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Medicinal plants and herbal medicines are used as integrative and complementary practices to provide comprehensive care, disease prevention, health promotion, and to improve quality of life (QoL). This scoping review aimed to identify and describe the use of phytotherapy in oral health care by adults and their outcomes, with a focus on perceptions of oral health-related QoL, healthcare access, and costs. A systematic search was conducted in six databases and supplemented in grey literature. According to a PRISMA-ScR protocol and eligibility criteria, publications were assessed for final inclusion, data charting, and narrative synthesis. Out of 4124 records, 542 publications were selected for full-text reading. A total of 32 studies were included: 21 studies assessed QoL, 7 reported access issues, and 11 reported costs issues. Herbal mouthwashes to prevent or treat non-infectious oral conditions were the most frequent treatment. Efficacy of phytotherapy was usually better than placebo or control treatment. Most studies reported QoL improvement, but several instruments were used with heterogeneous results. Limited healthcare access and high costs favoured traditional folk herbal medicine in underserved populations. It can be concluded that phytotherapy for oral health is used by adults worldwide, following modern clinical pharmacology and traditional knowledge concepts. Further studies should incorporate assessment of QoL, access, and costs in addition to clinical efficacy and safety, which are complementary aspects for delivering a comprehensive and efficient health care for all people.
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Objective: This scoping review aimed to map the adverse reactions in the oral mucosa and face caused by the use of natural products. Methodology: This review was performed according to the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with a protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/R57D8). The search was carried out systematically using PubMed, Scopus, Web of Science, Embase, LILACS, and LIVIVO databases, as well as gray literature through Google Scholar and OpenGrey. Reports of clinical cases on the adverse effects of natural products on the oral mucosa or perioral region of the face resulted from inappropriate use or self-medication were included. Data from the included studies were described in a narrative form. Results: Seven hundred and six studies were identified, and after removing duplicates and applying the eligibility criteria, 28 studies were included. The year of publication ranged from 1976 to 2022. The studies were conducted in 19 countries. Fifty patients were mentioned in the included studies and 34 were female (68%). The natural products most related to adverse reactions were propolis (n = 17), with manifestations such as perioral eczema, edema, erosions, erythema, allergic contact dermatitis, and garlic (n = 9), with manifestations such as chemical burn, burning sensation, vesicles and blisters, crusts, and ulcerations. Conclusion: Propolis and garlic were the natural products with the most reported adverse effects on the oral mucosa and perioral region.
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Productos Biológicos , Mucosa Bucal , Humanos , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Productos Biológicos/efectos adversos , Cara/patologíaRESUMEN
INTRODUCTION: Long-term clinical success of non-splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10-year follow-up of 6-mm implants supporting single crowns in the posterior region, and patient-reported outcomes. METHODS: Baseline sample comprised 20 patients treated with 46 screw-retained crowns supported by 6-mm implants with moderately rough implant surface. Participants were recalled for a 10-year clinical follow-up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP-14), and treatment satisfaction. Data were collected with clinical-radiographic exams and analyzed using descriptive and inferential statistics. RESULTS: Fourteen patients with 35 implant-crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, "maximum occlusal force" had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); "arch" and "bruxism" were not significant. Peri-implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri-implant bone level, "crown-to-implant ratio" (p < 0.001) and "time" (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP-14 was 2.3 ± 2.2. CONCLUSION: Single screw-retained crowns supported by 6-mm implants have an acceptable long-term clinical performance, with stable peri-implant bone levels after 10 years of function.
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Pérdida de Hueso Alveolar , Implantes Dentales , Humanos , Estudios de Cohortes , Estudios Prospectivos , Calidad de Vida , Fracaso de la Restauración Dental , Prótesis Dental de Soporte Implantado/efectos adversos , Coronas , Pérdida de Hueso Alveolar/etiología , Estudios de Seguimiento , Diseño de Prótesis Dental/efectos adversosRESUMEN
PURPOSE: This intra-patient retrospective study of up to 10 years evaluated the clinical success and risk factors of 6- and 8-mm long implants and their respective prostheses. MATERIALS AND METHODS: The sample consisted of patients treated at a Military Polyclinic dental service, who received both 6- and 8-mm long tissue level implants in the posterior region of the same arch. Data were collected from the dental charts, clinical and radiographic exams, self-report of sleep bruxism, measurement of maximum occlusal force, and clinical crown-to-implant (C/I) ratio. Data were analyzed by descriptive and inferential statistics with univariate and hierarchical multivariate models, at the 0.05 significance level. RESULTS: The 30 patients (27 women) had 85 implants and 83 prostheses. Two implants were lost before prosthesis installation (implant survival: 97.6%). Ten events of prosthetic complication (screw tightening loss) occurred in five patients (success rate: 87.9%) in a single moment. Only the variable C/I ratio had a significant effect for repairable prosthesis complication (P<.05). CONCLUSION: The results suggest that 6- and 8-mm long implants have similar long-term clinical success for implants and prostheses.
