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The aim of the study was to evaluate the biomechanical behavior, through photoelastic (PA) and strain gauge analysis (SA), of single crown implant-supported prosthesis with different implant connections (external hexagon (EH), Morse taper (MT), internal Morse hexagon (IMH), Morse taper hexagon (MTH), and frictional Morse taper (FMT)) and different occlusal loads (axial and oblique (45°)). The data were submitted to ANOVA and Tukey's test (α = 0,05). By photoelasticity, regarding axial load, EH produced more high-intensity fringes (2.784 kPa) than the other connections. For the oblique load, all connections generated the same high-intensity fringes (3.480 kPa), except by MT group, that produced the same amount as axial load (2.088 kPa). For the strain gauge analysis, for the axial load, EH showed the highest microstrains value (158,76) and lowets for MT (59,88). For all other groups, oblique load produced higher microstrains values than axial load. For the oblique load, MT showed the lowest microstrains value (88.79), followed by FMT (391,43), EH (468,47) and IMH (507,65). MTH presented the highest value (621,25) compared to all groups (P

This systematic review with meta-analysis aimed to evaluate the effect of the laser treatment on bond strength between Y-TZP and the resin cement or with the veneering ceramic, and the effect on the alteration of the Y-TZP surface roughness.Systematic review and meta analysis following PROSPERO guidelines.A comprehensive review was performed up to September 2020 on four databases (PubMed/MEDLINE, Embase, Scopus, and Cochrane Library), using the combination of keywords: "laser AND zirconia AND surface treatment AND bond strength".The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. The continuous outcome was evaluated by mean difference and the corresponding 95% confidence intervals.A total of 37 studies were identified for the inclusion of data, with only in vitro studies. The types of laser reported in the studies were: Er:YAG, Nd:YAG, Er,Cr:YSGG, CO2, Femtosecond, and Yb lasers. A random-effect model found statistically significant differences between lasers and control groups of Y-TZP (P0.00001; MD: 3.08; 95% CI: 2.58 to 3.58). Only the bond strength with the Er:YAG laser did not present statistical difference (P = 0.51; MD: 0.22; 95% CI: -0.44-0.88). In another analysis, a random-effect model found a statistically significant difference between the laser and control groups on surface roughness (P0.00001; MD: 0.96; 95% CI: 0.86 to 1.06).Laser irradiation is capable to improve the Y-TZP surface roughness and the bond strength of zirconia with resin cement and veneering ceramics. However, there is a lack of laser protocol for the zirconia surface, a fact that makes a simple and direct comparison difficult.

Made available in DSpace on 2021-06-25T11:05:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Objective: To evaluate the optical, chemical, and mechanical properties of feldspathic porcelain after handling with different instrument materials. Material and methods: Feldspathic porcelain was manipulated with different spatula compositions: metal spatula (MS), plastic spatula (PS), and glass spatula (GS) for the fabrication of 30 (n = 10) disks. Contrast ratio (CR), translucency parameter (TP), and surface Knoop microhardness (KHN) were measured. The color change (ΔE00) was evaluated using the CIEDE2000 system. Scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were used for surface analysis. Data were analyzed using one-way ANOVA and Tukey test (P < 0.05). Results: All groups presented different morphological surfaces with higher presence of Al on the MS. PS group presented lower Al, Si, K than MS, and GS. Higher CR was observed for PS (0.734; P < 0.043), followed by MS (0.696; P < 0.043) and GS (0.65; P < 0.011). The highest TP (13.06) and KHN (386.27) were presented by GS (P < 0.001). MS and PS presented similar