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Objective: The aim was to evaluate the difference in the heat generated between zirconia (Zr) and steel (SS) drills, during implant site preparation. Material and methods: This systematic review followed the PRISMA methodology criteria and used the JBI Critical Assessment Guidelines for Quasi-Experimental Studies for quality assessment. The electronic search was conducted by using the PubMed/MEDLINE, Embase, and Cochrane Library databases to January 2023. The formulated population, intervention, comparison, outcome (PICO) question was “Do zirconia drills generate less heat than steel drills during implant site preparation?“. The meta-analysis was based on an inverse variance (IV) method. Results: This review included 10 studies in vitro that used zirconia drills compared to steel drills with or without coatings. The meta-analysis indicated a significant difference between Zr drills and SS drills, with a lower bone temperature variation with Zr drills. Conclusions: Despite the limitations of this review, it was concluded that Zr drills had significantly less temperature variation than SS drills.

Abstract The objective of this study was to analyze the influence of insertion torque, bone type, and peri-implant bone loss on implant stability quotient (ISQ) of cylindrical external hexagon (EH) and Morse Taper (MT) implants. Forty-four single implants were placed in the edentulous areas of 20 patients who met the inclusion and exclusion criteria. Immediately after implant placement (t1) and after osseointegration (four and six months for mandible and maxilla, respectively) (t2), insertion torque, resonance frequency, and peri-implant bone loss were measured using probing depths and digital periapical radiography. A significant difference was noted in the ISQ values between t1 and t2 in type III bone for EH and MT implants. No significant difference in bone loss values was observed when comparing bone types for EH or MT in all evaluated sites. Based on marginal bone loss assessed using radiography, there was no significant difference between the MT and EH groups. A positive correlation between torque and ISQ t1 value was observed for MT (correlation: 0.439; p = 0.041) and EH (correlation: 0.461; p = 0.031) implants. For EH and MT implants, the greater the insertion torque, the greater was the ISQ value (moderately positive correlation). A weak negative correlation was found between bone type and ISQ t1 for MT implants. Contrarily, no correlation was observed between bone type and ISQ t1 for EH implants. In all cases, bone loss around the implants was clinically normal.

The objective of this article is to concisely review the main clinical techniques used to make the functional impression to manufacture a removable partial denture. Through this review, the dentist can develop his clinical knowledge.

During the fabrication of a complete denture, functional impression is taken. Literature studies show that polydimethylsiloxane (condensation silicone) has not been reported by United States dental schools to perform border molding. Thus, the purpose of this article is to review the functional impression technique when border molding is performed with a laboratory condensation silicone putty.

The gap formed at the abutment-implant interface brings about a bacterial colonization. In addition, a bacterial reservoir can be established within the implant. The build-up of microorganisms around the implant can cause soft tissue infections and bone loss around the implant, which can lead to implant failure. Our literature review aimed to evaluate the infiltration at the implant-abutment interface, comparing the Morse cone connection with the external hexagon and internal hexagon connections. A literature search using the PubMed database was performed on March 24, 2021. The search terms were combinations of “Morse cone” or “Morse taper” with each of the following terms (individually): “microleakage”, “leakage”, “infiltration”, and “penetration”. The inclusion criterion was in vitro studies comparing the Morse cone with the external hexagon and/or internal hexagon, based on infiltration at the implant-abutment interface. The exclusion criterion was the evaluation of microleakage at the implant-abutment interface after applying a sealant over this region. The search was expanded as needed. There was no limit on the year of publication, and only articles written in English were included. In addition, references cited in included articles were also included in this review when they were appropriate. This literature review concluded that, in most cases, the microleakage in the Morse cone connection was lower when compared with the external hexagon and internal hexagon connections.

Objective: To identify the presence and level of halitosis in edentulous individuals with or without prostheses, before and after rehabilitation with complete dentures (CD). Methods: Patients were verbally invited to participate and signed an Informed Consent. Halitosis was analyzed by the volatile sulfur compounds measurement method in the presence and absence of the old prostheses (M1) and 15 to 30 days after the patients received their new prostheses (M2). At M1, the patients answered a questionnaire with clinical data, and the saliva type and presence/absence of tongue coating were assessed. T-test and Spearman correlation test were used, and a p-value < 0,05 was considered statistically significant. Results: Twenty-seven patients (19 women) with an average age of 67 years participated in the study. The mean time of prosthesis usage was 20.2 years. Tong coating was present in 21 patients (77,8%). A good odor level of halitosis was self-claimed in 13 (41,8%) individuals. The odor level of halitosis was significantly lower in M2 compared to M1, either with or without CD and after hygiene (p < 0,001). There was a positive and statistically significant correlation between the level of halitosis and alcoholism, smoking, prostheses hygiene method, and the presence of disease (diabetes). Conclusion: The old complete replacement of the prostheses with new ones was able to improve the odor level in a period of 15 to 30 days after the treatment. The presence of halitosis was correlated with alcoholism, smoking, denture hygiene methods, and the presence of diabetes.

