RESUMO
Objetivo: Avaliar se customizações da prótese total mandibular (reembasamento e restabelecimento da dimensão vertical de oclusão) influenciam na amplitude eletromiográfica dos músculos masseter e temporal, força máxima de mordida e qualidade de vida relacionada à saúde oral de indivíduos edêntulos. Materiais e métodos: Usuários de próteses totais que usavam o mesmo par de próteses por mais do que 5 anos foram incluídos (sem disfunção temporomandibular) (n=15). Avaliações de qualidade de vida (Oral Health Impact Profile for Edentulous OHIP-EDENT), força máxima de mordida, e eletromiografia dos músculos masseter e temporal foram realizadas em 5 tempos diferentes (T1 próteses antigas originais; T2 após 18 dias de uso da prótese mandibular reembasada; T3 após 18 dias do restabelecimento da dimensão vertical de oclusão; e T4 e T5 30 e 100 dias de uso de novas próteses totais. Resultados: Não houve diferenças significativas entre os pontos de tempo para todos os testes eletromiográficos e de força máxima de mordida. O OHIP-EDENT mostrou que o reembasamento pode contribuir para uma maior adaptação da prótese total mandibular e conforto do paciente (T2), em contrapartida T3 foi associado com o desconforto do paciente (p<0.05). Conclusão: Baseado na avaliação de qualidade de vida relacionada à saúde oral, o reembasamento da prótese total mandibular ocasionou um aumento do conforto mastigatório para os pacientes, e o restabelecimento prévio da dimensão vertical de oclusão causou um desconforto para os pacientes. A amplitude eletromiográfica mostrou que as customizações realizadas neste estudo não aumentaram ou diminuíram o esforço mastigatório significativamente. Além disso, todos os valores de força máxima de mordida observados estavam dentro do clinicamente aceitável(AU)
Objective: To evaluate whether customizations of mandibular complete dentures (relining and restoration of the vertical dimension of occlusion) influence the electromyographic amplitude of the masseter and temporal muscles, maximum bite force and oral health-related quality of life of edentulous individuals. Materials and methods: Complete denture wearers who wore the same pair of dentures for more than 5 years were included (without temporomandibular dysfunction) (n=15). Assessments of quality of life (Oral Health Impact Profile for Edentulous OHIP-EDENT), maximum bite force, and electromyography of the masseter and temporal muscles were performed at 5 different times (T1 - original old dentures; T2 - after 18 days of wearing relined mandibular denture; T3 - after 18 days of restoration of the vertical dimension of occlusion; and T4 and T5 - 30 and 100 days of wearing new complete dentures. Results: There were no significant differences between the time points for all electromyographic and maximum bite force tests. The OHIP-EDENT showed that relining can contribute to greater adaptation of the mandibular denture and patient comfort (T2), in contrast, T3 was associated with patient discomfort (p<0.05). Conclusion: Based on the assessment of quality of life related to oral health, the reline of the mandibular complete denture caused an increase in masticatory comfort for the patients, and the previous definitive restoration of the vertical dimension of occlusion caused discomfort for patients. The electromyographic amplitude showed that the customizations performed in this study did not significantly increase or decrease masticatory effort. In addition, all observed maximum bite force values were within the clinically acceptable range(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Força de Mordida , Arcada Edêntula , Prótese Total , Músculos da Mastigação , Dimensão Vertical , Saúde Bucal , Reembasamento de Dentadura , Eletromiografia , Reabilitação BucalRESUMO