KHN results. The higher ΔE00 were found for plastic/metal comparison. Also, the L* values for the MS group (67.49) were lower than the other groups. Conclusion: The use of metal spatula promoted higher color alteration during feldspathic porcelain manipulation than did the other materials. Handling with glass instrument promoted higher microhardness than other spatula materials. Clinical significance: The effect of the material used for ceramic handling on feldspathic porcelain properties is often ignored. This study shows that the handling spatula material must be carefully chosen to avoid inadvertent changes to the feldspathic porcelain restoration. Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) School of Dentistry Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Laboratory of Technological Plasmas São Paulo State University (UNESP) Faculty of Dentistry University of Toronto Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) School of Dentistry Laboratory of Technological Plasmas São Paulo State University (UNESP)

Devido a evolução dos sistemas cerâmicos, atualmente, são permitidas inúmeras associações de materiais restauradores. Entretanto, mimetizar as características visuais das próteses livres de metal com próteses metalocerâmica permanece um desafio. Assim, o objetivo deste trabalho foi relatar o caso clínico de substituição de próteses desadaptadas, homogeneizando próteses parciais fixas livres de metal e metalocerâmicas dento e implantossuportadas, após cirurgia periodontal. O paciente de 55 anos, gênero masculino, compareceu à Clínica de Prótese Parcial Fixa, da Faculdade de Odontologia de Araçatuba – FOA/UNESP em 2017 queixando-se dos seus dentes anteriores estarem “feios” e com a “raiz aparecendo”. No exame clínico foi constatada recessão gengival nos elementos 11 e 13, os quais continham uma prótese parcial fixa de três elementos metalocerâmicas desadaptada, prótese sobre implante nos elementos 21 e 22, que apresentavam-se desadaptadas e com estética desfavorável. No exame radiográfico pôde-se observar a presença de um núcleo metálico fundido nos elementos 11 e 13. Foi proposto, então, a confecção de coroas totais livres de metal nos elementos anteriores superiores (13, 12, 11, 21 e 23) e coroa metalocerâmica para o elemento 22. Para isso, foi realizado enceramento diagnóstico inicial e, após o consentimento do paciente, foi efetuada a remoção das próteses antigas. Com a remoção, visualizamos uma depressão na vestibular do rebordo na área do 12 (ausente), solucionado com um enxerto gengival subepitelial. Após a realização dos preparos dentários e moldagem com silicone de adição as peças foram confeccionadas com sistema e.max Ceram (Ivoclar Vivadent). Após a prova estética e ajustes oclusais iniciais, as peças foram preparadas para cimentação resinosa com o sistema Variolink® N (Ivoclar Vivadent). O cimento transparente foi selecionado previamente por meio de provas com o kit Try-In. Conclui-se que, apesar da disparidade dos materiais, é possível mimetizá-los e oferecer resultados reabilitadores suficientemente estéticos e satisfatórios.Descritores: Implantação Dentária; Estética Dentária; Materiais Dentários.ReferênciasCardenas AFM, Mora CAP, Siqueira FSF, Parreiras SO, Gomes JC. Restabelecimento estético de um sorriso envelhecido: Caso clínico. Revista APCD de Estética. 2015;3(1):42-52.Strasding M, Fehmer V, Pjetursson BE, Sailer I. Extending the service life of existing dental restorations with esthetic and functional limitations. J Prosthet Dent. 2018;119(6):893-96.Koidou VP, Rosenstiel SF, Rashid RG. Celebrity smile esthetics assessment: Smile angulation. J Prosthet Dent, 2017;117(5):636-41.Levin, EI. Dental esthetics and the golden proportion. J Prosthet Dent. 1978;40(3):244-52.Flores-Mir C, Silva E, Barriga MI, Lagravere MO, Major PW. Lay person's perception of smile aesthetics in dental and facial views. 