diferentes: grupo 1, coronas de zirconia EZ-Pedo; grupo 2, coronas de zirconia NuSmile Zr; grupo 3, coronas estéticas hechas en el consultorio; grupo 4, coronas de fundas de celuloide; grupo 5, coronas estéticas prefabricadas NuSmile signature; y grupo 6, coronas estéticas fenestradas. Se llevaron a cabo encuestas con la finalidad de conocer las preferencias estéticas de estas diferentes coronas, con la finalidad de conocer cuál es la mejor opción para su uso en el consultorio dental. Resultados: Noventa miembros de la AMOP realizaron una encuesta válida, y se determinó que el grupo 4 fue el mejor evaluado, seguido de los grupos 2, 5, 1, 6 y 3. Se identificaron diferencias significativas entre los diferentes grupos. Conclusiones: Las coronas de fundas de celuloide fueron seleccionadas como mejor alternativa de uso en los dientes primarios anteriores, por parte de los miembros de la AMOP; asimismo, se consideró a las coronas de zirconia como una buena opción terapéutica. Es recomendable que se implemente el tratamiento estético en dientes primarios, para realizar un tratamiento integral.

Objectivo: Avaliar as preferências estéticas sobre cor e forma das coroas primários utilizados para a incisivos superiores primários, através da realização de uma pesquisa com membros da Academia Mexicana de Odontopediatria (Amop). Material e Métodos: Seis grupos de estudo com seis coroas diferentes foram estabelecidas: Grupo 1, coroas de zircônia EZ-Pedo; Grupo 2, coroas de zircônia NuSmile Zr; Grupo 3, coroas estéticas feitas no escritório; Grupo 4 casos coroas celulóide; Grupo 5, coroas estéticas prefabricados assinatura NuSmile; e Grupo 6, fenestrado coroas estéticas. Eles realizaram pesquisas, a fim de satisfazer as preferências estéticas destas coroas estéticas diferentes, a fim de saber qual é a melhor escolha para uso no consultório odontológico. Resultados: Noventa membros AMOP fez um levantamento válido, e determinou-se que o Grupo 4 foi o melhor avaliado, seguido pelos grupos foram identificados 2, 5, 1, 6 e 3. As diferenças significativas entre os grupos. Conclusões. As coroas de tampas de celulóide foram selecionados como o melhor uso alternativo nos dentes primários acima, por membros da Amop; Também as coroas de zircônia foi considerado como uma boa opção terapêutica. Recomenda-se que o tratamento cosmético é implementado em dentes primários, para um tratamento abrangente.

Objective: Evaluate the aesthetic preferences regarding color and shape of primary crowns used for primary upper incisors, by conducting a survey of members of the Mexican Academy of Pediatric Dentistry (AMOP). Material and Methods: Six study groups with six different crowns were established: Group 1, zirconia crowns EZ-PEDO; Group 2, zirconia crowns NuSmile Zr; Group 3 aesthetic crowns made in the office; Group 4 cases strip crowns; Group 5, aesthetic crowns prefabricated NuSmile signature; and Group 6, fenestrated esthetic crowns. They conducted surveys in order to meet the esthetic preferences of six different aesthetic crowns, in order to know the best choice for use in the dental office. Results: Ninety AMOP members made a valid survey, and it was determined that Group 4 was the best evaluated, followed by the groups 2, 5, 1, 6 and 3. Significant differences between groups were identified. Conclusions: Members of the AMOP selected strip crowns as the best alternative use in the above primary teeth; furthermore zirconium crowns were considered as a good alternative. It is recommended that the cosmetic treatment should be implemented in primary teeth, for a comprehensive treatment.

Trends in dental service provision in Australia: 1983-1984 to 2009-2010.

OBJECTIVE: To investigate time trends in dental service provision. METHODS: A random sample of Australian dentists was surveyed by mailed questionnaires in 1983-1984, 1993-1994, 2003-2004, and 2009-2010 (response rates 67-76%). The service rate per visit was collected from a log of services. RESULTS: The rate of service provision per visit [rate ratio (RR)] increased from 1983-1984 to 2009-2010 for the service areas of diagnostic (RR=1.8; 1.6-1.9), preventive (RR=1.9; 1.6-2.1), endodontic (RR=2.1; 1.7-2.6), and crown and bridge (RR=2.9; 2.3-3.8), whereas prosthodontic services decreased (RR=0.7; 0.6-0.9). CONCLUSIONS: The profile of services provided by dentists changed over the study period to include less emphasis on replacement of teeth and more on diagnosis, prevention, and retention of natural dentitions.

