RESUMO Objetivo: O estudo e a adoção de medidas preventivas odontológicas, em resposta à pandemia do COVID-19, são necessárias para evitar infecções cruzadas entre profissionais e pacientes. O objetivo desta revisão integrativa foi identificar as práticas preventivas do COVID-19 em odontologia. Métodos: A busca eletrônica foi realizada nas seguintes bases de dados: Pubmed / Medline, Web of Science, Cochrane Library, Scopus, LILACS e Scielo, utilizando os seguintes descritores e / ou palavras: “Coronavirus disease 2019”; “Coronavirus 2019”; “Covid-19”; “2019-ncov”; “Sars-cov2”; “Dental practice”; “Dental care”; “Dentistry”; “Dental medicine” and “Oral medicine”. O PRISMA foi utilizado como referência para sua realização. Resultados: Um total de 11 estudos foram incluídos e as medidas preventivas contra COVID-19 foram baseadas em diretrizes dos órgãos de saúde e consistiram em: realizar apenas tratamentos de emergência; reagendar pacientes com suspeita de doença; lavar as mãos; desinfetar superfícies com álcool a 70%; testar profissionais de odontologia para a doença; usar a máscara N95; jalecos descartáveis e protetores faciais. As crianças, além das medidas mencionadas acima, devem rotineiramente beber muita água e receber dietas saudáveis. Nenhum estudo avaliou a eficácia e a efetividade dessas medidas preventivas. Faltam evidências científicas sobre os protocolos preventivos adotados contra o COVID-19 em odontologia, uma vez que medidas preventivas são recomendadas pelos órgãos de saúde. Conclusão: Consequentemente, recomenda-se aos profissionais que sigam essas organizações até que sejam estabelecidos protocolos preventivos eficazes e eficientes, adaptados à odontologia.

ABSTRACT Objective: The study and enactment of dental preventive measures, in response to the COVID-19 pandemic, are necessary to prevent cross-infections between professionals and patients. The objective of this integrative review was to identify the COVID-19 preventive practices in dentistry. Methods: The electronic search was conducted on these databases: Pubmed / Medline, Web of Science, Cochrane Library, Scopus, LILACS and Scielo, using the following descriptors and / or words: “Coronavirus disease 2019”; “Coronavirus 2019”; “Covid-19”; “2019-ncov”; “Sars-cov2”; “Dental practice”; “Dental care”; “Dentistry”; “Dental medicine” and “Oral medicine”. PRISMA was used as a reference for designing it. Results: A total of 11 articles were included and the preventive measures against COVID-19 were based on guidelines from health agencies and consisted of: perform only emergency treatments; reschedule patients with suspected disease; hand washing; disinfection of surfaces with 70% alcohol; testing dental professionals for the disease; use the N95 mask; disposable lab coats, and face shields. Children, in addition to the measures mentioned above, should routinely drink a lot of water and be provided with healthy diets. No study has evaluated the efficacy and effectiveness of these measures. There is a lack of scientific evidence on the preventive protocols adopted against COVID-19 in dentistry since preventive measures are recommended by health agencies. Conclusion: Consequently, professionals are recommended to follow the guidelines by these organizations until effective and efficient preventive protocols tailored to dentistry are established.

RESUMO Objetivo Avaliar a influência do tratamento térmico do silano na resistência de união entre dois cimentos resinosos e uma cerâmica feldspática CAD/CAM. Métodos Quarenta blocos cerâmicos foram duplicados em resina micro-híbrida. Todas as cerâmicas foram condicionadas com ácido fluorídrico 10% por 20 s e receberam aplicação do silano. Os blocos foram randomizados em oito grupos (n = 5): P-Panavia F; PAg- Panavia F + Envelhecimento; HP-Tratamento térmico + Panavia F;HPAg-Tratamento térmico + Panavia F + Envelhecimento; R-RelyX ARC; RAg-RelyX ARC; HR-Tratamento térmico + RelyX ARC; HRAg - Tratamento térmico + RelyX ARC + Envelhecimento. O tratamento térmico foi realizado em forno a 100 °C durante2 min. Todos os blocos foram cimentados e cortados para obter amostras para microtração. Foram feitos 10000 ciclos térmicos. As amostras foram submetidas a teste de micro-tração. Resultados O teste ANOVA revelou uma interação significativa entre cimento/tratamento térmico (p=0,001) e tratamento térmico/ciclo térmico (p=0,001). Conclusão Dessa maneira, o tratamentotérmico do silano a 100ºC por 2 minutos foi capaz de aumentar a resistência de união entre o cimento resinoso e uma cerâmica feldspática mesmo após o envelhecimento.