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Comparison of bond strength of a pressed ceramic fused to metal versus feldspathic porcelain fused to metal. J Prosthodont. 2005;14(4):239-47.Venkatachalam B, Goldstein GR, Pines MS, Hittelman EL. Ceramic pressed to metal versus feldspathic porcelain fused to metal: a comparative study of bond strength. Int J Prosthodont. 2009;22(1):94-100.Holden JE, Goldstein GR, Hittelman EL, Clark EA. Comparison of the marginal fit of pressable ceramic to metal ceramic restorations. J Prosthodont. 2009;18: 645-48.Sinhori BS, de Andrada MAC, Lopes GC, Monteiro Junior S, Baratieri LN. Influence of Teeth Preparation Finishing on the Adaptation of Lithium Disilicate Crowns. Int J Biomater. 2017; ID 2078526.Hoppen LRC, Garbin CA, Rigo L, Schuh C, FederizzI L. Comparação estética entre coroas confeccionadas com os sistemas Cubo e metalocerâmico. Rev Sul-Bras Odontol. 2010;7(2):146-53.Mazur CE, Machado CT, Malheiros Pfau VJ, Augusto Pfau, E. Planejamento multidisciplinar na reconstrução do sorriso. 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Para alcançar a estética em dentes anteriores deve-se ter conhecimento de diversas técnicas e principalmente fazer a escolha correta dos materiais. As cerâmicas odontológicas estão cada vez mais presentes nas restaurações, visto que possuem ótimas propriedades ópticas e mecânicas. Assim, o objetivo deste estudo foi proporcionar a estética em dentes anteriores com diferentes subtratos através de uma prótese fixa metal-free. Paciente do gênero masculino, 38 anos, procurou atendimento queixando-se da estética do seu sorriso. No exame clínico foi observada uma coroa total metalocerâmica no elemento 21 e facetas de resina composta nos elementos 11,12 e 22, todas com estética insatisfatória. O dente 21 apresentava um núcleo metálico fundido adequado e os dentes 12 e 22 com tratamentos endodônticos. Foi proposta a instalação de pinos de fibra de vidro nos dentes 12 e 22. Além, da confecção de coroas totais metais-free em dissilicato de lítio nos quatro incisivos superiores com o sistema e-max ceram. O resultado final estético e funcional foi aprovado pelo paciente e pelos profissionais envolvidos.Descritores: Estética Dentária; Cerâmica; Reabilitação Bucal.ReferênciasOkida RC, De Moura AP, Franco LM, Salomão FM, Rahal S, Machado LS, Okida DSS. A utilização do DSD (Digital Smile Design) para a otimização da estética dental. Rev Odontol Araçatuba 2017;38(3):9-14.Sabatini C. Color stability behavior of methacrylate-based resin composites polymerized with light-emitting diodes and quartz-tungsten-halogen. Oper Dent. 2015;40(3):71-81.Wang X, Huyang G, Palagummi SV, Liu X, Skrtic D, Beauchamp C et al. High performance dental resin composites withhydrolytically stable monomers. Dent Mater. 2018;34(2):228-37.Yazici AR, Celik C, Dayangaç B, Ozgünaltay G. The effect of curing units and staining solutions on the color stability of resin composites. Oper Dent. 2007; 32(6):616-22.Aguiar EMG, Rodrigues RB, Lopes CCA, Silveira Júnior CD, Soares CJ, Novais VR. Diferentes sistemas cerâmicos na reabilitação oral: relato de caso clínico. Rev Odontol Bras Central. 2016;25(72):31-6.Mazaro JVQ, Zavanelli AC, Pellizzer EP, Verri FR, Falcón-Antennucci RM. Considerações clínicas para a restauração da região anterior com facetas laminadas. Rev Odontol Araçatuba. 2009;30(1):51-4.Vichi A, Louca C, Corciolani G, Ferrari M. Color related to ceramic and zirconia restorations: a review. Dent Mater. 2011;27(1):97-108.Rossato DM, Saade EG, Saad JRC, Porto-Neto ST. Coroas estéticas anteriores em cerâmica metal-free: relato de caso clínico. Rev Sul-Bras Odontol. 2010;7(4):494-98.Lanza MDS, Andreeta MRB, Pegoraro TA, Pegoraro LF, Carvalho RM. Influence of curing protocol and ceramic composition on the degree of conversion of resin cement. J Appl Oral Sci. 2017;25(6):700-7.Soares PFB, Siqueira JM, Carvalho VF, Bicalho AA, Soares CJ. Contenção interdentária empregando fibra de vidro e resina composta: Relato de caso e acompanhamento de 14 anos. Rev Odontol Bras Central. 