Aim: The aim of this meta analysis was to evaluate the influence of the processing method on the marginal and internal gaps of lithium disilicate inlays/onlays. Settings and Design: A systematic literature review was conducted using the PubMed/Medline, Embase, Scopus, and Cochrane Library databases. This review was registered on the PROSPERO platform. Materials and Methods: The studies were selected according to the marginal and internal gaps of two different fabrication methods for lithium disilicate (milled and pressed). Statistical Analysis Used: The meta analysis was performed based on the Mantel–Haenszel and inverse variance methods, using the random effects model and a 95% confidence interval. Results: From all databases, 127 studies were identified. Four in vitro studies were included in the qualitative analysis and three in the meta analysis. Moreover, 197 restorations were evaluated (103 pressed and 94 milled). During the evaluation of only the internal gap, there was a statistically significant difference favoring the pressed technique (P = 0.002). There was no statistically significant difference in the analyses of the marginal gap (P = 0.530) and the total gap (P = 0.450). Conclusion: Both the techniques provided acceptable marginal and total gaps, although the pressed technique revealed a more favorable internal adaptation than the milled onlays/inlays.

Irritation and biofilm adhesion are complaints associated with ocular prosthesis use. This study aimed to evaluate the effects of prosthesis repolishing on several conditions of anophthalmic volunteers. Participants were divided into two groups: intervention (IG, n = 10) and nonintervention (NIG, n = 6) groups. The anophthalmic cavity, contralateral eye, and prosthesis surface were evaluated at initial, day 15, and day 30 after repolishing. Microbiological analysis (colony-forming units), exfoliative cytology (conjunctiva inflammatory cells), sensory analysis (quantitative mechanical sensory test), tear production (Schirmer’s test), and conjunctival inflammation (clinical evaluation) were performed. Nonparametric tests were used to compare groups in the initial period and to analyze periods for the IG (p < 0.05). More microorganisms were formed in the anophthalmic socket and prosthesis than in the contralateral eye in the initial period. For IG, the anophthalmic cavity exhibited more microorganisms and inflammatory clinical signs in the initial period than at 15 and 30 after repolishing. The prosthesis showed greater accumulations of total bacteria and Candida albicans in the initial period than at 15 and 30 days after repolishing. The anophthalmic cavity had more palpebral inflammation than the contralateral eye. In conclusion, repolishing reduced the number of microorganisms and inflammatory signs over time.

Background. Implant fractures can cause difficult problems for patients and dentists. This systematic review aimed to determine the influence of some implant parameters on the occurrence of their fracture and to determine the incidence of fractures reported in recent years. Methods. A search was conducted in Pubmed database, from which 12 studies published in the last 12 years were selected. Results. This review reported a 2% incidence of implant fracture. Most implants had been in function between 3 and 4 years until fracture. The studies did not provide necessary information to establish a relationship between the different parameters of implants and the incidence of fractures. Conclusion. Thus, the indication of type, diameter and length of an implant and the bone quality in the region receiving it should be studied and accurately examined for each individual case in order to avoid future failures.

Abstract Background The aim was to analyze the levels of stress of edentulous patients through the state-trait anxiety inventory (STAI) and salivary flow through the visual analogue scale (VAS) xerostomia questionnaire, as well as analyze the levels of cortisol, capillary blood glucose, and blood pressure (BP) before and after the installation of complete dentures. Methods Fifty patients were evaluated. The STAI and VAS xerostomia questionnaire were applied before the installation of the prosthesis, on the day of its installation, and 1 month after the last recall visit. The BP measurement, as well as salivary and blood collections, were performed before the installation of the prothesis, and 1 month after the last recall visit. Data from the VAS xerostomia questionnaire and cortisol levels were submitted to ANOVA and the Tukey test (P = .05). Data from the STAI, as well as blood glucose and BP levels, were submitted to the Chi-square test (P = .05). The correlation between cortisol and blood glucose and between cortisol levels and BP was analyzed. Results There was no statistically significant association between the questions of the VAS xerostomia questionnaire, STAI-state and STAI-trait scores, or the periods analyzed. However, the cortisol level collected in the morning decreased after the installation of the prosthesis. There was a correlation between cortisol and blood glucose and BP levels. Conclusions The installation of complete dentures was beneficial for patients since it was probably responsible for the cortisol level reduction.

Background: The aim of this study was to verify, through self-assessment questionnaires, the influence of implant-supported prosthesis in salivary flow and anxiety of patients rehabilitated with them. Materials and Methods: Visual analog scale (VAS) questionnaire about xerostomia and State-Trait Anxiety Inventory were applied before (T1) and after 2 days (T2) and 3 weeks (T3) of prostheses installation. The study included patients rehabilitated with implant-supported prostheses containing three or more dental elements. A total of 17 patients were evaluated. Results: In VAS questionnaire, there was a significant increase in the difficulty of speaking and swallowing with dry mouth. The other VAS questions showed no statistically significant difference, indicating no changes in patients' salivary flow. Conclusions: It was concluded that the installation of implant-supported prostheses does not lead to major changes in patients' perception about their salivary flow and psychological state, causing no improvement or worsening in the characteristics evaluated.