ABSTRACT Objective Evaluate the influence of silane heat treatment in bond durability between two resin cements and CAD/CAM feldspathic ceramic. Methods 40 feldspathic ceramic blocks were obtained, and were duplicated in microhybrid composite. All ceramic blocks were etched with 10% hydrofluoric acid for 20 s and received application of silane agent. The blocks were randomizedinto eight groups (n=5) according to the surface treatments and luting agents: P- Panavia F; PAg- Panavia F + Aging; HP- Heat Treatment + Panavia F; HPAg- Heat Treatment + Panavia F + Aging; R- RelyX ARC; Rag- RelyX ARC + Aging; HR- Heat Treatment + RelyX ARC; HRAg- Heat Treatment + RelyX ARC + Aging. The heat treatment was performed in furnace at 100 °C for 2 min. All blocks were cemented and cut to obtain samples with adhesive area of 1 mm2. Aging was performed with 10000 thermal cycles. The samples were subjected to microtensile bond strength test. Results The three-way ANOVA test revealed a significant interaction between cement versus heat treatment (p=0.001) and heat treatment versus thermal cycling (p=0.001) indicating that there was a change in bond strength due to surface treatment and aging. Conclusion Therefore, the heat treatment of the silane at 100 ºC for 2 minutes obtained higher values of bond strength between the resin cement and a feldspathic ceramicafter aging.

Abstract This paper aims to evaluate the effect of different surface treatments on surface topography, wettability, and shear bond strength of resin cement to glass ceramic. Methodology: For SBS test, 32 blocks (7x7x2 mm) of lithium disilicate were obtained and randomly divided into eight groups (four blocks per group) according to each surface treatment (HF 20 s, 60 s, 120 s + silanization/S or Scotch Bond Universal/ SBU) and the Monobond Etch & Prime - MEP application followed or not by SBU. On each treated surface ceramic block, up to four dual-curing resin cement cylinders were prepared and light-cured for 40s (N=120/n=15). The specimens were thermocycled (10,000 cycles, 5-55°C, 30 s) and the SBS test (50KgF, 0.5 mm/min) was performed. Furthermore, failure analysis, wettability, AFM, and SEM were carried out. SBS data (MPa) were analyzed using Student's t-test, two-way ANOVA, Tukey's test (5%) and Weibull's analysis. Results: For HF experimental groups, two-way ANOVA presented the factors “etching time” and “bonding agent” as significant (p<0.05). After silane application, the HF groups presented similar bond strength. SBU application compromised the SBS, except for 120s etching time (HF120sS: 23.39ᵃ±6.48 MPa; HF120sSBU: 18.76ᵃ±8.81MPa). For MEP groups, SBU application did not significantly affect the results (p=0.41). The MEP group presented the highest Weibull modulus (4.08A) and they were statistically different exclusively from the HF20sSBU (0.58B). Conclusion: The HF 20s, 60s, 120 s followed by silane, promoted similar resin-bond strength to ceramic and the SBU application after HF or MEP did not increase the SBS.

Resumo Objetivo: Objetivou-se identificar os fatores associados à multimorbidade em idosos por meio de uma revisão integrativa da literatura. Método: Foram utilizadas as bases de dados “Cochrane Library”, “MEDLINE”, “Web of Science”, “Scopus” e “LILACS”. Também foram utilizados a biblioteca virtual “Scielo” e o buscador eletrônico “Google Acadêmico”. Empregaram--se os seguintes termos para as buscas: “multimorbidity”; “multi-morbidity”; “comorbidity”; “multiple diseases”; “elderly”; “major adults”, “older people”, “older persons”, “aged”, “associated factors”, “correlated factors”, “socioeconomic factors” e “demographic factors”. Os critérios de inclusão consistiram em: estudos transversais ou longitudinais que tinham como objeto de estudo a população idosa com multimorbidade. Foram excluídos os estudos em que a multimorbidade não foi a variável dependente. Resultados: Um total de sete artigos foi incluído nesta revisão. Observou-se uma prevalência variando de 30,7% a 57,0% de multimorbidade em idosos. Os fatores associados foram o ato de fumar, consumo de álcool, morar em áreas rurais, baixa escolaridade, sexo feminino, idosos mais envelhecidos e não morar com crianças. Para a maioria dos artigos, uma renda familiar baixa também se mostrou associada à multimorbidade. Conclusão: Os resultados sugerem que a multimorbidade em idosos é uma condição comum e que ela tem sido influenciada por fatores socioeconômicos, demográficos, estilo de vida e estrutura familiar.

