Abstract Temporomandibular disorders (TMD) is a term used to describe a set of clinical conditions that may compromise the temporomandibular joint (TMJ) and masticatory muscles and/or associated structures, considered the most frequent cause of orofacial pain of non-dental origin. In recent years, many forms of physical therapy have been used in the treatment of TMD to reduce pain and improve the range of mandibular movement present in this impairment. Among these resources are kinesiotherapy (exercise), electrothermal and manual therapy, acupuncture, training posture, mobilizations, and biofeedback. Objectives To determine if exercises with or without occlusal splints are effective in reducing pain in patients with temporomandibular disorders (TMD) of myogenic origin. Methodology This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD 42019134244). Controlled trials published in PubMed, Scopus, and Cochrane Library following PRISMA guidelines up to April 2022 were randomized and included. The population above 18 years, which evaluated the effectiveness of exercise with or without occlusal splints in reducing pain in patients with TMD of myogenic origin, diagnosed through the Research Diagnostic Criteria for Temporomandibular Disorders, was also included. There was no restriction on the period of publication. Cochrane risk of bias analysis was performed. Results Of the five included articles, all showed a reduction of pain, but without significant differences between the interventions performed. Additionally, studies that evaluated the quality of life and mandibular movements showed a reduction in pain, but no significant differences between therapies. Conclusion The analyzed studies showed no difference in the improvement of pain, quality of life, and mandibular movements between the groups that performed only exercises or the associated treatments.

Abstract This study aimed to investigate if SNP rs6313, SNP rs2770304, SNP rs4941573, and SNP rs1923884 of the 5-HT2A receptor gene and SNP rs6295 of the 5-HT1A receptor gene are associated with bruxism etiology. Methodology This systematic review was registered in PROSPERO (CRD42018094561). A search was conducted for articles published in or before May 2021. To qualify for eligibility in this review, the studies had to be case-controls, cohort or cross-sectional. The inclusion criteria were the articles with a group of patients with bruxism and a control group in which the presence of these SNPs was evaluated. The exclusion criteria were the investigations of other polymorphisms, the studies that did not consider a control group for comparison, case reports, and reviews. The NOS and JBI were used to evaluate the methodological quality of studies. Results We conducted this study with databases, such as Web of Science, Scopus, Embase, PubMed/MEDLINE, and ProQuest. We considered four studies eligible. A total of 672 participants were included,187 with sleep bruxism, 105 with awake bruxism, 89 with sleep and awake bruxism, and 291 controls. One study found a strong association between the SNPs rs6313, rs2770304 and rs4941573 of the 5-HT2A receptor gene and sleep bruxism. In one study, we considered the C allele of the SNP rs2770304 a risk factor for sleep bruxism. We found no significant results of other SNPs in sleep bruxers compared to controls. We found no positive association concerning the SNPs and groups of awake bruxism and sleep and awake bruxism. Conclusion The different results regarding the SNPs in sleep bruxers could be explained by the genetic distinction between Chilean, Mexican, Japanese, and Polish population. More clinical trials and prospective studies must be conducted with larger sample size and in different ethnicities to confirm the results of this review.

Abstract The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was “Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?” Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.

Resumo O objetivo deste estudo foi avaliar o efeito da variação do diâmetro e dos tipos de conexão na distribuição do estresse no osso cortical para implantes com a proporção coroa-implante. Seis modelos 3D foram simulados com os programas InVesalius, Rhinoceros 3D 4.0 e SolidWorks 2011. Os modelos foram compostos de osso da região mandibular posterior. Foram incluídos implantes de 8,5 mm de comprimento, diâmetro Ø 3,75 mm ou Ø 5,00 mm, e tipos de conexão como hexágono externo (EH), hexágono interno (IH) e cone Morse (MT). Os modelos foram processados usando os programas Femap 11.2 e NeiNastran 11.0 e usando uma força axial de 200 N e força oblíqua de 100 N. Os resultados foram registrados em termos da tensão principal máxima. O carregamento oblíquo mostrou alta tensão no osso cortical em comparação com a carga axial. Os resultados mostraram que os implantes com maior diâmetro apresentaram distribuição de tensões mais favorável, independentemente do tipo de conexão, enquanto que os implantes cone Morse apresentaram melhores distribuição de tensões comparado aos outros tipos de conexão, especialmente no carregamento oblíquo. Assim, os implantes de maior diâmetro foram mais favoráveis para distribuição das tensões na região de tecido ósseo cortical, enquanto que os implantes cone Morse apresentam menores concentrações de tensões do que as outras conexões.