ABSTRACT Objective: This study aimed to evaluate the dimensional stability and maintenance of details of conventional and high stability alginates up to 5-day storage. Methods: Two types of alginates were selected (n=10) for this study, conventional (Hydrogum) and high stability alginates (Hydrogum 5), which were produced with the aid of a cylindrical metal block and a ring-shaped metal mold (Specifications 18, 19, and 25, ANSI/ADA). Ten images were obtained from the molds for the dimensional stability test, which were taken immediately after their production and at each different storage periods (15 min, 24 h, 48 h, 72 h, 96 h, and 120 h) by a digital camera. The specimens were kept hermetically sealed in plastic bags (23°C) and then used to obtain 140 (n=70) dental stone models, used in the detail reproduction test, in which the angular accuracy of three grooves (20 µm, 50 µm, and 75 µm) was observed at each period. The details reproduction accuracy was classified using a predetermined score classification. Measurements of dimensional changes were made in the Corel DRAW X6 program. The data were submitted to the Student’s t-test (α?#8197;= 0.05). Results: A statistically significant difference concerning the size of the matrix was observed after 24h for both alginates, and a statistically significant negative linear dimensional change (contraction) was verified after 24 h of storage (1.52% for the high stability alginate, and 1.32% for the conventional alginate). The high stability alginate kept the full details for 72 hours, while the conventional alginate, for 24 h. Both alginates reproduced the 75 µm groove at all storage periods. Conclusion: Impressions made with both alginates presented satisfactory clinical results when the alginates were immediately poured.

The aim of this study was to evaluate the effect of disinfectants on the biofilm of Staphylococcus aureus and Staphylococcus epidermidis formed on the acrylic surface of ocular prostheses. In this study, 396 acrylic specimens were manufactured (50% for Staphylococcus epidermidis, and 50% for Staphylococcus aureus). For each bacterium, 66 specimens were subjected to biofilm formation on their surfaces for 24 hours, 66 specimens were subjected to biofilm formation on their surfaces for 48 hours, and 66 specimens were subjected to biofilm formation on their surfaces for 72 hours. Then, they were divided into groups according to disinfection method (n = 6): sterile distilled water for 10, 15, 30 min, and 6 hours (control); soap for 30 min (NES30); Opti-Free for 30 min (OPF30) and 6 h (OPF6); Efferdent for 15 min (EFF15); and 0.5%, 2%, and 4% chlorhexidine for 10 min (0.5% CHX10, 2% CHX10, and 4% CHX10). After the treatments, the specimens were vortexed to release the biofilm and the counting of bacterial colonies was performed (CFU/mL). Three-way ANOVA and the Tukey-Kramer HSD test were used (α = 0.05). For Staphylococcus epidermidis, there was no significant difference between NES30, OPF30, and OPF6 with their respective control groups; nor between NES30, OPF30, and OPF6 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, there was no significant difference between NES30 and OPF30 with their control group; nor between NES30 and OPF30 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, OPF6 showed a significant reduction in the number of CFU/mL when compared with its control group, NES30, and OPF30, regardless of the biofilm development period (P

Objective. To evaluate the influence of different pigmentations and accelerated aging on the hardness and tear strength of the A-2186 and MDX4-4210 silicones. Materials and Methods. The samples A-2186 and MDX4-4210 were manufactured without and with pigmentations (black, bronze, and pink). For the Shore A hardness test, 80 samples of each silicone were fabricated, and for the tear strength test, 320 samples of each silicone were fabricated. Eight groups were created for each test (n = 10). These tests were performed before and after 252, 504, and 1008 hours of aging. Three-way repeated-measures analysis of variance and the Tukey test were performed (α = 0.05). Results. The A-2186 silicone showed higher hardness and tear strength when compared with the MDX4-4210 silicone p0.05. All hardness values were between 25 and 35 units, regardless of the silicone type, period, and pigmentation (or no pigmentation). In most situations, the hardness of silicones used increased after 252 hours p0.05. All pigmented MDX4-4210 groups showed no change in tear strength from 0 (initial) to 1008 hours of aging p>0.05. In all A-2186 groups, from 252 to 504 hours, there was a reduction in tear strength p0.05. Conclusion. In most situations, the A-2186 silicone showed significantly higher values of hardness and tear strength than the MDX4-4210 silicone. All hardness values were considered clinically acceptable. Accelerated aging could increase, decrease, or not significantly change the hardness and tear strength of the silicones used. The results of hardness and tear strength suggest that MDX4-4210 was more influenced by the presence of pigmentation after aging.

Objective. The aim of this study was to evaluate the tear strength of MDX4-4210 and A-2186 silicones with different intrinsic pigments incorporated by mechanical and industrial methods, comparing nonaged and aged groups. Materials and Methods. Twenty-four groups were created according to the American Society for Testing and Materials D-624/type C, half nonaged and half aged (n = 10): bronze mechanical MDX4-4210, bronze industrial MDX4-4210, black mechanical MDX4-4210, black industrial MDX4-4210, pink mechanical MDX4-4210, pink industrial MDX4-4210, bronze mechanical A-2186, bronze industrial A-2186, black mechanical A-2186, black industrial A-2186, pink mechanical A-2186, and pink industrial A-2186. All specimens were submitted to tear strength analysis. Data were submitted to the ANOVA and Tukey test (p

This review presents a classification system for maxillofacial prostheses, while explaining its types. It also aims to describe their origin and development, currently available materials, and techniques, predicts the future requirements, and subsequently discusses its avenues for improvement as a restorative modality. A literature search of the PubMed/Medline database was performed. Articles that discussed the history, types, materials, fabrication techniques, clinical implications, and future expectations related to maxillofacial prostheses and reconstruction were included. Fifty-nine articles were included in this review. Maxillofacial prostheses were classified as restorative or complementary with subclassifications based on the prostheses finality. The origin of maxillofacial prostheses is unclear; however, fabrication techniques and materials have undergone several changes throughout history. Currently, silicones and acrylic resins are the most commonly used materials to fabricate customized prostheses. Maxillofacial prostheses not only restore several types of orofacial defects but also improve the patients’ quality of life. Although the current clinical scenario concerning the field of maxillofacial prostheses is promising, improvements in material quality and techniques for maxillofacial prostheses may be expected in the future, to produce better results in the treatment of patients.

