ABSTRACT Introduction: The cemento-ossifying fibroma is a benign bone neoplasm that affects mainly the female sex during the third or fourth decades of life. This lesion has a slow growth and the treatment is the surgical removal of the tumor, because radiotherapy is not indicated. Objective: to describe and discuss a case of central cemento-ossifying fibroma. Case report: A 41-year-old female patient sought dental treatment due to tooth mobility in the anterior region of the mandible. In this region of the mandible, an increase in volume was noted with a firm consistency on palpation, covered by normal mucosa, and displacement of teeth. Radiographically, the presence of an extensive lesion in this region was observed. An incisional biopsy was performed which led to the final diagnosis of central cemento-ossifying fibroma. Subsequently the tumor was completely removed. An autogenous bone graft was performed and four osseointegrated implants were installed to rehabilitate the patient. Implant-supported prostheses (lower arch) and a complete denture (upper arch) were installed to restore esthetics and function of the patient's oral cavity. Conclusion: Despite being a benign tumor, the central cemento-ossifying fibroma caused functional and aesthetic damage to the patient and required a complex rehabilitation treatment. After approximately 5 years of tumor removal, there was no recurrence of the lesion or signs of peri-implant or periodontal diseases, evidencing the success of the treatments.

RESUMEN Introducción: El fibroma cemento-osificante es una neoplasia ósea benigna que afecta principalmente al sexo femenino durante la tercera o cuarta décadas de la vida. Esta lesión tiene un crecimiento lento y el tratamiento es la extirpación quirúrgica del tumor, porque la radioterapia no está indicada. Objetivo: Describir y analizar un caso de un fibroma cemento-osificante central. Presentación caso: Paciente de 41 años de edad buscó tratamiento dental debido a la movilidad dental en la región anterior de la mandíbula. En esta región de la mandíbula se observó un aumento de volumen con una consistencia firme a la palpación, cubierta por la mucosa normal y desplazamiento de los dientes. Radiográficamente, se observó la presencia de una lesión extensa en esta región. Se realizó una biopsia incisional, que indicó el diagnóstico final del fibroma cemento-osificante central. Después el tumor fue completamente extirpado. Se realizó un injerto óseo autógeno y, posteriormente, se instalaron cuatro implantes osteointegrados para rehabilitar al paciente. Se instalaron prótesis soportadas por implantes (arco inferior) y una dentadura (arco superior) para restablecer la estética y la función de la cavidad bucal de la paciente. Conclusiones: A pesar de ser un tumor benigno, el fibroma cemento-osificante central causó daños funcionales y estéticos al paciente y requirió un complejo tratamiento de rehabilitación. Después de 5 años de la extirpación del tumor, no hubo recurrencia de la lesión. Además, no hubo signos de enfermedades periimplantarias y/o periodontales, lo que demuestra el éxito del tratamiento.

The objective of the present case report was to describe the aesthetic and functional rehabilitation of the upper anterior incisors of a patient with bruxism. A 23-year-old male patient, with bruxism, sought treatment for his upper anterior teeth due to diastemas and reduced lengths of the upper central incisors. The gingivoplasty and osteotomy were performed in the region of the upper central incisors to improve the positions of the gingival contours and increase the length of these teeth. After 90 days, teeth whitening was performed. After 1 month the composite resin veneers were made in the upper central incisors. During treatment, the needs and perspectives of the patient were considered to achieve clinical success. The treatments were finalized, and the final result was satisfactory. Therefore, an integrated treatment plan proved to be extremely important, especially when the patient is adequately informed of the available treatment options and collaborates with the treatment.

O objetivo do presente relato de caso clínico foi descrever a reabilitação estética e funcional dos incisivos anteriores superiores de um paciente com bruxismo. Paciente do gênero masculino, 23 anos de idade, bruxoma, procurou tratamento para os dentes anteriores superiores devido aos diastemas dentários e também por causa dos comprimentos reduzidos dos incisivos centrais superiores. Para isso, foi realizada a gengivoplastia e osteotomia na região dos incisivos centrais superiores com o objetivo de melhorar as posições dos contornos gengivais e aumentar o comprimento desses dentes. Após 90 dias, o clareamento dentário foi realizado. Depois de 1 mês as facetas de resina composta foram confeccionadas nos incisivos centrais superiores. Durante o tratamento as necessidades e perspectivas do paciente foram levadas em consideração para alcançar o sucesso clínico. Após a conclusão dos procedimentos, o resultado final foi satisfatório. Portanto, um plano de tratamento integrado se mostrou de extrema valia, principalmente quando o paciente é devidamente esclarecido das opções disponíveis de tratamento e colabora com o mesmo.

