ABSTRACT: The aim of this study was to evaluate the influence of overtorque on integrity, strength and stress on external hexagonal implants (EH), with two different grades (N=10): conventional (C), grade 4; and modified (M), grade 4 with thermal treatment. The dimensions of EH were 3.75 x 13 mm; the specimens were fixed and submitted to SEM analysis and image acquisition. The abutment was then retained with 70 N/cm, re-analyzed by SEM, and a second image was obtained. The images were analyzed by Image J software (1.44o- NIH, USA) for dimensional variations measurement on surface of the hexagonal area. The finite element method was applied with a similar compliance to calculate the resultant stress (MPa) during the torque. Results were statistically analyzed with t-student test (5 %). The dimensional accuracy of M (0.22 mm2) was statistically significant (p<0.05). Minimum principal stress and von-Mises stress of C (-19.95 MPa, -19.94 MPa), were lower than M values (-55.83 MPa, -55.96 MPa), respectively. However, the M group showed lower deformation than C group. Therefore, more rigid titanium alloy is a promising alternative to avoid plastic deformation of prosthetic connec tions even concentrating higher stress magnitude on its structure.

RESUMEN: El objetivo de este estudio fue evaluar la influencia del sobrepar en la integridad, la fuerza y la tensión en los implantes hexagonales externos (EH), con dos grados diferentes (N = 10): convencional (C), grado 4; y modificado (M), grado 4 con tratamiento térmico. Las dimensiones de EH eran 3,75 de diámetro x 13 mm de longitud; las muestras se fijaron y se sometieron a análisis SEM y adquisición de imágenes. A continuación, el pilar se retuvo con 70 N / cm, se volvió a analizar por SEM y se obtuvo una segunda imagen. Las imágenes se analizaron con el software Image J (1.44o-NIH, EE. UU.) Para medir las variaciones dimensionales en la superficie superior del área hexagonal, que fue causada por un par excesivo. El método de los elementos finitos se aplicó con un cumplimiento similar para calcular la tensión resultante (MPa) durante el par. Los resultados se analizaron estadísticamente con la prueba t-student (5 %). La precisión dimensional de M (0,22 mm2) fue estadísticamente significativa (p <0,05). La tensión principal mínima y la tensión de von-Mises de C (-19,95 MPa, -19,94 MPa), fueron inferiores a los valores de M (-55,83 MPa, -55,96 MPa), respectivamente. Sin embargo, el hexágono del grupo M mostró menor deformación que el grupo C. Por lo tanto, la aleación de titanio más rígida es una alternativa prometedora para evitar la deformación plástica de las conexiones protésicas incluso concentrando una mayor magnitud de tensión en su estructura.

ABSTRACT: To evaluate the stresses generated in upper premolars rehabilitated with ceramic fragments (table-top) of lithium disilicate on the occlusal surface. An upper premolar was modeled following its anatomical references using computer aided design software (Rhinoceros version 5.0 SR8, USA). The dental tissues were individually designed containing enamel, dentin and periodontal ligament. The main anatomical points were used as parameters for model creation. Ceramic fragments were modeled varying their maximum thicknesses as: 0.5 mm, 1.0 mm and 1.5 mm. Solid geometries were exported to the analysis software (ANSYS 17.2, USA) in STEP format. The materials were considered isotropic, homogeneous and linear, and the values of the elastic modulus of the materials and structures were used to perform a static structural mechanical analysis. The set was submitted to 200 N load. The system fixation was defined on the basis of the three- dimensional model, and the results were obtained in MPa according to the failure criteria of the analyzed materials (tensile stress). Occlusal restoration was not detrimental to mechanical behavior. Stress distribution in the internal region of the restoration was similar between the groups. Thicker fragments presented a lower concentration of tensile stress, therefore suggesting better prognosis in attenuating tensile stresses in the tooth region. More conservative occlusal ceramic fragments presented worse prognosis. However, all evaluated thickness for table-tops support the occlusal rehabilitation of upper premolars when submitted to 200 N loading.