Abstract Objective: The objective of the present study was to identify factors associated with multimorbidity in the elderly through an integrative literature review. Method: The “Cochrane Library”, “MEDLINE”, “Web of Science”, “Scopus” and “LILACS” databases were used, as well as the “SciELO” virtual library and the electronic search engine “Google Academic”. The following search terms were applied: “multimorbidity”; “multi-morbidity”; “comorbidity; “multiple diseases”; “elderly”; “major adults”, “older people”, “older persons”, “aged”, “associated factors”, “correlated factors”, “socioeconomic factors” and “demographic factors.” The inclusion criterion was that the object of the study was the elderly population with multimorbidity. Studies in which multimorbidity was not the dependent variable were excluded. Results: a total of seven articles were included in this review. A prevalence of multimorbidity in the elderly ranging from 30.7% to 57% was found. The associated factors were smoking, alcohol consumption, lived in rural areas, low levels of schooling, the female gender, older elderly persons and not living with children. In the majority of articles a low level of family income was also associated with multimorbidity. Conclusion: The results suggest that multimorbidity in the elderly is a common condition and that it is influenced by socioeconomic and demographic factors, lifestyle and family structure.

RESUMO Este é um relato de caso de reabilitação estética anterior com facetas laminadas dos elementos 14 ao 24 confeccionadas com a cerâmica IPSE.max Ceram (Ivoclar -Vivadent), as quais substituíram facetas de resina composta insatisfatórias dos elementos 13 ao 23. Ressalta-se que o paciente possuía agenesia dos elementos 12 e 22, tornando-se necessária a reanatomização dos dentesanteriores. Inicialmente ocorreu o planejamento digital, seguido pelo enceramento diagnóstico. Foi realizado em consulta única: cirurgia periodontal pela técnica “flapless” para conquista de espaço protético; confecção dos preparos para facetas; moldagem com silicona de adição; e confecção de múltiplos provisórios em resina bisacrilica. Na consulta de cimentação, as peças foram tratadas comácido fluorídrico 5% por 20s; silanizadas com Relyxceramic primer (3M ESPE), submetidas ao tratamento térmico; e banho ultrassônico. O sistema adesivo utilizado foi o Single Bond (3M ESPE) associado ao RelyxVenner (3M ESPE). Imediatamente a cimentação foi realizado um ajuste oclusal. Após 14 dias o paciente retornou para uma nova consulta de acompanhamento, na qual foi realizada mais um ajuste oclusal, e relatou total satisfação com o tratamento realizado.

ABSTRACT This article had the objective of reporting a case of aesthetic rehabilitation with laminated facets from the 14 to the 24 teeth made with IPS E.max Ceram ceramics (Ivoclar-Vivadent), which replaced previous unsatisfactory composite resin restorations in the anterior region. The patient had agenesis of 12 and 22 teeth, making it necessary to anatomize the anterior teeth. A digital smile design was first virtually created and then followed by a diagnostic wax-up. The following was performed in a single day: periodontal surgery using the flapless technique to achieve prosthetic space; teeth preparation; an additionalsilicone impression; and multiple provisional restorations of bis-acryl composite resins were fabricated. Fourteen days later, in the second session the ceramic veneers were etched with 5% hydrofluoric acid for 20s; they received a silane application and a silane heat treatment, then lastly an ultrasonic bath. A universal adhesive was used in combination with a light curing cement.Cementation was performed immediately following an occlusal adjustment. The patient returned for a follow-up appointment another fourteen days after the luting process, in which a further occlusal adjustment was performed, and he reported complete satisfaction with the treatment.