Resumo Introdução A utilização de fio de afastamento gengival com uma substância de afastamento gengival é um procedimento comum para se realizar uma moldagem com qualidade do término cervical em dentes com finalidade protética. Objetivo Avaliar se o método mecânico-químico com cloridrato de tetrizolina a 0,05% ou cloreto de alumínio a 25% são capazes de reduzir o fluido crevicular e afastar o tecido gengival verticalmente em uma quantidade maior, estatisticamente significante, em comparação com o método mecânico de afastamento (sem substâncias químicas). Material e método Dez pacientes foram selecionados, e os fios Ultrapak n° 000 e 1 foram posicionamos de maneira randomizada nos dentes 13, 21 e 23. Grupo I: fio sem substância química; Grupo II: fio impregnado com cloridrato de tetrizolina; Grupo III: fio impregnado com cloreto de alumínio. Utilizando modelos de gesso, foram capturadas trinta imagens com uma câmera acoplada a uma lupa, para análise do grau de afastamento. O fluxo crevicular foi quantificado através de uma balança de alta precisão, a partir de tiras de papel absorvente personalizadas para cada dente que recebeu afastamento gengival. Resultado Não houve diferença estatística entre os três grupos quanto a quantidade de afastamento gengival vertical (Anova, p=0,26). Quanto a redução de fluido crevicular, não houve diferença entre os grupos teste e controle (Wilcoxon e Friedman, p < 0,05). Conclusão A utilização do cloridrato de tetrizolina ou cloreto de alumínio em fio de afastamento gengival não melhorou a quantidade de afastamento vertical da gengiva e não reduziu a quantidade de fluido crevicular.

Abstract Introduction The use of a gingival displacement cord with a gingival displacement substance is a common procedure for taking a quality impression of the cervical terminal in teeth for prosthetic purposes. Objective To evaluate whether the mechanical-chemical method with 0.05% tetryzoline hydrochloride or 25% aluminum chloride is capable of reducing crevicular fluid, and displacing a statistically significant larger quantity of gingival tissue vertically, compared with the mechanical method (without chemical substances). Material and method Ten patients were selected, and then No. 000 and 1 Ultrapak cords were randomly positioned on teeth 13, 21 and 23. Group I – cord with no chemical substance; Group II – cords impregnated with tetryzoline hydrochloride and Group III – cords impregnated with aluminum chloride. Using dental stone models, thirty images were captured with a camera coupled to a loupe to analyze the degree of gingival displacement. Crevicular fluid was quantified using a high-precision scale and individualized strips of absorbent paper for each tooth on which gingival displacement was performed. Result There was no statistical difference between the three groups relative to the amount of vertical gingival displacement (Anova, p=0.26). As regards reduction in crevicular fluid, there was no difference between the test and control groups (Wilcoxon and Friedman, p < 0.05). Conclusion The use of tetryzoline hydrochloride or aluminum chloride to impregnate the gingival displacement cord did not improve the quantity of vertical gingival displacement and did not reduce the amount of crevicular fluid.

The mucosa-supported implant-retained overdentures are effective for rehabilitation of edentulous patients, a less invasive and less expensive alternative compared to fixed prostheses. This paper aims to show a clinical case of a 65-year-old patient, female, toothless, that presented with 03 implants in the anterior region of mandible. The proposal rehabilitative therapy combined maxillary conventional denture and overdenture mandibular clip bar. It is concluded that the prosthetic pieces made were effective in achieving clinical success expected by the patient. The analysis and planning of each clinical stage of each case, it is essential to obtain the best possible result.

As overdentures implanto-retidas mucosa-suportadas são eficazes para reabilitação de pacientes edêntulos, sendo uma alternativa menos invasiva e menos onerosa em comparação as próteses fixas. O presente trabalho objetiva mostrar um caso clínico, de uma paciente de 65 anos, gênero feminino, desdentada, que se apresentou com 03 implantes na região anterior de mandíbula. A terapia reabilitadora proposta combinou uma prótese total convencional maxilar e um overdenture barra-clip mandibular. Conclui-se que as peças protéticas confeccionadas foram eficazes para alcançar o sucesso clinico esperado pela paciente. A análise e o planejamento de cada etapa clínica de cada caso, é fundamental para obtenção do melhor resultado possível.

In the present study, two types of tests (tensile strength test and polymerization inhibition test) were performed to evaluate the physical and chemical properties of four impression materials [a polysulfide (Permlastic), a polyether (Impregum), a condensation silicone (Xantopren) and a polyvinylsiloxane (Aquasil),3; when polymerized in contact with of one conventional (Hemostop) and two experimental (Vislin and Afrin) gingival retraction solutions. For the tensile strength test, the impression materials were mixed and packed into a steel plate with perforations that had residues of the gingival retraction solutions. After polymerization, the specimens were tested in tensile strength in a universal testing machine. For the polymerization inhibition test, specimens were obtained after taking impressions from a matrix with perforations that contained 1 drop of the gingival retraction solutions. Two independent examiners decided on whether or not impression material remnants remained unpolymerized, indicating interference of the chemical solutions. Based on the analysis of the results of both tests, the following conclusions were reached: 1. The tensile strength of the polysulfide decreased after contact with Hemostop and Afrin. 2. None of the chemical solutions inhibited the polymerization of the polysulfide; 3. The polyether presented lower tensile strength after polymerization in contact with the three gingival retraction agents; 4. The polyether had its polymerization inhibited only by Hemostop; 5. None of the chemical solutions affected the tensile strength of the condensation silicone; 6. Only Hemostop inhibited the polymerization of the condensation silicone; 7. The polyvinylsiloxane specimens polymerized in contact with Hemostop had significantly lower tensile strength; 8. Neither of the chemical solutions (Afrin and Vislin) affected the tensile strength of the polyvinylsiloxane and the condensation silicone; 9. Results of the tensile strength and polymerization inhibition tests suggest that Vislin can be used as substance of gingival retraction without affecting the tested properties of four impression materials.