RESUMO A reabilitação imediata da região posterior da mandíbula com implantes dentários, amplia o conjunto de ações possíveis ao cirurgião dentista, frente as perdas dentárias. O intuito desse estudo é descrever dois casos de reabilitação unitária de molares inferiores com implantes cônicos internos híbridos indicados para carregamento imediato em alvéolos pós-extração, associado a manutenção do espaço protético e peri-implantar. Foram utilizados implantes com macrogeometria e tratamento de superfície que otimizassem a estabilidade primária (Hidrofílicos), bem como o tipo de conexão interna e abutments protéticos que permitisse melhor acomodação e cicatrização dos tecidos adjacentes, e proteção do enxerto ósseo. Diferentes metodologias de guias cirúrgicos não influenciaram o resultado final. A previsibilidade da associação de técnicas e componentes pode ser observada no follow-up de 2 anos. O planejamento inicial aliado às novas tecnologias permite restaurações finais estáveis e funcionais. dentários dentista dentárias pósextração, pósextração pós extração, extração pós-extração periimplantar. periimplantar peri implantar. implantar peri-implantar Hidrofílicos, Hidrofílicos , (Hidrofílicos) adjacentes ósseo final followup follow up anos funcionais (Hidrofílicos

ABSTRACT The immediate rehabilitation of the posterior region of the mandible with dental implants, expands the set of possible actions for the dental surgeon, in the face of tooth loss. The purpose of this study is to describe two cases of single rehabilitation of mandibular molars with hybrid internal tapered implants indicated for immediate loading in post-extraction socket, associated with the maintenance of the prosthetic and peri-implant space. Implants with macrogeometry and surface treatment (Hydrophilic) were used to optimize primary stability, as well as the type of internal connection and prosthetic abutments that allows better accommodation and healing of adjacent tissues, and protection of the bone graft. Different methodologies of surgical guides did not influence the final result. The predictability of associating techniques and components can be observed in the 2-year follow-up. The initial planning combined with the new technologies enable to achieve stable and functional final restorations. surgeon loss postextraction post extraction socket periimplant peri implant space Hydrophilic (Hydrophilic stability tissues graft result 2year year 2 followup. followup follow up. up follow-up restorations

RESUMO Estudos tem encontrado a associação entre os episódios de bruxismo e a presença dos sinais e sintomas de disfunção temporomandibular (DTM). O objetivo do presente trabalho foi relatar o diagnóstico e terapia paliativa do bruxismo associado à DTM. Paciente, 23 anos, gênero masculino, apresentou-se à clínica odontológica, queixando-se de dor na articulação temporomandibular do lado esquerdo e alteração da forma dos dentes anteriores. Durante a anamnese foi documentado que esse sintoma era recorrente e relatado o hábito de ranger os elementos dentais. No exame clínico observou-se discrepância entre relação cêntrica e máxima intercuspidação habitual, guia protrusiva insatisfatória, presença de facetas de desgaste, estalido e desvio mandibular durante o movimento de abertura bucal. O questionário Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) foi aplicado para diagnosticar a DTM. Por meio de algoritmos específicos essa desordem foi classificada como dor miofascial, deslocamento de disco com redução e osteoartrite, todos acometendo o lado esquerdo. Desta forma, foi proposto a montagem dos modelos em articulador semi-ajustável para mapeamento oclusal e enceramento diagnóstico. Em seguida o ajuste oclusal por desgaste seletivo e acréscimo de material foi executado. Finalizado esse procedimento, a placa estabilizadora da oclusão foi instalada como terapia paliativa para o bruxismo. Esse relato de caso sugere que a abordagem odontológica por meio do ajuste oclusal e placa oclusal, em paciente diagnosticado com bruxismo e disfunção temporomandibular, reduz os sinais e sintomas que afetam os componentes do Aparelho Estomatognático.

ABSTRACT Studies have found the association between episodes of bruxism and the presence of signs and symptoms of temporomandibular disorder (TMD). The aim of the present study was to report the diagnosis and palliative therapy of bruxism associated with TMD. Patient, 23 years old, male gender, presented at dental clinic, complaining of pain in the temporomandibular joint on the left side and alteration of the form of the anterior teeth. During the anamnesis it was documented that this symptom was recurrent and reported the habit of grinding teeth. The clinical examination observed discrepancy between the centric relation and the maximum habitual intercuspation, unsatisfactory protrusive guide, presence of wear facets, clicking and mandibular deviation during mouth opening. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) questionnaire was applied to diagnose TMD. By means of specific algorithms this disorder was classified as myofascial pain, disc displacement with reduction and osteoarthritis, all affecting the left side. Thus, it was proposed the assembly of the models in semi-adjustable articulator for occlusal mapping and waxing diagnosis, then the occlusal adjustment by selective wear and material addition was executed. After this procedure, the occlusal splint was installed as a palliative therapy for bruxism. This case report suggests that the dental approach by means of occlusal adjustment and occlusal splint, in a patient diagnosed with bruxism and temporomandibular disorder, reduces the signs and symptoms that affect the components of the Stomatognathic System.