This paper reports the experience of an extension project "Optimization of multidisciplinary care of patients with head and neck cancer of Oral Oncology Center, School of Dentistry, UNESP-Araçatuba-". The objective of this project is evaluate the physical structure and the quality of multidisciplinary care offered to cancer patients. A questionnaire with twelve questions closed January 2013 to June 2014-165 patients treated at the Oral Oncology Center was applied. It was observed that most patients were male (91%) and evaluating both the physical structure and the quality of care as excellent (74.8%). As suggestion for improvement, 52 patients requested increased waiting and clinical care room and 10 improved meeting room in multi-therapy group. It is concluded that patients proved to be generally satisfied with the service provided, but it is necessary an improvement in the physical sectors and care. Some weaknesses in the process were identified, providing information to the improvement of their work, thus contributing to the optimization of services and patient satisfaction. This implies the awareness of the whole team for their importance and value of their shares.

OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation.

Objectives: This study aimed to evaluate the influence of the incorporation of pigments on surface hardness of four acrylic resins subjected to thermocycling and analyze their elemental composition using energy dispersive X-ray spectroscopy (EDS). Materials and Methods: Twenty-one discs of each resin were fabricated, whereas seven had no additive, seven had 3% of nanoscale pigments and last seven had 10% of them. The percentage was obtained by measuring the total weight of each resin disc. Besides, seven discs composed by only nanoscale pigments were also fabricated, totalizing 91 discs. The pigment was weighed by using an analytical balance (BEL Analytical Equipment, SP, Brazil). The surface hardness was measured through a hardness tester machine before and after thermocycling (5-55°C, for 2000 cycles). Data were analyzed by ANOVA and Tukey′s test (P < 0.05). The chemical composition of the discs composed only by nanoscale pigments was analyzed with EDS test. Results: Hardness of all resins decreased after thermocycling. The lowest values were observed on the discs with 3% of nanoscale pigments and discs fabricated only with them. EDS showed the presence of titanium dioxide. Conclusion: Discs with 7% of pigments (after thermocycling) showed higher hardness values.

Introduction: New materials are developed all the time to better suit the patients' needs, such as flexible injectable thermoplastic resins that provide more esthetics to patients using removable partial dentures. Aim: The objective of this study was to evaluate the color change, microhardness and flexural strength of an experimental flexible acrylic resin under the influence of thermocycling. Materials and Methods: This in vitro study was conducted in Aracatuba Dental School, UNESP University. Two types of samples were made, 30 in circular format (3×10 mm) for color and microhardness tests, and 60 in rectangular format (64×10×3.3 mm) for the flexural strength test. The samples were divided into three groups (n=10), one of the experimental flexible resin tested, one with a flexible resin already marketed (Sorriflex), and a control group of a conventional thermopolymerisable acrylic resin (Lucitone). After the preparation, color, microhardness and flexural strength readings were taken, initially and after 2000 thermocycling cycles. The obtained data was submitted to analysis of variance ANOVA and post-hoc Tukey’s test when necessary. Results: All resins presented a clinically acceptable color variation (ΔE), with no significant difference between resin type (p>0.05). There was a difference in the hardness of resins in ascending order (Sorriflex, experimental and Lucitone) and the hardness increased after thermocycling (p

Purpose: The aim of this study was to evaluate the effect of a surface treatment with Sofreliner primer on tensile bond strength of a resin-based soft liner (Coe-Soft) bonded to a polymethylmethacrylate (PMMA) resin before and after accelerated aging simulated by a thermocycling machine. Material and Methods: One hundred and twenty rectangular specimens of PMMA resin were fabricated with 10 × 10 mm² of cross-section and 40 mm of height. The resin-based soft liner was positioned between two PMMA resin specimens. The specimens were divided randomly into 6 groups (n = 10) according to the surface treatment and accelerated aging cycles (0, 500 and 1000). After accelerated aging, specimens were submitted to tensile bond strength test. The fractures were classified as adhesive, cohesive or both. Results: Most failures were classified as cohesive (p = 0.025) and there was an increase on the mean values of tensile bond strength for group with primer application regardless the cycles of accelerated aging, and also an increase along thermocycling periods. The scanning electronic microscopy was used to illustrate the types of failures and the effect of primer application on PMMA acrylic resin surface. Conclusion: The primer application associated with resin-based soft liners is clinically viable, once this treatment strategy provides a reliable adhesion.

