OBJECTIVE:The aim of this cross-sectional study was to evaluate the relationship among pain intensity and duration, presence of tinnitus and quality of life in patients with chronic temporomandibular disorders (TMD). MATERIAL AND METHODS: Fifty-nine female patients presenting with chronic TMD were selected from those seeking for treatment at the Bauru School of Dentistry Orofacial Pain Center. Patients were submitted to the Research Diagnostic Criteria anamnesis and physical examination. Visual analog scale was used to evaluate the pain intensity while pain duration was assessed by interview. Oral Health Impact Profile inventory modified for patients with orofacial pain was used to evaluate the patients' quality of life. The presence of tinnitus was assessed by self report. The patients were divided into: with or without self report of tinnitus. The data were analyzed statistically using the Student's t-test and Pearson's Chi-square test, with a level of significance of 5%. RESULTS: The mean age for the sample was 35.25 years, without statistically significant difference between groups. Thirty-two patients (54.24%) reported the presence of tinnitus. The mean pain intensity by visual analog scale was 77.10 and 73.74 for the groups with and without tinnitus, respectively. The mean pain duration was 76.12 months and 65.11 months for the groups with and without tinnitus, respectively. The mean OHIP score was 11.72 and 11.74 for the groups with and without tinnitus, respectively. There was no statistically significant difference between groups for pain intensity, pain duration and OHIP scoreS (p>0.05). CONCLUSION: Chronic TMD pain seems to play a more significant role in patient 's quality of life than the presence of tinnitus.

A desadaptação na interface abutment-cilindro protético pode causar perda da pré-carga, levando ao afrouxamento ou fratura dos parafusos de ouro e titânio. OBJETIVOS: Avaliar a influência do tipo de parafuso, liga e posição do cilindro na adaptação marginal de infra-estruturas sobre implante antes e após a soldagem a laser. MÉTODOS: Após os abutments do tipo Estheticone serem aparafusados nos implantes, trinta cilindros protéticos de plástico foram montados e encerados com 15 barras cilíndricas. Cada espécime possuía três componentes protéticos interconectados. Cinco espécimes foram fundidos em monobloco com liga de titânio e liga de cobalto-crômio. Em cada espécime, os testes foram conduzidos com parafusos hexagonais de titânio e com parafusos de ouro com fenda, separadamente, num total de 30 parafusos testados. As medidas nas interfaces foram feitas com microscópio óptico com 5mm de precisão. Após o seccionamento, os espécimes foram soldados a laser e novas medidas obtidas. Os dados foram submetidos para análise com os testes ANOVA a quatro critérios e Tukey para comparações múltiplas (alfa=0,05). RESULTADOS: Os parafusos com fenda e hexágono não apresentaram diferenças significantes independente da adaptação dos cilindros fundidos em titânio, tanto em monobloco como após a soldagem a laser. Quando os parafusos com hexágono e fenda foram testados nos espécimes de cobalto-crômio, diferenças estatisticamente significantes foram encontradas na condição monobloco, com os parafusos fendidos apresentando melhor adaptação (24,13µm) do que os com hexágono (27,93 µm). Além disso, nenhuma diferença significante foi encontrada após a soldagem a laser. CONCLUSÕES: 1) O uso de diferentes ligas metálicas exerce influência nos resultados, 2) Os parafusos com hexágono e fenda somente possuem o papel de fixar a prótese, e não melhoram a adaptação dos cilindros e 3) a posição do cilindro não afetou os valores de adaptação marginal.

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. OBJECTIVES: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. METHODS: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5mm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (alpha=0.05). RESULTS: Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13µm) than the hexagonal screws (27.93 µm). Besides, no statistically significant differences were found after laser welding. CONCLUSIONS: 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values.

