Abstract Glass ceramics’ fractures in zirconia fixed dental prosthesis (FDP) remains a clinical challenge since it has higher fracture rates than the gold standard, metal ceramic FDP. Nanoindentation has been shown a reliable tool to determine residual stress of ceramic systems, which can ultimately correlate to failure-proneness. Objectives: To assess residual tensile stress using nanoindentation in veneered three-unit zirconia FDPs at different surfaces of pontics and abutments. Methodology: Three composite resin replicas of the maxillary first premolar and crown-prepared abutment first molar were made to obtain three-unit FDPs. The FDPs were veneered with glass ceramic containing fluorapatite crystals and resin cemented on the replicas, embedded in epoxy resin, sectioned, and polished. Each specimen was subjected to nanoindentation in the following regions of interest: 1) Mesial premolar abutment (MPMa); 2) Distal premolar abutment (DPMa); 3) Buccal premolar abutment (BPMa); 4) Lingual premolar abutment (LPMa); 5) Mesial premolar pontic (MPMp); 6) Distal premolar pontic (DPMp); 7) Buccal premolar pontic (BPMp); 8) Lingual premolar pontic (LPMp); 9) Mesial molar abutment (MMa); 10) Distal molar abutment (DMa); 11) Buccal molar abutment (BMa); and 12) Lingual molar abutment (LMa). Data were assessed using Linear Mixed Model and Least Significant Difference (95%) tests. Results: Pontics had significantly higher hardness values than premolar (p=0.001) and molar (p=0.007) abutments, suggesting lower residual stress levels. Marginal ridges yielded higher hardness values for connectors (DPMa, MMa, MPMp and DPMp) than for outer proximal surfaces of abutments (MPMa and DMa). The mesial marginal ridge of the premolar abutment (MPMa) had the lowest hardness values, suggesting higher residual stress concentration. Conclusions: Residual stress in three-unit FDPs was lower in pontics than in abutments. The outer proximal surfaces of the abutments had the highest residual stress concentration.

Resumo Este estudo avaliou comparativamente duas configurações (pó e massa) de um biomaterial composto com base de PLGA (Poli(láctico-co-glicólico)/hidroxiapatita em nanoescala (ReOss®, Intra-Lock International) através da morfologia microscópica, citotoxicidade in vitro, biocompatibilidade e resposta in vivo como substituto ósseo. MEV e EDS caracterizaram os biomateriais antes/após o enxerto. A citocompatibilidade foi avaliada em pré-osteoblastos murinos. A osteocondutividade e a biocompatibilidade foram avaliadas em coelhos Branco da Nova Zelândia. Ambas as configurações foram implantadas na calvária de dezoito animais em defeitos não-críticos, com coágulo sanguíneo como grupo controle. Após 30, 60 e 90 dias, os animais foram eutanasiados e os fragmentos contendo os biomateriais e controles coletados. Blocos ósseos foram embebidos em parafina (n=15) destinados às análises histológica e histomorfométrica, e em resina (n=3) destinadas à MEV e EDS. Antes da implantação, a configuração massa mostrou ambas fases morfológicas porosa e fibrosa. O pó revelou partículas porosas com granulometria variável. EDS mostrou cálcio, carbono e oxigênio na configuração massa, enquanto o pó mostrou também fósforo. Após a implantação a EDS revelou cálcio, carbono e oxigênio em ambas configurações. Os materiais foram considerados citotóxicos pelo teste XTT. A análise histológica mostrou nova formação óssea e nenhuma reação inflamatória nos sítios de implante. Entretanto, a análise histomorfométrica indicou que a quantidade de osso neoformado não foi estatisticamente diferente entre os grupos experimentais. Embora ambos os materiais tenham apresentado citotoxicidade in vitro, foram biocompatíveis e osteocondutores. A configuração do ReOss® afetou as características morfológicas e a citocompatibilidade in vitro, porém não impactou a resposta biológica in vivo, como medido pelo presente modelo.

