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Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness.The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation.Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents.The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P.001), salivary changes (P=.003), and trismus (P.02). A funnel plot showed asymmetry among the differences of means in all selected studies.Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.

Dental avulsion is still public health problem and tooth replantation has important unsuccess rates due to root resorption. Strontium ranelate (SRAN) presents antiresorptive property on the bone tissue and stimulates bone formation. So we aimed to comprehensively review the literature to 1- understand the mechanism of action of SRAN regarding to its propaedeutic in periodontics, dental implantology, oral surgery, orthodontics and endodontics, 2- present the current scientific knowledge about the SRAN efficiency on tooth avulsion; 3- observe fails and gaps in the literature and open up for unexplored ideas for SRAN uses and applications. An electronic search was performed crossing the key words ‘strontium ranelate’, ‘periodontics’, ‘dental implantology’, ‘oral surgery’, ‘orthodontics’ and ‘endodontics’, PubMed/Medline, Lilacs and BBO electronic databases were searched for research articles, reviews of literature, animal laboratory studies and laboratory studies, which had been published in English until July 2020. Twenty-five articles fulfilled the inclusion and exclusion criteria. The available literature demonstrates that SRAN provides a really better propaedeutic on the bone tissue and that the topical applications show a lower risk of side effects. That open up new perspectives and for the use of SRAN as a potential storage media for avulsed teeth.

Introdução: A persistência de microrganismos é um dos fatores determinantes de insucesso do tratamento endodôntico, que ocorre devido às iatrogenias, patologias e negligencias. Para solucionar este problema, pode-se indicar a extração dentária ou um tratamento mais conservador, como o retratamento endodôntico. Objetivo: Frente ao exposto, o principal objetivo no presente artigo é relatar um caso clínico de insucesso do tratamento endodôntico primário e o sucesso na abordagem de retratamento que culminou para a finalização positiva do caso clínico. Relato de caso clínico: Paciente com sintomatologia dolorosa ao mastigar no dente 26 foi diagnosticada com periodontite apical crônica com radioluscência periapical por meio da propedêutica clínica e radiográfica com vistas à Endodontia. Foi realizado tratamento endodôntico e após 1 ano da finalização, o paciente apresentava fístula recorrente e foi proposto a extração do dente em questão. Descontente com o plano de tratamento, buscou uma segunda opinião e foi realizado o retratamento endodôntico em sessões múltiplas com a utilização de hidróxido de cálcio como opção para medicação intracanal. Após 60 dias de medicação intracanal, realizou-se a obturação do sistema de canais radiculares e a reabilitação dentária. Conclusão: O sucesso do tratamento endodôntico é dependente da excelente limpeza e desinfecção do sistema de canais radiculares e conseguinte obturação hermética; a persistência de microrganismos é um dos fatores que pode determinar um prognóstico desfavorável e uma nova reintervenção endodôntica pode levar ao sucesso, a despeito de alternativas radicais, como a exodontia e reabilitação com implantes. Por meio do caso clínico apresentado, conclui-se que o planejamento minucioso e a execução do tratamento baseado em evidência científica levam ao sucesso de tratamentos mais conservadores para o paciente e sua satisfatoriedade.

The aim of this systematic review was to determine whether combining laser therapy with conventional endodontic treatment would improve apical periodontitis (AP) repair. This study was developed according to the Cochrane criteria for the creation of systematic reviews and meta-analyses and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed/MedLine, SCOPUS, and Cochrane Library databases were searched for articles published up to September 2020 to answer the PICO question: Could lasers used in conjunction with endodontic treatment (ET) improve AP repair, compared with conventional ET, in permanent teeth with necrotic pulp and AP? The outcome evaluated was reduction of AP. The literature search retrieved a total of 1719 articles, and, after applying the eligibility criteria, 5 were included in the present study. All studies compared the use of laser to ET of teeth with AP. Radiographic analysis was performed between 0 and 12 months, and the data revealed a reduction in the size of AP for both treatments. The results of this systematic review evidenced scarcity of randomized clinical trials, few studies analyzing AP repair, short time of clinical control, methodological differences and high risk of bias among researches, and absence of evidence-based clinical protocols; thus, these aspects do not permit to conclude whether combining laser therapy with conventional ET would improve AP repair and indicate the necessity of more studies.

O objetivo do presente artigo foi relatar uma técnica de moldagem funcional utilizando uma moldeira individual modificada com a finalidade de realizar a etapa de moldagem funcional e registro interoclusal na mesma consulta. Paciente compareceu ao consultório odontológico queixando-se de não ter conseguido se adaptar a prótese total feita a um ano, assim, um novo tratamento realizando somente a prótese inferior foi proposto. A moldagem funcional e registro interoclusal foram realizadas na mesma consulta, com a finalidade de reduzir o tempo de confecção da prótese total inferior. O uso de moldeira individual modificada permitiu a redução dos números de consulta para a confecção de prótese total mandibular em situações que o paciente já possui prótese total superior e deseja realizar somente uma nova prótese total inferior.

Background This study assesses and compares the knowledge level of endodontists (ENDs) and general dental practitioners (GPs) from Brazil and United States of America (USA) in the diagnosis and treatment of internal and external inflammatory root resorptions through periapical radiographic (PA) and cone beam computed tomography (CBCT) examinations. Material and Methods A cross-sectional online questionnaire-based survey was presented to the volunteers containing questions regarding personal and professional profile, as well as three clinical cases of internal and external inflammatory root resorption. A series of multiple-choice questions about the diagnosis and treatment options were surveyed. The data collected was analysed by the Chi-square test with Yates correction with a significance level of 5 %. Results Most answers were considered adequate when all three questions about the diagnosis and all two questions relating to the treatment were answered accurately. A total of 374 dentists answered the survey (n: 229 from Brazil vs. 145 from USA) being 41% END and 59% GP. END presented higher level of knowledge than GP regarding to diagnosis and treatment of inflammatory root resorptions both in Brazil and USA (p

The use of tilted implants has been considered a suitable option for completely edentulous patients. However, consensus on their clinical performance is lacking, specifically for partial rehabilitation.The purpose of this systematic review and meta-analysis was to evaluate the marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs).A systematic search of the MEDLINE/PubMed, Web of Science, Embase, Cochrane, and ProQuest databases and reference lists for articles published until May 2022 was performed by 2 independent reviewers without language or publication date restrictions. A meta-analysis was performed using the RevMan version 5.4 program. Quality assessments were performed using the Newcastle-Ottawa scale.Nine studies were included, totaling 258 participants and 604 implants (269 tilted implants and 335 axial implants). No significant differences were found between the tilted and axial implants for the implant survival rate (P=.81; risk ratio: 1.14). However, higher marginal bone loss values were observed for tilted implants (P=.001; mean difference: 0.12 mm). No significant heterogeneity was observed in either analysis.No significant relationship was found between tilted and axial implants for ISFPD rehabilitation. However, tilted implants presented greater risks of marginal bone loss than axial implants.

Context: Is it possible that the irrigating solutions can have the potential to cause post-operative pain? Unfortunately, the current literature does not provide clear guidance. Aim: The purpose of this systematic review and meta-analysis was to comprehensively review two different irrigation solutions (sodium hypochlorite and chlorhexidine) regarding the post-operative pain after endodontic treatment. Settings and Design: This study was prepared according to the Cochrane criteria for creating a systematic review and meta-analysis and confirms the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Material and Methods: This search was conducted in the PubMed/MEDLINE, SCOPUS and Cochrane Library databases until February 2018 to answer the In [(Population) what is the effect of (Intervention) on (Outcome), compared with (Comparison) Intervention] (PICO) question: could sodium hypochlorite cause more post-operative pain than chlorhexidine in teeth subjected to endodontic treatment? The primary outcome was overall post-operative pain after 24 h. Results: After applying the inclusion and exclusion criteria, three randomized clinical trials fulfilled the eligibility criteria, and two were subjected to the meta-analysis. There was no difference in post-operative pain between the tested irrigating solutions. Conclusions: There are few studies published in the current literature; therefore, additional randomized clinical studies are required to on this topic to help clinicians make the best decision concerning treatment.