Abstract The aim of this study was to evaluate the effect of varying the diameter, connection type and loading on stress distribution in the cortical bone for implants with a high crown-implant ratio. Six 3D models were simulated with the InVesalius, Rhinoceros 3D 4.0 and SolidWorks 2011 software programs. Models were composed of bone from the posterior mandibular region; they included an implant of 8.5 mm length, diameter Ø 3.75 mm or Ø 5.00 mm and connection types such as external hexagon (EH), internal hexagon (IH) and Morse taper (MT). Models were processed using the Femap 11.2 and NeiNastran 11.0 programs and by using an axial force of 200 N and oblique force of 100 N. Results were recorded in terms of the maximum principal stress. Oblique loading showed high stress in the cortical bone compared to that shown by axial loading. The results showed that implants with a wide diameter showed more favorable stress distribution in the cortical bone region than regular diameter, regardless of the connection type. Morse taper implants showed better stress distribution compared to other connection types, especially in the oblique loading. Thus, oblique loading showed higher stress concentration in cortical bone tissue when compared with axial loading. Wide diameter implant was favorable for improved stress distribution in the cortical bone region, while Morse taper implants showed lower stress concentration than other connections.

Abstract 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.

Abstract Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, “Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?” A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54–1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57–4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37–2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.

Resumo Introdução O comportamento biomecânico de dentes tratados endodonticamente é variável conforme o material restaurador selecionado e situação do dente a ser restaurado. Objetivo Analisar por meio do método dos elementos finitos bidimensional o comportamento biomecânico de diferentes retentores intrarradiculares e diâmetros em dentes com 2mm de remanescente coronário. Material e método Foram confeccionados seis modelos com três tipo de retentores: pino de fibra de vidro, pino de fibra de carbono e núcleo metálico fundido, ambos com diâmetro #1 (1,1mm de diâmetro) e #2 (1,3mm de diâmetro). A modelagem foi realizada através do programa Rhinoceros 4.0, e em seguida nos programas FEMAP 10.2 e NeiNastran 9.2 para desenvolvimento d os modelos de elementos finitos. Nos carregamentos foram utilizadas forças de 100N axial e oblíquo. Os resultados foram visualizados pelo mapa de tensão von Mises, e pela análise de variância (ANOVA) e pós-teste Tukey, com nível de significância à 5%. Resultado O carregamento oblíquo apresentou maiores valores de tensões (p<0,001). O pino de fibra de vidro apresentou menores concentrações de tensões em ambos os carregamentos (p<0,001). O pino de fibra de carbono apresentou diferença significativa em relação ao núcleo metálico somente no carregamento oblíquo (p=0,007). O diâmetro não influenciou para o aumento de tensões dos retentores avaliados (p=0,302). Conclusão Os pinos de fibras são mais favoráveis para restaurações de dentes tratados endodonticamente; O aumento do diâmetro não influenciou no aumento de tensões; A carga oblíqua é mais prejudicial à tanto para o retentor quanto para a estrutura dentária.

Abstract Introduction The biomechanical behavior of endodontically treated teeth depending on the selected restorative material and tooth situation to be restored. Objective To analyze by the two-dimensional finite element method the biomechanical behavior of different diameters in intraradicular posts and teeth with coronal remaining of 2mm. Material and method Six models were made with three types of posts, as follows: Glass fiber post, carbon fiber post, and cast metal post, both with diameter # 1 (1.1 mm in diameter) and # 2 (1.3 mm of diameter). The modeling was performed using the Rhinoceros 4.0 program. The FEMAP 10.2 and NEiNastran 9.2 programs were used to develop finite element models. The loading used was 100N for axial and oblique forces. The results were visualized using the von Mises stress map. The statistical analysis was made using analysis of variance (ANOVA) and Tukey post-test, with a significance level of 5%. Result The oblique loading stress values were higher than the axial loading (p<0.001) for both situations. The glass fiber post showed the lowest concentrations of stress on both loads (p<0.001). The carbon fiber post presented significant difference compared to the cast metal post, only in the oblique load (p=0.007). The diameter did not increase the stress of the evaluated posts (p=0.302). Conclusion The fiber posts were more favorable for restoration of endodontically treated teeth; the increase of diameter did not influence the increase of tension; the oblique load was more harmful for both posts and tooth structure.

OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation.