Durante o período de osseointegração de implantes em uma reabilitação oral com prótese do tipo protocolo ou overdenture, uma prótese total convencional provisória poderá ser utilizada e revestida com materiais reembasadores macios, os quais têm por objetivo reduzir o estresse para a interface ossoimplante. A avaliação mecânica de tal situação clínica é de extrema relevância, a fim de se estabelecer protocolos mais seguros durante esta fase inicial da implantodontia. O objetivo deste estudo foi realizar uma análise biomecânica pelo método dos elementos finitos 3D, da distribuição de tensões durante a fase provisória de reabilitação com implantes osseointegrados simulando uma situação clínica de protocolo/overdenture inferior sobre 4 implantes do tipo cone morse, na fase de cicatrização. Para este estudo foram confeccionados 6 modelos 3D, sob carregamento em 2 direções (vertical e oblíquo em relação ao plano oclusal), simulando osso tipo II, variando a altura do tecido gengival (2 mm e 3 mm) e a espessura do material reembasador (0 mm - sem material, 2 mm e 4 mm), sendo utilizado um cicatrizador compatível com a altura + 0,5 mm para cada situação gengival. A posição dos 4 implantes cone morse (UNITITE, UCM 3510N, SIN) foi sempre a mesma, nas posições perdidas dos dentes 46, 43, 33 e 36. Para a altura gengival de 2 mm foi utilizado cicatrizador de 2,5 mm de altura (UNITITE, CIMU 4525, SIN) e para a altura gengival de 3 mm, o cicatrizador de 3,5 mm de altura (UNITITE, CIMU 4535, SIN). Os modelos utilizados foram: (G2C2,5-SR) altura gengival de 2mm, cicatrizador de 2,5mm, sem material reembasador; (G2C2,5-R2) altura gengival de 2mm, cicatrizador de 2,5mm, com soft rreembasador de 2mm; (G2C2,5-R4) altura gengival de 2mm, cicatrizador de 2,5mm, com material reembasador de 4mm; (G3C3,5-SR) altura gengival de 3mm, cicatrizador de 3,5mm, sem material reembasador; (G3C3,5-R2) altura gengival de 3mm, cicatrizador de 3,5mm, e reembasador de 2mm e (G3C3,5-R4) altura gengival de 3mm, cicatrizador de 3,5mm e soft reembasador de 4mm. A metodologia para modelagem se baseou em um escaneamento de superfície de uma prótese total inferior montada, sob um modelo inferior padrão, e de seu modelo de assentamento. As geometrias dos implantes (CM 3,5x10mm) e de seus cicatrizadores foram obtidas por simplificação do desenho dos mesmos no programa SolidWorks e no programa Rhinoceros 3D. O software utilizado para análise foi o ANSYS 17.0. A visualização dos resultados foi qualitativa através de mapas de deslocamento, von Mises e tensão máxima principal. As regiões com maiores deslocamentos foram as dos implantes mais anteriores (#33 e #43), sendo os do modelo 6 submetidos a forças verticais os que apresentaram maiores deslocamentos, próximos a 0,05 mm. A força oblíqua, de forma geral, tendeu a sobrecarregar mais os implantes do lado onde as cargas foram aplicadas. No tecido ósseo foi possível observar que o osso cortical se mostrou com mais concentração de tensão de tração que o osso trabecular. A utilização do material reembasador gerou menores tensões transmitidas para o tecido gengival, concentrando estas tensões principalmente no material reembasador. A não utilização de material reembasador aumenta as concentrações de tensões nos implantes/cicatrizadores, independentemente de sua espessura ou da espessura gengival. Concluiu-se que o uso de reembasador soft diminuiu as tensões nos implantes/cicatrizadores e tecido gengival; o aumento da espessura do material reembasador não influenciou na diminuição das tensões aos tecidos de suporte e tecidos gengivais mais espessos foram favoráveis em diminuir as tensões transmitidas ao tecido ósseo, mas concentram mais tensões nos implantes/cicatrizadores(AU)
During the period of osseointegration of implants in an oral rehabilitation with a protocol or overdenturetype prosthesis, a conventional temporary complete denture can be used and coated with soft reline materials, which aim to reduce the stress to the bone-implant interface. The mechanical assessment of such a clinical situation is extremely relevant in order to establish safer protocols during this initial phase of implantology. The objective of this study was to perform a biomechanical analysis by the 3D finite element method, of the stress distribution during the provisional phase of rehabilitation with osseointegrated implants simulating a clinical situation of protocol/lower overdenture on 4 cone morse implants, in the healing phase. For this study, 6 3D models were made, under loading in 2 directions (vertical and oblique in relation to the occlusal plane), simulating type II bone, varying the