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BACKGROUND: The COVID-19 global pandemic and the uncertainty of an effective treatment protocol have resulted in fear and anxiety, which have increased the search for natural products to prevent the disease and to manage the symptoms. AIMS: To discuss the negative effects of garlic used as a preventive measure against the novel coronavirus. METHODS AND RESULTS: This study reports a case of oral mucosa burn on the dorsal surface of the tongue in a 72-year-old woman. The patient was using raw garlic daily during the pandemic to improve her immunological system. She scheduled a dental appointment and was assessed by teledentistry due to the pandemic, in which a detailed anamnesis was carried out. The burned area and ulceration were identified by video call and photographs. The patient was instructed to cease the habit immediately and change to a soft and non-acid/spicy/hot diet, which resulted in a great recovery 2 days later. She was monitored for 2 weeks until her tongue was completely healed. CONCLUSION: This case highlights the consequences of inappropriate use of natural product and how self-treatment could negatively influence oral health. Additionally, it shows the importance of teledentistry for oral diagnosis and treatment during a pandemic.
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Productos Biológicos , COVID-19 , Ajo , Anciano , Brotes de Enfermedades , Humanos , Mucosa Bucal , Salud Bucal , Pandemias , SARS-CoV-2RESUMEN
OBJECTIVES: This study evaluated hyaluronic acids (HA) with different molecular weights as potential matrices for tissue-engineered bone grafting and their possible influence on the paracrine mechanisms of adipose-derived mesenchymal stromal cells. MATERIAL AND METHODS: Murine adipose mesenchymal stromal cells (mASCs) on the fourth passage were seeded in 96-well plates, osteoinduced for 27 days and exposed for 3 days to low (HA-LW) and high/low molecular weight (HA-HLW) at previously defined concentrations. Cytokines IGF-1, VEGF, FGF-2, and BMP-2 were evaluated by quantification in the supernatant. RESULTS: Greater expression of growth factors was observed in groups with HA-HLW compared to HA-LW. Results indicated that differentiated cells secreted fewer cytokines, namely VEGF, FGF, and BMP-2 than undifferentiated mASCs (p < 0.05). IGF-1 showed its greatest expression in the mASC HA-LW group (p < 0.05). CONCLUSIONS: The application of HA-HLW as cell matrix in tissue engineering did not compromise mASC paracrine effect. Also, the association of HA-HLW matrix and mASCs resulted in greater expression of osteogenic growth factors. Longer periods of cell differentiation seemed to negatively affect their capacity for local paracrine stimulation. CLINICAL RELEVANCE: The use of HA-HLW as matrix for undifferentiated ASCs can be positive for bone regeneration, favoring its application as cell matrix in bone grafting procedures.
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Células Madre Mesenquimatosas , Tejido Adiposo , Animales , Regeneración Ósea , Diferenciación Celular , Células Cultivadas , Ácido Hialurónico , Ratones , Osteoblastos , Osteogénesis , Comunicación ParacrinaRESUMEN
The impact of oral rehabilitation on masticatory function and oral health-related quality of life (OHRQoL) may vary with the experience of the individual with tissue loss. Our hypothesis is that patient-centered outcomes vary among adults who have experienced large defects in the maxilla due to congenital or acquired conditions even after oral rehabilitation to restore aesthetics and function. This study compared OHRQoL, perceived masticatory ability, maximum bite force (MBF), and symptoms of pain and depression among subjects with acquired (edentulous maxilla) and congenital (cleft lip and palate) loss of oral tissues in the maxilla after dental treatment. A gender-matched sample (n = 60) of cleft lip and palate (CLP), maxillary denture wearers (DENT) and controls (CONT) was recruited. OHRQoL was assessed using OHIP-14. Chewing was evaluated through a masticatory ability questionnaire and by MBF. The RDC/TMD Axis II questionnaire was used to assess symptoms of pain and depression. Data were analyzed by Fisher's test, Kruskal Wallis test, and Spearman correlation coefficients. CLP showed higher OHIP-14 and depression scores than DENT and CONT (p < 0.05). Sub-analysis by OHIP-14 items (%FOVO) showed higher prevalence of psychological impact for CLP and of functional impacts for DENT. The number of foods difficult to chew, of food textures difficult to chew, and avoided foods were similar between CLP and DENT. OHIP-14, MBF, and depression scores showed significant correlation (p < 0.05). The results suggest that adults with treated CLP or maxillary DENT have chewing impairment and lower MBF than healthy subjects, with different psychological and functional impacts.