Made available in DSpace on 2022-04-29T08:38:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Purpose: To assess the effects of tilted external hexagon implants and splinted restorations in terms of stress distribution on the bone tissue, implants, and prosthetic screws, using three-dimensional finite element analysis. Materials and Methods: Six models were used to simulate a posterior maxilla bone block (type IV) from the first premolar to the first molar. Each model included three 4.1-mm-diameter external hexagon implants with varying inclinations (0°, 17°, and 30°) and crown designs (splinted and nonsplinted restorations). The forces applied were as follows: 400 N axially (50 N for each slope of the cusp) and 200 N obliquely (45° only on the buccal slope of the cusp). Stress distribution on the implants and prosthetic screw was evaluated using Von Mises stress, while the maximum principal stress was used to evaluate the stress distribution in the bone tissue. Results: The oblique load increased the stress on all the structures in all the models. Increased inclination of the implants resulted in higher stress concentration in the bone tissue, implants, and prosthetic screws. However, splinted restorations contributed to reduction of the stress for the oblique loading, mainly in the bone tissue and prosthetic screw of the first molar, as the stress was shared between the first and second premolar restorations. Conclusions: Tilted implants increased proportionally the stress on bone tissue and prosthetic screws of models. Additionally, splinting restorations reduced the stress concentration area in the simulated bone tissue, implants, and prosthetic screws in the first molar, as the stress was shared with the adjacent implants. Alfenas Dental School Federal University of Alfenas, Minas Gerais Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista Araçatuba, Sao Paulo Department of Dentistry Federal University of Juiz de Fora (UFJF-GV) Governador Valadares, Minas Gerais Department Prosthodontics Presidente Prudente Dental School University of the West of São Paulo (UNOESTE) Department of Health Sciences Sagrado Coração University (USC), Sao Paulo Renato Archer's Information Technology Center Campinas, Sao Paulo Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista Araçatuba, Sao Paulo

Introdução: o sistema reciprocante pode preparar o canal radicular usando um único instrumento; entretanto, para garantir o sucesso endodôntico, a obturação radicular deve ser de alta qualidade. Para isso, várias técnicas podem ser usadas, e é importante que sua eficiência seja determinada. Assim, o presente estudo analisou três técnicas diferentes, considerando a capacidade de preenchimento da obturação do canal radicular. Métodos: o estudo envolveu 30 molares inferiores humanos extraídos; os canais mesiais desses dentes foram instrumentados com o sistema WaveOne e, então, divididos em três grupos, de acordo com a técnica utilizada para o preenchimento do canal radicular. A técnica de cone único, técnica híbrida de Tagger e uma técnica experimental (cone único mais o uso do condensador guta-percha) foram utilizadas para os Grupos I, II e II, respectivamente. Os dentes obturados foram cortados transversalmente em seções de 0,3 mm a 2, 4 e 6 mm do ápice do canal radicular. As seções foram, então, digitalizadas e analisadas. Os dados foram comparados estatisticamente pelos testes de Kruskal-Wallis e Dunn, com valores de p < 0,05 indicando significância. Resultados: não houve diferença significativa entre os grupos experimentais em relação às quantidades de guta-percha ou cimento utilizado. No entanto, nos Grupos II e III, houve menor ocorrência de espaços vazios no preenchimento do canal radicular do que no Grupo I (p < 0,05). Conclusão: conclui-se que as técnicas de preenchimento do canal radicular apresentadas no presente estudo geraram um baixo número de espaços vazios e que as técnicas termoplastificadoras conferem menos espaços vazios.

Made available in DSpace on 2018-12-11T17:21:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Statement of problem: The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. Purpose: The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. Material and methods: This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was “Should the restoration of adjacent implants be splinted or nonsplinted?” The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. Results: Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. Conclusions: Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure. Associate Professor Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo (UNOESTE) Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista

This is an in silico study aimed to evaluate the biomechanical influence of different implant-abutment interfaces (external hexagon and Morse taper implants), retention systems (cement and screw retained), and restorative crowns (metal-ceramic and monolithic) using 3-dimensional finite element analysis (3D-FEA). Eight 3D models were simulated for the maxillary first molar area using InVesalius, Rhinoceros, and SolidWorks and processed using Femap and NEi Nastran software. Axial and oblique forces of 200 and 100 N, respectively, were applied on the occlusal surface of the prostheses. Microstrain and von Mises stress maps were used to evaluate the deformation (cortical bone tissue) and stress (implants/fixation screws/crowns), respectively, for each model. For both loadings, Morse taper implants had lower microstrain values than the external hexagon implants. The retention system did not affect microstrain on the cortical bone tissue under both loadings. However, the cemented prosthesis displayed higher stress with the fixation screw than the external hexagon implants. No difference was observed between the metal-ceramic and zirconia monolithic crowns in terms of microstrain and stress distribution on the cortical bone, implants, or components. Morse taper implants can be considered as a good alternative for dental implant rehabilitation because they demonstrated better biomechanical behavior for the bone and fixation screw as compared to external hexagon implants. Cement-retained prosthesis increased the stress on the fixation screw of the external hexagon implants, thereby increasing the risk of screw loosening/fracture in the posterior maxillary area. The use of metal-ceramic or monolithic crowns did not affect the biomechanical behavior of the evaluated structures.

The aim in the present study was to analyze the stress in the external hexagon implant (EH) in a situation of parafunction on three-unit implant-supported prostheses with and without the use of the acrylic occlusal device (AOD) using three-dimensional (3D) finite element analysis (FEA). Eight 3D models referring to the posterior maxilla with three EH supporting single and or splinted screwed metal-ceramic restoration and use of the AOD. AOD was modeled with a thickness of 2 mm. EHs were analyzed using von Mises criteria in the ANSYS 19.2 program. AOD showed to be effective in reducing stress in the EH. However, the use of the AOD was not effective enough to suggest the non-splinting of EH dental implant. The association of splinting and the use of an AOD in the posterior region of the maxilla may be an effective way to decrease the stress in the EH implant in a situation of parafunction. El objetivo em el presente estudio fue analizar la tensión en el implante de hexágono externo (HE) en una situación de parafunción en prótesis implantosoportadas de tres unidades con y sin el uso del dispositivo oclusal acrílico (DOA) utilizando tres dimensiones (3D) análisis de elementos finitos. Ocho modelos 3D referidos al maxilar posterior con tres HE que soportan la restauración metalocerámica atornillada y/o ferulizada y el uso del AOD. El DOA se modeló con un espesor de 2 mm. Los HE se analizaron utilizando los criterios de von Mises en el programa ANSYS 19.2. DOA demostró ser eficaz para reducir el estrés en el HE. Sin embargo, el uso del DOA no fue lo suficientemente eficaz como para sugerir la no ferulización del implante dental HE. La asociación de ferulización y el uso de un DOA en la región posterior del maxilar puede ser una forma eficaz de disminuir la tensión en el implante HE en una situación de parafunción. O objetivo no presente estudo foi analisar a tensão no implante de hexágono externo (HE) em situação de parafunção em próteses de três elementos implantossuportadas com e sem o uso do dispositivo oclusal de acrílico (DOA) por meio da análise de elementos finitos (AEF) tridimensional (3D). Oito modelos 3D simulados referentes à região posterior da maxila com três HE suportando próteses metalocerâmica unitária e/ou esplintada parafusada e uso de DOA. O DOA foi modelado com espessura de 2 mm. Os HEs foram analisados usando os critérios de von Mises no programa ANSYS 19.2. O DOA mostrou-se eficaz na redução da tensão no HE. No entanto, o uso do DOA não foi eficaz o suficiente para sugerir a não esplintagem do implante dentário HE. A associação de esplintagem e o uso de DOA na região posterior da maxila pode ser uma forma eficaz de diminuir a tensão no implante de HE em situação de parafunção.

Dentist community needs to understand the esthetic perception of laypeople and correlate the standards of dental esthetics to avoid unnecessary treatment. Thus, the aim was to compare the perception of smile attractiveness before and after performing esthetic dental procedures by general practitioners (GP), periodontists (P), restorative dentistry (RD), undergraduate students (UGrad), and laypeople (L). Two photographs of smile were taken, before (PSB) and after (PSA) the esthetic dental procedures. Photographs were exposed to 5 groups: GP (n = 20), P (n = 20), RD (n = 20), UGrad (n = 60), and L (n = 20). The smiles were evaluated using the visual scale with scores ranging from 1 (unattractive) to 10 (very attractive). Data were statistically evaluated (Kruskal-Wallis, Dunn, Mann Whitney). The PSA of the esthetic dental procedures was more attractive than PSB (p < 0.05). In PSB, P group presented the lowest values of smile attractiveness scores (p < 0.05). On the other hand, in PSA, RD group attributed lower values (p < 0.05). The perception of smile attractiveness after performing dental procedures was higher than before, and P and RD were more critical in evaluating the smiles before and after treatment, respectively. La comunidad dental necesita comprender la percepción estética de los legos y correlacionar los estándares de la estética dental para evitar tratamientos innecesarios. Así, el objetivo fue comparar la percepción del atractivo de la sonrisa antes y después de la realización de procedimientos estéticos dentales por médicos generales (MG), periodoncistas (P), especialistas en odontología restauradora (D), estudiantes de pregrado (UGrad) y legos (L). Se tomaron dos fotografías de la sonrisa, antes (FSA) y después (FSD) de los procedimientos de estética dental. Las fotografías se expusieron en 5 grupos: MG (n = 20), P (n = 20), D (n = 20), UGrad (n = 60) y L (n = 20). Las sonrisas fueron evaluadas usando la escala visual con puntuaciones que iban de 1 (poco atractivo) a 10 (muy atractivo). Los datos se evaluaron estadísticamente (Kruskal-Wallis, Dunn, Mann Whitney). La FSD de los procedimientos estéticos dentales fue más atractiva que la FSA (p