height of the gingival tissue (2 mm and 3 mm) and the thickness of the reline material (0 mm - without material, 2 mm and 4 mm), using a healer compatible with the height + 0.5 mm for each gingival situation. The position of the 4 cone morse implants (UNITITE, UCM 3510N, SIN) was always the same, in the missing positions of teeth 46, 43, 33 and 36. For the 2 mm gingival height, a 2.5 mm high healer was used. (UNITITE, CIMU 4525, SIN) and for a gingival height of 3 mm, the healer with a height of 3.5 mm (UNITITE, CIMU 4535, SIN). The models used were: (G2H2,5-WS) 2mm gingival height, 2.5mm healing, without soft material; (G2H2,5-S2) 2mm gingival height, 2.5mm healing, with 2mm reline; (G2H2,5-S4) 2mm gingival height, 2.5mm healing, with 4mm reline; (G3H3,5-WS) gingival height of 3mm, healing of 3.5mm, without soft material; (G3H3,5-S2) 3mm gingival height, 3.5mm healing, and 2mm reline and (G3H3,5-S4) gingival height of 3mm, healing of 3.5mm and reliner of 4mm. The methodology for modeling was based on a surface scan of a complete lower denture assembled, under a standard lower model, and its seating model. The geometries of the implants (CM 3.5x10mm) and their healers were obtained by simplifying their design in the SolidWorks program and in the Rhinoceros 3D program. The software used for analysis was ANSYS 17.0. The visualization of the results was qualitative through displacement maps, von Mises and maximum principal stress. The regions with the greatest displacements were those of the most anterior implants (#33 and #43), and those of model 6 submitted to vertical forces presented the greatest displacements, close to 0.05 mm. The oblique force, in general, tended to place more stress on the implants on the side where the loads were applied. In the bone tissue, it was possible to observe that the cortical bone showed a higher concentration of tensile stress than the trabecular bone. The use of soft material generated lower tensions transmitted to the gingival tissue, concentrating these tensions mainly in the soft material. The non-use of soft material increases stress concentrations on implants/healers, regardless of their thickness or gingival thickness. It was concluded that the use of a soft reliner reduced the stresses on the implants/healers and gingival tissue; the increase in the thickness of the reline material did not influence the reduction of tensions to the supporting tissues and thicker gingival tissues were favorable in reducing the tensions transmitted to the bone tissue, but concentrated more tensions in the implants/healing agentes(AU)
Assuntos
Implantes Dentários , Osseointegração , Prótese Dentária Fixada por Implante , Reembasadores de Dentadura , Reembasamento de Dentadura , Prótese Dentária , Análise de Elementos Finitos , Interface Osso-ImplanteRESUMO
O uso de próteses mal adaptadas pode ocasionar o surgimento de processos proliferativos não neoplásicos. A hiperplasia fibrosa inflamatória (HFI) é uma lesão benigna, proveniente de reação hiperplásica do tecido conjuntivo fibroso em resposta às injúrias crônicas de baixa intensidade. O objetivo do presente trabalho é relatar um caso clínico sobre remoção cirúrgica de HFI, seguida de reabilitação oral com próteses removíveis. Paciente de 75 anos do sexo masculino relatou que gostaria de fazer a troca da sua prótese, pois a mesma estava fraturada. Ao exame clínico intra-oral constatou-se que suas próteses possuíam higienização precária, e, a superior, possuía uma borda cortante que causou uma lesão hiperplásica na região de fundo de vestíbulo anterior. Quanto ao aspecto clínico, apresentava-se com consistência fibrosa e firme à palpação, de coloração semelhante a mucosa e assintomática. O plano de tratamento proposto foi reembasamento da prótese antiga com resina Soft Confort (Dencril, Brasil) eliminando as áreas que traumatizavam a mucosa, cirurgia pré-protética para a remoção da HFI, exame histopatológico e a confecção de novas próteses, sendo a superior prótese total convencional e a inferior prótese parcial removível. Observa-se a importância no cuidado do planejamento reabilitador protético dos pacientes, pois, como foi descrito neste caso, em algumas situações pode haver necessidade de lançarmos mão de diversas modalidades de tratamento prévias à reabilitação(AU)