RESUMEN: El objetivo fue evaluar las tensiones generadas en los premolares superiores rehabilitados con fragmentos cerámicos (tablero) de disilicato de litio en la superficie oclusal. Se modeló un premolar superior siguiendo sus referencias anatómicas utilizando un software de diseño asistido por computadora (Rhinoceros versión 5.0 SR8, EE. UU.). Los tejidos dentales se moldearon individualmente conteniendo esmalte, dentina y ligamento periodontal. Los principales puntos anatómicos se utilizaron como parámetros para la creación del modelo. Los fragmentos cerámicos se modelaron variando sus espesores máximos como: 0,5 mm, 1,0 mm y 1,5 mm. Las geometrías sólidas se exportaron al software de análisis (ANSYS 17.2, EE. UU.) En formato STEP. Los materiales se consideraron isotrópicos, homogéneos y lineales, y los valores del módulo elástico de los materiales y estructuras se utilizaron para realizar un análisis mecánico estructural estático. El conjunto se sometió a una carga de 200 N. La fijación del sistema se definió a partir del modelo tridimensional, y los resultados se obtuvieron en MPa según los criterios de falla de los materiales analizados (tensión de tracción). La restauración oclusal no perjudica el comportamiento mecánico. La distribución de la tensión en la región interna de la restauración es similar entre los grupos. Los fragmentos más gruesos presentaron una menor concentración de tensión de tracción, lo que sugiere un mejor pronóstico en la atenuación de las tensiones de tracción en la región dentaria. Los fragmentos cerámicos oclusales más conservadores presentaron peor pronóstico. Sin embargo, todos los espesores evaluados para tableros de mesa en disilicato de litio apoyan la rehabilitación oclusal de los premolares superiores cuando se someten a una carga de 200 N.

ABSTRACT: This study aimed to compare the trueness and precision of physical models manufactured chairside (intraoral scanner and 3D printed) or by plaster models obtained using impression with alginate or addition silicone. A full- arch stainless steel die was impressed to obtain ten physical models for each group. The models were measured in a stereomicroscope, considering four linear distances. To assess the precision accuracy, an analysis of the measurement variability was carried out, identified by the coefficients of variation and by the Levene’s test to compare the groups. To analyze trueness, the data average was subtracted from the database and compared considering alpha as 5 %. Considering precision, the higher dispersion of data occurred in the models obtained with silicone impression. And for trueness, Kruskal Wallis and Dunn tests results did not indicate differences between the groups in the anteroposterior linear distances (p> 0.05). Only in anterior transverse distance obtained through TRIOS (0.31 mm), it presented lower accuracy compared to the models from silicone impression (0.13 mm); however, at transverse posterior distance, the models from silicone impression showed the lowest accuracy (p <0.05). There was no difference between the models from scanning (p> 0.05). The physical dental models obtained by digital and analog workflows showed acceptable dimensional accuracy expressed by high precision and trueness. There is no difference between the evaluated intraoral scanner systems and the impression materials for the full-arch impression.

RESUMEN: Este estudio tuvo como objetivo comparar la veracidad y precisión de modelos físicos fabricados en la clínica dental (escáner intraoral e impreso en 3D) o por modelos de yeso obtenidos mediante impresión con alginato o silicona de adición. Una matriz de acero inoxidable de arco completo fue impresa para obtener diez modelos físicos para cada grupo. Los modelos se midieron en un estereomicroscopio, considerando cuatro distancias lineales. Se realizó un análisis de la variabilidad de la medida para evaluar la precisión, identificada por los coeficientes de variación y por la prueba de Levene para comparar los grupos. Para analizar la veracidad, el promedio de los datos se restó de la base de datos y se comparó considerando alfa como 5 %. Considerando la precisión, la mayor dispersión de datos ocurrió en los modelos obtenidos con impresión de silicona. Y para la veracidad, los resultados de las pruebas de Kruskal Wallis y Dunn no indicaron diferencias entre los grupos en las distancias lineales anteroposteriores (p> 0,05). Solo en la distancia transversal anterior obtenida mediante TRIOS (0,31 mm) presentó menor precisión en comparación con los modelos de impresión de silicona (0,13 mm); sin embargo, la distancia transversal posterior, los modelos de impresión de silicona mostraron la menor precisión (p <0,05). No hubo diferencia entre los modelos de escaneo (p> 0,05). Los modelos dentales físicos obtenidos mediante flujos de trabajo digitales y analógicos mostraron una precisión dimensional aceptable expresada por alta precisión y veracidad. No se observó diferencia entre los sistemas de escáner intraoral evaluados y los materiales de impresión para la impresión de arco completa.