This clinical report describes the ocular rehabilitation of a child, initially using an acrylic expander and subsequently the conventional prosthesis. A two-month-old anophthalmic female patient was referred to Araçatuba Dental School, for rehabilitation with ocular prosthesis. The treatment chosen was the manufacturing of expander prostheses changed periodically until the socket reached an adequate size, so that a definitive ocular prosthesis could be installed. The acrylic expander remained in patient’s anophthalmic socket for 60 days in order to restore its volume. After this period, ocular prosthesis was installed and replaced according to facial growth. It can be observed that the expander prostheses increased the anophthalmic cavity and provided patient’s adaptation for using an ocular prosthesis. The ocular prosthesis set the face aesthetic balance which eventually reflects positively on psychological and social development of the child.

Purpose: This study aimed to investigate the etiology, clinical manifestations, and treatment options of dental implants fractures through a literature review and to relate a clinical report. Methods: A literature review was performed using the Medline database and this paper describes a case demonstrating the management of implant fracture. Twenty two articles were selected in the present literature review. Results: Nowadays the use of dental implants to rehabilitate completely and partially edentulous patients became the best treatment option; however, this treatment is suitable to failure. The fracture of implant body is a possible complication. The fracture of implant body is a late complication and is related to the failure in implant design or material, non-passive fitting of the prosthetic crown and overloading. Clinically, prosthesis instability and spontaneous bleeding are observed. Three options of treatment have been indicated: complete removal of implant fragment, maintenance of implant fragment, and surface preparation of the fragment with insertion of a new abutment. Conclusion: The literature indicates the complete removal of the fragment as the best treatment option.

The aim of this study was to evaluate the effect of thermocycling and immersion in mouthwash or beverage solutions on the color stability of four different acrylic resin-based dentures (Onda Cryl, OC; QC20, QC; Classico, CL; and Lucitone, LU). The factors evaluated were type of acrylic resin, immersion time, and solution (mouthwash or beverage). A total of 224 denture samples were fabricated. For each type of resin, eight samples were immersed in mouthwashes (Plax-Colgate, PC; Listerine, LI; and Oral-B, OB), beverages (coffee, CP; cola, C; and wine, W), and artificial saliva (AS; control). The color change (DE) was evaluated before (baseline) and after thermocycling (T1), and after immersion in solution for 1 h (T2), 3 h (T3), 24 h (T4), 48 h (T5), and 96 h (T6). The CIE Lab system was used to determine the color changes. The thermocycling test was performed for 5000 cycles. Data were submitted to three-way repeated-measures analysis of variance and Tukey's test (p < 0.05). When the samples were immersed in each mouthwash, all assessed factors, associated or not, significantly influenced the color change values, except there was no association between the mouthwash and acrylic resin. Similarly, when the samples were immersed in each beverage, all studied factors influenced the color change values. In general, regardless of the solution, LU exhibited the greatest DE values in the period from T1 to T5; and QC presented the greatest DE values at T6. Thus, thermocycling and immersion in the various solutions influenced the color stability of acrylic resins and QC showed the greatest color alteration.

The objective of this study was to report a case of tooth fracture during the sport practice and the treatment performed for the patient. A 17-year-old male patient was subjected to an endontic treatment followed by the reattachment of the fractured teeth. Teeth were endodontically treated by conventional method. After, the acid etching with 37% phosphoric acid gel was performed and a bonding agent was applied on the dental surface. The fragments were reattachment and bonded with minimum amount of composite resin since the teeth/fragment interface was small. The occlusal contacts were adjusted in the finish line of restorations with a diamond bur and the polishing was performed with aluminum oxide discs. Positive esthetical and periodontal outcomes with no complications in the endodontic treatment were observed on radiographic examinations after twelve months of follow up. The endodontic treatment associated with the reattachment of the fractured teeth by a bonding procedure was a conservative treatment for the patient. The use of mouthguards is important to prevent such dramatic events.

Introduction: The use of removable partial denture (RPD) is considered as low-cost and common treatment option to rehabilitate edentulous areas. Aim: This study aimed to investigate the epidemiological data of patients rehabilitated with removable partial denture (RPD) in order to assess treatment survival rate and failures. Materials and Methods: Epidemiological data and medical records of patients treated with RPD between 2007 and 2012 at the RPD discipline of a Brazilian University (Aracatuba Dental School- UNESP) were evaluated as well as dental records of patients who underwent RPD treatments (fabrication or repairs) between 2000 and 2010. Factors such as gender, age, presence of systemic disease, main complaint, edentulous arch, period and cause of denture replacement and the prosthesis characteristics were recorded. The chi-square test was used to assess the differences between the variables and the Kaplan Meyer to assess the survival of the RPDs evaluated. Results: A total of 324 maxillary RPD and 432 mandibular RPD were fabricated. Most of the patients were women aging 41 to 60-year-old. The number of mandibular RPD Kennedy class I (26%) was statistically higher for the maxillary arch (p