The use of poorly adapted prostheses can lead to the emergence of non-neoplastic proliferative processes. Inflammatory fibrous hyperplasia (HFI) is a benign lesion, resulting from a hyperplastic reaction of fibrous connective tissue in response to low-intensity chronic injuries. The aim of the present study is to report a clinical case about surgical removal of HFI, followed by oral rehabilitation with removable prostheses. A 75-year-old male patient reported that he would like to change his prosthesis, because it was fractured. On intra-oral clinical examination, it was found that his prostheses had poor hygiene, and the upper one had a cutting edge that caused a hyperplastic lesion in the deep region of the anterior vestibule. As for the clinical aspect, it was fibrous and firm on palpation, mucosa-like and asymptomatic. The proposed treatment plan was to repurpose the old prosthesis with Soft Confort resin (Dencril, Brazil), eliminating the areas that traumatized the mucosa, pre-prosthetic surgery for the removal of HFI, histopathological examination and the making of new prostheses, the upper prosthesis being conventional total and the lower partial removable prosthesis. It is observed the importance in the care of the prosthetic rehabilitation planning of the patients, because, as it was described in this case, in some situations it may be necessary to resort to different treatment modalities prior to the rehabilitation(AU)
Assuntos
Planejamento de Prótese Dentária , Hiperplasia , Tecido Conjuntivo , Prótese Total , Prótese Parcial Removível , Reembasamento de DentaduraRESUMO
A ausência de um adequado rebordo alveolar em pacientes desdentados é, de fato, um dos problemas que o profissional enfrenta para realização de uma prótese total bem retida. Em alguns casos, é necessária a realização de cirurgias pré-protéticas que preparem as bases ósseas e os tecidos moles para melhor retenção das próteses mucossuportadas. O objetivo deste trabalho é fazer um relato de caso de aprofundamento de vestíbulo como alternativa para melhorar a retenção e estabilidade de próteses totais removíveis. No relato de caso apresentado, trata-se de um paciente do sexo masculino, 79 anos de idade, portador uma prótese total superior com baixa retenção devido à extensa perda óssea adjacente. Ao examiná-lo clinicamente, observamos rebordos bastante reabsorvidos. Devido à falta de estabilidade e retenção da prótese, optou-se por realizar uma cirurgia para aprofundamento do vestíbulo, através da utilização do laser de alta intensidade. Estes lasers têm a capacidade de corte, vaporização, coagulação e descontaminação dos tecidos por ele irradiados. Proporcionam melhor campo operatório devido à hemostasia que promove, não necessita de sutura e sua reparação tecidual é mais rápida. Ao final do tratamento, obtivemos um aumento de rebordo ósseo considerável, proporcionando melhor retenção da prótese total (AU).
The absence of an adequate alveolar ridge in edentulous patients is indeed one of the problems faced by the professional to perform well retained dentures. In some cases, the completion of pre-prosthetic surgery I required in order to prepare the bone and soft tissues basis for better retention of the mucous supported prosthesis. The objective of this work is to report of vestibule deepening as an alternative to improve the retention and stability of removable dentures. This paper reports the case of a male patient, 79 years old, with upper prosthesis with low retention due to extensive adjacent bone loss. During clinical exam, considerable resorption of the ridge was observed. Due to the lack of stability and compromised retention of the prosthesis, we chose to perform surgery to deepen the hall, through the use of high intensity laser. These lasers have the ability to cut, vaporization, coagulation, and decontamination of irradiated tissues for it. They also provide better surgical field promoting hemostasis, do not require suturing, and tissue repair is faster. At the end of the treatment, we had a significant increase in bone edge, providing better retention of the denture (AU).