Abstract With the onset of the new coronavirus disease (COVID-19) pandemic, the dental treatment of patients at risk of infection has become quite challenging. In view of this, patients with head and neck cancer may present with oral complications due to anticancer therapy, making dental assistance necessary. Thus, the objective of the study was to review the literature and critically discuss important concerns about the treatment of patients with head and neck cancer during the COVID-19 pandemic. Because dental professionals are in close contact with the main viral transmission routes, this study presents recommendations for management and protection during clinical dental care. The main characteristics and transmission routes of COVID-19 are also discussed. Dental professionals should control pain and the side effects of antineoplastic treatment and use preventive measures for infection control. During this pandemic, patients with head and neck cancer should not undergo elective procedures, even if they do not have symptoms or a history of COVID-19; therefore, in asymptomatic or painless cases, only preventive actions are recommended. In symptomatic or painful cases, precautions for safe interventional treatments must be implemented by following the hygiene measures recommended by health agencies and using personal protective equipment. During health crises, new protocols emerge for cancer treatment, and professionals must act with greater attention toward biosafety and updated knowledge. It is important to offer adequate individualized treatment based on the recommendations of preventative and interventional treatments so that patients can face this difficult period with optimized quality of life.

Abstract Resin cements have led to great advances in dental ceramic restoration techniques because of their ability to bond to both dental structures and restorative materials. Objective The aim of this study was to assess the performance of resin cements when different curing modes are used, by evaluating the degree of conversion and bond strength to a ceramic substrate. Material and Methods Three resin cements were evaluated, two dual-cured (Variolink II and RelyX ARC) and one light-cured (Variolink Veneer). The dual-cured resin cements were tested by using the dual activation mode (base and catalyst) and light-activation mode (base paste only). For degree of conversion (DC) (n=5), a 1.0 mm thick feldspathic ceramic disc was placed over the resin cement specimens and the set was light activated with a QTH unit. After 24 h storage, the DC was measured with Fourier transform infrared spectroscopy (FTIR). For microshear bond strength testing, five feldspathic ceramic discs were submitted to surface treatment, and three cylindrical resin cement specimens were bonded to each ceramic surface according to the experimental groups. After 24 h, microshear bond testing was performed at 0.5 mm/min crosshead speed until the failure. Data were submitted to one-way ANOVA followed by Tukey test (p<0.05). Scanning electron microscopy (SEM) was used for classifying the failure modes. Results Higher DC and bond strength values were shown by the resin cements cured by using the dual activation mode. The Variolink II group presented higher DC and bond strength values when using light-activation only when compared with the Variolink Veneer group. Conclusion The base paste of dual-cured resin cements in light-activation mode can be used for bonding translucent ceramic restorations of up to or less than 1.0 mm thick.

Abstract The characteristics of non-obese patients with mild to moderate Obstructive Sleep Apnea Syndrome (OSAS) who will present with a good response to Mandibular Repositioning Appliance (MRA) treatment have not yet been well established in the literature. The aim of this study is to assess whether polysomnographic (PSG), demographic, anthropometric, cephalometric, and otorhinolaryngological parameters predict MRA success in the treatment of OSAS. Forty (40) males with mild and moderate OSAS were assessed pretreatment and 2-months post-treatment after wearing an MRA. Demographic, anthropometric, otorhinolaryngological (ENT), cephalometric, and polysomnographic parameters, including continuous positive airway pressure (CPAP) titrated pressure, dental models, Epworth Sleepiness Scale, quality of life (Short Form SF-36), and mood state (Profile of Mood States – POMS), were assessed. The responders exhibited fewer oropharyngeal alterations, increased upper pharyngeal space, reduced lower airway space, and increased mandibular intercanine width, and they had milder disease. Nevertheless, no predictive factors of MRA success could be found. MRA was more successful among men with a more pervious airway, a larger interdental width and milder OSAS. However, a combined [1] functional and structural assessment is needed to successfully predict the [2] effectiveness of MRA treatment of OSA.