[Stress analysis of prosthodontics by finite element method].

Finite element stress analysis has been widely used in stomatology. In this article, we summarized the stress distributions of all-ceramic crowns, post crowns, fixed partial dentures and implant support fixed dentures; and with the use of finite element method, we investigated the stress levels of the periodontal ligament of abutment. The results showed: the tensile stress and compressive stress concentrated at the cervical margin of all-ceramic crown and post crown; the stress at the surface of the crown was the highest; the stress concentration exhibited at the connector of fixed parital denture, the molar was an ideal abutment tooth for the fixed bridge; the largest stress appeared around the neck of the implant abutment. These results have provided a theoretical basis for clinical dentistry in terms of restoration design and manufacture. It is suggested that clinical dentists should be careful to avoid the horizontal laoding applied on the prostheses so as to improve the resistance of abutment tooth to fracture.

Coronas implantosoportadas: ¿individualizar o ferulizar? / Implant-supported crowns: Individualized or splinting?

Existen diferentes formas de rehabilitación de coronas sobre implantes adyacentes en un tramo edéntulo. Las opciones que pueden encontrarse son la de restaurar con varias coronas unitarias, o bien unir esas coronas en una sola prótesis. Material y Método: Se llevó a cabo una búsqueda bibliográfica a través de bases de datos en revistas especializadas de Odontología. Resultados: En la bibliografía revisada se observa que existen defensores y detractores de cada una de las técnicas, basándose cada autor en distintos estudios y argumentos. Discusión: Se encontraron ventajas e inconvenientes en ambas opciones prostodóncicas, valorando en base a éstos cuándo utilizar cada una de las técnicas propuestas. Conclusiones: Cuando las condiciones son idóneas, se considera adecuada la restauración con coronas individuales; por otro lado cuando existan condiciones adversas (implantes cortos, hueso de mala calidad, carga inmediata o factores oclusales no adecuados), en las que el reparto de fuerzas pueda comprometer el pronóstico de la restauración, la ferulización será el tratamiento de elección (AU)

There are different methods of crown rehabilitation refering to implants adjacent in edentulous sites. The options can be: rehabilitation with several single crowns or the splinting of the crowns in the prostheses. Material and method: A bibliographical research through the data base of the U.C.M. library and a review of clinical files of patients treated under the title implant-prostheses has been carried out. Results: There are supporters and non-supporters of each technique, based on different arguments and studies. Discussion: Advantages and inconvenients have been found in each method, taking these into consideration when it comes to using the appropriate restoration. Conclusions: When conditions are suitable, the implants can be restored by using single crowns. On the other hand, when there are no ideal factors (short implants, low bone quality, early loading, adverse oclussal factors) the use of splinting crowns will be more appropriate (AU)

Desarrollo psicomotor en prótesis fija / Psychomotor development in fixed prosthodontics

La preclínica en Odontología, cuya estrategia es de laboratorio para el aprendizaje de destrezas motoras, se basa en el concepto del modelo Flexner, sustentado en la taxonomía de Bloom, la cual describe la selección de las situaciones de aprendizaje clasificadas en áreas cognoscitivas, afectivas y psicomotoras, siendo estas últimas las que incluyen habilidades ó destrezas motoras. Se han propuesto distintas taxonomías para el desarrollo psicomotor en Odontología, desde algunas simplificadas, con maniquíes, con dientes sembrados, con dibujo, hasta la computarizada, virtual, a distancia. Es indispensable la revisión de los planes de estudio en Odontología para establecer una posición de avanzada en la preclínica, la cual pudiera estar dada en el concepto de la clínica aplicada.

The preclinical in dentistry, whose strategy is of laboratry for the learning of motor skills, is based on the concep of Flexner, sustained in taxonomie of Bloom, cal describes the selection of classified situations of learning in cognoscitivas, affective areas and psicomotor, being these you complete those that include motor abilities or skills. They have seted out different taxonomies for development motor in dentistry, from some simplified, with maniquies, to teeth seeded, drawings, to the computerized ones, virtual, at a distance. The revision of the curricula to establish advance position of the preclinical is indispensable, which cold be based on the concept of applied clinical.