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Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Dentaduras , Masticación/fisiología , Calidad de Vida , Adulto , Anciano , Fuerza de la Mordida , Estudios de Casos y Controles , Dolor Crónico/fisiopatología , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Estudios Transversales , Depresión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/rehabilitación , Salud Bucal , Valores de Referencia , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Abstract The impact of oral rehabilitation on masticatory function and oral health-related quality of life (OHRQoL) may vary with the experience of the individual with tissue loss. Our hypothesis is that patient-centered outcomes vary among adults who have experienced large defects in the maxilla due to congenital or acquired conditions even after oral rehabilitation to restore aesthetics and function. This study compared OHRQoL, perceived masticatory ability, maximum bite force (MBF), and symptoms of pain and depression among subjects with acquired (edentulous maxilla) and congenital (cleft lip and palate) loss of oral tissues in the maxilla after dental treatment. A gender-matched sample (n = 60) of cleft lip and palate (CLP), maxillary denture wearers (DENT) and controls (CONT) was recruited. OHRQoL was assessed using OHIP-14. Chewing was evaluated through a masticatory ability questionnaire and by MBF. The RDC/TMD Axis II questionnaire was used to assess symptoms of pain and depression. Data were analyzed by Fisher's test, Kruskal Wallis test, and Spearman correlation coefficients. CLP showed higher OHIP-14 and depression scores than DENT and CONT (p < 0.05). Sub-analysis by OHIP-14 items (%FOVO) showed higher prevalence of psychological impact for CLP and of functional impacts for DENT. The number of foods difficult to chew, of food textures difficult to chew, and avoided foods were similar between CLP and DENT. OHIP-14, MBF, and depression scores showed significant correlation (p < 0.05). The results suggest that adults with treated CLP or maxillary DENT have chewing impairment and lower MBF than healthy subjects, with different psychological and functional impacts.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Calidad de Vida , Dentaduras , Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Masticación/fisiología , Valores de Referencia , Fuerza de la Mordida , Estudios de Casos y Controles , Salud Bucal , Estudios Transversales , Encuestas y Cuestionarios , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Boca Edéntula/rehabilitación , Estadísticas no Paramétricas , Depresión , Dolor Crónico/fisiopatologíaRESUMEN
BACKGROUND: The use of short implants is still not a consensus for challenging clinical situations, such as unfavorable crown-to-implant (C/I) ratio. PURPOSE: This prospective study evaluated the rates of prosthetic complications and implant failure, the mean marginal bone loss of 6-mm dental implants with single crowns in posterior regions and the potential risk factors. MATERIALS AND METHODS: Forty-six dental implants, 6-mm long and 4.1-mm wide, were placed in the posterior region in 20 patients. Patients were clinically and radiographically examined after the restoration with single crowns and on a yearly basis. Potential risk factors (arch, bruxism, maximum bite force, anatomical and clinical C/I ratios, and occlusal table area) were analyzed according to the following outcomes: implant survival, bone loss, and prosthetic complications. RESULTS: The mean follow-up time was 45 ± 9 (16-57) months. There was no early loss of implants. After prosthetic loading, 4 implants were lost (2 in the mandible and 2 in the maxilla; 91.3% survival), and there were 13 prosthetic complications (28.3%), yielding a 65.2% success rate. The frailty term showed a 95% greater chance of loss in the mandible than the maxilla. Mean peri-implant bone loss was of 0.2 ± 0.4 mm, 0.1 ± 0.2 mm, 0.1 ± 0.3 mm, and 0.2 ± 0.4 mm in the first, second, third, and fourth years, respectively, with a mean cumulative loss of 0.3 ± 0.5 mm at 48 months. In the multilevel model, the effects of the clinical C/I ratio and time were significant for bone loss (P < .001). It was estimated that a mean bone loss of 0.1 mm is associated with both a one-unit increase in time (12 months) and a 0.1 increase in the clinical C/I ratio. The other potential risk factors showed no significant relationship with the outcomes. CONCLUSIONS: The 6-mm implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss.