Assuntos
Humanos , Masculino , Idoso , Reabsorção Óssea , Procedimentos Cirúrgicos Bucais , Prótese Total , Lasers , Brasil , Relatos de Casos , Radiografia/instrumentação , Reembasamento de DentaduraRESUMO
STATEMENT OF PROBLEM: Incorporating antifungals into interim denture resilient liners has been proposed to prolong their clinical longevity and to treat denture stomatitis. However, information is lacking on the effect of this addition on water sorption and solubility. PURPOSE: The purpose of this in vitro study was to evaluate the addition of minimum inhibitory concentrations (MICs) of antifungals for Candida albicans biofilm on the water sorption (WS) and solubility of interim denture resilient liners. MATERIAL AND METHODS: Disk-shaped specimens (n=10; 50×0.5 mm) of tissue conditioner (Softone) and resilient liner (Trusoft) were created either without (control) or with the incorporation of 1 of the 3 following drugs at MICs (g of drug per g of resilient material powder): nystatin (Ny, 0.032g/g), chlorhexidine diacetate (Chx, 0.064g/g), and ketoconazole (Ke, 0.128g/g). Specimens were dried; immersed in water for 24 hours and 7 or 14 days; weighed, dried, and weighed again. Data (µg/mm(3)) were analyzed by 3-way ANOVA followed by the Tukey-Kramer honest significant differences test (α=.05). RESULTS: At the 14-day interval, only the addition of Chx (483.0 ±61.0 µg/mm(3)) increased the WS of the tissue conditioner compared with the control group (244.0 ±42.0 µg/mm(3); P<.001). For all periods, the solubility of both materials increased with the addition of Chx (27.7 ±6.1 µg/mm(3)) and Ke (30.9 ±5.3 µg/mm(3)) compared with the control group (22.5 ±6.0 µg/mm(3); P<.001). CONCLUSIONS: After 14 days, the addition of Ny and Ke at MICs in both Softone and Trusoft and addition of Chx in Trusoft did not affect WS. The solubility of the 2 interim materials was not altered by the addition of Ny for up to 14 days.
Assuntos
Antifúngicos/uso terapêutico , Bases de Dentadura , Reembasamento de Dentadura/métodos , Antifúngicos/administração & dosagem , Biofilmes/efeitos dos fármacos , Candidíase Bucal/prevenção & controle , Humanos , Técnicas In Vitro , Testes de Sensibilidade Microbiana , Água/metabolismoRESUMO
O sucesso clínico do reembasamento laboratorial de uma prótese total depende decuidados em relação à correta indicação do procedimento, ao espaço adequado para acolocação do material de moldagem e atenção especial às referências basais e oclusais,de modo a permitir a correta função da prótese após sua instalação e, assim, reabilitaro paciente.
Assuntos
Planejamento de Prótese Dentária , Reembasamento de Dentadura , Prótese Total , Falha de Prótese , Retenção da PróteseRESUMO
STATEMENT OF PROBLEM: Routine cleaning of a denture may increase the surface roughness of the material. PURPOSE: The purpose of this study was to investigate the effect of denture cleansers and time on the roughness and Candida albicans biofilm formation on a reline resin. MATERIAL AND METHODS: Specimens of Tokuyama Rebase Fast II (20 × 10 × 2 mm) were prepared and divided into 9 groups (n=15): Test groups were toothbrushed (30 cycles per day) in 1 of the following solutions: water, soap, or toothpaste. After toothbrushing, the specimens were immersed in solutions of water, sodium perborate, or chlorhexidine. These treatments were done once a day for 365 days. The surface roughness was evaluated at 0, 7, 15, 30, 90, 180, 270, and 365 days, and the C albicans biofilm formation was measured after 365 days. The roughness data were analyzed by 3-way repeated measures ANOVA and the Tukey test (α=.05), and the C albicans biofilm formation was analyzed by 2-way ANOVA. RESULTS: Significant differences were found in the toothbrush and time interaction and in the toothbrush, immersion, and time interaction (P<.001). No significant differences were found between the toothbrush agent and chemical disinfection (P=.085) or between chemical disinfection and time interaction (P=.604). Brushing with dentifrice (PPb and PCh) showed a gradual decrease in surface roughness. The comparison among groups showed that PCh produced the lowest values of roughness. For C albicans biofilm formation, no significant differences were found among the experimental groups. CONCLUSIONS: The roughness values ranged from 0.31 to 0.69 µm for all evaluated groups. For all groups, no significant differences were found in the quantification of C albicans.