2016;25(73):80-3.Martinez-Insua A, da Silva L, Rilo B, Santana U. Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon-fiber post with a composite core. J Prosthet Dent. 1998;80(5):527-32.Rocha IJPB, Silva LDR, de Santa Maria SL, Oliveira DP, Porfírio Z. Análise de dois métodos de desinfecção de condutos radiculares após preparo para pinos: proposta de protocolo protético: estudo in vitro. Rev Odontol UNESP. 2017;46(4):189-95.Dede DÖ, Ceylan G, Yilmaz B. Effect of brand and shade of resin cements on the final color of lithium disilicate ceramic. J Prosthet Dent. 2017;117(4):539-44.Lopes Cde C, Rodrigues RB, Silva AL, Simamoto Júnior PC, Soares CJ, Novais VR. Degree of conversion and mechanical properties of resin cements cured through different all-ceramic systems. Braz Dent J. 2015;26(5):484-89.Martins FV, Vasques WF, Fonseca EM. How the variations of the thickness in ceramic restorations of lithium disilicate and the use of different photopolymerizers influence the degree of conversion of the resin cements: a systematic review and meta‐analysis. J Prosthodont. 2019;28(1):e395-403.Turp V, Turkoglu P, Sen D. Influence of monolithic lithium disilicate and zirconia thickness on polymerization efficiency of dual‐cure resin cements. J Esthet Restor Dent. 2018;30(4):360-68.Tavarez RR, Gonçalves LM, Dias AP, Dias AC, Malheiros AS, Silva AC. An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: a case report. J Int Oral Health. 2014;6(3):90-2.Vaz EC, Vaz MM, de Torres ÉM, de Souza JB, Barata TDJE, Lopes LG. Resin cement: correspondence with try in paste and influence on the immediate final color of veneers. J Prosthodont. 2019;28(1):e74-81.Ladha K, Verma M. Conventional and contemporary luting cements: an overview. J Indian Prosthodont Soc. 2010;10(2):79-88.

Statement of problem Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. Purpose The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). Material and methods An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. Results The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). Conclusions The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.

Introduction: The consensus statement recommends at least two implants to support a mandibular overdenture for edentulous patients. However, to reduce cost and time of treatment, the concept of single implant-retained overdentures provides another option. Nonetheless, the optimal number of implants required to retain a mandibular overdenture is still under evaluation. Aim: To evaluate the biomechanical behaviour of overdentures supported by 1 or 2 implants with different types of connections and submitted to compression, by using Photoelastic (PA) and Strain Gauge Analysis (SGA). Materials and Methods: Based on one cast of an edentulous mandible, the specimens were divided in four groups of one specimen each for the PA and four groups of five specimens each for the SGA, divided by the type of connection (morse taper and external hexagon) and the number of implants (1 or 2). For PA, the photoelastic implant/prosthesis cast assembly was positioned in a circular polariscope associated with a universal testing machine (DL3000, INSTRON/EMIC) applying compression. The tension generated was photographed and analysed qualitatively (number of high-intensity (pink-green transition) and moderate (green/red) fringes). For SGA, two strain gauges were positioned on the mesial and distal aspect of each implant and the electrical signals were captured by a data acquisition device (ASD2001). The data were submitted to three-Way ANOVA and the Bonferroni Test (α=0.05) as post-hoc test for multiple comparisons. Results: Through PA, the greatest number of tension fringes in both connection types was presented by the two-implant supported overdentures when compared with the singleimplant supported overdentures. Through SGA, a statistical difference was verified between the connections in groups with one implant (p