Made available in DSpace on 2021-06-25T10:40:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Statement of problem: A consensus regarding the biomechanical effects of vertical bone loss in normal and osteoporotic bone tissue according to different implant-abutment interfaces is lacking. Purpose: The purpose of this finite element analysis study was to evaluate the effect of vertical bone loss (without bone loss; with 1.5-mm bone loss; with 3-mm bone loss; and with 4.5-mm bone loss) in normal and osteoporotic bone that received a Ø4×10-mm implant with different implant-abutment connections (external connection [external hexagon] and internal connection [Morse taper]) by using 3D finite element analysis. Material and methods: Sixteen 3D models were simulated. Axial and oblique forces of 200 N and 100 N, respectively, were applied on the occlusal surfaces of the prostheses. Maximum principal stress and microstrain were determined from the bone tissue of each model. von Mises stress analysis was used to evaluate the stress distribution in implants and prosthetic components (fixation screws, abutment, and crown). Results: The results showed higher stress concentrations in models with bone loss as increased vertical bone loss contributed to higher stress and microstrain in the bone tissue, regardless of the quality of bone and implant-abutment connection. Osteoporotic bone contributed to increase in microstrain in the trabecular bone. The internal connection showed lower stress than the external connection implants only in models without marginal bone loss. Furthermore, higher stress concentrations were observed in the implants and fixation screws in models with increased bone loss and external connection implants, mainly under oblique loading. Osteoporotic bone did not affect stress distribution in the implants and prosthetic components. Conclusions: Progressive bone loss contributed to higher stress in the bone tissue, implants, and prosthetic components. The osteoporotic bone affects only the microstrain in the trabecular bone, but not the stress in the implants and prosthetic components. The internal connection implants showed lower stress in the cortical bone only in models without bone loss, while external connection implants exhibited higher stress in the implants and screws under oblique loading. Adjunct Professor Division of Prosthodontics Department of Dentistry Federal University of Juiz de Fora (UFJF-GV) Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Researcher Tridimensional Technology Division Renato Archer's Information Technology Center Department Prosthodontics Presidente Prudente Dental School University of the West of São Paulo (UNOESTE) PhD student Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Titular Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) PhD student Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Titular Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) FAPESP: 2009/16164-7 FAPESP: 2015/24442-8 CNPq: 306288/2016-8

Made available in DSpace on 2022-04-29T08:29:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 The oral cavity is an environment that allows for the development of complex ecosystems; the placement of prosthetic devices as a consequence of partial or total tooth loss may alter the diversity of microbial communities. Biofilms on the surface of materials used in dental prostheses can promote important changes in the mechanic and aesthetic properties of the material itself and may cause local and systemic diseases for the prosthetic wearer. This review presents the main features of the oral microbiome associated with complete or partial dentures and dental implants. The main diseases associated with microbial colonization of prosthetic surfaces, factors that may affect biofilm formation on prosthetic materials, as well as novel alternative therapies aiming to reduce biofilm formation and/or to eradicate biofilms formed on these materials are also explored. Graduate Program in Dentistry University of Western São Paulo (UNOESTE) Presidente Prudente School of Dentistry Araçatuba Department of Preventive and Restorative Dentistry São Paulo State University (Unesp) School of Dentistry Araçatuba Department of Preventive and Restorative Dentistry São Paulo State University (Unesp)

Made available in DSpace on 2021-06-25T10:28:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-04-01 Background: This photoelastic analysis evaluated stress distribution in different osteosynthesis systems, conventional and locking, used for treatment of mandibular angle fractures with a single plate. Material and Methods: Angle fractures were simulated in mandibles made of photoelastic resin. Following Champy’s method, plate osteosynthesis was performed. The samples were divided into five groups: Group 1, non-fractured mandible; Group 2, two screws were installed in each segment using a conventional system; Group 3, two screws were installed in each segment using a locking system; Group 4, three screws were installed in the proximal segment and four screws in the distal segment using a conventional plate; Group 5, three screws were installed in the proximal segment and four screws in the distal segment using a locking plate. In universal testing machine coupled to a polariscope, a load was applied to the first molar 10 times. The 50 images were randomly numbered and analyzed qualitatively and quantitatively by two raters. Results: The locking system promoted better stress distribution along the osteosynthesis. The locking system redu- ced stress magnitude in the distal segment, with a significant between-group difference (P≤ 0.001). Conclusions: The locking plate/screw system can distribute stress more evenly throughout the osteosynthesis, especially when long seven-hole plates are used. Department of Oral and Maxillofacial Surgery Universidade do Oeste Paulista (UNOESTE), R. José Bongiovani, 700 Department of Prosthodontics UNOESTE, R. José Bongiovani, 700 Department of Health Sciences Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP) Department of Oral and Maxillofacial Surgery Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP)

Objective To evaluate implant and prosthetic survival rates of full-arch rehabilitations retained by three implants in patients with edentulous mandibles. Methods This systematic review was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The focused question addressed was: Are fixed mandibular 3-implant retained prostheses safe and predicable for full-arch mandibular prostheses? The Medline/PubMed and Cochrane Library databases were used to conduct the systematic search for clinical trials on fixed mandibular 3-implant retained prostheses published between 1999 and 2020. Only English-language studies that presented information on their implant and prosthetic survival were included. Results A total of 302 studies were identified, of which 13 addressed the inclusion criteria. Additionally, 574 participants were included in these studies. As reported, 73 (4.57%) of 1596 implants failed, with a survival rate of 95.43%. In addition, the mean survival rate of the presented prostheses was 89.66%. The mean marginal bone loss was 1.09 mm. Conclusion Within the limitations of the present review, implant and prosthetic survival rates of fixed mandibular 3-implant retained prostheses were similar to those of full-arch mandibular prostheses retained by four or more implants. Further research exploring the topic are necessary. This article is protected by copyright. All rights reserved.

This systematic review evaluated the most effective therapeutic approach to treat periodontal furcation defects with a minimum follow-up of 12 months. The primary outcome was clinical attachment level (CAL). Secondary outcomes were probing pocket depth, gingival margin level, gingival index and plaque index.A comprehensive search of studies published up to December 2019 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Two reviewers independently searched eligible studies, made a final article selection, and extracted the data of the selected studies to evaluate qualitatively and quantitatively (meta-analysis).Overall, 19 studies were selected for the analysis. Six hundred and eighteen patients (mean age, 45.3) were treated. More commonly used treatment was polytetrafluoroethylene barrier (ePTFE), followed by enamel matrix derivative (EMD) and open-flap debridement (OFD). Only one study evaluated maxillary arch and remaining evaluated mandibular arch. All treatments provided CAL gain, but meta-analysis did not show significant difference among more commonly used treatments and controls (P=0.91; P=0.47; P=0.08, respectively).There is no difference on effectiveness of main therapeutic approaches evaluated for treatment of Class II periodontal furcation defects.

Made available in DSpace on 2021-06-25T10:22:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting. Material and Methods: PubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration's domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals. Results: The search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups (P