Assuntos
Biofilmes , Candida albicans/fisiologia , Desinfetantes de Equipamento Odontológico/química , Materiais Dentários/química , Reembasadores de Dentadura , Reembasamento de Dentadura , Escovação Dentária/métodos , Boratos/química , Clorexidina/química , Higienizadores de Dentadura/química , Humanos , Imersão , Teste de Materiais , Metacrilatos/química , Sabões/química , Propriedades de Superfície , Fatores de Tempo , Cremes Dentais/química , Água/químicaRESUMO
AIM: To assess the histopathological changes of rat palatal mucosa exposed to soft reline materials. METHODS: Forty-five adult female Wistar rats with controlled living conditions and fed ad libitum were employed. Palatal appliances of heat-polymerized acrylic resin Lucitone 550 were manufactured and worn by forty animals during 14 days. Five animals did not use the appliances (G1) and were used to control the appliance influence. One experimental group (nâ=â10) used the appliances without any relining material (G2) to control the material effect. Three experimental groups (nâ=â10) received the following soft reline materials below appliances: Dentusoft (G3), Dentuflex (G4), and Trusoft (G5). Appliances from half of each experimental group(nâ=â5) was immersed in water bath at 55°C for 10 min before use. Animals were slaughtered and the palates were fixed in 10% buffered formalin. Hematoxylin and eosin stained sections of 5 µm were analyzed by computerized planimetry. Cellular compartment, keratin and total epithelial thickness, and basement membrane length were measured to histopathological description.Analysis of variance and Tukey post-hoc test were used to data examination(αâ=â0.05). RESULTS: For heat-treatment groups, G4 showed less elongated ridges at the basal layer interface (pâ=â0.037) than G2. When comparing the conditions with and without heat-treatment, only G2 showed a significant decrease in the cellular compartment, keratin layer and total epithelium thickness (p<0.05). CONCLUSION: The post-polymerization for Lucitone 550 was an effective method to reduce the changes in the rat palatal mucosa. The soft reline materials tested did not cause significant histopathological changes in the rat palatal mucosa.
Assuntos
Reembasamento de Dentadura/efeitos adversos , Mucosa Bucal/citologia , Mucosa Bucal/efeitos dos fármacos , Animais , Feminino , Temperatura Alta , Polimerização , Ratos , Ratos Wistar , Testes de ToxicidadeRESUMO
PURPOSE: The aim of this in vivo animal study was to investigate changes in the surface roughness of soft liners over time. MATERIALS AND METHODS: Forty adult Wistar rats (Rattus norvergicus albinus) were fitted with acrylic custom-made palatal plates relined by dynamic impressions and tested with the following soft liners: Dentuflex (DF), Trusoft (TS), Dentusoft (DS), and Ufi Gel P (UG). Half of the animals for each tested material had the plates fitted during the material reline procedure. Their surface roughness was read immediately (IRa group, n = 5). The other half used the palatal plates for 14 days before roughness readings were performed (FRa group, n = 5). The surface roughness (Ra) of the inner surface from the relined dentures was recorded using a Surftest SJ-401 with eight readings per specimen, and mean values were obtained. Data (µm) were analyzed by two-way ANOVA and Tukey's test (α = 0.05). RESULTS: IRa means (2.92 ± 0.87 µm) and FRa means (3.35 ± 0.65 µm) were significantly different (p = 0.016). UG showed a lower (p = 0.01) Ra mean (2.1 ± 0.52 µm) than DF (3.94 ± 0.81 µm), TS (4.12 ± 0.64 µm), and DS (3.27 ± 0.64 µm). CONCLUSIONS: Ufi Gel P showed the smoothest surface among the materials evaluated. The period of use resulted in changes in the surface roughness of the materials tested.