Abstract: The objective of this study was to evaluate the effect of the hydrofluoridric acid (HF) concentration and time of acid conditioning on bond strength of three glass ceramics to a resin cement. Thus, fifty blocks (10 mm x 5 mm x 2 mm) of each ceramic (LDCAD: IPS e.max CAD; LCAD: IPS Empress CAD and LDHP: IPS e.max Press) were made and embedded in acrylic resin. The surfaces were polished with sandpaper (#600, 800, 1000, and 1200 grits) and blocks were randomly divided into 15 groups (n = 10) according to the following factors: Concentration of HF (10% and 5%), conditioning time (20 s and 60 s) and ceramic (LDCAD, LDHP, and L). After conditioning, silane (Prosil / FGM) was applied and after 2 min, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block using a Teflon strip as matrix and light cured for 40 s (1,200 mW/cm2). Then, the samples were thermocycled (10,000 cycles, 5/55°C, 30s) and submitted to the shear bond test (50 KgF, 0.5 mm/min). The data (MPa) were analyzed with 3-way ANOVA and Tukey's test (5%). Failure analysis was performed using a stereomicroscope (20x) and a scanning electron microscope (SEM). ANOVA revealed that the “concentration” factor (p = 0.01) and the interaction “acid concentration X ceramic” (p = 0.009) had a significant effect, however, the “ceramic” (p = 0.897) and “conditioning time” (p = 0.260) factors did not influence the results. The LDHP10%60s (10.98 MPa)aA* group presented significantly higher bond strength than LDHP10%20s (6.57 MPa)bA, LCAD5%20s (6,90 ±3,5)aB and LDHP5%60s (5.66 ± 2,9MPa)aA* groups (Tukey). Failure analysis revealed that 100% of specimens had mixed failure. In conclusion, etching with 5% HF for 20 seconds is recommended for lithium disilicate and leucite-reinforced CAD/CAM ceramics. However, for pressed lithium disilicate ceramic, 10% HF for 60 s showed significantly higher bond strength to resin cement.

Resumo Introdução Apesar de ser uma das cerâmicas mais estudadas atualmente, a zircônia ainda não possui um protocolo bem definido para uma cimentação adesiva. Objetivo Avaliar a influência de diferentes tempos de condicionamento e concentrações do ácido fluorídrico (AF) na superfície da zirconia e na resistência de união entre uma cerâmica Y-TZP vitrificada e um cimento resinoso. Material e método Os tratamentos de superfície foram: jateamento com óxido de alumínio revestido com sílica (Co); aplicação de glaze + condicionamento com AF 5% por 5s (G5-5s), 10s (G5-10s) ou 20s (G5-20s); aplicação de glaze + condicionamento com AF 10% por 5s (G10-5s), 10 (G10-10s) ou 20s (G10-20s). Em seguida, cilindros de cimento (3,3 × 3,3mm) para teste de cisalhamento foram feitos em todos os espécimes. Os espécimes foram submetidos a 6000 ciclos térmicos antes do teste de adesão. As fraturas foram analisadas por estereomicroscópio. Os dados foram analisados estatisticamente por Kruskal-Wallis e Dunn (5%). Amostras extra de cada grupo foram feitas para realização de perfilometria e microscopia eletrônica de varredura (MEV). Resultado A resistência de união zircônia-cimento foi afetada pelos tratamentos de superfície (p = 0,001). Os grupos G10-5s (2,71 MPa) registraram os maiores valores de resistência de união, seguidos pelos Co (2,05 MPa), enquanto os grupos G5 apresentaram o menor valor de união. Falhas adesivas foram predominantes. As análises por imagem revelaram que os grupos G5 parecem ser menos rugosos quando comparados aos grupos tratados com AF 10%. A criação de poros na superfície vítrea (glaze) ocorreu apenas quando foi utilizado AF 10%. Conclusão A aplicação de camada de vidro de porcelana de baixa fusão foi capaz de superar o jateamento e obter uma maior adesão adesiva ao cimento resinoso, no entanto, somente quando foi utilizado 10% de HF por um intervalo de 5 segundos.