Resumo O presente estudo é um estudo clínico prospectivo, controlado, randomizado e de longo curto prazo, com o objetivo de avaliar o desempenho clínico de restauraç ões adesivas cerâmica vítrea reforçada com dissilicato de lítio e cerâmica feldspática por um período de até 2 anos. Um total de 11 pacientes (7 mulheres, 4 homens; faixa etária: 18-60 anos, idade média: 39 anos) foram inseridas para este estudo. Cada paciente recebeu duas restaurações por grupo em um delineamento de boca dividida. LD: Onze onlays, realizados com cerâmica à base de dissilicato de lítio (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein); e FP: Onze onlays, realizados com cerâmica feldspática (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Os retornos foram realizados em 2 semanas (linha de base = R1), 1 ano (R2) e 2 anos (R3) após a cimentação, por três investigadores independentes, cegos e calibrados, usando espelhos, óculos de aumento, sondas e radiografias interproximais. Foram avaliadas a sensibilidade pós-operatória, cárie secundária, integridade marginal, descoloração marginal, correspondência de cores, rugosidade da superfície, integridade dentária e integridade da restauração. O teste de Friedman (95%) foi utilizado para determinar se havia uma diferença estatisticamente significante na comparação periódica dos parâmetros nas restaurações cerâmicas. Um total de 95,4% das restaurações estava clinicamente aceitável no retorno de 2 anos, sem diferença para qualquer parâmetro de avaliação para ambos os materiais cerâmicos. Com base nos dados de 2 anos, as restaurações CAD-CAM fabricados com cerâmica feldspática e à base de dissilicato de lítio apresentaram desempenho clínico semelhante.

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Abstract The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey’s test. Only the factor “HF concentration” was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.

Resumo O objetivo deste estudo foi investigar o desgaste tridimensional, perda volumétrica e rugosidade após a simulação de mastigação de dois materiais vitro-cerâmicos. Discos de dissilicato de lítio (LD, Emax CAD, Ivoclar) e silicato de lítio reforçado com zircônia (ZLS, Vita Suprinity, Vita Zhanfabrick) (n=20/g) foram confeccionados e digitalizados para obtenção de arquivos de estereolitografia (STL) de cada amostra. Todos os discos foram submetidos à simulação de mastigação com configuração deslizante (30 N, 300.000 ciclos, 6 mm e 1,7 Hz) com esteatita como antagonista. As amostras foram escaneadas novamente e a perda de volume e o defeito mais profundo foram medidos usando o arquivo sobreposto da linha de base através de um software de inspeção paramétrica digital e tridimensional (GOM Inspect, Braunschweig, Alemanha). A rugosidade superficial (Ra e Rz) foi avaliada através de rugosímetro de contato. Os resultados foram analisados por ANOVA 1-fator e teste Tukey (α=0,5%). ANOVA mostrou diferenças significantes entre os grupos. Considerando a perda de volume cerâmico, comprimento do defeito e rugosidade Rz, LD (-22,09±5,57%; 0,80±0,06 µm; 3,08±1.02 µm) apresentou valores médios superiores a ZLS (-15,67±4,51%; 0,56±0,09 µm; 1.51±0.90 µm). Todos os discos exibiram pequenos arranhões na superfície conforme a direção de deslizamento com padrões de desgaste, enquanto grandes ranhuras foram observadas nos traços de desgaste. Essas mesmas áreas podem ser identificadas em azul, sobrepondo os arquivos STL antes e depois da simulação de mastigação no software de inspeção. A redução linear gerada pelo contato deslizante mostra um gráfico com uma forma de padrão de desgaste semelhante. ZLS foi mais resistente ao desgaste do que LD, com menor perda de volume e menores defeitos superficiais.