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Coronas/efectos adversos , Prótesis Dental de Soporte Implantado/efectos adversos , Adulto , Anciano , Pérdida de Hueso Alveolar/etiología , Bruxismo/complicaciones , Prótesis Dental de Soporte Implantado/métodos , Fracaso de la Restauración Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de RiesgoRESUMEN
Clefts of the lip and/or palate (CLP) are oral-facial defects that affect health and overall quality of life. CLP patients often need multidisciplinary treatment to restore oral function and esthetics. This paper describes the oral rehabilitation of a CLP adult patient who had maxillary bone and tooth loss, resulting in decreased occlusal vertical dimension. Functional and cosmetic rehabilitation was achieved using a maxillary removable partial denture (RPD) attached to telescopic crowns. Attachment-retained RPDs may be a cost-effective alternative for oral rehabilitation in challenging cases with substantial loss of oral tissues, especially when treatment with fixed dental prostheses and/or dental implants is not possible.
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Diseño de Dentadura/métodos , Prótesis de Recubrimiento , Dentadura Parcial Removible , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Coronas , Femenino , Humanos , Arcada Parcialmente Edéntula/diagnóstico por imagen , Arcada Parcialmente Edéntula/rehabilitación , Maxilar/anomalías , Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Calidad de Vida , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/terapia , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/rehabilitación , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodosRESUMEN
Evaluation of the influence of laser application on osseointegration around implants with different surface characteristics is limited. This study aims to evaluate the influence of low-level lasers on the early stages of osseointegration. Ninety-six external hex implants (3.75 mm × 5.0 mm) were placed in 24 rabbits-one machined and one sandblasted acid-etched per tibia. The rabbits were later divided into the laser group, which received a total dose of 24 J/cm(2) of gallium-aluminum-arsenide laser over 15 days, and a control group. At 16 and 30 days after surgery, removal torque and histomorphometric analyses were performed. No statistical differences in removal torque or histomorphometric analyses were verified between laser and control groups regardless of implant surface (P > .05). Time was the only variable presenting significant differences between measurements (P < .05). Low-level laser had no significant short-term effect on bone-to-implant contact and removal torque values regardless of implant surface characteristics.
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Implantes Dentales , Oseointegración , Animales , Diseño de Prótesis Dental , Conejos , Propiedades de Superficie , Tibia , Titanio , TorqueRESUMEN
The biomechanical stability of the implant-abutment connection is critical for the success of implant-supported restorations. This study investigated the effect of a positioning index on the abutment screw preload values of tapered connection implants. Twenty Morse taper implants presenting an internal locking hex received 10 solid and 10 straight screw retained abutments for cemented single-crown restorations. Ten abutments had a positioning index to fit the internal locking hex of the implant (straight), and 10 were locked only by the implant taper (solid). The preload values for each abutment screw after a tightening torque were registered by strain gauges. Prosthetic crowns were placed on each abutment and subjected to mechanical cycling. Detorque forces were applied to each abutment and compared with the initial torque values. Data were statistically analyzed using Kolmogorov-Smirnov and Student t tests. The nonindexed group presented higher initial preload (6.05 N ± 0.95 N) compared with the indexed group (4.88 N ± 0.92 N; P < .05). After cycling, the nonindexed group exhibited less reduction of preload (13.84% ± 6.43%) compared with the indexed group (52.65% ± 14.81%; P < .01). Indexed tapered abutments for single-crown restorations might represent greater biomechanical risk under function.