Abstract Introduction Despite being one of the most studied ceramics today, zirconia still does not have a well-defined adhesion protocol. Objective Evaluate the influence of different etching times and hydrofluoric acid (HF) concentrations on the zirconia surface and bond strength between a vitrified Y-TZP ceramic and a resin cement. Materials and method The zirconia surface treatments were: sandblasting with silica-coated alumina (Co); glaze application + 5% HF etching for 5s (G5-5s), 10s (G5-10s) or 20s (G5-20s); glaze application + 10% HF etching for 5s (G10-5s), 10 (G10-10s) or 20s (G10-20s) . Then, cement cylinders (3.3 × 3.3 mm) were built up for shear bond test on all specimens. The specimens were subjected to 6000 thermal cycling before the test. Fractures were analyzed by stereomicroscope. Data were statistically analyzed by Kruskal-Wallis and Dunn statistical tests (5%). Extra samples of each group were made to obtain profilometry and scanning electron microscopy (SEM). Result Zirconia-cement bond strength was affected by the ceramic surface treatments (p = 0.001). G10-5s (2.71 MPa) recorded the highest bond strength values, followed by the Co (2.05 MPa) while G5 groups had the lowest bond value. Adhesive failure of the samples predominated. The image analysis revealed G5 groups seem to have a lower roughness when compared to groups treated by 10% HF. The creation of pores in the low-fusing porcelain glass layer surface occurred only when 10% HF was used. Conclusion The low-fusing porcelain glass layer application was able to overcome the sandblasting and obtain a greater adhesive bond to the resinous cement, however, only when 10% HF was used for an interval of 5 seconds.

Abstract To evaluate the effect of different surface treatments on the marginal misfit and retentive strength between Y-TZP crowns and an epoxy resin. Forty (40) epoxy resin (G10) abutments (height: 5mm, conicity: 60, finish line: large chamfer) with equal dimensions were milled and included in polyurethane to simulate the periodontal ligament. Next, 40 Y-TZP crowns (thickness: 1mm) were milled (Cerec in Lab) and randomly divided into four groups (n=10) according to the surface treatment: GS(glaze spray), GP(glaze powder/liquid), P(zirconia primer) and RS(tribochemical silica coating). The conditioned surfaces were cemented with dual self-adhesive cement, light cured and submitted to thermomechanical cycling (2x106, 100N, 4Hz, 5°/55°C). Marginal misfit was analyzed by a stereomicroscope and SEM. Retentive strength test was performed (1mm/min) until crown debonding. Glaze layer thickness was also performed to GS and GP groups. Marginal misfit data were analyzed by Kruskal Wallis and Dunn tests; one-way ANOVA and Tukey (5%) analyzed the tensile strength data. The marginal misfit of the GS (48.6±19.9μm) and GP (65.4±42.5μm) were statistically lower than the RS (96±62.9μm) and P (156±113.3μm) (p=0.001). The retentive strength of the GP (470.5±104.1N) and GS (416.8±170.2N) were similar to the P (342.1±109.7N), but statistically higher than those of the RS (208.9±110N). The GS and GP glaze layer was 11.64μm and 9.73μm respectively. Thus, glaze application promoted lower marginal discrepancy and higher retentive strength values than conventional techniques.