O objetivo deste estudo foi avaliar, através do método dos elementos finitos tridimensionais, a influência do carregamento oclusal parafuncional e da altura da coroa na distribuição das tensões em próteses unitárias implantossuportadas de hexágono externo. Foram confeccionados três modelos com o auxílio de programas de desenho assistido. Cada modelo foi composto por um bloco ósseo da região molar mandibular, por um implante de tipo hexágono externo (5x10,0 mm) e por coroa com diferentes alturas: 10, 12,5 e 15 mm. Os modelos foram exportados para o programa de elementos finitos NEiNastran 9.0, para geração das malhas e estabelecer as condições de contorno. Aplicou-se uma carga funcional (200 N axial e 100 N oblíqua), bem como uma carga parafuncional (1.000 N axial e 500 N oblíqua). Os resultados foram visualizados por meio de mapas de Tensão de von Mises e mapas de Tensão Máxima Principal. O carregamento parafuncional induziu um aumento da área de distribuição e da magnitude das tensões no implante (plataforma e primeiras roscas) e parafuso (pescoço) em comparação com o carregamento funcional. A cortical óssea apresentou maiores áreas de tensão por tração sob carregamento parafuncional oblíquo. A concentração de tensões aumentou à medida que aumentou a altura da coroa. O aumento da altura da coroa induziu um aumento na concentração de tensões, tanto nos componentes do implante, quanto na cortical óssea; o carregamento parafuncional induziu um aumento entre 4-5 vezes da magnitude das tensões no tecido ósseo; o tipo de carregamento apresenta-se como um fator de variação mais influente do que a proporção coroa/implante.

The aim of this study was to assess, by the three-dimensional finite element method, the influence of crown-to-implant ratio and parafunctional occlusal loading on stress distribution in single external hexagon implant-supported prosthesis. Computer-aided design software was used to confection three models. Each model was composed of a block bone and an external hexagon implant (5x10.0 mm) with screw-retained implant prostheses, varying the height crown: 10, 12.5 and 15 mm. Finite element analysis software was used to generate the finite element mesh and to establish the loading and boundary conditions. Normal (200 N axial and 100 N oblique load) and parafunctional forces (1,000 N axial and 500 N oblique load) were applied. The results were visualized by von Mises and maximum principal stress. In comparison with the normal occlusal force, the parafunctional occlusal force induced an increase in stress concentration and magnitude on implant (platform and first threads) and screw (neck). The cortical bone showed the highest tensile stress under parafunctional force (oblique load). The stress concentration increased as the crown height increased. It was concluded that: increasing the C/I increased stress concentration in both implant components and cortical bone; parafunctional loading increased between 4-5 times the value of stresses in bone tissue compared with functional loading; the type of loading variation factor is more influential than the crown-to-implant factor.

A proposta deste estudo foi avaliar a influência da altura da coroa de implantes de hexágono externo sobre o deslocamento e distribuição de tensões para o sistema implante/osso utilizando o método de elementos finitos. Os softwares InVesalius e Rhinoceros 4.0 foram usados para gerar o modelo de osso por meio de uma tomografia computadorizada. Cada modelo foi composto de um bloco ósseo com um implante (3.75 x 10.0 mm) com conexão de hexágono externo e coroas de 10 mm, 12.5mm e 15 mm em altura. Uma carga axial de 200 N e oblíqua (45°) de 100 N foram aplicadas. Os modelos foram resolvidos pelo software NeiNastram 9.0 e Femap 10.0 para obtenção dos resultados que foram visualizados por meio de mapas de deslocamento, de von Mises (coroa/implante) e tensão máxima principal (osso). A altura da coroa sob carga axial não influenciou o deslocamento e concentração de tensões, enquanto que a carga oblíqua aumentou a ação destes fatores. A maior concentração de tensões foi observada no pescoço do parafuso do implante no lado oposto à aplicação de carga. Esta tensão foi transferida para a interface coroa/plataforma/interface óssea. Os resultados deste estudo sugerem que o aumento da coroa amplia a concentração de tensões no tecido ósseo/implante, aumentando o deslocamento no tecido ósseo, principalmente sob carga oblíqua.

The purpose of this study was to assess the influence of the crown height of external hexagon implants on the displacement and distribution of stress to the implant/bone system, using the three-dimensional finite element method. The InVesalius and Rhinoceros 4.0 softwares were used to generate the bone model by computed tomography. Each model was composed of a bone block with one implant (3.75x10.0 mm) with external hexagon connections and crowns with 10 mm, 12.5 mm and 15 mm in height. A 200 N axial and a 100 N oblique (45°) load were applied. The models were solved by the NeiNastran 9.0 and Femap 10.0 softwares to obtain the results that were visualized by maps of displacement, von Mises stress (crown/implant) and maximum principal stress (bone). The crown height under axial load did not influence the stress displacement and concentration, while the oblique loading increased these factors. The highest stress was observed in the neck of the implant screw on the side opposite to the loading. This stress was also transferred to the crown/platform/bone interface. The results of this study suggest that the increase in crown height enhanced stress concentration at the implant/bone tissue and increased displacement in the bone tissue, mainly under oblique loading.