Assuntos
Resinas Acrílicas/química , Materiais Dentários/química , Reembasadores de Dentadura , Silicones/química , Animais , Bases de Dentadura , Reembasamento de Dentadura , Feminino , Metacrilatos/química , Metilmetacrilatos/química , Modelos Animais , Ratos , Ratos Wistar , Elastômeros de Silicone/química , Propriedades de Superfície , Fatores de TempoRESUMO
A incorporação do diacetato de clorexidina em resinas macias para reembasamento de próteses pode se tornar uma boa alternativa na terapia com antimicrobianos usados para candidíase oral, uma vez que é independente da cooperação do paciente. Este trabalho teve como objetivo analisar a hipótese que a incorporação de diacetato de clorexidina em resinas macias não alteraria as suas propriedades físico-químicas. Foram analisadas duas resinas macias, uma à base de polimetilmetacrilato (PMMA) e outra à base de polietilmetacrilato (PEMA), com a incorporação de 0,5%, 1,0% e 2,0% de diacetato de clorexidina, além do grupo controle sem diacetato de clorexidina. Os espécimes foram armazenadas em água destilada a 37º durante 2hrs, 48 hrs, 7, 14, 21 e 28 dias e analisados quanto a cristalinidade do polímero através da difração de Raios X, a dureza mensurada com durômetro na escala shore A, o grau de conversão dos monômeros pela Espectroscopia de Infravermelho Transformada de Fourier (FTIR), a lixiviação de monômeros residuais e a liberação da clorexidina por Cromatografia Líquida de Alta Performace (HPLC). Os resultados mostraram que quanto à cristalinidade dos polímeros nas resinas macias à base de PMMA e de PEMA não alteraram após a incorporação de clorexidina, o que está relacionado à dureza Shore A, que aumentou ao longo do tempo, mas sem alteração significativa para nenhuma das concentrações de diacetato de clorexidina testadas. Já quanto ao grau de conversão, após a incorporação de clorexidina, a resina macia à base de PMMA não apresentou diferença estatisticamente significativa (р>0,05), porém a resina macia à base de PEMA apresentou diminuição significativa do grau de conversão (p<0,05), o que refletiu no aumento significativo da lixiviação de monômeros residuais nas concentrações 0,5% e 1,0% de clorexidina (p<0,05), principalmente nas primeiras 48 horas nessa resina. A resina macia à base de PMMA não apresentou alterações do padrão...
Chlorhexidine incorporation in soft denture liners can become a good antimicrobial treatment alternative for oral candidiasis, since it is independent of patient compliance. Considering this, the present study evaluate the hypothesis that chlorhexidine diacetate (CDA) incorporation in soft denture liners would not change their physical-chemical properties. For this, two soft resins were tested, one based on poly methylmethacrylate (PMMA) and the other based on poly ethylmethacrylate (PEMA), which received 0.5%, 1.0% and 2.0% of CDA incorporation, in addition to a control group without CDA. Specimens were stored in distilled water at 37º C during 2 hrs, 48 hrs, 7, 14, 21 and 28 days, then analyzed for polymer crystallinity through X-Ray diffraction, Shore A hardness measured with a durometer, degree of monomers conversion by Fourier transform infrared spectroscopy (FTIR), the leaching of residual monomers and release of CDA by high performance liquid chromatography (HPLC). Results showed that polymer crystallinity of PEMA and PMMA were not changed after CDA incorporation, this results is related to Shore A hardness, which increased over time, but not for any CDA concentrations tested. Considering the degree of monomers conversion, PMMA based resin did not present significant statistic difference (р>0.05), however the PEMA based resin had a significantly decrease on its degree of conversion (p<0.05), which was reflected in a significant increase of residual monomers leaching from PEMA based resin with 0.5% and 1.0% CDA incorporation (p<0.05), mainly in the firsts 48 hours. PMMA based resin had no alteration on its monomers leaching (р>0.05) and for both resins their CDA release kinetics was related to the monomers leaching, which for PEMA based resin was significantly greater in the first 48 hours (p<0.05) and for PMMA based resin was more sustained up to the last day of analysis. Thus, it is concluded that CDA incorporation do not affect polymers...