Este estudo avaliou o efeito de diferentes formas de tratamento térmico de um silano pré-hidrolisado na adesão de um cimento resinoso à base de monómeros fosfatados (MDP) à uma cerâmica vítrea. Blocos em resina e cerâmica feldspática (n=48, n=6 para teste de união, n=2 para microscopia) foram divididos aleatoriamente em 4 grupos e submetidos a tratamentos de superfície: G1-ácido fluorídrico (HF) 9,6% por 20 s + Silano + cimento resinoso com MDP (Panavia F) ; G2-HF 9,6% por 20 s + Silano + Tratamento Térmico (forno) + Panavia F; G3-Silano + Tratamento Térmico (forno) + Panavia F; G4-HF 9,6% por 20 s + Silano + Tratamento Térmico (ar quente) + Panavia F; G5-Silano + Tratamento Térmico (ar quente) + Panavia F; G6-Silano + Panavia F. Teste de microtração (MTBS) foi realizado utilizando máquina de ensaios universal (1 mm/min). Após o descolamento, substrato e superfícies aderentes foram analisadas utilizando estereoscópico e microscópio eletrônica de varredura (MEV) para classificação dos tipos de falha. Os dados foram analisados estatisticamente utilizando o teste ANOVA dois fatores e o teste de Tukey (=0,05). O tratamento térmico do silano contendo MDP, com condicionamento prévio com HF (G2:13,15±0,89a e G4:12,58±1,03a) resultou em valores de resistência de união significativamente superiores aos do grupo controle (G1:9,16±0,64b). Os grupos sem condicionamento prévio (G3:10,47±0,70b e G5:9,47±0,32b), apresentaram valores de resistência de união estatisticamente semelhantes entre eles e ao controle (G1). O silano utilizado sem condicionamento prévio e tratamento térmico apresentou os menores valores de resistência de união (G6:8,05±0,37c). As análises em MEV mostraram predominância de falhas adesivas e as análises em EDS demonstraram espectros com elementos semelhantes (Si, Na, Al, K, O, C) caracterizando a microsestrutura da vitro-cerâmica estudada. O tratamento térmico do silano pré-hidrolisado contendo MDP, realizado em forno a 100 °C durante 2 min ou com ar quente a 50±5 °C durante 1 min, foi eficaz no aumento dos valores de união entre cimento resinoso contendo MDP e cerâmica.

This study evaluated the influence of different forms of heat treatment on a pre-hydrolyzed silane to improve the adhesion of phosphate monomer-based (MDP) resin cement to glass ceramic. Resin and feldspathic ceramic blocks (n=48, n=6 for bond test, n=2 for microscopy) were randomly divided into 6 groups and subject to surface treatments: G1: Hydrofluoric acid (HF) 9.6% for 20 s + Silane + MDP resin cement (Panavia F); G2: HF 9.6% for 20 s + Silane + Heat Treatment (oven) + Panavia F; G3: Silane + Heat Treatment (oven) + Panavia F; G4: HF 9.6% for 20 s + Silane + Heat Treatment (hot air) + Panavia F; G5: Silane + Heat Treatment (hot air) + Panavia F; G6: Silane + Panavia F. Microtensile bond strength (MTBS) test was performed using a universal testing machine (1 mm/min). After debonding, the substrate and adherent surfaces were analyzed using stereomicroscope and scanning electron microscope (SEM) to categorize the failure types. Data were analyzed statistically using two-way test ANOVA and Tukey's test (=0.05). Heat treatment of the silane containing MDP, with prior etching with HF (G2: 13.15±0.89a; G4: 12.58±1.03a) presented significantly higher bond strength values than the control group (G1: 9.16±0.64b). The groups without prior etching (G3: 10.47±0.70b; G5: 9.47±0.32b) showed statistically similar bond strength values between them and the control group (G1). The silane application without prior etching and heat treatment resulted in the lowest mean bond strength (G6: 8.05±0.37c). SEM analysis showed predominantly adhesive failures and EDS analysis showed common elements of spectra (Si, Na, Al, K, O, C) characterizing the microstructure of the glass-ceramic studied. Heat treatment of the pre-hydrolyzed silane containing MDP in an oven at 100 °C for 2 min or with hot air application at 50±5 ºC for 1 min, was effective in increasing the bond strength values between the ceramic and resin cement containing MDP.

Dental ceramics are known for their excellence in the artificial reproduction of natural teeth. Clinical cases with severe marked discoloration in the anterior region, need of crown replacement or extensive restorations associated to a redefinition and length of the teeth, are successfully treated with new ceramic systems such as IPS system e. Max. The system is based on glass-reinforced ceramic lithium disilicate crystals (6065%). This article describes a case of a 47 year old woman with four full crowns made with IPS e.max ceramic system is reported. The final result shows a natural and functional aesthetic with excellent optical properties, which are particular to the ceramic system used. In conclusion the IPS e.max ceramic system is a versatile system in addition to currently becoming an excellent alternative for restoration systems, both aesthetically and functionally, achieving an excellent balance between the patient's smile and aesthetic restorations.