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Pilares Dentales , Implantes Dentales , Fenómenos Biomecánicos , Coronas , Diseño de Implante Dental-Pilar , TorqueRESUMEN
Purpose: To describe a kinesiologic EMG method and determine the reliability of EMG activity of representative muscles of mastication (temporal, masseter), posture of neck (sternocleidomastoid, trapezius) and trunk (rectus abdominis, paravertebral), and lower extremity strength (rectus femoris, medial gastrocnemius) during simulation of activities of daily living. Methods: Ten edentulous healthy women (age: 58.2±5.6 yr old) were tested with and without their dentures. EMG signals were recorded for each subject during three trials of each kinesiologic test: to stand up/sit down on a chair (TC), to rise/lie down in the bed (TB), and to lift/lower bags (TW). The same-day reprodutibility of the EMG values was estimated by test-retest reliability analyses. For each test (TC, TB, and TW) the intraclass correlation coefficient (ICC) and 95% confidence interval were estimated stratified by muscle, presence or not of complete dentures, and movement during the test (up and down) considering the three repetitions per subject to assess consistency. Results: All muscles showed activation during the tests. The method yielded moderate to high ICCs; the highest test-retest reliability levels were estimated for the sternocleidomastoid (0.82-0.97) and paravertebral (0.86-0.99) muscles. Conclusion: These findings suggest that the described kinesiologic EMG method showed satisfactory reliability in this sample.
Objetivo: Descrever uma metodologia de EMG cinesiológica e determinar a reprodutibilidade da atividade eletromiográfica dos músculos mastigatórios (m. temporal e m. masseter), posturais do pescoço (mm. esternocleidomastoideo e trapézio), posturais do tronco (mm. reto abdominal e paravertebrais) e de força das extremidades inferiores (mm. reto femoral e gastrocnemius medial) durante simulação de atividades de vida diária (AVDs). Metodologia: A amostra foi constituída por dez mulheres saudáveis, usuárias de prótese total bimaxilar, com idade média de 58,2 anos. Foram realizados três testes AVDs: levantar/sentar da cadeira (TCAD), levantar/deitar na cama (TCAM) e pegar/largar sacolas (TSAC). A reprodutibilidade dos valores EMG foi analisada por teste-reteste. Para cada teste AVD foram estimados coeficiente de correlação intraclasse (CCIC) e intervalo de confiança de 95% com estratificação por músculo, condição com e sem prótese (suporte oclusal) e movimento durante o teste, considerando três repetições por sujeito para avaliar consistência. Resultados: Todos os grupos musculares apresentaram ativação durante os testes simulando AVDs. O método utilizado mostrou reprodutibilidade satisfatória com CCICs considerados moderados a altos. Os maiores valores de CCIC foram estimados para os m. esternocleidomastoideo (0,82 a 0,97) e m. paravertebrais (0,86 a 0,99). Conclusão: Os resultados sugerem que o método de EMG cinesiológico descrito apresentou reprodutibilidade satisfatória nesta amostra.
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Humanos , Femenino , Persona de Mediana Edad , Anciano , Actividades Cotidianas , Dentadura Completa , Electromiografía/métodos , Quinesiología AplicadaRESUMEN
Este artigo relata um caso clínico de reabilitação implantossuportada de uma área posterior de maxila, com extensa reabsorção óssea e pneumatização do seio maxilar. Paciente do sexo feminino, submetida à instalação de dois implantes Replace Select Tapered (NobelBiocare AB, Gotemburgo, Suécia) na região dos dentes 15 e 16 e concomitante levantamento de seio maxilar. O seio maxilar foi preenchido com osso xenógeno liofilizado (Bio-Oss, Geistlich Pharma AG, Wolhusen, Suíça). Após o período de seis meses de cicatrização foi realizada a confecção da prótese metalo-cerâmica fixa parafusada. Com a utilização deste substituto ósseo e implantes, foi possível diminuir o tempo de tratamento e realizar uma cirurgia com menor morbidade e desconforto para a paciente.
This article reports a clinical case of an implant-supported oral rehabilitation in the posterior maxillary with extensive bone resorption and sinus pneumatization. Two Replace Select Tapered implants (NobelBiocare AB, Gotemburgo, Suécia) were placed in a female patient replacing teeth 15 and 16 immediately after the sinus lifting procedure. The Sinus was filled up (grafted) with xenograft lyophilized bone (Bio-Oss, Geistlich Pharma AG, Wolhusen, Suíça). After six months of the healing process a screw-retained metalloceramic prosthesis was fabricated. With this protocol of treatment by using bone substitute and immediate implant placement, there was a reduction of treatment time and surgical performance with less morbidity and discomfort for the patient.