The development of implant dentistry improved the possibilities of rehabilitation with maxillofacial prosthesis. However, clinically it is difficult to bond the silicone to the attachment system. OBJECTIVES: This study aimed to evaluate the effect of an adhesive system on the bond strength between acrylic resin and facial silicone. MATERIAL AND METHODS: A total of 120 samples were fabricated with auto-polymerized acrylic resin and MDX 4-4210 facial silicone. Both materials were bonded through mechanical retentions and/or application of primers (DC 1205 primer and Sofreliner primer S) and adhesive (Silastic Medical Adhesive Type A) or not (control group). Samples were divided into 12 groups according to the method used to attach the silicone to the acrylic resin. All samples were subjected to a T-peel test in a universal testing machine. Failures were classified as adhesive, cohesive or mixed. The data were evaluated by the analysis of variance (ANOVA) and the Tukey's HSD test (α=.05). RESULTS: The highest bond strength values (5.95 N/mm; 3.07 N/mm; 4.75 N/mm) were recorded for the samples that received a Sofreliner primer application. These values were significantly higher when the samples had no scratches and did not receive the application of Silastic Medical Adhesive Type A. CONCLUSIONS: The most common type of failure was adhesive. The use of Sofreliner primer increased the bond strength between the auto-polymerized acrylic resin and the Silastic MDX 4-4210 facial silicone.

The use of ocular prostheses for ophthalmic patients aims to rebuild facial aesthetics and provide an artificial substitute to the visual organ. Natural intemperate conditions promote discoloration of artificial irides and many studies have attempted to produce irides with greater chromatic paint durability using different paint materials. OBJECTIVES: The present study evaluated the color stability of artificial irides obtained with two techniques (oil painting and digital image) and submitted to microwave polymerization. MATERIAL AND METHODS: Forty samples were fabricated simulating ocular prostheses. each sample was constituted by one disc of acrylic resin N1 and one disc of colorless acrylic resin with the iris interposed between the discs. The irides in brown and blue color were obtained by oil painting or digital image. The color stability was determined by a reflection spectrophotometer and measurements were taken before and after microwave polymerization. Statistical analysis of the techniques for reproducing artificial irides was performed by applying the normal data distribution test followed by 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Chromatic alterations occurred in all specimens and statistically significant differences were observed between the oil-painted samples and those obtained by digital imaging. There was no statistical difference between the brown and blue colors. Independently of technique, all samples suffered color alterations after microwave polymerization. CONCLUSION: The digital imaging technique for reproducing irides presented better color stability after microwave polymerization.

Esthetics and durability of materials used to fabricate artificial eyes has been an important issue since artificial eyes are essential to restore esthetics and function, protect the remaining tissues and help with patients' psychological therapy. However, these materials are submitted to degrading effects of environmental agents on the physical properties of the acrylic resin. OBJECTIVE: This study assessed the color stability of acrylic resins used to fabricate sclera in three basic shades (N1, N2 and N3) when subjected to accelerated aging, mechanical and chemical polishing. MATERIAL AND METHODS: Specimens of each resin were fabricated and submitted to mechanical and chemical polishing. Chromatic analysis was performed before and after accelerated aging through ultraviolet reflection spectrophotometry. RESULTS: All specimens revealed color alteration following polishing and accelerated aging. The resins presented statistically significant chromatic alteration (p

We evaluated the effects of disinfection and aging on the hardness of silicones containing opacifiers and intended for use in facial prosthetics. A total of 90 samples were produced using a cylindrical metal mold 3 mm in height and 30 mm in diameter. The samples were fabricated from Silastic MDX 4-4210 silicone in three groups: GI contained no opacifier, GII contained barium sulfate (Ba), and GIII contained titanium dioxide (Ti). The samples were disinfected using effervescent tablets (Ef), neutral soap (Ns), or 4% chlorhexidine (Cl) 3 times a week for 60 days. After this period the samples underwent 1,008 hours of accelerated aging. The hardness was measured using a durometer immediately following the disinfection period and after 252, 504, and 1,008 hours of aging. The data were statistically analyzed using 3-way ANOVA and the Tukey test (p < .05). The GIII group exhibited the greatest variation in hardness regardless of elapsed time. All groups displayed greater hardness after 1,008 hours of accelerated aging independent of disinfectant type. All of the hardness values were within the clinically acceptable range.

Acrylic resins have been widely used due to their acceptable esthetics and desirable characteristics such as easy handling, good thermal conductivity, low permeability to oral fluids and color stability. Flexible resins were introduced on the market as an alternative to the use of conventional acrylic resins in the construction of complete and partial removable dentures. Although these resins present advantages in terms of esthetics and comfort, studies assessing chromatic and microhardness alterations of these materials are still scarce in the related literature. The aim of this study was to evaluate the chromatic and microhardness alterations of two commercial brands of flexible resins in comparison to the conventional resin Triplex when submitted to accelerated aging. The resins were manipulated according to manufacturers' instructions and inserted into a silicone matrix to obtain 21 specimens divided into 3 groups: Triplex, Ppflex and Valplast. Triplex presented the highest microhardness value (p < 0.05) for all the aging periods, which was significantly different from that of the other resins, followed by the values of Valplast and Ppflex. Comparison between the flexible resins (Ppflex and Valplast) revealed a statistically significant difference (p < 0.05) as regards color. The flexible resin Ppflex and the conventional resin Triplex presented no statistically significant difference (p < 0.05) as regards aging. The accelerated aging significantly increased the microhardness values of the resins, with the highest values being observed for Triplex. Valplast presented the greatest chromatic alteration after accelerated aging.