Abstract The aim of this study was to investigate the three-dimensional wear, volumetric loss and surface roughness after chewing simulation of two glass ceramics. Lithium disilicate (LD, Emax CAD, Ivoclar) and Zirconia reinforced lithium silicate (ZLS, Vita Suprinity, Vita Zhanfabrick) discs (n=20/g) were scanned to obtain stereolithography (STL) files for each sample. All discs were submitted to chewing simulation with sliding configuration (30 N, 300,000 cycles, 6 mm and 1.7 Hz) with steatite as antagonist. The samples were then scanned again and the volume loss and the deepest defect depth was measured using the superimposed file from the baseline using three-dimensional digital parametric inspection software (GOM Inspect, Braunschweig, Germany). Surface roughness (Ra and Rz) was analyzed with a contact profilometer. Data were analyzed by one-way ANOVA and Tukey test (α=0.5%). ANOVA showed significant differences among the groups. Considering the ceramic volume loss, wear depth defect length and Rz roughness, LD (-22.09±5.57%; 0.80±0.06 µm; 3.08±1.02 µm) showed higher mean values than ZLS (-15.67±4.51%; 0.56±0.09 µm; 1.51±0.90 µm). Ra mean values were similar for both materials (p=0.064). All discs exhibited slight surface scratches along with the sliding direction with pitted wear patterns, while large cracks were observed on wear traces. These same areas can be identified in blue, overlapping the STL files before and after chewing simulation in inspection software. The linear reduction generated by sliding contact shows a graph with a similar wear pattern shape. ZLS was more resistant to wear than LD, with less volume loss and shallower surface defects.

Resumo O objetivo deste estudo foi avaliar a probabilidade de falha de dois tipos de parafusos para pilar protético após a compressão e analisar a distribuição da tensão com o método dos elementos finitos. Sessenta (60) restaurações unitárias foram montadas em implantes de titânio (e-fix, A.S. Technology - Titanium Fix). Os grupos foram divididos em parafusos convencionais (parafuso de pescoço 1,5 ø mm) e parafuso experimental (parafuso de pescoço estreitado com 1,2 ø mm). As amostras foram sujeitas ao teste de compressão de acordo com ISO 14801. Os espécimes fraturados foram submetidos a estereomicroscopia para a mensuração dos parafusos restantes dentro do implante e caracterização da origem da fratura. Os espécimes representativos foram analisados por microscopia eletrônica de varredura. Para o método de elementos finitos (FEM), utilizou-se um modelo 3D idêntico dos dois grupos de teste in vitro com condições semelhantes (30º, 100 N). A tensão no parafuso do pilar foi analisada pelo critério de von-Mises. Os resultados de resistência a compressão foram 4132,5 ± 76 MPa e 4528,2 ± 127,2 para grupos convencionais e experimentais, respectivamente. Durante a microscopia, a média do remanescente do parafuso restante dentro dos implantes foi de 0,97 ± 0,23 e 1,32 ± 0,12 mm para os grupos convencionais e experimentais, respectivamente. Em FEM, o grupo convencional mostrou tensão concentrada em uma região desfavorável (pico de 39,23 MPa), enquanto o grupo experimental apresentou mais áreas de tensão, porém menor concentração do que o grupo convencional (36,6 MPa). Ao usar a geometria experimental testada, o parafuso do pilar pode ter sua resistência melhorada e a origem da falha pode ser mais favorável à resolução clínica.

