RESUMO
A intercorrência de fratura em próteses do tipo protocolo provisório na região de cantiléver tem sido relatada na literatura. Para conferir resistência, impedindo uma possível fratura em toda a sua extensão, o seguinte caso clínico relata a utilização de barras pré-fabricadas idealizadas por Freitas e Viana, em uma prótese provisória do tipo protocolo com carga imediata na mandíbula. A finalidade da utilização das barras, além de conferir resistência, foi apresentar uma alternativa mais econômica em relação às barras distais para reforço do cantiléver, existentes no mercado (Neodent®) e eliminar a etapa laboratorial, proporcionando um tratamento mais rápido e de custo inferior. No caso clínico descrito, após constatação de intensa perda óssea e de mobilidade nos dentes presentes, foi realizada moldagem, confecção de prótese total superior e inferior, exodontias e instalação de cinco implantes Cone Morse (SIN Sistema de Implantes) na mandíbula, minipilares e sutura. A prótese total inferior foi capturada sobre os cilindros de titânio unidos com barras pré-fabricadas Freitas e Viana colocadas na região de cantiléver, entre os cilindros na região anterior e presas com fio 012. A prótese foi desgastada por lingual até ficar na posição correta, observando a oclusão e capturada. A prótese permaneceu sem fraturas até a confecção do protocolo final. A utilização das barras pré-fabricadas Freitas e Viana permitiu rigidez à prótese, reforçando a região de cantiléver e também anterior, proporcionando custo mais baixo, além de agilidade no tratamento (AU).
The intercurrence of fracture in provisional protocol type prosthesis in the cantilever region has been reported in the literature. To confer resistance, preventing a possible fracture in its entire length, the following clinical case reports the use of prefabricated bars designed by Freitas and Viana in a provisional protocol type prosthesis with immediate loading in the jaw. The purpose of the bars use, besides conferring resistance, was to present a cost-effective alternative to the distal bars for cantilever reinforcement existing in the market (Neodent®) and to eliminate the laboratory stage, providing a faster and lower cost treatment. In the clinical case described, after finding severe bone loss and mobility loss in the teeth present, molding was carried out, making full upper and lower prosthesis, tooth extraction, installation of five Cone Morse (SIN Implant System) in the jaw, mini pillars and suturing. The total lower denture was captured on titanium cylinders attached with Freitas' and Viana's prefabricated bars put in the cantilever region between the cylinders in the anterior region and joined with wire 012. The prosthesis was worn out by lingual until the correct position, observing the occlusion and capture. The prosthesis remained without fractures until manufacturing of the final protocol. The use of Freitas' and Viana's prefabricated bars allowed rigidity to the prosthesis, enhancing the cantilever region and also the anterior region, providing lower cost and a prompt treatment (AU).
Assuntos
Humanos , Prótese Dentária Fixada por Implante , Carga Imediata em Implante Dentário/métodos , Mandíbula , Brasil , Radiografia Panorâmica/instrumentaçãoRESUMO
BACKGROUND/AIMS: This study aimed to evaluate the stress distribution around external hexagon (EH) and Morse taper (MT) implants with different prosthetic systems of immediate loading (distal bar (DB), casting technique (CT), and laser welding (LW)) by using photoelastic method. METHODS: Three infrastructures were manufactured on a model simulating an edentulous lower jaw. All models were composed by five implants (4.1 mm × 13.0 mm) simulating a conventional lower protocol. The samples were divided into six groups. G1: EH implants with DB and acrylic resin; G2: EH implants with titanium infrastructure CT; G3: EH implants with titanium infrastructure attached using LW; G4: MT implants with DB and acrylic resin; G5: MT implants with titanium infrastructure CT; G6: MT implants with titanium infrastructure attached using LW. After the infrastructures construction, the photoelastic models were manufactured and a loading of 4.9 N was applied in the cantilever. Five pre-determined points were analyzed by Fringes software. RESULTS: Data showed significant differences between the connection types (p < 0.0001), and there was no significant difference among the techniques used for infrastructure. CONCLUSION: The reduction of the stress levels was more influenced by MT connection (except for CT). Different bar types submitted to immediate loading not influenced stress concentration.