Article This study evaluated comparatively two configurations (powder and putty) of a composite biomaterial based on PLGA (Poly(lactide-co-glycolide)/nanoescale hydroxyapatite (ReOss®, Intra-Lock International) through microscopic morphology, in vitro cytotoxicity, biocompatibility and in vivo response as a bone substitute. SEM and EDS characterized the biomaterials before/after grafting. Cytocompatibility was assessed with murine pre-osteoblasts. Osteoconductivity and biocompatibility were evaluated in White New Zealand rabbits. Both configurations were implanted in the calvaria of eighteen animals in non-critical size defects, with blood clot as the control group. After 30, 60 and 90 days, the animals were euthanized and the fragments containing the biomaterials and controls were harvested. Bone blocks were embedded in paraffin (n=15) aiming at histological and histomorphometric analysis, and in resin (n=3) aiming at SEM and EDS. Before implantation, the putty configuration showed both a porous and a fibrous morphological phase. Powder revealed porous particles with variable granulometry. EDS showed calcium, carbon, and oxygen in putty configuration, while powder also showed phosphorus. After implantation EDS revealed calcium, carbon, and oxygen in both configurations. The materials were considered cytotoxic by the XTT test. Histological analysis showed new bone formation and no inflammatory reaction at implant sites. However, the histomorphometric analysis indicated that the amount of newly formed bone was not statistically different between experimental groups. Although both materials presented in vitro cytotoxicity, they were biocompatible and osteoconductive. The configuration of ReOss® affected morphological characteristics and the in vitro cytocompatibility but did not impact on the in vivo biological response, as measured by the present model.

Although the use of zirconia abutments for implant-supported restorations has gained momentum with the increasing demand for esthetics, little informed design rationale has been developed to characterize their fatigue behavior under different clinical scenarios. However, to prevent the zirconia from fracturing, the use of a titanium connection in bi-component aesthetic abutments has been suggested. Objective Mechanical testing of customized thin-walled titanium-zirconia abutments at the connection with the implant was performed in order to characterize the fatigue behavior and the failure modes for straight and angled abutments. Material and Methods Twenty custom-made bi-component abutments were tested according to ISO 14801:2007 either at a straight or a 25° angle inclination (n=10 each group). Fatigue was conducted at 15 Hz for 5 million cycles in dry conditions at 20°C±5°C. Mean values and standard deviations were calculated for each group. All comparisons were performed by t-tests assuming unequal variances. The level of statistical significance was set at p≤0.05. Failed samples were inspected in a polarized-light and then in a scanning electron microscope. Results Straight and angled abutments mean maximum load was 296.7 N and 1,145 N, the dynamic loading mean Fmax was 237.4 N and 240.7 N, respectively. No significant differences resulted between the straight and angled bi-component abutments in both static (p=0.253) and dynamic testing (p=0.135). A significant difference in the bending moment required for fracture was detected between the groups (p=0.01). Fractures in the angled group occurred mainly at the point of load application, whereas in the straight abutments, fractures were located coronally and close to the thinly designed areas at the cervical region. Conclusion Angled or straight thin-walled zirconia abutments presented similar Fmax under fatigue testing despite the different bending moments required for fracture. The main implication is that although zirconia angled or straight abutments presented similar mechanical behavior, the failure mode tended to be more catastrophic in straight (fracture at the cervical region) compared to angled abutments.

INTRODUÇÃO: A desinfecção das superfícies de dentina é desejada desde que não haja interferência na adesão dos agentes adesivos. OBJETIVO: Testar a hipótese nula de que a resistência adesiva não é afetada pela aplicação prévia de uma solução desinfetante de iodo. MATERIAL AND MÉTODO: Vinte e quatro molares hígidos foram selecionados. O esmalte oclusal destes dentes foi removido, e sobre as superfícies planas de dentina expostas foi aplicada da solução desinfetante de Iodo a 2% (I2DDS), que permaneceu sobre a superfície por 20 s e foi lavada por 20 s com água deionizada. Sobre as superfícies desinfetadas foram aplicados um dos seguintes sistemas adesivos (n=3): Single Bond; Prime & Bond NT; Clearfil SE Bond; Opti-Bond Plus. Os grupos controle (n=3) não tiveram a supeficie de dentina tratada com I2DDS antes dos precedimentos adesivos. Em todos os grupos, após hibridização da dentina, foi construída uma "restauração" de resina composta com cerca de 4 mm de espessura. Após 7 dias de armazenagem em água destilada, os dentes foram secionados de modo a originarem espécimes a serem submetidos ao teste de microtração (palitos). Análise estatística para comparação dos dados foi realizada pelo teste t de student (alfa=0,05). RESULTADOS: De forma geral, os grupos experimentais (tratados com I2DDS) apresentraram resistência adesiva significativamente menor do que os respectivos grupos controle (p<0.05), exceção se fez apenas para o grupo P&BI2, que não diferiu significativamente de seu grupo controle P&BC (p>0.05). Assim, a hipótese nula deve ser rejeitada para os adesivos a base de etanol e/ou a base de água, mas aceita para o adesivo a base de acetona. CONCLUSÃO: O uso da solução experimental de iodo previamente à realização dos procedimentos adesivos afetou a efetividade da união à dentina apenas quando do emprego de sistemas adesivos a base de etanol e/ou água.