Abstract The aim of this study was to evaluate the failure probability of two types of abutment screws after compressive load and to analyze the stress distribution with finite element method. Sixty (60) single-tooth implant restorations were assembled on titanium implants (e-fix, A.S. Technology - Titanium Fix). The groups were divided into Conventional screw (Screw neck 1.5 ø mm) and Experimental screw (Screw neck constricted with 1.2 ø mm). Specimens were subjected to single load to failure with compressive test according ISO 14801. The fractured specimens were subjected to stereomicroscopy for measurement of remaining screws inside the implant and characterization of fracture origin. Representative specimens were analyzed by scanning electronic microscopy. For finite element method (FEM), an identical 3D model of the two in vitro test groups were used with similar conditions (30º, 100 N load). The stress in the abutment screw was analyzed by von-Mises criteria. The results of strength means were 4132.5 ± 76 MPa and 4528.2 ± 127.2 for conventional and experimental groups, respectively. During microscopy, the mean (mm) of the remaining screw piece inside the implants were 0.97 ± 0.23 and 1.32 ± 0.12 for conventional and experimental groups, respectively. In FEM, the conventional group showed stress concentered in an unfavorable region (peak of 39.23 MPa), while the experimental group showed more stress areas but less concentration than the conventional group (36.6 MPa). In using the tested experimental geometry, the abutment screw can have its strength improved, and the origin of failure can be more favorable to clinical resolution.

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 A inclinação dos implantes pode ser corrigida através de mini-pilares de diferentes angulações. Objetivo Analisar a influência de implantes com hexágono externo em diferentes inclinações (3 níveis) na distribuição de microdeformações geradas em torno de três implantes. Método Um modelo geométrico de osso foi criado através do software CAD Rhinoceros (versão 5.0 SR8, Mcneel North America, Seattle, WA, EUA). Três implantes (4,1 × 13 mm) foram modelados e inseridos no interior do substrato em três diferentes inclinações: 0º, 17º e 30º. Em seguida, todos os grupos receberam mini-pilares cônicos, parafusos de fixação e prótese simplificada. A geometria final foi exportada em formato STEP para software de análise e todos os materiais foram considerados homogêneos, isotrópicos e linearmente elásticos. Uma carga axial (300N) foi aplicada no centro da prótese. Um estudo in vitro foi conduzido com as mesmas condições e grupos para validar o modelo tridimensional. Resultado A concentração de tensão ocorreu na área externa dos implantes, em contato com o osso cortical e o hexágono externo. Para o simulador ósseo, a deformação aumentou na região peri-implantar de acordo com o aumento da inclinação do implante. A diferença entre os grupos foi significativa (p = 0.000). O grupo de 30º apresentou maior concentração de tensão e deformação. Conclusão O aumento da microdeformação e das tensões ao redor dos implantes aumenta diretamente proporcional ao aumento do ângulo de instalação.

Abstract Introduction Implant inclinations can be corrected using mini abutments at different angulations. Objective To analyze the influence of external hexagon implants in different inclinations (3 levels) on the microstrain distribution generated around three implants. Method A geometric bone model was created through Rhinoceros CAD software (version 5.0 SR8, Mcneel North America, Seattle, WA, USA). Three implants (4.1 × 13 mm) were modeled and inserted inside the substrate at three different inclinations: 0º, 17º and 30º. Next, all groups received mini conical abutments, fixation screws and a simplified prosthesis. The final geometry was exported in STEP format to analysis software and all materials were considered homogeneous, isotropic and linearly elastic. An axial load (300N) was applied on the center of the prosthesis. An in vitro study was conducted with same conditions and groups for validating the tridimentional model. Result Stress was concentrated on the external area of the implants, in contact with the cortical bone and external hexagon. For the bone simulator, the strain increased in the peri-implant region according to the increase in the implant’s inclination. The difference between groups was significant (p = 0.000). The 30º group presented higher stress and strain concentration. Conclusion The microstrain and stress increase around implants directly proportional to the increase of the installation angle.