Las cerámicas dentales son conocidas por su excelencia en reproducir artificialmente los dientes naturales. Casos clínicos más severos en el sector anterior, con acentuada alteración del color, necesidad de substitución de coronas o amplias restauraciones, asociado a una redefinición y largura de los dientes, son solucionadas satisfactoriamente a través de los nuevos sistemas cerámicos como lo sistema IPS e.Max. Este sistema es basado en una cerámica vítrea reforzada con cristales de disilicato de litio (6065%). En este artículo sereporta un caso deunapaciente de 47 años de edadque se realizaron cuatro coronas totales con el sistema cerámico IPS e.Max. El resultado final muestra una estética natural y funcional, con óptimas propiedades ópticas, que son peculiares al sistema cerámico empleado. La conclusión es que el sistema cerámico IPS e.Max es un sistema muy versátil, además de convertirse actualmente en una excelente alternativa como sistema de restauración, tanto estética como funcionalmente, consiguiendo una excelente armonía entre la sonrisa del paciente y la estética de las restauraciones.

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p ≤ 0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p = 0.042), clinical stage (p = 0.007) and performance status (p = 0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

O objetivo deste estudo foi avaliar o efeito da ciclagem térmica sobre a resistência de adesão entre a superfície da cerâmica In-Ceram Alumina (VITA) e o cimento resinoso Panavia F (Kuraray). Foram confeccionados quatro blocos de cerâmica In-Ceram com dimensões de 5x6x6mm. Uma das faces com 6x6mm de cada bloco cerâmico, após condicionamento com o sistema Cojet (ESPE-3M) (jateamento com óxido de alumínio/jateamento com óxido de sílica/ silanização) foi cimentada com Panavia F, sob peso constante de 750g, a outro bloco idêntico de resina composta Clearfil AP-X (Kuraray). Os blocos de resina foram obtidos por meio de duplicação daqueles de cerâmica a partir de moldes com silicona de adição Express (3M). Os quatro conjuntos formados por cerâmica, cimento e resina foram seccionados em 20 corpos-de-prova com forma de palitos, de modo que a região adesiva apresentasse 1mm² de área. Dois grupos (n=10) foram constítuidos: G1- estocagem por 7 dias em água deionizada à 36 ± 2ºC; G2- 1500 ciclos entre 5ºC e 55ºC com intervalos de 30 segundos. A seguir, foi realizado o teste de microtração em máquina de ensaio universal (EMIC) com velocidade de 0,5 mm/min. Os resultados mostraram que os valores médios de tensão de ruptura (MPa) para o grupo G2: (22,815 ± 5,254) não tiveram diferenças estatisticamente significantes daqueles do grupo G1: (25,628 ± 3,353) (t= 1,427; gl = 18; p-valor = 0,171), ao nível de significância de 5%. A partir destes resultados, entendemos lícito concluir que o efeito da ciclagem térmica não produziu alterações estatisticamente significantes nos valores da resistência adesiva.

The aim of the present study was to evaluate the effect of thermocycling on the bond strength between the surface of the glass-infiltrated alumina ceramic In-Ceram (VITA) and the Panavia F resin cement (Kuraray CO.). Four 5x6x6mm In-Ceram blocks were obtained. One of the 6x6mm faces of each block was conditioned with Cojet - System (tribochemical silica coating, ESPE-3M) and then luted under a constant 750g pressure with Panavia F cement to another identical face of a resin composit block (Clearfil AP-X, Kuraray) obtained by reproduction of the ceramic one from Express (3M) addition curing silicone impressions. The four sets so formed by ceramic, luting cement and resin have been each one serially sectioned in 20 sticks so that the adhesive surface in each presented 1mm² of area. The samples were divided in 2 groups (n=10): G1- stored for 7 days in deionized water at 36 ± 2ºC; G2 - thermocycled 1500 times between 5 and 55ºC dwell times. The microtensile tests were accomplished in an universal testing machine (EMIC) at a crosshead speed of 0,5 mm/min. The results showed that the mean tensile bond strength values (MPa) for the group G2: (22,815 ± 5,254) had not statistically differ of the values of group G1: (25,628 ± 3,353) (t = 1,427; gl = 18; p-value = 0,171), at the level of a= 5%. It can be concluded that the thermocycling technique used in the present experiment had not produced statistically significant differences between the bond strength results of the specimens obtained by the two used techniques.