RESUMEN

Two clinical cases are presented to explore technical differences and discusses the advantages and disadvantages of using veneered or monolithic zirconia to manufacture posterior single crowns. The first case describes the clinical steps in manufacturing a monolithic crown on a mandibular left second premolar using high translucency zirconia. It shows the use of a conservative tooth preparation based on the superior mechanical properties that this material presents as well as the final optical characteristics achieved by shading and staining. In the second case, a conventional bilayer restorative treatment was made using zirconia framework followed by veneering with feldspar ceramic on a mandibular left first molar. Recent literature indicates that each of these restorative alternatives presents specific advantages and disadvantages. Factors such as mechanical performance, fracture, esthetic characteristics, clinical success, complication rates, adhesion and antagonist wear performance are discussed comparing the two restorative assemblies. The data highlight that monolithic crowns prevent a major problem reported on bilayer restorations: the chipping of veneering ceramic. Monolithic crowns also allow minimally invasive tooth preparations, thus increasing tooth remnant preservation. However, data that support esthetic performance similarity between monolithic and bilayer assemblies are lacking, thus the predictability of use is restricted for the posterior region, as cases demanding high esthetic appeal continue to fundamentally use bilayer restorations. Failures were not found, and patient satisfaction was reported in both techniques after the 12-month follow up.

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RESUMEN

A ansiedade frente ao tratamento odontológico é um fenômeno comum e geralmente inicia-se na infância ou adolescência. A reversão desse quadro requer intervenções não medicamentosas e medicamentosas, ambas com o intuito de reduzir o estresse e a ansiedade. Os benzodiazepínicos são os fármacos mais utilizados na sedação consciente oral do paciente odontológico. Com o intuito de verificar a efetividade dos ansiolíticos na cirurgia bucal. o presente trabalho tem como objetivo avaliar clinicamente sua ação no pré-operatório, comparando-a com um placebo, em um mesmo paciente, observando os níveis de ansiedade e os parâmetros. Foram incluídos 30 pacientes de ambos os gêneros, entre 18 e 30 anos, nos quais havia a indicação de remoção cirúrgica dos terceiros molares retidos, totalizando 60 procedimentos cirúrgicos. Os pacientes foram divididos em dois grupos experimentais. Concluiu-se que: (a) com relação a ansiedade, não houve diferença estatística entre os dois grupos, no pré-operatório, embora possa ser considerado clinicamente benéfico para os dois grupos; (b) o ansiolítico foi eficiente na redução da pressão sistólica dos pacientes do grupo 1, na sala de espera e após a anestesia na primeira intervenção, assim como da pressão diastólica no pós-cirúrgico do grupo 2, na segunda intervenção; e (c) embora não fosse objetivo deste trabalho analisar a experiência prévia odontológica, notou-se que a mesma contribuiu para a redução dos níveis de ansiedade dos pacientes.

Anxiety dealt in odontological treatment is a regular phenomenon and most often start in childhood or adolescence. Reversion of this picture requires interventions, such as behavioral techniques and medicamental treatment, both of them aiming to reduce stress and anxiety. Benzodiazepines are the most used medicines in pharmacological intervention for oral conscious sedation. This work aims to evaluate anxiolytic effectiveness when administered for the preoperative in oral surgery, compared to placebo, in the same patient, and analyses the anxiety levels and cardiovascular parameters. We evaluated 30 subjects of both genders in this research (18-30 years old), for whom both third molar removal surgeries were recommended, for a total of 60 surgical procedures. Subjects were divided into two experimental groups. We were able to verify: (a) the anxiolytic use was not statistically significant in pre-operative for anxiety, although it was clinically benefic for both groups; (b) anxiolytic was efficient in reducing sistolyc pressure in group 1 patients, at first intervention trans-operative and diastolic pressure in group 2, at second intervention pos-operative; and (c) although we did not mean to analyse previous dental surgery experience, we noticed that it contributed to reduce patient’s anxiety levels.

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