O objetivo deste estudo foi medir a adaptação marginal na interface intermediário-cilindro, antes e após a sobrefundição. Um implante do tipo hexágono externo afixado numa base de aço inoxidável e um intermediário do tipo Estheticone foram usados durante todo o experimento. Antes das fundições, cilindros pré-usinados de ouro (Grupo I) e de Ni-Cr-Be (Grupo II) foram aparafusados ao intermediário com parafusos de ouro e titânio em ambos os grupos, com torques de 10Ncm e 20Ncm para o mesmo tipo de parafuso. As medidas verticais foram feitas num microscópio óptico (Mitutoyo 5050, Tóquio, Japão) três vezes em seis locais diferentes ao longo da interface intermediário-cilindro para cada valor de torque. Os cilindros foram encerados e fundidos tanto em liga de Ag-Pd (Grupo I) ou liga de Ni-Cr-Be (Grupo II). Após as fundições, as mesmas medidas e os mesmos valores de torque foram repetidos. As diferenças intra-grupo (torques de 10 ou 20Ncm, antes e após as fundições) e as diferenças inter-grupos (torques de 10 e 20Ncm, antes ou após as fundições) foram analisadas pelo teste t pareado (p<0.05). Diferenças intra-grupo foram observadas em G-I (ouro, 20Ncm, parafuso de titânio, p=0,044) e em G-II (Ni-Cr-Be, 10Ncm, parafuso de ouro, p=0,002). As diferenças inter-grupos não foram observadas somente no grupo G-II (Ni-Cr-Be, 10 e 20Ncm, parafuso de titânio, p=0,534). Dentro dos limites deste estudo, as seguintes conclusões podem ser feitas: 1) Independente do tipo de parafuso, os valores de desadaptação marginal foram mais altos para os cilindros de Ni-Cr-Be após as fundições, mas dentro dos níveis aceitáveis de adaptação; 2) A combinação cilindro de ouro com parafuso de ouro ou de titânio foi a mais efetiva para reduzir o desajuste marginal; 3) Ambos os tipos de parafusos não melhoraram a adaptação marginal dos cilindros de Ni-Cr-Be após as fundições, e 4) Embora um torque de 20Ncm tenha melhorado a adaptação marginal em todas as situações, seu uso não é recomendado devido ao risco aumentado de falha na prótese . As ligas de Ni-Cr-Be podem ser usadas com sucesso nas restaurações unitárias sobre implantes, sem prejuízo na adaptação entre o abutment e o cilindro protético.

The aim of this study was to measure marginal fit at cylinder-abutment interface, before and after overcasting procedure. A hexagonal implant was fixed to a stainless steel base and a Estheticone-like abutment used during all the experiment. Before casting procedure, gold (Group I) and Ni-Cr-Be (Group II) premachined cylinders were tightened to the abutment with gold and titanium screws (in both groups), with 10Ncm and 20Ncm torque values for the same screw type. Vertical measures were taken at the light microscope (Mitutoyo 5050, Tokyo, Japan) three times in six different parts along the abutment-cylinder interface for each torque value. Cylinders were overcast with Ag-Pd (Group I) or Ni-Cr-Be (Group II) alloy. After casting, the same measures and torque values were repeated. Intragroup differences (10 or 20Ncm torque values, before and after casting) and intergroup differences (10 and 20Ncm torque values, before or after casting) were analyzed by the Paired t Test; (p<0.05). Intragroup differences were observed for G-I (gold, 20Ncm, titanium screw, p=0.044) and for G-II (Ni-Cr-Be, 10Ncm, gold screw, p=0.002). Intergroup differences only were not observed in the G-II group (Ni-Cr-Be, 10 and 20Ncm, titanium screw, p=0.534). Within the limits of this study, the following conclusions can be drawn: 1) Regardless of screw type, marginal misfit was higher for Ni-Cr-Be cylinders after casting, but within acceptable levels of fit; 2) The combination of gold cylinders with gold or titanium screws was the most effective to reduce marginal misfit; 3) Both screw types did not improve marginal fit of Ni-Cr-Be cylinders after overcastting, and 4) Although a 20Ncm torque improved marginal fit in all situations, its use is not recommended due to the increased risk of prosthesis failure. Ni-Cr-Be alloys may be successfully used in single-tooth implant restorations, with no damage to the fit between abutment and prosthetic cylinder.