The use of ocular prostheses for ophthalmic patients aims to rebuild facial aesthetics and provide an artificial substitute to the visual organ. Natural intemperate conditions promote discoloration of artificial irides and many studies have attempted to produce irides with greater chromatic paint durability using different paint materials. OBJECTIVES: The present study evaluated the color stability of artificial irides obtained with two techniques (oil painting and digital image) and submitted to microwave polymerization. MATERIAL AND METHODS: Forty samples were fabricated simulating ocular prostheses. each sample was constituted by one disc of acrylic resin N1 and one disc of colorless acrylic resin with the iris interposed between the discs. The irides in brown and blue color were obtained by oil painting or digital image. The color stability was determined by a reflection spectrophotometer and measurements were taken before and after microwave polymerization. Statistical analysis of the techniques for reproducing artificial irides was performed by applying the normal data distribution test followed by 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Chromatic alterations occurred in all specimens and statistically significant differences were observed between the oil-painted samples and those obtained by digital imaging. There was no statistical difference between the brown and blue colors. Independently of technique, all samples suffered color alterations after microwave polymerization. CONCLUSION: The digital imaging technique for reproducing irides presented better color stability after microwave polymerization.

Actualmente el uso de prótesis sobre implantes se incrementó gradualmente desde el descubrimiento de la oseointegración. La indicación inicial de los implantes fue para pacientes edéntulos totales extendiéndose después para pacientes parcialmente edéntulos. Las alternativas de retención de las piezas protésicas van desde las prótesis atornilladas hasta las prótesis cementadas o por preparación de los pilares de la forma convencional. Las prótesis cementadas sobre implantes se utilizan frecuentemente en los casos donde la inclinación de los implantes imposibilita la confección de prótesis atornilladas, debido a la salida de los tornillos de fijación por vestibular o entre los espacios interdentales comprometiendo la estética, y la resistencia cuando están localizados en las cúspides oclusales de los dientes posteriores. En ese sentido, la confección de "copings" en los pilares preparados, puede tornar el tratamiento en un proceso más rápido y seguro. No obstante, pueden surgir problemas en el momento de la instalación, debido a que el intermediario puede asumir diversas posiciones en relación a la posición del implante dificultando la colocación de la prótesis definitiva, principalmente en situaciones clínicas con más de dos implantes. De este modo, el objetivo de este trabajo fue mostrar una técnica del uso de una guía para posicionamiento de los pilares protésicos en prótesis fija cementada sobre implantes, por medio de la descripción de un caso clínico.

Nowadays, the use of implant-retained prostheses has been increasing progressively since the advent of the osseointegration. The basic indication was in total edentulous patients and it was also enlarged for partially edentulous patients. Alternatives of retention could be from screw-retained implant prostheses, cement-retained implant prostheses or conventional preparations. Cement-retained implant prostheses are used frequently when the implant inclination don't allow the use of screw-retained prostheses because the screw emerge in vestibular surface or the interdental space resulting in an unaesthetic appearance and when the screw emerge on the top of the posterior cuspid teeth, diminishing the resistance. The confection of the copings on the abutments, turn the treatment faster and secure. Although, some complications can appear in the placement, because the abutment can take different positions in relation to the implant modifying the set of the prosthesis, mainly in clinical situations with more than two implants support. Thus, the aim of this study was demonstrated the use of guide to positioning of cement-retained implant prostheses, by means of a clinical case.

A pesquisa teve como objetivo determinar as forças de mordida de 73 indivíduos, por meio de um gnatodinamômetro. Os pacientes eram portadores de próteses parciais removíveis inferiores classes I, II ou III. A arcada antagonista era prótese, parcial removível ou fixa, ou total. Os resultados permitiram concluir que: as selas de extremidade livre, principalmente em suas posições extremas, conduziram a forças de mordida muito baixas; o envolvimento de prótese total, também, conduziu a forças de mordida baixas; o sexo masculino alcançou valores maiores que o feminino; com prótese parcial removível classe III, os dentes naturais molares e pré-molares desenvolveram valores maiores do que com classes I e II.

The purpose of this study was to determine the biting forces of individuals wearing classes I, II or III partially removable mandibular dentures. Upper jaws presented fixed bridges, classes I, II or III partially removable dentures, or complete dentures. Measurements of biting forces were obtained by a gnathodynamometer. The conclusions were: classes I and II presented low biting forces, specially far from the last abutment tooth; when the opposite arcade was a complete denture, biting forces were low; males presented higher biting forces than females; natural molars and bicuspids presented higher biting forces with class III than with classes I or II.