Resumo O objetivo deste estudo foi avaliar a resistência à flexão e módulo de flexão de diferentes pinos reforçados com fibra (PRF) e determinar a correlação entre propriedades mecânicas e características estruturais. Foram analisadas onze marcas de pinos de fibra (n=10): Exacto Cónicos (Angelus), DT Luz SL (VDW), RelyX Fiber Post (3M ESPE), Glassix Radiopaque (Nordim), Pará Publicar Fiber White (Coltène), FRC Postec Plus (Ivoclar), Aestheti-Plus Post (Bisco), Superpost Cónicos Estriado (Superdont), Superpost Ultrafino (Superdont), Reforpost (Angelus), e White Post DC (FGM). Os pinos foram avaliados por meio de ensaio de flexão de três pontos para calcular a resistência à flexão e módulo de flexão utilizando uma máquina de ensaios mecânicos (EMIC 2000 DL) a 0,5 mm/min. Os dados foram submetidos a ANOVA one-way e teste de Scott-Knot (p<0,05). As secções transversais dos pinos foram examinadas usando microscopia eletrônica de varredura (MEV). A correlação entre as propriedades mecânicas e de cada uma das variáveis estruturais foi calculada por coeficientes de correlação de Pearson (p<0,05). Os valores da resistência à flexão variaram de 493-835 MPa e foram diretamente correlacionados com a proporção de fibra/matriz (p=0,011). O módulo de flexão variou de 4500 a 8824 MPa e foi inversamente correlacionado com o número de fibras por mm2 (p<0,001). Concluiu-se que as características estruturais afetam de forma significativa as propriedades dos pinos de fibra. As características estruturais e propriedades mecânicas dos pinos de fibra de vidro são dependentes do processo de fabricação. Existe uma correlação linear entre a resistência à flexão e proporção de fibra/matriz, bem como entre o módulo de flexão e a quantidade de fibras.

Abstract The aim of this study was to evaluate the flexural strength and flexural modulus of different fiber-reinforcement composite (FRC) posts and determine the correlation between mechanical properties and structural characteristics. Eleven brands of fiber posts were analyzed (n=10): Exacto Cônico (Angelus), DT Light SL (VDW), RelyX Fiber Post (3M-Espe), Glassix Radiopaque (Nordim), Para Post Fiber White (Coltène), FRC Postec Plus (Ivoclar), Aestheti-Plus Post (Bisco), Superpost Cônico Estriado (Superdont), Superpost Ultrafine (Superdont), Reforpost (Angelus), and White Post DC (FGM). The posts were loaded in three-point bending test to calculate the flexural strength and flexural modulus using a mechanical testing machine (EMIC 2000 DL) at 0.5 mm/min. Data were submitted to one-way ANOVA and Scott-Knot test (p<0.05). The cross-sections of the posts were examined by scanning electron microscopy (SEM). Correlation between the mechanical properties and each of the structural variables was calculated by Pearson's correlation coefficients (p<0.05). The flexural strength values ranged from 493 to 835 MPa and were directly correlated with the fiber/matrix ratio (p=0.011). The flexural modulus ranged from 4500 to 8824 MPa and was inversely correlated with the number of fibers per mm2 of post (p<0.001). It was concluded that the structural characteristics significantly affected the properties of the FRC posts. The structural characteristic and mechanical properties of fiber glass posts are manufacture-dependent. A linear correlation between flexural strength and fiber/matrix ratio, as well as the flexural modulus and the amount of fiber was found.

Resumo: O objetivo deste estudo foi mensurar grau de conversão (GC), microdureza Vickers (VH) e módulo de elasticidade (E) de cimentos resinosos polimerizados através de diferentes sistemas cerâmicos. Um disco de 1,5 mm de espessura de cada sistema cerâmico (cerâmica feldspática, dissilicato de lítio e zircônia coberto por cerâmica feldspática) foi utilizado. Três cimentos resinosos duais (Allcem, Variolink II e RelyX U200) e um cimento resinoso quimicamente ativado (Multilink) foram ativados através dos discos de cerâmica. Para os cimentos resinosos duais foi utilizado um aparelho de lâmpada halógena (Optilux 501 a 650 mW/cm2 por 120 s). Amostras polimerizadas sem a interposição do disco de cerâmica foram utilizadas como controle. As amostras foram armazenadas a 37 °C durante 24 h. ATR/FTIR foi utilizado para avaliar a extensão da polimerização nas amostras (n=5). Propriedades micromecânicas - VH e E - dos cimentos resinosos (n=5) foram medidas com um teste dinâmico de indentação. Os dados foram analisados através de análise de variância a dois fatores, teste de Tukey e correlação de Pearson (α=0,05). O GC foi afetado somente pelo tipo de cimento resinoso (p=0,001). Para VH, houve interação entre o tipo de cimento resinoso e o tipo de cerâmica (p=0,045). Os cimentos resinosos duais não apresentaram diferenças significativas nos valores médios de E e valores significativamente maiores que o cimento resinoso quimicamente ativado. O grau de conversão e as propriedades mecânicas dos cimentos resinosos avaliados dependem do seu modo de ativação e do tipo de cerâmica usada na espessura de 1,5 mm. Os cimentos resinosos duais desempenharam melhor que o cimento resinoso quimicamente ativado em todas as propriedades estudadas.