Resumo Introdução Um novo design de pilar para implantes dentários está disponível com a possibilidade de melhorar a estética sem comprometer a resistência mecânica, usando blocos cerâmicos perfurados para CAD/CAM. Objetivo Este estudo avaliou a influência da combinação de diferentes materiais cerâmicos para coroa e para pilar híbrido na distribuição de tensões de prótese sobre implante hexágono externo. Método Zircônia, dissilicato de lítio e cerâmica híbrida foram avaliados, totalizando 9 combinações de materiais para coroa e mesoestrutura. Para análise de elementos finitos, uma coroa monolítica cimentada sobre um pilar híbrido (mesoestrutura + base de titânio) foi modelada sobre um implante de hexágono externo. Os modelos foram exportados em formato STEP para o software de análise, e os materiais foram considerados isotrópicos, lineares, elásticos e homogêneos. Uma carga oblíqua (30°, 300N) foi aplicada no fundo da fossa central e a fixação do sistema ocorreu na base do osso. Resultado Para a estrutura da coroa, os materiais flexíveis concentram menos tensão que os rígidos. Ao analisar o pilar híbrido, maiores valores de tensão foram observados quando feito com zircônia combinada com uma coroa de cerâmica híbrida. Em todas as combinações simuladas, a distribuição de tensões foi semelhante para o parafuso de fixação e o implante. Conclusão Associar um material cerâmico com elevado módulo elástico para a coroa com um material de menor módulo elástico para o pilar híbrido resulta em menor concentração de tensão máxima principal, sugerindo um comportamento mecânico promissor para o sistema hexágono externo.

Abstract Introduction A new dental implant-abutment design is available with the possibility of improving aesthetic with no compromise of mechanical strength, using perforated CAD/CAM ceramic blocks. Objective This study evaluated the influence of crown and hybrid abutment ceramic materials combination on the stress distribution of external hexagon implant supported prosthesis. Method Zirconia, lithium disilicate and hybrid ceramic were evaluated, totaling 9 combinations of crown and mesostructure materials. For finite element analysis, a monolithic crown cemented over a hybrid abutment (mesostructure + titanium base) was modeled and screwed onto an external hexagon implant. Models were then exported in STEP format to analysis software, and the materials were considered isotropic, linear, elastic and homogeneous. An oblique load (30°, 300N) was applied to the central fossa bottom and the system’s fixation occurred on the bone’s base. Result For crown structure, flexible materials concentrate less stress than rigid ones. In analyzing the hybrid abutment, it presented higher stress values when it was made with zirconia combined with a hybrid ceramic crown. The stress distribution was similar regarding all combinations for the fixation screw and implant. Conclusion For external hexagon implant, the higher elastic modulus of the ceramic crowns associated with lower elastic modulus of the hybrid abutment shows a better stress distribution on the set, suggesting a promising mechanical behavior.

Resumo Este estudo avaliou a efetividade de um adesivo “multi-mode” (Single Bond Universal/3M) como um substituto para a silicatização e aplicação do silano na resistência de união das cerâmicas de zircônia e um cimento resinoso. Para isso, 120 blocos cerâmicos sinterizados de zircônia nas dimensões de (5 x 5 x 5 mm) foram obtidos, lixados com lixas de granulação decrescente (#600, #800, #1000 e #1200) e divididos aleatoriamente em 12 grupos (n = 10), de acordo com os fatores “tratamento de superfície” (ScSi - silicatização + silanização; ScSBU - silicatização + Single Bond; SBU - SBU sem fotoativação e SBUp - SBU com fotoativação) e “cerâmica” (Lava/3M ESPE, Ceramill Zircônia/ Amann Girrbach e Zirkonzahn/Zirkonzahn). Posteriormente, cilindros de cimento resinoso dual (RelyX Ultimate/3M ESPE) foram confeccionados no centro de cada bloco com auxílio de uma matriz de silicone (Ø=2 mm; h=5 mm) e fotopolimerizados por 40 s (1200 mW/ cm²). Em seguida, as amostras foram armazenadas durante trinta dias em água destilada (37 °C) e submetidas ao ensaio de resistência de união ao cisalhamento (1 mm/min, 100 kgF). Os dados (MPa) foram analisados sob ANOVA (2 fatores) e teste de Tukey (5%). Análises complementares também foram realizadas. ANOVA revelou que apenas o fator “tratamento de superfície” foi significativo (p=0,0001). O tratamento ScSi (14.28A) promoveu valores de adesão estatisticamente superiores aos demais ScSBU (9.03B), SBU (8.47B) e SBUp (7.82B), os quais foram semelhantes entre si (Tukey). A Análise de falhas revelou que 100% da falhas que ocorreram foram mistas. A silicatização seguida da silanização promoveu a melhor resistência de união entre cimento resinoso e a cerâmica, independentemente do tipo da cerâmica ou do SBU.