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Humanos , Femenino , Adulto , Sustitutos de Huesos , Trasplante Óseo , Implantes Dentales , Oseointegración , Seno Maxilar/cirugíaRESUMEN
Purpose: To assess the magnitude and distribution of axial forces and bending moments in abutments as a function of cantilever length and inclination of implants. Methods: Ten metallic bars simulated frameworks of fixed implant-supported prosthesis over two master models with five implants: one with all implants straight and parallel (n=5) and one with the two distal implants tilted (n=5). Strain gauges were fixed on abutments to measure deformation when a 50N-load was applied on the cantilever at 10, 15, and 20mm-distance from the distal abutment. Deformation values were transformed into axial force and bending moment and analyzed by ANOVA and Tukey test (α = 5%). Results: Comparing 10mm- to 20mm-cantilever, there was an increase of approximately 50% for axial force and of 70% for saggital bending moment. On the abutment adjacent to the cantilever, the axial force in the inclined model was 70% lower than in the straight model, and bending moments did not vary. Conclusion: The results suggest that the inclination of distal implants does not have any deleterious biomechanical effect on abutments of the tested models and may reduce the cantilever effect on force magnitude.
Objetivo: Avaliar a magnitude e a distribuição de forças axiais e momentos fletores em pilares em função da extensão do cantilever e da inclinação dos implantes. Metodologia: Dez barras metálicas simularam infraestruturas de prótese fixa implantossuportada sobre dois modelos mestre com 5 implantes: um modelo com todos os implantes retos e paralelos (n=5) e um com os dois implantes distais inclinados (n=5). Extensômetros foram fixados nos pilares para medir sua deformação quando uma carga de 50N foi aplicada no cantilever a 10, 15 e 20 mm do implante distal. Os valores de deformação foram convertidos em força axial e momento fletor e analisados por ANOVA e teste de Tukey (α = 5%). Resultados: Comparando-se as distâncias de 10 e 20 mm, houve um aumento de aproximadamente 50% da força axial e de 70% do momento fletor sagital. No pilar adjacente ao cantilever, a força axial no modelo com implantes inclinados foi 70% menor que no modelo com implantes retos, e os momentos fletores não variaram. Conclusão: Os resultados sugerem que a inclinação dos implantes distais não promoveu nenhum efeito deletério sobre os pilares nos modelos testados e pode reduzir o efeito do cantilever na magnitude da força.
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Implantes Dentales , Prótesis Dental de Soporte Implantado , Fenómenos BiomecánicosRESUMEN
Purpose: To evaluate the cumulative effect of two protocols of microwave disinfection (Protocol 1: 690 W/6 min; Protocol 2: 345 W/6 min) on surface roughness (Ra) and baseplate adaptation of two denture resins polymerized by microwave energy (Onda Cryl) or hot water bath(QC-20). Methods: For Ra evaluation, rectangular specimens were fabricated and subjected to the following disinfection treatment (n=8/group): 1) Control (no disinfection), 2) Protocol 1, and 3) Protocol 2. Ra was measured using a profilometer at baseline (T0) and after two disinfection procedures (T1, T2) with a 7-day interval immersed in distilled water. To evaluate dimensional stability, maxillary baseplates were divided into the disinfection treatment groups (n=6), and adaptation was measured by weighing a silicon film reproducing the gap between resin baseplate and a metallic master model. Results: Ra had a significant interaction between type of resin/polymerization technique, disinfection treatment, and number of disinfection procedures (P<0.001). For Ra, Protocol 2 and control groups had similar increase of Ra over time, but Protocol 1 groups showed a significant decrease of Ra in T2. Baseplate adaptation was affected by a significant interaction between disinfection treatment and number of disinfection procedures (P<0.001), and Protocol 1 yielded the largest mean in T2. Conclusion: Onda Cryl displayed greater changes of Ra and adaptation than QC-20. Protocol 1 promoted overall damage to both types of denture resins after two disinfection procedures.