Abstract: The aim of this study was to verify the degree of conversion (DC), Vickers microhardness (VH) and elastic modulus (E) of resin cements cured through different ceramic systems. One 1.5-mm-thick disc of each ceramic system (feldspathic, lithium dissilicate and zircônia veneered with feldspathic) was used. Three dual-cured (Allcem, Variolink II and RelyX U200) and one chemically-cured (Multilink) resin cements were activated through ceramic discs. For dual-cured resin cements was used a conventional halogen light-curing unit (Optilux 501 at 650 mW/cm2 for 120 s). Samples cured without the ceramic disc were used as control. The samples were stored at 37 °C for 24 h. ATR/FTIR spectrometry was used to evaluate the extent of polymerization in the samples (n=5). Micromechanical properties - VH and E - of the resin cements (n=5) were measured with a dynamic indentation test. Data were statistically analyzed with two-way ANOVA, Tukey's test and Pearson's correlation (α=0.05). DC was affected only by the type of resin cement (p=0.001). For VH, significant interaction was detected between resin cement and ceramic (p=0.045). The dual-cured resin cements showed no significant differences in mean values for E and significantly higher values than the chemically-cured resin cement. The degree of conversion and the mechanical properties of the evaluated resin cements depend on their activation mode and the type of ceramics used in 1.5 mm thickness. The dual-cured resin cements performed better than the chemically-cured resin cement in all studied properties.

The aim of this prospective clinical study was to evaluate patient rehabilitation with two immediately loaded implants and bar-retained mandibular overdentures after 48 months of follow-up. Twenty patients were treated with two implants each; of these, 17 patients were re-evaluated for comparison. Gender, age, plaque index, gingival inflammation, keratinized mucosa, probing depth, bleeding, and implant loss data were recorded, and periapical radiographs were obtained for measurement of marginal bone loss. The results were statistically analyzed with one-way analysis of variance (ANOVA) followed by Student’s t-test and Pearson’s correlation test. To compare the data at baseline and after 48 months, a Wilcoxon Signed Rank Test was performed (α = 0.05). One implant failed (2.9%) during the first year and was replaced. A total of 35 implants were evaluated. Bone loss values were 0.52–2.89 mm (mean, 1.46 mm). Probing depth was 1.75–3.75 mm (mean, 2.22 mm). Correlations were found between bone loss and plaque index and between bone loss and gender, but bone loss did not correlate with gingival inflammation, keratinized mucosa, probing depth, or age. The overall survival rate of the implants was 97.1%. Based on these results, the use of two immediately loaded splinted interforaminal implants to retain an overdenture with a bar attachment is a clinically viable option with a high survival rate.

O objetivo deste estudo foi avaliar o efeito de diferentes parâmetros de solda a plasma verificando a resistência flexural de barras de liga de titânio (Ti-6Al-4V). Quarenta espécimes de Ti-6AL-4V e dez espécimes de liga de NiCr foram preparados (40 mm de altura e 3,18 mm de diâmetro) e divididos em 5 grupos (n=10). As barras de liga titânio do grupo controle não foram seccionadas e nem submetidas a processo de soldagem. Os grupos PL10, PL12 e PL14, continham barras de titânio seccionadas e soldadas com uma corrente de 3 A por períodos de 10,12 e 14 ms, respectivamente. O grupo NCB consistiu de barras de liga de NiCr soldadas pelo método de brasagem convencional. Em seguida as barras foram submetidas ao teste de flexão de três pontos e os valores obtidos foram transformados em resistência flexural (MPa). Análise estatística foi realizada usando ANOVA de fator único e o teste Tukey com o nível de significância de 0,05. Diferença estatística foi verificada entre os grupos avaliados (p<0,001), com os maiores valores pra o grupo controle. Não foram encontradas diferenças entre os grupos de solda plasma (p>0,05). O grupo NCB apresentou os menores valores de resistência flexural embora tenha sido estatisticamente semelhante ao grupo PL14. Não houve diferença significante na profundidade de penetração entre os grupos de solda plasma (p=0,05). Três espécimes representativos foram aleatoriamente selecionados para serem avaliados por meio de microscopia eletrônica de varredura. A composição das regiões soldadas foi verificada por meio de espectroscopia por energia dispersiva. Este estudo fornece informações iniciais de parâmetros para permitir a utilização de soldagem plasma durante a fabricação de estruturas em liga de titânio.