O objetivo do presente artigo foi relatar uma forma de confecção de prótese total utilizando a clonagem da prótese provisória com a finalidade de reduzir as etapas do tratamento. Paciente desdentada total superior e classe I de Kennedy inferior compareceu ao consultório apresentando inflamação severa do tecido periodontal, mobilidade grau III de todos os dentes e supuração à sondagem. Optou-se por realizar prótese total superior convencional e realização das exodontias dos dentes remanescentes, seguida de prótese total provisória e como tratamento definitivo mandibular uma prótese total convencional. Na primeira sessão foi realizada a reavaliação dos tecidos bucais, moldagem da prótese total superior para obter o modelo antagonista, seleção da cor do dente, registro para montagem no articulador semi-ajustável e a clonagem da prótese total inferior provisória. Após polimerizada, a réplica em resina acrílica incolor foi ajustada em boca e realizada a moldagem de borda com godiva em bastão, seguida da moldagem funcional com silicone de condensação. Ambos modelos foram montados no articulador para montagem dos dentes artificiais. A prova estética e funcional foi realizada na segunda consulta e na terceira a prótese foi instalada junto com as instruções de uso e higiene oral. Os controles foram realizados após 24 horas, 3, 7 e 14 dias. O uso de uma técnica alternativa para confecção de uma moldeira individual pode reduzir o tempo clinico, trazendo assim vantagens tanto para o paciente como para o profissional, desde que haja um bom planejamento e conhecimento da técnica.Descritores: Prótese Total; Técnica de Moldagem Odontológica; Materiais para Moldagem Odontológica.ReferênciasEmami E, Souza RF, Kabawat M, Feine JS. The impact of edentulism on oral and general health. Int J Dent. 2013;2013:498305Williams SE, Slice DE. Influence of edentulism on human orbit and zygomatic arch shape. Clin anat. 2014;27(3):408-16.Brasil. Ministério da Saúde. Projeto SB Brasil 2010: Brasil Sorridente - A saúde bucal levada a sério. Brasília: Ministério da Saúde; 2010.Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2003;31(Suppl 1):3-23.Agostinho ACMG, Campos ML, Silveira JLGC. Edentulismo, uso de prótese e autopercepção de saúde bucal entre idosos. Rev odontol UNESP. 2015; 44(2):74-9.Di Fiori SR, Di Fiori M, Di Fiori AP. Atlas de prótese parcial removível. São Paulo: Santos; 2010.Telles D. Prótese total: convencional e sobre implantes. São Paulo: Santos; 2011.Carlsson GE, Omar R. The future of complete dentures in oral rehabilitation. A critical review. J Oral Rehabil. 2010;37(2):143-56.Mericske-Stern RD, Taylor TD, Belser U. Management of the edentulous patient. Clin Oral Implants Res. 2000;11(1):108-25.Telles D, Coelho AB. Próteses sobre implantes. Rio de Janeiro: SobreImplantes.com; 2006.Calvani L, Michalakis K, Hirayama H. The influence of full-arch implant-retained fixed dental prostheses on upper lip support and lower facial esthetics: preliminary clinical observations. Eur J Esthet Dent. 2007;2(4):420-28.Cooper LF. The current and future treatment of edentulism. J Prosthodont. 2009;18(2):116-22Thomason JM, Lund JP, Chehade A, Feine JS. Patient satisfaction with mandibular implant overdenture and conventional denture 6 months after delivery. Int J Prosthodont. 2003;16(5):467-73.Silva-Junior MF, Fonseca EP, Batista MJ, Sousa MLR. Spatial distribuition of tooth loss in a population of adults. RGO. 2017;65(2):115-20.Ettinger RL. Managing and treating the atrophic mandible. J Am Dent Assoc. 1993;124(7):234-41Lindquist TJ, Narhi TO, Ettinger RL. Denture duplication technique with alternative materials. J Prosthet Dent. 1997;77(1):97-8.Barros AWP, Porto E, Lima JFS, Brito NMSO, Soares RSC. Steps for biomodel acquisition through addtive manufacturing for health. RGO. 2016;64(4):442-6.Watamabe Y. Observation of horizontal mandibular positions in an edentulous patient using a digital gothic arch tracer: a clinical report. J Prosthet Dent. 2004;91(1):15-9.Williamson RA, Williamson AE, Bowley J, Toothaker R. Maximizing mandibular prosthesis stability utilizing linear occlusion, occlusal plane selection, and centric recording. J Prosthodont. 2004;13(1):55-61.Paixão F, Silva WAB, Silva FA, Ramos GG, Cruz MVJ. Evaluation of the reproducibility of two techniques used to determine and record centric relation in Angle's class I patients. J Appl Oral Sci. 2007;15(4):275-79.Duncan JP, Taylor TD. Simplified complete dentures. Dent Clin North Am. 2004; 48(3):25-40.Nascimento DFF, Patto RBL, Marchini L, Cunha VPP. Double-nlind study for evaluation of complete dentures made by two techniques with and without face-bow. Braz J Oral Sci. 2004;3(9):439-45.Kawai Y, Murakami H, Takanashi Y, Lund JP, Feine JS. Efficient resource use in simplified complete denture fabrication. J Prosthodont. 2010;19(7):512-16.Heydecke G, Vogeler M, Wolkewitz M, Türp JC, Strub JR. Simplified versus comprehensive fabrication of complete dentures: patient ratings of denture satisfaction from a randomized crossover trial. Quintessence Int. 2008;39(2):107-16.Duncan JP, Taylor TD. Teaching an abbreviated impression technique for complete dentures in an undergraduate dental curriculum. J Prosthet Dent. 2001;85(2):121-25.Heydecke G, Akkad AS, Wolkewitz M, Vogeler M, Türp JC, Strub JR. Patient ratings of chewing ability from a randomised crossover trial: lingualised vs. first premolar/canine-guided occlusion for complete dentures. Gerodontology. 2007;24(2):77-86.Ansari IH. A one-appointment impression and centric relation record technique for compromised complete denture patients. J Prosthet Dent. 1997;78(3):320-23.Davis DM, Watson RM. A retrospective study comparing duplication and conventionally made complete dentures for a group of elderly people. Br Dent J. 1993;175(2):57-60.Clark RfK. The future of teaching of complete denture construction to undergraduates. Br Dent J. 2002;193(1):13-4.Ellis JS, Pelekis ND, Thomason JM. Conventional rehabilitation of edentulous patients: the impact on oral health-related quality of life and patient satisfaction. J Prosthodont. 2007;16(1):37-42.Rodrigues AHC, Morgano SM. An expedited technique for remaking a single complete denture for an edentulous patient. J Prosthet Dent. 2007;98(3):232-34.Tamaki T. Dentaduras completas, 4. ed. São Paulo: Sarvier; 1983.Reis JMSN, Perez LECP, Nogueira S, Ariolli Filho JN, Moll Júnior FA. Moldagem em prótese total: uma revisão de literatura. RFO. 2007;12(1):70-4.Bonachela WC, Rosseti PHO. Overdentures: das raízes implantadas osseointegrados - planejamentos, tendências e inovações. São Paulo: Santos; 2002.Telles D. Prótese total - convencional e sobre implantes. 2. ed. São Paulo: Santos; 2010.Felton DA, Cooper LF, Scurria MS. Predictable impression procedures for complete dentures. Dent Clin North Am. 1996; 40(1):39-51.Lee RE. Mucostatics. Dent Clin North Am. 1980; 24(1):81-96.DeFranco RL, Sallustio A. An impression procedure for the severely atrophied mandibule. J Prosthet Dent. 1995;73(6):574-77.Tripathi A, Singh SV, Aggarwal H, Gupta A. Effect of mucostatic and selective pressure impression techniques on residual ridge resorption in individuals with different bone mineral densities: A prospective clinical pilot study. J Prosthet Dent. 2019;121(1):90-4.Levin BL. Impressions for complete dentures. Chicago: Quintessence; 1984.Turano JC, Turano LM. Consertos e Reembasamentos. Fundamentos da prótese total, 7.ed. São Paulo: Santos; 2004.Caputi S, Murmura G, Ricci L, Varvara G, Sinjari B. Immediate denture fabrication: a clinical report. Ann Stomatol (Roma). 2013;4(3-4):273-77.Seals Jr RR, Kuebker WA, Stewart KL. Immediate complete dentures. Dent Clin North Am. 1996; 40(1):151-67.Cerveira Neto H. Prótese total imediata. 2. ed. São Paulo: Pancast Editorial; 1987.Marchini L, Santos JFF, Cunha VPP. Prótese total imediata: considerações clínicas. Robrac. 2000;9(27):45-9.Wagner AG. Making duplicate dentures for use as final impression trays. J Prosthet Dent. 1970;24(1):111-13.Anusavice KJ. Phillips: materiais dentários. 10.ed. Rio de Janeiro: Guanabara Koogan;1998.Elie E. Daou. The elastomers for complete denture impression: a review of the literature. Saudi Dent J. 2010;22(4):153-60.Goldfogel M, Harvey WL, Winter D.Dimensional change of acrylic resin tray materials. J Prosthet Dent. 1985;54(2):284-86.Pagniano RP, Scheid RC, Clowson RL, Dagefoerde RO, Zardiackas LD. 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This study investigated how Brazilian dentists are performing their clinical activities during the pandemic in different dentistry specialties and whether changes in biosafety protocols and the use of personal protective equipment (PPE) made will continue in the post-pandemic period. For that, a cross-sectional online questionnaire-based survey was presented to the volunteers. A total of 423 dentists (298 females) responded to the survey. Their age ranged from 22-73 (38.07 ± 10.58) years and years of dental practice ranged from 1-45 (14.68 ± 10.56). Most of the responders (66.43%) worked in private clinic. Since the beginning of the outbreak, 53.9% limited its activities only to urgent and emergency care; 75% starting limit its activities between March 18th and April 1st; and 25.88% limited for more than 15 weeks. Most of dentists are aware about the setting of dental office and are taking actions to prevent the transmission of the COVID-19 virus. The majority are all personal protective equipment. After the pandemic period, volunteers stated that will continue with the use of personal protective equipment, exception only to the use of the respirator. There was continuity of dental care, following the recommendations for safe care. There was a tendency for changes in relation to PPE to last after the end of the pandemic.

Made available in DSpace on 2018-12-11T17:19:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The purpose of this study was to analyze the stress distribution of bone tissue around implants with different implant-abutment interfaces: platform switching (PSW); external hexagon (EH) and Morse taper (MT) with different diameters (regular: Ø 4 mm and wide: Ø 5 mm), bone types (I–IV) and subjected to axial and oblique load conditions using three-dimensional finite element analysis (3D-FEA). Sixteen 3D models of various configurations were simulated using InVesalius, Rhinoceros 3D 4.0, and SolidWorks 2011 software, and processed using Femap 11.2 and NeiNastran 11.0 programs. Axial and oblique forces of 200 N and 100 N, respectively, applied at the occlusal surface of prostheses. Maximum principal stress values were obtained from the peri-implant cortical bone of each model. Statistical analyses were performed using ANOVA and Tukey's test for maximum principal stress values. Oblique loading showed higher tensile stress than axial loading (P < 0.001). Wide-diameter implants showed lower stress concentration rather than regular-diameter implants, regardless of both connection and bone type (P < 0.001). Under axial loading, wide-diameter EH implants with regular platforms showed more favorable stress distribution than PSW implants for axial loading (P < 0.001); however, under oblique loading, PSW implants exhibited lower stress concentrations (P < 0.001). Regular-diameter MT implants showed lower stress than EH implants (P < 0.001). Bone type IV showed higher stress in the cortical region than bone types I and II (P < 0.001), but no significant difference when compared with bone type III (P > 0.05). The conclusion drawn from this in silico is that MT implants should be considered for use in situations that preclude the placement of wide-diameter implants, particularly where bone types III and IV are concerned. Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista Department of Health Sciences University of Sacred Heart – USC Department of Restorative Dentistry Federal University of Alfenas Department Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista FAPESP: 09/16164-7 CNPq: 303874/2010-4