The purpose of this study was to assess color alteration of the paints used for iris painting in artificial eyes. Five disks of heat cured acrylic resin were confectioned by microwave energy for each paint analyzed, in a total of 40 specimens. Each specimen consisted of a colorless acrylic resin disk and another of equal size, of scleral white colored acrylic resin, with the painting interposed between the two disks. The specimens were submitted to an accelerated aging process in a chamber under ultraviolet radiation for 1,008 hours. To assess color variation, a reflective spectrophotometer was used. The results were statistically analyzed by ANOVA and the Tukey test (p < 0.05). All the paints underwent chromatic alteration. The oil paint presented the highest resistance to accelerated aging.

Prosthetic eyes are artificial substitutes for the eyeball, made of heat-curing acrylic resin, serving to improve the esthetic appearance of the mutilated patient and his/her inclusion in society. The aim of this study was to assess the flexural strength of two heat-curing acrylic resins used for manufacturing prosthetic eyes. Thirty-six specimens measuring 64 x 10 x 3.3 mm were obtained and divided into four groups: acrylic resin for artificial sclera N1 (Artigos Odontológicos Clássico, São Paulo, SP, Brazil), heat-cure water technique (GI) and microwave-cured (GII); colorless acrylic resin for prosthetic eyes (Artigos Odontológicos Clássico, São Paulo, SP, Brazil), heat-cure water technique (GIII) and microwave-cured (GIV). Mechanical tests using three point loads were performed in a test machine (EMIC, São José dos Pinhais, PR, Brazil). The analysis of variance and the Tukey test were used to identify significant differences (p < 0.01). Groups GII and GIV presented, respectively, the highest (98.70 ± 11.90 MPa) and lowest means (71.07 ± 8.93 MPa), with a statistically significant difference. The cure method used for the prosthetic eye resins did not interfere in their flexural strength. It was concluded that all the resins assessed presented sufficient flexural strength values to be recommended for the manufacture of prosthetic eyes.

One of the greatest challenges faced by buccomaxillofacial prosthetists is to reproduce the patient's exact skin color and provide adequate esthetics. To reach this objective, professionals must use materials with easy characterization and that maintain color over long periods of time. The objective of this study was, thus, to evaluate the color stability of two types of silicones, Silastic 732 and Silastic MDX4-4210. Twenty-four test specimens were made from each type of silicone and were divided into a colorless group and groups intrinsically pigmented with ceramics, cosmetics or iron oxide. The specimens were submitted to an accelerated system of aging for non-metallic materials. Readings were carried out initially and after periods corresponding to 163, 351, 692 and 1,000 hours of aging, using a reflection spectrophotometer analysis, and color alterations were calculated by the CIE L*a*b* system. The data were submitted to variance analysis and Tukey's test at a 5% level of probability. The results demonstrated that, irrespective of the period of time analyzed, all the materials underwent some type of chromatic alteration (ΔE > 0). The test specimens made with Silastic 732 and MDX4-4210, without pigmentation, presented the lowest color alteration values after 1,000 hours of aging. Of the pigments, ceramic presented the lowest color alteration values and cosmetic powder presented the highest values. Thus, it may be concluded that the materials without the incorporation of pigments presented similar color alteration values, and did not differ statistically. The cosmetic powder used in this study was the pigment that most altered the color of the test specimens.

The purpose of this study was to evaluate the Shore A hardness and surface roughness of two silicones for maxillofacial prosthetic treatment, under the influence of chemical disinfection and storage. Twenty-eight specimens were obtained, half of which were made of Silastic MDX 4-4210 silicone and, the other half were made of Silastic 732 RTV silicone. The specimens were divided into four groups: Silastic 732 RTV and MDX 4-4210 with disinfection 3 times a week with Efferdent tablets and the same materials without disinfection. The hardness of the materials was analyzed with a Shore A Durometer. The surface roughness was established by a digital portable roughness tester, initially and 2 months after the confection of the specimens. A variance test was applied (2-way ANOVA), followed by Tukey test (the level of significance was set at 1%). The storage time factor statistically influenced (p < 0.01) the materials' properties of hardness and roughness. MDX 4-4210 (28.59 Shore A, 0.789 Ra) presented higher values than Silastic 732 RTV (18.08 Shore A, 0.656 Ra) for both properties. Regarding the disinfection period, there was no significant difference in any of the materials tested.

Introduction: With the population aging, the number of chronic and degenerative illnesses, own of the old age, it will appear more frequently. Objective: The objective of this study was to do a literature revision in order to approach the illnesses that more they attack the patients of the third age (from the chronic diseases even the degenerative chronic diseases). Para that, a description will be accomplished as the concept and the signs and symptoms of the illnesses observed more frequently in the senior patients that will be depression, stress, loss of the memory, aterosclerose, osteoporosis, arthritis reumatóide and disorder temporomandibular, arterial hypertension, vascular diseases, heart diseases, obesity, diabetes mellitus, urinary incontinence, hearing and visual disturbances, disease of Parkinson and still the disease of Alzheimer. Conclusion: Based on the literature revision, we ended that, not only the professionals of the health, as well as all those that work with the seniors in general, they should have the concern of treating him with larger attention, patience and perseverance, to the point of to minimize the limitations that each one presents.