Abstract This study evaluated the effectiveness of a multi-mode adhesive (SBU-Scotch Bond Universal/3M) as a substitute for silica coating and silane application on the bonding of zirconia ceramics to resin cement. One-hundred and twenty sintered zirconia ceramic blocks (5 x 5 x 5 mm) were obtained, finished by grounding with silicon carbide paper (#600, #800, #1000 and #1200) and randomly divided into 12 groups (n=10) in accordance with the factors “surface treatment” (ScSi - silicatization + silanization; ScSBU - silicatization + SBU; SBU - SBU without photoactivation and SBUp - SBU photoactivated) and “ceramic” (Lava / 3M ESPE, Ceramill Zirconia / Amann Girrbach and Zirkonzahn / Zirkonzahn). Dual resin cement cylinders (RelyX Ultimate/3M ESPE) were subsequently produced in the center of each block using a silicon matrix (Ø=2 mm, h=5 mm) and photoactivated for 40 s (1200 mW/cm2). The samples were stored for 30 days in distilled water (37ºC) and submitted to shear bond strength test (1 mm/min, 100 KgF). Data (MPa) were analyzed under ANOVA (2 levels) and Tukey test (5%). Complementary analyzes were also performed. ANOVA revealed that only the factor “surface treatment” was significant (p=0.0001). The ScSi treatment (14.28A) promoted statistically higher bond strength values than the other ScSBU (9.03B), SBU (8.47B) and SBUp (7.82B), which were similar to each other (Tukey). Failure analysis revealed that 100% of the failures were mixed. The silica coating followed by the silanization promoted higher bond strength values of resin cement and ceramic, regardless of the zirconia ceramic or SBU.

Abstract The aim of this study was to evaluate stress distribution in an occlusal veneer according to the restorative material, restoration thickness, and cement layer thickness. A tridimensional model of a human maxillary first molar with an occlusal veneer preparation was constructed using a modeling software of finite element analysis. The model was replicated 9 times to evaluate the factors: restoration thickness (0.6, 1.2, and 1.8 mm) and cement layer thickness (100, 200, and 300 μm). Then, each model received different restorative materials (High Translucency Zirconia – [YZHT], Lithium Disilicate – [LD], Zirconia Reinforced Lithium Silicate – [ZLS], Feldspathic – [F], and Hybrid Ceramic – [HC]), totaling forty-five groups. An axial load (600 N) was applied on the occlusal face for static structural analysis. Solids were considered isotropic, homogeneous, and linearly elastic. Contacts were considered perfectly bonded. Fixation occurred in the dental root and a mechanical static structural analysis was performed. Descriptive statistical analysis and one-way ANOVA (α =10%) were performed for tensile stress peak values in the restoration and cement layer. The difference between groups was compared using the Tukey's test with 10% significance to match the percentage of the mesh convergence test. According to the results, the cement layer thickness did not influence stress distribution in the restoration (p ≥ 0.10). The thicker the restoration, the higher the tensile stress concentration in the restoration. The graphs showed higher stress concentration in the YZHT, followed by LD, F, ZLS, and HC. Also, the restorative material influenced stress concentration on the cement layer, which decreased according to the sequence HC>YZHT>ZLS>LD>F. HC stood out for causing the least stress concentration in the restoration. Cement layer thickness did not interfere in the mechanical performance of the restorations.