This study comprehensively reviewed two different treatments for regenerative endodontic: platelet-rich plasma and induced blot clot, in regarding to periapical healing. Two investigators performed a systematic review. MEDLINE/PubMed, Cochrane Library and Scopus supplied relevant data from studies published until December 2020 to answer the PICO question. Primary outcome was periapical healing. Eight randomized clinical trials fulfilled eligibility criteria. Primary outcome indicated that platelet-rich plasma results in similar or better periapical healing compared to blot clot group. The reported failures were related to blot clot group due to incomplete radiographic parameters, pain and reinfection; however, few cases of unsuccess were reported to platelet-rich plasma group. Only two studies observed better results to blot clot group in relation to increase of radiographic area and partial pulp canal obliteration. This review showed that procedures using platelet-rich plasma were successful in treating permanent teeth with root development. Este estudio revisó exhaustivamente dos tratamientos diferentes para la endodoncia regenerativa: plasma rico en plaquetas y coágulo de transferencia inducido, en lo que respecta a la curación periapical. Dos investigadores realizaron una revisión sistemática. MEDLINE / PubMed, Cochrane Library y Scopus proporcionaron datos relevantes de estudios publicados hasta diciembre de 2020 para responder a la pregunta PICO. El resultado primario fue la curación periapical. Ocho ensayos clínicos aleatorizados cumplieron los criterios de elegibilidad. El resultado primario indicó que el plasma rico en plaquetas produce una cicatrización periapical similar o mejor en comparación con el grupo de coágulos de transferencia. Los fracasos informados se relacionaron con el grupo de coágulos de transferencia debido a parámetros radiográficos incompletos, dolor y reinfección; sin embargo, se informaron pocos casos de fracaso al grupo plasma rico en plaquetas. Sólo dos estudios observaron mejores resultados con el grupo de coágulos de transferencia en relación con el aumento del área radiográfica y la obliteración parcial del canal pulpar. Esta revisión mostró que los procedimientos que utilizan plasma rico en plaquetas tuvieron éxito en el tratamiento de dientes permanentes con desarrollo radicular. Este estudo revisou de forma abrangente dois diferentes tratamentos endodônticos regenerativos: com plasma rico em plaquetas e coágulo induzido no que diz respeito à cicatrização periapical. Dois investigadores realizaram uma revisão sistemática. MEDLINE / PubMed, Cochrane Library e Scopus forneceram dados relevantes de estudos publicados até dezembro de 2020 para responder à pergunta PICO. O desfecho primário foi a cura periapical. Oito ensaios clínicos randomizados preencheram os critérios de elegibilidade. O desfecho primário indicou que o plasma rico em plaquetas resulta em cicatrização periapical semelhante ou melhor em comparação com o grupo coágulo induzido. As falhas relatadas foram relacionadas ao grupo coágulo induzido devido a parâmetros radiográficos incompletos, dor e reinfecção; no entanto, poucos casos de insucesso foram relatados ao grupo plasma rico em plaquetas. Apenas dois estudos observaram melhores resultados para o grupo coágulo induzido em relação ao aumento da área radiográfica e obliteração parcial do canal pulpar. Esta revisão mostrou que procedimentos com plasma rico em plaquetas tiveram sucesso no tratamento de dentes permanentes necróticos com desenvolvimento radicular incompleto.

This study aimed to evaluate the stress distribution in bone tissue, in Morse tapper implants and components supporting a single crown in the maxillary anterior area, under different bone anchorages (conventional, bicortical and bicortical with nasal floor elevation) and implant lengths (8.5 mm, 10 mm and 11.5 mm) using 3D finite element analyses. Three 3D models including element #11 were simulated using software InVesalius, Rhinoceros 3D and SolidWorks. Bone block models were reconstructed from computed tomography and simulated the placement of one implant of 4 mm of diameter and lengths above mentioned, supporting cemented zirconia crown. The 3D models were processed by the finite element FEMAP and NeiNastran software, using a load of 178N were applied at 0º, 30º and 60º, considering the implant long axis. Results were visualized as the von Mises stress, maximum principal stress and microstrain maps. Bicortical bone anchorages showed lower stress and microstrain bone tissue when compared to conventional bone anchorage. However, no differences were observed between bicortical and nasal floor elevation. Regarding implants and components, the stress distribution was similar between models with little stress relief in the apical region of the implants for implants with conventional anchorage. The conclusion drawn from this study is that non-axial loading showed worse biomechanical behavior for bone tissue and implants/components. The bicortical techniques (bicortical and nasal floor elevation) should be preferred during the implant placement to reduce the stress and microstrain in the bone tissue. Este estudio tuvo como objetivo evaluar la distribución de tensiones en tejido óseo, en implantes Morse y componentes que sostienen una corona en la zona anterior maxilar, bajo diferentes anclajes óseos (convencional, bicortical y bicortical con elevación nasal) y longitudes de implante (8,5mm, 10mm y 11,5mm) utilizando análisis de elementos finitos 3D. Se simularon tres modelos 3D, incluido el elemento 11, utilizando el software InVesalius, Rhinoceros 3D y SolidWorks. Se reconstruyeron modelos de bloques óseos a partir de tomografía computarizada y se simuló la colocación de un implante de 4mm de diámetro y longitudes antes mencionadas, soportando la corona de circonio cementado. Los modelos 3D fueron procesados por el software de elementos finitos FEMAP y NeiNastran, utilizando una carga de 178N se aplicaron a 0º, 30º y 60º, considerando el eje largo del implante. Los resultados se visualizaron como el estrés de von Mises, el estrés principal máximo y microdeformación. Los anclajes óseos bicorticales mostraron menor tensión y microesfuerzo del tejido óseo en comparación con el convencional. No se observaron diferencias entre la elevación bicortical y del piso nasal. En cuanto a implantes y componentes, la distribución de tensiones fue similar entre modelos con escaso alivio de tensiones en la región apical de los implantes con anclaje convencional. llegamos a la conclusión de que es que la carga no axial mostró un peor comportamiento biomecánico para el tejido óseo y los implantes/componentes. Se deben preferir las técnicas bicorticales durante la colocación del implante para reducir la tensión y la microesfuerzo. O objetivo deste estudo foi avaliar a distribuição de estresse em implantes cone morse, no tecido ósseo e em coroas unitárias na região anterior da maxila, em diferentes ancoragens ósseas (convencional, bicortical e bicortical com levantamento de assoalho nasal) utilizando a metodologia de elementos finitos 3D variando o comprimento dos implantes (8.5mm, 10mm, 11,5mm). Três modelos 3D, incluindo o elemento #11, foram simulados usando o software InVesalius, Rhinoceros 3D e SolidWorks. Modelos de blocos ósseos foram reconstruídos a partir da tomografia computadorizada e simularam a instalação de um implante de 4mm de diâmetro e comprimentos acima mencionados, suportando coroa de zircônia cimentada. Os modelos 3D foram processados nos softwares de elementos finitos FEMAP e NeiNastran, utilizando uma carga de 178N foram aplicados a 0º, 30º e 60º, considerando o longo eixo do implante. Os resultados foram visualizados como mapas de tensão de von Mises, a tensão máxima principal e microdeformação. As ancoragens ósseas bicorticais apresentaram menor estresse e microdeformação do tecido ósseo quando comparadas à ancoragem óssea convencional. No entanto, não foram observadas diferenças entre a elevação bicortical e do assoalho nasal. Em relação aos implantes e componentes, a distribuição de tensões foi semelhante entre os modelos com pouco alívio de tensões na região apical dos implantes para ancoragem convencional. Concluímos cargas oblíquas apresentam pior comportamento biomecânico para tecido ósseo e implantes/componentes. As técnicas bicorticais (elevação bicortical e do assoalho nasal) devem ser preferidas durante a instalação do implante para reduzir o estresse e a microdeformação no tecido ósseo.

Made available in DSpace on 2021-06-25T11:01:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Statement of problem: Whether providing an occlusal device for a patient with bruxism and an implant-supported fixed dental prosthesis leads to improved biomechanics is unclear. Purpose: The purpose of this 3D finite element analysis (FEA) study was to evaluate the biomechanical behavior of 3-unit implant-supported prostheses under parafunctional forces with and without an occlusal device. Materials and methods: Eight 3D models consisting of a posterior (type IV) maxillary bone block with 3 external hexagon implants (Ø4.0×7.0 mm) and 3-unit implant-supported prostheses with different crown connections (splinted or unsplinted) and an occlusal device under functional and parafunctional loading were simulated. The abutment screws were evaluated by von Mises stress maps, and the bone tissue by maximum principal stress and microstrain maps by using a finite element software program. Results: An occlusal device improved the biomechanical behavior of the prostheses by reducing stress in the abutment screws and stress and strain in the bone tissue. However, the use of an occlusal device was not sufficiently effective to negate the biomechanical benefit of splinting. Conclusions: The use of splinted crowns in the posterior maxillary region with an occlusal device was the most effective method of reducing stress in the abutment screws and stress and strain in the bone tissue when parafunction was modeled. Graduate student Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Adjunct Professor Department of Dentistry (Division of Prosthodontics) Federal University of Juiz de Fora Campus Avançado Governador Valadares (UFJF/GV) Associate professor Department of Endodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Associate professor Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista

Background: Extrusion of infected debris into the periapical tissue has been cited as the major cause of postoperative pain, regardless of instrumentation technique. Aim: Comprehensively review two different kinematics of instrumentation (reciprocating and rotary) and association to the postoperative pain after endodontic treatment. Methods: Two investigators performed a systematic review with meta-analysis. MEDLINE/PubMed, Cochrane Library, and Scopus supplied relevant data from studies published until February 2018 to answer the PICO question. Primary outcome was overall postoperative pain, and the secondary outcomes were nature of the pain (mild, moderate, and severe) at 12, 24, and 48 h. Results: Ten randomized clinical trials fulfilled eligibility criteria, and five of them were submitted in the meta-analysis. Primary outcome indicated that reciprocating system results in less postoperative pain compared to rotary system (P < 0.05). As a secondary outcome, there was no statistical difference for mild, moderate, and severe pain after 12 and 24 h using reciprocating or rotary systems (P > 0.05). However, the reciprocation system showed less severe pain after 48 h (P < 0.05). Conclusion: Rotary motion had a negative impact on postoperative pain after endodontic treatment. Furthermore, after 48 h, more patients presented severe pain under rotary motion. More randomized clinical studies would be helpful.