Background: Well-planned orthognathic surgery improves psychological health, aesthetics and function of patients. Aim: The present study aimed to investigate patients’ satisfaction after orthognathic surgery by means of a satisfaction questionnaire before and after surgery. Materials and Methods: A total of 29 patients was selected (17 women and 12 men), with a mean age of 28 years, randomly selected from a private clinic at Araçatuba – São Paulo by two investigators. Anamnesis and clinical examination were performed. Subjects with facial deformities submitted to orthodontic treatment before and after orthognathic surgery with a minimum post-surgery period of 6 months, answered a satisfaction questionnaire composed of 10 questions regarding dental and facial aesthetics. In this study, the maximum satisfaction score was 10. Results: Regarding aesthetics, two satisfaction parameters were investigated: dental and facial. For all indices, the average satisfaction was up to score 7. Conclusion: According to the results, it can be concluded that orthognathic surgery has been an effective treatment for dentofacial deformities, aesthetics and functional problems, what was verified by pre and postoperative questionnaire application.

The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient’s satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success.

Introduction: The world population is getting old, mainly in countries in development like Brazil. So, the number of pathologies, which appears in the elderly, will happen in a higher frequency. Among these diseases, we can point Alzheimer, an irreversible dementia, that has been related to age, cerebral vascular disease, stroke, immunological defects and to genetic factors (Down Syndrome). It is known that with the progression of dementia, patients present difficulties of oral hygiene caused by decrease of motor and cognitive functions of Alzheimer's bearers. These patients demand specific strategies for a dental treatment without bigger difficulties. Objective: the aim of this paper was to review the articles about the relationship of geriatric dentistry and Alzheimer disease focusing and the characteristics of the patients with this kind of dementia and the cares to them. For this purpose, a peer-reviewed literature was completed using Medline database for the period from 1972 to 2006, including alzheimer disease and dentistry, and BBO for the period from 1987 to 2004, with geriatric keyword. Conclusion: The available data indicate that individuals with Alzheimer disease have more oral health problems than individuals without dementia.

Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA), which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mutilated patients, resulted in greater clinical results. Therefore, the present study aims to conduct a literature review on the relevance and effectiveness of facial transplants in mutilated subjects. It was observed that the facial transplants recovered both the aesthetics and function of these patients and consequently improved their quality of life.

Purpose: This study investigated the biomechanical behavior of screwed partial fixed prosthesis supported by implants with different diameters (2.5 mm; 3.3 mm and 3.75 mm) by using a photoelastic analysis. Materials and Methods: Six photoelastic models were fabricated in PL-2 resin as single crowns or splinted 3-unit piece. Models were positioned in a circular polariscope and 100-N axial and oblique (45 degrees) loads were applied in the occlusal surface of the crowns by using a universal testing machine (EMIC). The stresses were photographically recorded and qualitatively analyzed using a software (Adobe Photoshop). Results: Under axial loading, the number of fringes was inversely proportional to the diameter of the implants in the single crown models. In the splinted 3-unit piece, the 3.75-mm implant promoted lower number of fringes regardless of loading area application. Under oblique loading, a slight increase of fringes number was observed for all groups. Conclusion: The standard implant diameter promoted better stress distribution than the narrow and mini diameter implants. Additionally, the splinted crowns showed a more uniform stress distribution.

The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

Las prótesis faciales constituyen parte integrante de la rehabilitación de pacientes que sufrieron daños en la cara, sea de origen patológica, traumática o congénita. Aunque el éxito del tratamiento con prótesis faciales está asociado con la capacidad artística del profesional en reproducir las estructuras perdidas, no se puede descuidar la buena adaptabilidad de las prótesis en cuanto a la asociación de materiales y técnicas empleadas para la confección de prótesis buco-maxilofaciales. El objetivo de este trabajo fue, mediante la revisión de la literatura, mostrar los principales conceptos relacionados con las técnicas de confección de prótesis faciales y asociar nuestra experiencia clínica con el pronóstico de las prótesisFacial prostheses are a integral part of rehabilitation of patients underwent face damages, being of pathologic, traumatic or congenital origin. Although success of treatment with facial prostheses is associated with artistic ability of professional to reproduce lost structures, we can not to obviate the good adaptability of prostheses regards association of material and techniques used to make buccomaxillofacial prostheses.

Las prótesis radíferas son un medio de tratamiento para pacientes portadores de tumores malignos. Estas prótesis son indicadas en casos de braquirradioterapia o actinoterapia externa por contacto, y permiten un tratamiento con altas dosis de radiación, que son rápidamente liberadas en las áreas próximas al tumor, de modo que la radiación quede restringida a la región, evitando que tejidos sanos sean dañados o destruidos por las emisiones. Basados en esas consideraciones, el presente trabajo tiene el objetivo hacer una revisión de literatura sobre la utilización de prótesis radíferas en el tratamiento de neoplasias de cabeza y cuello.Radipherpus protheses are a means of treatment for malignant tumor-carrying patients. These protheses are used in cases of brachytherapy or external actinotherapy by contact and allow treating them with high radiation doses that are quickly released from the areas next to tumor, so that the radiations be restricted to the affected region, without the emissions damaging or destroying the soft tissues. Based on these considerations, the present paper was aimed at making literature review on the use of radipherous protheses for the treatment of head and neck neoplasias.