The aim of this study was to assess the effect of different plasma arc welding parameters on the flexural strength of titanium alloy beams (Ti-6Al-4V). Forty Ti-6Al-4V and 10 NiCr alloy beam specimens (40 mm long and 3.18 mm diameter) were prepared and divided into 5 groups (n=10). The titanium alloy beams for the control group were not sectioned or subjected to welding. Groups PL10, PL12, and PL14 contained titanium beams sectioned and welded at current 3 A for 10, 12 or 14 ms, respectively. Group NCB consisted of NiCr alloy beams welded using conventional torch brazing. After, the beams were subjected to a three-point bending test and the values obtained were analyzed to assess the flexural strength (MPa). Statistical analysis was carried out by one-way ANOVA and Tukey's HSD test at 0.05 confidence level. Significant difference was verified among the evaluated groups (p<0.001), with higher flexural strength for the control group (p<0.05). No significant differences was observed among the plasma welded groups (p>0.05). The NCB group showed the lowest flexural strength, although it was statistically similar to the PL 14 group (p>0.05). The weld depth penetration was not significantly different among the plasma welded groups (p=0.05). Three representative specimens were randomly selected to be evaluated under scanning electron microcopy. The composition of the welded regions was analyzed by energy dispersive X-ray spectroscopy. This study provides an initial set of parameters supporting the use of plasma welding during fabrication of titanium alloy dental frameworks.

Um ajuste inadequado na interface pilar/implante pode gerar problemas mecânicos e biológicos. Etapas laboratoriais podem induzir a um desajuste em tal interface quando pilares do tipo UCLA calcináveis são utilizados. Este estudo propôs-se a avaliar comparativamente o desempenho de três laboratórios de prótese dentária (Labs A, B e C) pela análise do ajuste vertical de pilares UCLA calcináveis durante o processo de fundição e solda de uma mesma prótese. Quatro próteses fixas foram confeccionadas por cada laboratório utilizando pilares do tipo UCLA calcinável. A avaliação foi feita em microscopia eletrônica de varredura sob aumento de 500 x nas faces mesial e distal de cada elemento da prótese, totalizando 24 medidas por laboratório. Os resultados foram analisados estatisticamente pelo teste de Kruskal-Wallis (p<0,05). Na fundição, os valores apresentados pelos laboratórios diferiram estatisticamente (p=0,004). Após a análise da solda, os valores não apresentaram diferença significante entre os laboratórios (p=0,948). Pode-se concluir que os valores de ajuste obtidos no estágio de fundição de pilares UCLA, podem ser influenciados quando processados por diferentes laboratórios e que o processo de solda convencional, por si só, aumenta o grau de desajuste da infra-estrutura, independente do laboratório que a realizou.

An inadequate fit at the abutment/implant interface can generate mechanical and biological problems. The laboratorial stages could induce misfit in such interface when the castable UCLA abutment type is used. The purpose of this study was to comparatively evaluate the performance of three prosthetic laboratories (Labs A, B and C) by vertical fit analysis of castable UCLA abutments on the casting and soldering stages of the same prosthesis. Four fixed prostheses were built by each laboratory using castable UCLA abutments. The evaluation was made by scanning electron microscopy under 500x magnification in the mesial and distal regions of each element of the prosthesis, totalizing 24 measurements per laboratory. The results were analyzed statistically by Kruskal-Wallis test (p<0.05). In the casting process, the values presented by the laboratories differed significantly to each other (p=0.004). After soldering, the values presented by the laboratories showed no significant difference (p=0.948). It may be concluded that the fit values obtained in the casting stage of UCLA abutments can be influenced when processed by different laboratories, and that conventional soldering itself increased the degree of framework misfit, regardless of which laboratory made it.