The objective of the present study was to analyze the stress and microstrain on cortical bone tissue caused by occlusal forces on three-unit implant-supported prostheses placed in the maxillary posterior region through varying configuration factors and implant lengths using 3D finite element analysis. Fifteen three-dimensional models were simulated with the support of the In Vesalius, SolidWorks 2016, and Rhinoceros 4.0 software programs. Each three-dimensional model included a maxillary bone block corresponding to the region from the 1st premolar to the 1st right molar with three EH implants measuring 4.0 mm in diameter, which supported the three-unit metal-ceramic screw-retained prosthesis through varying configuration factors (single-unit and splinted crowns: straight-line and tripod design) and implant lengths (10, 8.5, and 7 mm × Ø4 mm). The FEMAP 11.4.2 program was used to generate the finite element models in the pre- and post-processing phases. Bone tissue was analyzed using Maximum Principal Stress (MPa) and Microstrain (με) maps. The highest stress/microstrain values were observed in oblique loading. In addition, splinting associated with the offset configuration generated improved biomechanical behavior. Furthermore, the association of short implants with longer implants did not exhibit any biomechanical benefits. Moreover, a reduced implant length (i.e., 7 mm) generated unfavorable biomechanical behavior. Splinting was effective in reducing the stress/microstrain on cortical bone tissue, especially when associated with the offset configuration of the implants. Also, an increased implant length decreased the stress/microstrain in the bone tissue, and splinted short implants presented similar biomechanical behavior to short implants associated with longer implants. El objetivo del presente estudio fue analizar la tensión y microdeformación del tejido óseo cortical generada por las fuerzas oclusales sobre las prótesis de tres elementos implantosoportados, variando la unión y longitud de los implantes, instalados en la región posterior del maxilar. Quince modelos tridimensionales se simularon y cada modelo tridimensional consistió en un bloque óseo maxilar referido a la región de la 1ª PM a la 1ª M derecha, presentando tres implantes de hexágono externo (HE) de 4.0 mm de diámetro, soportando una prótesis metalocerámica atornillada, variando el factor unión (coronas unitarias y ferulizadas: rectas y en posición tripoide), longitud con implantes (10 mm, 8,5 mm y 7 mm Ø4 mm). El análisis del tejido óseo se realizó utilizando los mapas de Máxima Máxima Tensión (MPa) y Microdeformación (µε). Los mayores valores de la tensión/microdeformación se observaron en la carga oblicua. El entablillado asociado al posicionamiento del trípode generó un mejor comportamiento biomecánico. La asociación de implantes cortos con implantes más largos no ha demostrado un beneficio biomecánico. La reducción de la longitud del implante (7 mm) generó un comportamiento biomecánico desfavorable. La ferulización fue eficaz para reducir la tensión/microdeformación del tejido óseo cortical, especialmente cuando se asocia con el posicionamiento trípode de los implantes. El aumento de la longitud del implante disminuyó la tensión/microdeformación en el tejido óseo. Los implantes ferulizados cortos mostraron un comportamiento biomecánico similar al de los implantes cortos asociados con implantes más largos. O objetivo do presente estudo foi analisar a tensão e a microdeformação do tecido ósseo cortical geradas pelas forças oclusais sobre próteses de três elementos implantossuportadas, variando o fator união e comprimento dos implantes, instaladas na região posterior de maxila. Quinze modelos tridimensionais foram simulados com auxílio dos programas In Vesalius, SolidWorks 2016, Rhinoceros 4.0. Cada modelo tridimensional foi constituído de um bloco ósseo maxilar referente à região do 1º PM ao 1º M direito, apresentando três implantes do tipo hexágono externo (HE) de 4,0 mm de diâmetro, suportando prótese de três elementos metalocerâmica parafusada, variando o fator união (coroas unitárias e esplintadas: em linha reta e em posicionamento tripoidal), comprimento com implantes (10 mm, 8,5 mm e 7 mm de Ø4 mm). O programa FEMAP 11.4.2 foi utilizado para gerar os modelos de elementos finitos nas fases de pré- e pós-processamento. A análise do tecido ósseo foi feita utilizando os mapas de Tensão Máxima Principal (MPa) e Microdeformação (µε). Os maiores valores de tensão/microdeformação foram observados no carregamento oblíquo. A esplintagem associada ao posicionamento tripoidal gerou melhor comportamento biomecânico. A associação de implantes curtos com implante de maior comprimento não demonstrou benefício biomecânico. A redução do comprimento do implante (7 mm) gerou um comportamento biomecânico desfavorável. A esplintagem foi efetiva na redução de tensão/microdeformação do tecido ósseo cortical, principalmente quando associada ao posicionamento tripoidal dos implantes. O aumento do comprimento do implante diminuiu a tensão/microdeformação no tecido ósseo. Implantes curtos esplintados mostraram comportamento biomecânico similar a implantes curtos associados a implantes de maior comprimento.

In this study evaluated the effect of different adhesive systems and resin composites on the microtensile bond strength of repairs using a bulk-fill composite. Ninety specimens were prepared using a half-hourglass mold of composite Filtek Bulk Fill using a silicone matrix. Specimens were randomly distributed in 9 experimental groups (n=10) according to adhesive [Universal Single Bond (SBU), Scotchbond Multipurpose Adhesive (SBMP), and Single Bond 2 (SB2)] and resin composite (Filtek Bulk Fill, Aura Bulk Fill, and Filtek Z250). For control group, hourglass specimens were used to measure the ultimate bond strength. Specimens were submitted to thermal cycling (5,000 cycles, 5 and 55°C, 30s) to simulate the aging of restoration and then the repair procedure was performed. After the diamond-tipped surface roughening to be repaired, the adhesive protocol was performed according to group, the specimen was placed in an hourglass-shaped mold and the other half was filled with the repair composite. After 24h, bond strength of specimens was obtained by microtensile using a universal testing machine at a speed of 0.5mm/min. Data were statistically analyzed by two-way ANOVA, Tukey’s and Dunnett’s tests (α=0.05). SBU showed higher bond strength compared to SB2, while SBMP showed intermediate values. However, all experimental groups showed lower bond strength compared to ultimate bond strength. In conclusion, bulk-fill composite repair using universal or conventional solvent-free adhesive improved the adhesion independent of composite tested. En este estudio, se evaluó el efecto de diferentes sistemas adhesivos y resinas compuestas sobre la fuerza de adhesión de las reparaciones utilizando un compuesto de relleno a granel. Se prepararon noventa muestras del compuesto Filtek Bulk Fill utilizando una matriz de silicona cada media hora. Las muestras se asignaron aleatoriamente a 9 grupos experimentales (n=10) según el adhesivo [Single Bond Universal (SBU), Scotchbond Multipurpose Adhesive (SBMP) y Single Bond 2 (SB2)] y el compuesto (Filtek Bulk Fill, Aura Bulk Fill y Filtek Z250). Para el grupo de control, se utilizaron muestras de reloj de arena para medir la fuerza cohesiva del material. Las probetas se sometieron a ciclos térmicos (5.000 ciclos, 5 y 55 ° C, 30s) simulando el envejecimiento de la restauración y la reparación realizada. Después de la asperización con punta de diamante en la superficie a reparar y se realizó el protocolo de adhesivo, la muestra se colocó en una matriz en forma de reloj de arena y la otra mitad de la matriz se rellenó con el composite de reparación. Después de 24h, se obtuvo la fuerza de adhesión de las probetas mediante el ensayo de microtensión utilizando una máquina de ensayo universal a una velocidad de 0,5mm/min. El modo de falla se analizó con una lupa estereoscópica. Los datos se analizaron estadísticamente mediante ANOVA, pruebas de Tukey y Dunnett (α=0,05). SBU mostró una mayor fuerza de adhesión en comparación con SB2, mientras que SBMP mostró valores intermedios. Sin embargo, todos los grupos experimentales mostraron valores de fuerza de adhesión más bajos que la fuerza de cohesión del grupo de control. El modo de falla predominante fue el tipo adhesivo. La reparación del material compuesto de relleno a granel utilizando el adhesivo sin disolvente universal o convencional mostró una mejor adhesión independientemente del compuesto probado. Neste estudo foi avaliado o efeito de diferentes sistemas adesivos e resinas compostas na resistência de união de reparos utilizando um compósito bulk fill. Noventa espécimes do compósito Filtek Bulk Fill foram preparados utilizando uma matriz de silicone de meia ampulheta. Os espécimes foram distribuídos aleatoriamente em 9 grupos experimentais (n=10) de acordo com adesivo [Single Bond Universal (SBU), Scotchbond Multipurpose Adesivo (SBMP) e Single Bond 2 (SB2)] e compósito (Filtek Bulk Fill, Aura Bulk Fill e Filtek Z250). Para o grupo controle, espécimes no formato de ampulheta foram utilizados para mensurar a resistência coesiva do material. Os espécimes foram submetidos à ciclagem térmica (5,000 ciclos, 5 e 55°C, 30s) simulando o envelhecimento da restauração e o reparo realizado. Após asperização com ponta diamantada da superfície a ser reparada e realizado o protocolo adesivo, o espécime foi posicionado em uma matriz em formato de ampulheta e a outra metade da matriz foi preenchida com o compósito de reparo. Após 24h, a resistência de união dos espécimes foi obtida por microtração usando uma máquina de ensaio universal sob velocidade de 0,5mm/min. Os dados foram estatisticamente analisados pelos testes de ANOVA, Tukey e Dunnett (α=0,05). O SBU apresentou maior resistência de união quando comparado ao SB2, enquanto o SBMP mostrou valores intermediários. Entretanto, todos os grupos experimentais apresentaram valores de resistência de união inferiores à resistência coesiva do grupo controle. O reparo do compósito bulk fill usando o adesivo universal ou convencional livre de solvente mostrou melhor adesão independente do compósito testado.