[Full crown preparation of a vital tooth is outdated]. / De volledige omslijping van een (vitaal) frontelement is niet meer van deze tijd.

The restorative solutions for esthetic problems are becoming minimal invasive. Adhesive technology and materials as composite luting cements are biocompatible and therefor less harmfull for vital pulps. Necrosis of vital pulps hardly occurs and the survival of porcelain veneers is very good. The esthetic result is also quite impressive, although marginal discoloration is frequently reported. Full crown preparations can be avoided, but replacement of failing crowns is not banned out in dental practice. Full ceramic crowns however can also be luted with adhesive cements and the amount of hard tissue that has to be removed for optimal esthetic results is much less than for porcelain fused to metal crowns. Saving hard and soft tooth tissues is promoted and advocated as a quality standard. Longevity of treatment outcome has been reported and should be an evidence-based decision in the future.

Treatment trends during a thirteen-year period in a student pediatric dentistry clinic.

This manuscript reports the treatment trends in a pediatric dentistry clinic from 1980 to 1992 and discusses their implication in clinical teaching. Analysis of the records of the senior year pediatric dentistry students indicated: no significant change with time in the patients/student ratio, the number of preformed crowns, pulpotomies, and pulpectomies by student or by patient; a significant decrease in the number of one-surface and > or = 2-surface restorations by student and by patient; a significant increase in the number of pit-and-fissure sealants and preventive resin restorations by student and by patient. During the thirteen-year period, the students performed an average of 7.3 one-surface; 12.9 > or = 2-surface restorations; 5.5 preformed crowns; 6.4 pit-and-fissure sealants; 2.4 pulpotomies. There was a significant increase with time in the number of students who performed pit-and-fissure sealants.

Colagem de fragmentos dentários em molares decíduos / Dental reattachment in primary molars

Os autores apresentam uma alternativa para restabelecimento anátomo-funcional de molares decíduos com destruiçäo coronária total. No cumprimento desse objetivo, utilizam coroa dentária total de dentes decíduos, previamente tratados e mantidos em um "banco de dentes", através de colagem no remanescente dentário do paciente pediátrico

Changes over time in the clientele and restoration pattern in a dental school prosthodontic department.

The clientele and the production of single artificial crowns and fixed partial dentures in the Department of Prosthodontics were compared from 1964/68-1982/87. In the first period 65 per cent of the single crowns were made for women versus 55 per cent in the second. In the first period 69 per cent of the crowns were placed in the upper jaw as against 60 per cent in the second period. On average 1.6 crowns were made per female patient in the first period versus 1.4 per male patient. In the second period both sexes averaged 1.8 units. In both jaws the percentage of root-filled crowned teeth had increased in the second period to 60 per cent from 48 per cent in the upper jaw and 46 per cent in the lower jaw. In both sexes maxillary and mandibular teeth were crowned on average 13 years later in the second period than in the first. Sixty per cent of the fixed partial dentures were made for women in the first period versus 55 per cent in the second. In the first period 74 per cent of the bridges were made for the upper jaw as against 70 per cent in the second period. The mean pontic to abutment ratio was 0.7 in both periods. The maximum number of bridges in the first period were made for patients 40-59 years of age versus 50-69 years in the second period.(ABSTRACT TRUNCATED AT 250 WORDS)

Rehabilitación bucal total en la práctica diaria

Preparaciones con hombro completo. Impresiones con bandas de cobre y compuesto para modelar. Recubrimiento temporario de los muñones. Impresiones para confeccionar el modelo mayor. Confección de las coronas veneer. Terminación de las restauraciones. Cirugía gingival durante el período de preparación. Cirugía ósea correctora durante el período de preparación. Modificaciones quirúrgicas de la arquitectura para mejorar la forma de los dientes. Mejoramiento estético de los dientes anteriores. Rehabilitación de los dientes no vitales. Las cofias telescópicas en las reconstrucciones de toda la boca. Manejo mecánico de las fuerzas de oclusión