INTRODUCTION: Disinfection of dentin surfaces is desirable so long as it does not interfere with subsequent bonding of adhesive resins. OBJECTIVE: To test the null hypothesis that bond strengths to dentin are not affected by previous application of an iodine disinfecting solution. MATERIALS AND METHODS: Twenty-four extracted non-carious molars were selected. Occlusal enamel was removed producing a flat dentin substrate. Test teeth were all treated with 2% Iodine disclosing/disinfecting solution (I2DDS) for 20 sec and rinsed for 20 sec followed by the application of self- or total- etching bonding systems, generating five adhesive groups (n=3): Single Bond; ; Prime & Bond NT; Clearfil SE Bond; Opti-Bond Plus. The control groups (n=3 per adhesive) had no disclosing/disinfectant application prior to adhesive application. A 4-mm thick resin restoration was built up on each tooth for microtensile testing. Statistical analyses between experimental and control groups were performed by student's t-test (alpha= 0.05). RESULTS: In general, experimental groups (previously treated with I2DDS) showed significantly lower bond strength values when compared with their respective controls (p<0.05), except for group Prime &Bond I2 that did not significantly differ from its control (p>0.05). CONCLUSION: Acetone-base adhesive systems seem not to be affected by the application of I2DDS prior to etching and bonding procedures.

Recobrimentos biocerâmicos de baixa espessura são potenciais alternativas para compensar as limitações de outros recobrimentos biocerâmicos disponíveis comercialmente como o plasma spray de hidroxiapatita, onde a dissolução desigual e a presença de uma fraca interface metal-cerâmica são problemas inerentes ao seu processamento. O propósito desta investigação foi determinar os níveis de atividade óssea total e específica a uma área (0.5 mm da superfície do implante) ao redor de um implante de liga de titânio (superficie jateada seguida de ataque ácido) recoberto com um filme biocerâmico de baixa espessura processado através de deposição auxiliada por feixe iônico, contra um implante de liga de titânio sem recobrimento biocerâmico em cães. O modelo cirúrgico utilizou a epífise proximal da tibia, com quatro implantes colocados em cada uma, onde permaneceram por um período de 2 e 4 semanas. Oxitetraciclina (10 mg/Kg) foi administrada 48 horas antes dos animais serem sacrificados. As tíbias foram dissecadas, reduzidas a blocos, e processadas para análise em microscópio ótico. Microfotografias com aumento de 20x foram obtidas da região perimetral do implante e foram alinhadas para análise da resposta biológica total. Subsequentemente, quatro micro-fotografias com aumento de 40x, sub- divididas em retângulos, foram obtidas de um dos lados do implante para quantificação da área marcada por tetraciclina. Os resultados mostraram biocompatibilidade e osseocondutividade dos implantes de liga de titânio com ou sem filme biocerâmico de baixa espessura. Análise da área marcada por tetraciclina mostrou que os implantes com recobrimento apresentaram uma maior atividade óssea total e específica ao redor do implante em 2 e 4 semanas. Os valores de atividade óssea específica à área adjacente à superfície do implante foram significantemente maiores comparados aos valores obtidos em regiões afastadas dos implantes com ou sem recobrimento biocerâmico. De acordo com os resultados obtidos neste estudo, concluímos que os implantes com recobrimento biocerâmico de baixa espessura aumentaram a resposta biológica após 2 e 4 semanas de tempo de implantação.

Thin-film bioceramic coatings are potential alternatives to overcome the limitations provided by other commercially available coating techniques like PSHA, where variable bioceramic dissolution added to a metalloceramic weak link are process- inherent. The purpose of this investigation was to determine the overall and site specific (to 0.5 mm from implant surface) levels of osseoactivity around a thin-film (IBAD processed) coated titanium alloy implant versus a non surface modified (sand-blasted/acid etched) titanium alloy implant in a canine model. The surgical model comprised the proximal tibiae epiphyses with four implants placed in each limb remaining for 2 and 4 weeks in-vivo. 10 mg/Kg oxytetracycline was administered 48 hours prior to euthanization. The limbs were retrieved by sharp dissection, reduced to blocks, and subsequently nondecalcified processed for fluorescent microscopy. Micrographs (20x mag) were acquired around the implant perimeter and merged for overall biological response evaluations, and four micrographs (40x mag. subdivided in rectangles) were acquired along one of the implant sides for tetracycline labeled area fraction quantification. The results showed biocompatible and osseoconductive properties for the thin-film coated and uncoated titanium alloy implants. Tetracycline labeled area fraction analyses showed that the thin-film coated implants presented significantly higher overall and site specific osseoactivity levels at 2 and 4 weeks. The site specific osseoactivity values were significantly higher compared to overall values for control and thin-film coated implants at both times in-vivo. According to the results obtained in this study, thin-film coated implants enhanced biological response at the early implantation times evaluated.