Reabilitações orais sobre implantes osteointegráveis enfrentam crescentes exigências protéticas e estéticas, necessitando de um planejamento protético-cirúrgico preciso. O planejamento em pacientes edêntulos pode ser realizado usando análise cefalométrica para determinar o posicionamento dos dentes na prótese e conseqüentemente dos implantes. Esse caso clínico descreve o planejamento e tratamento de uma reabilitação oral sobre implantes usando análise cefalométrica para otimizar o sucesso protético assim como o conforto do paciente. Paciente apresentando edentulismo total mandibular e parcial maxilar com elementos anteriores insatisfatórios estética e funcionalmente, com inclinação vestibular acentuada. Para a determinação do correto posicionamento dos elementos superiores foi necessário a utilização de traçado cefalométrico de Steiner para o posicionamento do incisivo central superior no enceramento diagnóstico. Dessa forma, foi realizado exodontia dos elementos anteriores superiores, instalação de implantes osteointegraveis (Neodent(r), Curitiba, Brasil) e instalação de prótese fixa provisória imediata. Após 30 dias, foi realizada cirurgia para instalação de 4 implantes osteointegráveis (Neodent(r), Curitiba, Brasil) na região intermentoniana, sobre os quais foi instalada uma prótese total implanto-suportada inferior provisória. Após período de osteointegração, as próteses sobre implantes definitivas foram confeccionadas.

There are growing prosthetic and esthetic demands for Oral Rehabilitations on osseointegratable implants, requiring precise prosthetic-surgical planning. In edentulous patients planning may be done using cephalometric analysis to determine the position of the teeth in the dental prosthesis, and consequently, those of the implants. In this clinical case, the planning and treatment of an oral implant-supported rehabilitation is described, using cephalometry to optimize prosthetic success and patient comfort. The patient presented complete mandibular and partial maxillary edentulism, with unsatisfactory esthetics and function of the anterior teeth, with accentuated vestibular inclination. In order to determine the correct position of maxillary teeth it was necessary to use a Steiner cephalometric tracing to position the maxillary central incisor in the diagnostic wax-up. Therefore, the maxillary anterior teeth were extracted, osseointegratable implants were placed (Neodent(r), Curitiba, Brazil), and an immediate temporary fixed denture was inserted. After 30 days, surgery was performed for the placement of 4 osseointegratable implants (Neodent(r), Curitiba, Brazil) in the inter-mentonian region, on which a complete, temporary, implant-supported denture was placed. After the period of osseointegration, the definitive implant-supported dental prosthesis were fabricated.

INTRODUCTION: Marginal discrepancies may lead to cement washout and marginal leakage, damaging periodontal and pulp tissues or causing premature loss of the restoration. PURPOSE: This study evaluated the influence of application site of provisional cement on the marginal adaptation of provisional crowns. MATERIAL AND METHODS: Four different application sites of provisional cement (Temp Bond NE, Kerr Corporation) were used for cementation of provisional crowns on phantom teeth prepared for full crown restorations, performing 4 experimental groups (n=10): cement applied to all internal surfaces of the crown (CAO); cement applied to all internal surfaces of the crown, except for the occlusal surface (CA); cement applied to the cervical crown margin (CM); and cement applied to the cervical tooth margin (TM). A comparison microscope (Mitutoyo America Corporation) was used to measure the distances between the internal tangents of two circular marks, one made on the provisional crown and one made apical to the tooth preparation margin, in areas corresponding to buccal, lingual, mesial and distal surfaces. Marginal adaptation was determined before and after cementation, with 0.0001-mm accuracy. Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. RESULTS: Mean values of marginal opening obtained for each group were: CAO: 145 µm; CA: 67 µm; CM: 46 µm; TM: 34 µm. CA, CM and TM presented significantly lower marginal openings than CAO (p<0.05). CONCLUSION: complete filling of the crown with provisional cement, including the occlusal surface, provided grater marginal discrepancies when compared to the other methods evaluated.

Muitas marcas de cimentos temporários estão disponíveis no mercado odontológico, sendo necessário adequá-los a cada necessidade clínica no que diz respeito à resistência à remoção dos retentores protéticos. Assim, o objetivo desse estudo foi avaliar a retenção de coroas provisórias cimentadas com oito cimentos temporários sobre preparos para coroa total com princípios mecânicos padrozinados como altura, conicidade e extensão. Para isso, oitenta primeiros pré-molares humanos receberam preparos para coroa total com altura e conicidade padronizadas. Coroas provisórias foram confeccionadas e cimentadas com oito marcas de cimentos temporários. Vinte e quatro horas após a cimentação, as restaurações foram tracionadas em uma máquina universal de ensaios e os dados submetidos aos testes estatísticos de ANOVA e Bonferroni. Os valores médios de resistência à tração variaram de 20,1 para o Nogenol a 67,5 para o Hydro C. Diferença estatisticamente significante (p<0.05) foi encontrada entre o cimento Hydro C e os outros grupos, com exceção do Rely X Temp e do Temp Bond, que apresentaram diferença estatisticamente significante quando comparados aos cimentos Freegenol e Nogenol. As coroas cimentadas com Hydro C foram mais retentivas do que aquelas cimentadas com os outros cimentos com exceção do Rely X Temp e do Temp Bond. As coroas menos retentivas foram aquelas cimentadas com os cimentos Nogenol e Freegenol.

Many temporary cements are commercially available; therefore, it is necessary to indicate them for each clinical requirement with regard to the tensile strength of prosthetic retainers. Thus, the purpose of this study was to compare the retention of provisional crowns cemented with eight temporary cements, over full crown preparations with standardized mechanical principles as height, taper, and length. For that purpose, eighty human first premolars received full crown preparation with standardized height and taper. Provisional crowns were fabricated and luted with eight brands of temporary cements. Twenty four hours after cementation, the restorations were submitted to tensile strength test in a universal testing machine and the data submitted to ANOVA and Bonferroni tests. Mean tensile strength values ranged from 20.1N for Nogenol cement to 67.5N for Hydro C cement. Statistically significant difference (p<0.05) was found between Hydro C and the other groups, except for Temp Bond and Rely X Temp, which presented statistically significant difference when compared to Freegenol and Nogenol temporary cements. The crowns cemented with Hydro C cement were more retentive that than those cemented with the other cements, except for Rely X Temp and Temp Bond. The less retentive crowns were those cemented with Nogenol and Freegenol temporary cements.