Resumo Introdução O ajuste entre a prótese e o implante é fundamental para determinar a longevidade do tratamento e manutenção do osso periimplantar. Objetivo Avaliar o desajuste vertical entre diferentes infraestruturas metálicas e plataforma dos implantes, a fim de fornecer informação, para auxiliar na escolha do metal a ser utilizado. Material e método O estudo utilizou componentes do tipo UCLA (N=40), com antirrotacional, foram divididos da seguinte forma: componentes usinados em titânio (n=10), componentes fundidos em titânio (n=10), níquel-cromo-titânio-molibdênio (n=10) e em níquel-cromo (n=10). Após o torque, as amostras foram analisados em estereomicroscópio. Para caracterização em MEV, foram utilizadas as amostras mais representativas, com maior e menor desajuste vertical. Resultado Os dados foram analisados por média e desvio padrão e submetidos ao teste ANOVA ONE way, onde os grupos foram estatisticamente diferentes (p=<0,05), seguido do teste TUKEY. Conclusão A escolha do infraestrutura influencia no valor do desajuste vertical, sendo que o grupo usinado em Ti apresentou o menor valor de desajuste, e o grupo fundido em Ni Cr o grupo com maior valor de desajuste vertical.

Abstract Introduction The fit between abutment and implant is crucial to determine the longevity of implant-supported prostheses and the maintenance of peri-implant bones. Objective To evaluate the vertical misfit between different abutments in order to provide information to assist abutment selection. Material and method UCLA components (N=40) with anti-rotational system were divided as follows: components usinated in titanium (n=10) and plastic components cast proportionally in titanium (n=10), nickel-chromium-titanium-molybdenum (n=10) and nickel-chromium (n=10) alloys. All components were submitted to stereomicroscope analysis and were randomly selected for characterization by SEM. Result Data were analyzed using mean and standard deviation and subjected to ANOVA-one way, where the groups proved to statistically different (p=<0.05), followed by Tukey’s test. Conclusion The selection of material influences the value of vertical misfit. The group machined in Ti showed the lowest value while the group cast in Ni Cr showed the highest value of vertical misfit.

Abstract This study evaluated the effect of implantoplasty on different bone insertion levels of exposed implants. A model of the Bone Level Tapered implant (Straumann Institute, Waldenburg, Switzerland) was created through the Rhinoceros software (version 5.0 SR8, McNeel North America, Seattle, WA, USA). The abutment was fixed to the implant through a retention screw and a monolithic crown was modeled over a cementation line. Six models were created with increasing portions of the implant threads exposed: C1 (1 mm), C2 (2 mm), C3 (3 mm), C4 (4 mm), C5 (5 mm) and C6 (6 mm). The models were made in duplicates and one of each pair was used to simulate implantoplasty, by removing the threads (I1, I2, I3, I4, I5 and I6). The final geometry was exported in STEP format to ANSYS (ANSYS 15.0, ANSYS Inc., Houston, USA) and all materials were considered homogeneous, isotropic and linearly elastic. To assess distribution of stress forces, an axial load (300 N) was applied on the cusp. For the periodontal insert, the strains increased in the peri-implant region according to the size of the exposed portion and independent of the threads’ presence. The difference between groups with and without implantoplasty was less than 10%. Critical values were found when the inserted portion was smaller than the exposed portion. In the exposed implants, the stress generated on the implant and retention screw was higher in the models that received implantoplasty. For the bone tissue, exposure of the implant’s thread was a damaging factor, independent of implantoplasty. Implantoplasty treatment can be safely used to control peri-implantitis if at least half of the implant is still inserted in bone.