Made available in DSpace on 2018-12-11T17:04:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-01-25 The aim of study was to evaluate the stress distribution in implant-supported prostheses and peri-implant bone using internal hexagon (IH) implants in the premaxillary area, varying surgical techniques (conventional, bicortical and bicortical in association with nasal floor elevation), and loading directions (0°, 30° and 60°) by three-dimensional (3D) finite element analysis. Three models were designed with Invesalius, Rhinoceros 3D and Solidworks software. Each model contained a bone block of the premaxillary area including an implant (IH, Ø4 × 10 mm) supporting a metal-ceramic crown. 178 N was applied in different inclinations (0°, 30°, 60°). The results were analyzed by von Mises, maximum principal stress, microstrain and displacement maps including ANOVA statistical test for some situations. Von Mises maps of implant, screws and abutment showed increase of stress concentration as increased loading inclination. Bicortical techniques showed reduction in implant apical area and in the head of fixation screws. Bicortical techniques showed slight increase stress in cortical bone in the maximum principal stress and microstrain maps under 60° loading. No differences in bone tissue regarding surgical techniques were observed. As conclusion, non-axial loads increased stress concentration in all maps. Bicortical techniques showed lower stress for implant and screw; however, there was slightly higher stress on cortical bone only under loads of higher inclinations (60°). Department of Dental Materials and Prosthodontics Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Pediatric and Community Dentistry Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Operative Dentistry School of Dentistry Federal University of Alfenas–UNIFAL-MG Department of Dental Materials and Prosthodontics Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Pediatric and Community Dentistry Aracatuba Dental School UNESP–Univ Estadual Paulista

Made available in DSpace on 2018-12-11T17:02:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-11-17 The aim of this study was to assess stress/strain of different implant modeling simplifications by 3D-FEA. Three variation of external hexagon implant (Ã 3.75 Ã 10Â mm) supporting one molar crown were simulated: A (no threads); B (slightly threads simplification); C (original design). 200Â N (axial) and 100Â N (oblique) were applied. Cortical bone was evaluated by maximum principal stress and microstrain qualitatively and quantitatively (ANOVA and Tukey post hoc (pÂ

Statement of problem No consensus has been reached on which retention system, cement- or screw-retained, is best to avoid bone loss around the implant of a fixed implant-supported restoration. Purpose The purpose of this systematic review and meta-analysis was to compare cement- and screw-retained retention systems in fixed implant-supported restorations in terms of marginal bone loss, implant survival, and prosthetic complications. Material and methods A comprehensive search of studies published from January 1995 to March 2015 and listed in the PubMed/MEDLINE, Embase, Scopus and the Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Marginal bone loss was the continuous outcome measure evaluated by mean difference (MD), and implant survival and prosthetic complications were the dichotomous outcome measures evaluated by risk ratio (RR), both with corresponding 95% confidence intervals (CI). Results The 20 studies selected for review evaluated 2139 participants, whose mean age was 47.14 years and who had received 8989 dental implants. The mean follow-up was 65.4 months (range: 12-180 months). Results of the MD for marginal bone loss showed statistically significant differences in favor of the cement-retained prosthesis ( P =.04; MD: −0.19; CI: −0.37 to −0.01). The implant survival rate was higher for the cement-retained prosthesis ( P =.01; RR: 0.49; CI: 0.28 to 0.85), and the prosthetic complication rate was higher for the screw-retained prosthesis ( P =.04; RR: 0.52; CI: 0.28 to 0.98). Additional analysis of the mean plaque index did not show differences between retention systems ( P =.58; MD: 0.13; CI: −0.32 to 0.57). Conclusions The current meta-analysis indicated that cement-retained, fixed implant-supported restorations showed less marginal bone loss than screw-retained, fixed implant-supported restorations during the follow-up period, which ranged from 12 to 180 months. However, the small difference between the mean values may not show clinical significance. The rates of prosthetic complication and implant survival also compared favorably with cement-retained prostheses.

The aim of this study was to report a patient of rehabilitation with removable partial denture retained by implants in-patient who suffered injury after firearm shooting. A 19-year-old man presented to the hospital of the Val Paraíso city after being hit by a bullet in the right on the face, affecting the teeth 12 to 16. The surgery to remove the shards of teeth, and bullet was performed. Surgical team opted for installation of implants without bone grafts; however, due to extensive loss of alveolar bone, only 3 tilted implants (2 Ø3.75 × 8.5 mm and 1 Ø3.75 × 10 mm) were installed. After recovery, the patient was referred to the Araçatuba Dental School-UNESP for the rehabilitation on the affected region. The difficulty of rehabilitation with conventional fixed prostheses was verified during the prosthetic phase. This way, it was opted for rehabilitation with removable partial dentures associated with dental implant. Two attachment system ERA (ERA, Sterngold) were positioned in the bar to make the removable partial denture. After 5 years of follow-up, the authors can conclude that the use of removable partial denture retained by implants is effective for functional and aesthetic rehabilitation, favoring socialization and self-esteem of the patient.

Made available in DSpace on 2020-12-12T01:50:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-03-01 Acrylic-based resin is the material of choice for the fabrication of definitive and provisional prostheses. In order to achieve clinical success, it is important to know the most suitable polymerization process for this material. The aim of this study was to evaluate the influence of different polymerization methods on several physical and mechanical properties, before and after thermocycling, of a heat-activated acrylic resin (HAAR). In addition, the degree of conversion (DC) was evaluated for all polymerization methods. Ninety HAAR samples were divided into three groups: conventional polymerization (CP), dry-heat polymerization (DHP), and digital pneumatic polymerization (DPP). Color, microhardness (n = 10), and flexural strength tests (n = 20) were performed, before and after 2000 cycles of thermocycling. The analysis of the DC was performed by using Fourier transform infrared spectroscopy (n = 4). Color alteration and DC data were submitted to one-way analysis of variance (ANOVA). Microhardness and flexural strength data were submitted to two-way repeated measures ANOVA. All results were submitted to the Tukey test (α = .05). The color alteration was statistically lower in the DHP group. The DPP group exhibited higher initial microhardness with a statistically significant difference from other the groups. There was no statistical difference between the groups in regards to flexural strength. The CP and DPP groups had higher DC results. The proposed polymerization methods had divergent results for the different properties analyzed. However, these results were similar to those of conventional polymerization, which is a viable and adequate alternative. Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP) Presidente Prudente Dental School University of Western Sao Paulo (UNOESTE) Presidente Prudente Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP)

Statement of problem The survival and/or success of post-retained restorations is influenced by the amount of residual coronal structure, known as the “ferrule effect.” Purpose The purpose of this systematic review and meta-analysis was to evaluate whether the presence or absence of the ferrule effect influences the failure rate of fiber-reinforced composite post-and-core restorations. Material and methods A comprehensive review of the literature was performed using the PubMed/Medline, Embase, Scopus, and Cochrane Library databases for articles published up to May 2018. The risk ratio with 95% confidence interval was estimated using the Mantel-Haenszel method. Potentially eligible studies were selected based on the reading of the abstracts and full text of prospective clinical trials, randomized clinical trials, or prospective randomized studies, all with a minimum of 10 participants in each group, with a follow-up period longer than 6 months, and published in English. Results Of the 380 studies retrieved, 4 were included in this meta-analysis. A total of 297 teeth were evaluated, 157 with a ferrule and 140 without a ferrule. The mean survival rate was 88.35% in the ferrule group and 78.05% in the nonferrule group. No statistically significant difference was noted in the general failure analysis (risk ratio: 0.71 [95% confidence interval: 0.47 to 1.06]; P=.09), although a higher number of failures occurred in nonferrule restorations. More controlled and randomized clinical trials are needed to establish a clinical protocol for the use of post-retained restorations. Conclusions Despite the limited number of available studies, the results of this meta-analysis suggest that the ferrule effect does not significantly reduce the failure rate in fiber-reinforced composite post-and-core restorations.

The aim of this study was to compare the values of bone-implant contact (BIC) and removal torque (RTQ) reported in different animal studies for titanium–zirconium (TiZr) and titanium (Ti) dental implants. This review has been registered at PROSPERO under number CRD42016047745. We undertook an electronic search for data published up until November 2017 using the PubMed/Medline, Embase, and The Cochrane Library databases. Eligibility criteria included in vivo studies, comparisons between Ti and TiZr implants in the same study, and studies published in English that evaluated BIC and RTQ. After inclusion criteria, 8 studies were assessed for eligibility. Of the 8 studies, 7 analyzed BIC outcome and 3 analyzed RTQ outcome. Among such studies, 6 studies were considered for meta-analysis of quantitative for BIC and 2 studies for RTQ. There was no significant difference for BIC analysis (P = .89; random ration [RR]: −0.21; 95% confidence interval [CI]: −3.14 to 2.72). The heterogeneity of the primary outcome studies was considered low (7.19; P = .21; I2: 30%). However, the RTQ analysis showed different results favoring the TiZr dental implants (P = .001; RR: 23.62; 95%CI: 9.15 to 38.10). Low heterogeneity was observed for RTQ (χ2: 1.25; P = .26; I2: 20%). Within the limitations of this study, there was no difference between TiZr and Ti alloys implants in terms of BIC. However, TiZr implants had higher RTQ than Ti alloys.