Objetivo: Avaliar o efeito cumulativo de dois protocolos de desinfecção por energia de micro-ondas (Protocolo 1: 690 W/6 min; Protocolo 2: 345 W/6 min) na rugosidade superficial (Ra) e adaptação de bases de dentadura de duas resinas polimerizadas por micro-ondas (Onda Cryl) ou banho de água quente (QC-20). Metodologia: Para Ra, espécimes retangulares foram fabricados e dividid os de acordo com o tratamento de desinfecção (n=8/grupo): 1) Controle (sem desinfecção), 2) Protocolo 1, e3) Protocolo 2. Para medir Ra usou-se um rugosímetro no baseline (T0) e após 2 procedimentos de desinfecção (T1, T2) com intervalo de 7 dias de imersão em água destilada. Para avaliar a estabilidade dimensional, bases maxilares foram divididas nos 3 grupos (n=6) e a adaptação foi medida por pesagem de uma película de silicone que reproduzia o espaço entre a base de resina e um modelo-mestre metálico. Resultados: Para Ra, houve interação significativa entre tipo de resina e técnica de polimerização, tratamento de desinfecção, e número de procedimentos desinfecção (P<0,001). Os grupos Protocolo 2 e controle apresentaram aumento semelhante de Ra ao longo do tempo, mas os grupos Protocolo 1 tiveram uma redução significativa de Ra em T2. A adaptação da base foi afetada por uma interação significante entre tratamento de desinfecção e número de procedimentos de desinfecção (P<0,001); o Protocolo 1 apresentou a maior média em T2. Conclusão: Onda Cryl teve maiores alterações de Ra e adaptação que QC-20. O Protocolo 1 promoveu dano geral para ambos os tipos de resina após dois procedimentos de desinfecção.
Asunto(s)
Microondas , Desinfección/métodos , Resinas Acrílicas , Propiedades de SuperficieRESUMEN
Purpose: This study evaluated the influence of different methods of dentin surface pre-treatment on microtensile bond strength and failure mode of a single-bottle adhesive. Methods: Twenty-four third molars were embedded in acrylic resin and ground until exposure of occlusal dentin. Six groups were tested according to the dentin surface pre-treatment: G1) 35% phosphoric acid (pa) (positive control); G2) slurry of pumice + pa; G3) air-abrasion with 25μm-aluminum oxide + pa; G3) air abrasion with 50μm-aluminum oxide + pa; G5) air abrasion with sodium carbonate + pa; G6) no treatment (negative control). The adhesive Single Bond (3M-ESPE) was applied on the dentin surface and photoactivated before a 6mm-height composite restoration was built (Z250, 3M-ESPE). After storage in distilled water at 37ºC for 24h, all specimens (sectional area of 1mm²) were subjected to a microtensile bond strength test at a crosshead speed of 0.5mm/min. Results: Bond strength mean values (MPa) were: G1=29.28, G2=21.04, G3=21.66, G4=18.94, G5=19.90, and G6=19.03. Only G1 was statistically different from the other groups (ANOVA and Tukey's test, α=0.05). SEM images of the adhesive interface after rupture showed prevalence of mixed failure type (adhesive fracture between dentin and adhesive agent plus partial cohesive fracture in the composite restoration or dentin) for all groups but G6. Conclusion: The use of cleaning agents on dentin surface might not be necessary for adhesive procedures with dentin total acid-etching.
Objetivo: Este estudo avaliou a influência de diferentes métodos de pré-tratamento da superfície dentinária sobre a resistência de união à microtração e modo de falha de um sistema adesivo de frasco único. Metodologia: Vinte e quarto terceiros molares foram incluídos em resina acrílica e desgastados até exposição da dentina oclusal. Seis grupos foram testados de acordo com o pré-tratamento da dentina: G1) ácido fosfórico a 35% (pa) (controle positivo); G2) pasta de pedra- pomes + pa; G3) jateamento com óxido de alumínio 25μm + pa; G3) jateamento com óxido de alumínio 50μm + pa; G5) jateamento com carbonato de sódio + pa; G6) sem tratamento (controle negativo). O sistema adesivo Single Bond (3M-ESPE) foi aplicado na superfície dentinária e fotoativado antes da simulação de uma restauração de resina de 6mm de altura (Z250, 3M-ESPE). Após armazenamento em água destilada a 37ºC por 24h, todos os espécimes (área transversal de 1mm²) foram submetidos ao teste de microtração à velocidade de 0,5mm/min. Resultados: Os valores médios de resistência de união (MPa) foram: G1=29,28; G2=21,04; G3=21,66; G4=18,94; G5=19,90; e G6=19,03. Somente o G1 foi estatisticamente diferente dos demais grupos (ANOVA e teste de Tukey, α=0,05). A observação em MEV da interface adesiva após ruptura mostrou prevalência de falha do tipo mista (fratura adesiva entre dentina e agente adesivo associada à fratura coesiva parcial na restauração de resina ou dentina) para todos os grupos, exceto G6. Conclusão: O uso de agentes de limpeza na superfície dentinária pode não ser necessário para procedimentos adesivos com condicionamento ácido total da dentina.