Made available in DSpace on 2022-04-29T08:14:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-02-01 Graduate student Graduate Program in Dentistry Department of Dental Materials and Prosthodontics São Paulo State University Araçatuba Dental School Adjunct Professor Department of Dental Materials and Prosthodontics São Paulo State University Araçatuba Dental School Graduate student Graduate Program in Dentistry Department of Dental Materials and Prosthodontics São Paulo State University Araçatuba Dental School Adjunct Professor Department of Dental Materials and Prosthodontics São Paulo State University Araçatuba Dental School

The purpose of this study was to evaluate different retention systems (cement- or screw-retained) and crown designs (non-splinted or splinted) of fixed implant-supported restorations, in terms of stress distributions in implants/components and bone tissue, by 3-dimensional (3D) finite element analysis. Four 3D models were simulated with the InVesalius, Rhinoceros 3D, and SolidWorks programs. Models were made of type III bone from the posterior maxillary area. Models included three 4.0-mm-diameter Morse taper (MT) implants with different lengths, which supported metal-ceramic crowns. Models were processed by the Femap and NeiNastran programs, using an axial force of 400 N and oblique force of 200 N. Results were visualized as the von Mises stress and maximum principal stress (σmax). Under axial loading, there was no difference in the distribution of stress in implants/components between retention systems and splinted crowns; however, in oblique loading, cemented prostheses showed better stress distribution than screwed prostheses, whereas splinted crowns tended to reduce stress in the implant of the first molar. In the bone tissue cemented prostheses showed better stress distribution in bone tissue than screwed prostheses under axial and oblique loading. The splinted design only had an effect in the screwed prosthesis, with no influence in the cemented prosthesis. Cemented prostheses on MT implants showed more favorable stress distributions in implants/components and bone tissue. Splinting was favorable for stress distribution only for screwed prostheses under oblique loading. Resumo O objetivo deste estudo foi avaliar diferentes sistemas de retenção (cimentada x parafusada) e configuração da coroas (unitárias x esplintadas) de próteses fixas implantossuportadas em relação a distribuição de tensões nos implantes/componentes e tecido ósseo pela análise de elementos finitos 3D. Quatro modelos 3D foram simulados com auxílio dos programas Invesalius, e Rhinoceros 3D, e SolidWorks. Os modelos foram confeccionados simulando bloco ósseo de região posterior da maxila (tipo ósseo III), com 3 implantes cone Morse com 4,0 mm de diâmetro e diferentes comprimentos, suportando prótese metalocerâmica de 3 elementos. Os modelos foram processados pelos programas FEMAP e NEiNastran sob força axial de 400 N e oblíqua de 200N. Os resultados foram plotados através de mapas de tensão de von Mises (vM) (implantes e componentes) e tensão máxima principal (TMP) (tecido ósseo). Sobre o carregamento axial, não foi observada diferenças entre os diferentes sistemas de retenção e tipo de prótese na distribuição das tensões nos implantes/componentes, porém, sobre o carregamento oblíquo as próteses cimentadas apresentaram melhor distribuição de tensões em comparação com as próteses parafusadas, enquanto que as próteses esplintadas apresentou uma tendência de redução das tensões no implante do primeiro molar. No tecido ósseo as próteses cimentadas apresentaram melhor distribuição das tensões em comparação com as próteses parafusadas, independente do carregamento. A esplintagem foi favorável somente para as próteses parafusadas, não havendo influência sobre as próteses cimentadas. As próteses cimentadas sobre implantes cone Morse apresentam melhor comportamento biomecânico nos implantes/componentes e tecido ósseo. A esplintagem foi efetiva somente nas próteses parafusadas sob carregamento oblíquo.

Made available in DSpace on 2018-11-26T17:55:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The aim of this study was to evaluate stress distribution in the implants/components and bone tissue for splinted and nonsplinted prostheses with different lengths of implants using three-dimensional finite element analysis. Six models from the posterior maxillary area were used in simulations. Each model simulated three Morse taper implants of 4.0 mm diameter with different lengths, which supported metal-ceramic crowns. An axial load of 400 N and an oblique load of 200 N were used as loading conditions. Splinted prostheses exhibited better stress distribution for the implants/components, whereas nonsplinted prostheses exhibited higher stress in the first molar under axial/oblique loading. Implant length did not influence stress distribution in the implants/components. In cortical bone tissue, splinted prostheses decreased the tensile stress in the first molar, whereas nonsplinted prostheses were subjected to higher tensile stress in the first molar; implant length had no influence on stress distribution. Within the limitations of this study, we conclude that splinted prostheses contributed to better stress distribution in the implant/abutment and cortical bone tissue; however, the reduction in the implant length did not influence the stress distribution. State Univ UNESP, Aracatuba Sch Dent, Dept Dent Mat & Prosthodont, Aracatuba, SP, Brazil Sacred Hearth Univ USC, Dept Hlth Sci, Bauru, SP, Brazil Univ Western Sao Paulo UNOESTE, Dept Prosthodont, Presidente Prudente, SP, Brazil Informat Tecnol Ctr Renato Archer, Campinas, SP, Brazil State Univ UNESP, Aracatuba Sch Dent, Dept Dent Mat & Prosthodont, Aracatuba, SP, Brazil FAPESP: 2014/02490-8

The aim of this study was to analyze the stress distribution of short implants supporting single unit or splinted crowns by the photo-elasticity method. Four photo-elastic models were produced: A (3.75×7 mm); B (3.75×7 mm, 3.75×7 mm and 3.75×7 mm); C (3.75×10 mm, 3.75×7 mm and 3.75×7 mm); D (3.75×13 mm, 3.75×7 mm and 3.75×7 mm). The prostheses were made with Ni-Cr alloy. A load of 100 N in the axial and oblique directions was applied, totaling 380 applications, individually capturing their images in each model. The data were randomized and analyzed qualitatively and quantitatively by 2 examiners. The oblique loading was significantly more damaging. The increase in length was favorable for stress distribution (p0.05). The splinting was beneficial for the transmission of stresses mainly (p0.05). The splinting of the crowns, as well as increasing the length of the first implant and axial loading was most beneficial in the stress distribution. Short splinted implants behaved better than single unit implants. Increasing of the length of the first implant significantly improved the stress distribution in all analyzed situations.

The study of short implants is relevant to the biomechanics of dental implants, and research on crown increase has implications for the daily clinic. The aim of this study was to analyze the biomechanical interactions of a singular implant-supported prosthesis of different crown heights under vertical and oblique force, using the 3-D finite element method. Six 3-D models were designed with Invesalius 3.0, Rhinoceros 3D 4.0, and Solidworks 2010 software. Each model was constructed with a mandibular segment of bone block, including an implant supporting a screwed metal-ceramic crown. The crown height was set at 10, 12.5, and 15 mm. The applied force was 200 N (axial) and 100 N (oblique). We performed an ANOVA statistical test and Tukey tests; p0.05 was considered statistically significant. The increase of crown height did not influence the stress distribution on screw prosthetic (p0.05) under axial load. However, crown heights of 12.5 and 15 mm caused statistically significant damage to the stress distribution of screws and to the cortical bone (p0.001) under oblique load. High crown to implant (C/I) ratio harmed microstrain distribution on bone tissue under axial and oblique loads (p0.001). Crown increase was a possible deleterious factor to the screws and to the different regions of bone tissue.

To characterize the surface of glass fiber posts (GFP) after different surface treatments and evaluate which method incorporates higher amounts of silicon (Si) particles, as well as to evaluate the bond strength at the post/ composite-cement interface with four different surface treatments of glass fiber posts luted with composite cement.Twelve glass fiber posts were obtained from the manufacturer. The posts were randomly distributed into four groups (n = 3): Co (control), no surface treatment; S, 70% alcohol and silane (60 s); HF + S, 10% hydrofluoric acid gel (60 s) and silane (60 s); NTP, nonthermal plasma of hexamethyldisiloxane (HMDSO) associated with argon (30 min). The surface of each GFP was characterized through scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Forty GFPs were randomly divided into 4 groups according the surface treatments (n = 10) and cemented with one composite cement (Rely X U200) into artificial canine teeth. The specimens were placed in a universal testing machine and subjected to tensile testing until failure occurred. Statistical analysis of the atomic percentage and bond strength was performed using ANOVA, followed by the post-hoc Tukey test (p = 0.05).EDS graphics showed that the NTP group had a higher Si atomic percentage (at%) than the other groups (p0.001). The HF + S group had a higher Si at% than did the Co and S groups. SEM images illustrated that the surfaces of the GFPs were variously modified after different treatments. The NTP group incorporated higher Si levels on the GFP surface and yielded the highest bond strengths (p0.005) compared to the other tested groups.Treatment with HMDSO + Ar plasma (NTP) incorporated higher Si levels on the surface of the GFPs without inducing critical defects. NTP treatment promoted better bond strength results when compared to the other tested group when GFPs were cemented with composite cement.

Made available in DSpace on 2022-04-29T08:45:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered. Department of Dental Materials and Prosthodontics Aracatuba Dental School Universidade de São Paulo Department Prosthodontics Presidente Prudente Dental School Universidade do Oeste Paulista