Assuntos
Anti-Infecciosos/uso terapêutico , Clorexidina , Candidíase Bucal/prevenção & controle , Reembasadores de Dentadura , Reembasamento de Dentadura , Resinas Sintéticas , Cromatografia Líquida de Alta Pressão , Testes de Dureza , Teste de Materiais , Fenômenos Químicos , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios XRESUMO
OBJECTIVE: The shear bond strengths of two hard chairside reline resin materials and an auto-polymerizing denture base resin material to cast Ti and a Co-Cr alloy treated using four conditioning methods were investigated. MATERIAL AND METHODS: Disk specimens (diameter 10 mm and thickness 2.5 mm) were cast from pure Ti and Co-Cr alloy. The specimens were wet-ground to a final surface finish of 600 grit, air-dried, and treated with the following bonding systems: 1) air-abraded with 50-70-µm grain alumina (CON); 2) 1) + conditioned with a primer, including an acidic phosphonoacetate monomer (MHPA); 3) 1) + conditioned with a primer including a diphosphate monomer (MDP); 4) treated with a tribochemical system. Three resin materials were applied to each metal specimen. Shear bond strengths were determined before and after 10,000 thermocycles. RESULTS: The strengths decreased after thermocycling for all combinations. Among the resin materials assessed, the denture base material showed significantly (p<0.05) greater shear bond strengths than the two reline materials, except for the CON condition. After 10,000 thermocycles, the bond strengths of two reline materials decreased to less than 10 MPa for both metals. The bond strengths of the denture base material with MDP were sufficient: 34.56 MPa for cast Ti and 38.30 for Co-Cr alloy. CONCLUSION: Bonding of reline resin materials to metals assessed was clinically insufficient, regardless of metal type, surface treatment, and resin composition. For the relining of metal denture frameworks, a denture base material should be used.
Assuntos
Resinas Acrílicas/química , Ligas Dentárias/química , Colagem Dentária/métodos , Bases de Dentadura , Reembasamento de Dentadura , Análise de Variância , Teste de Materiais , Polimerização , Resistência ao Cisalhamento , Propriedades de Superfície , Temperatura , Fatores de Tempo , Titânio/químicaRESUMO
OBJECTIVE: This study evaluated the fracture toughness (FT) of denture base and autopolymerizing reline resins, with and without thermocycling (T). MATERIAL AND METHODS: Specimens of each material (denture base acrylic resin - Lucitone 550 - L; autopolymerizing reline resins - Ufi Gel Hard-UH, Tokuyama Rebase II-TR, New Truliner-NT and Kooliner-K), were produced, notched and divided into two groups (n=10): CG (control group of autopolymerizing reline resins and L): FT tests were performed after polymerization; TG (thermocycled group): FT tests were performed after T (5°C and 55°C for 5,000 cycles). RESULTS: Results (MPa.m1/2) were analyzed by two-way ANOVA and Tukey's test (p=0.05). L exhibited the highest FT mean values in both groups (CG - 2.33; TG - 2.17). For the CG groups, NT showed the highest FT (1.64) among the autopolymerizing reline resins, and K the lowest (1.04). After T, when the autopolymerizing reline resins were compared, a statistically significant difference in FT was found only between the NT (1.46) and TR (1.00). CONCLUSIONS: Thermocycling increased the FT of K and did not influence the FT of L, UH, TR and NT.
Assuntos
Resinas Acrílicas/química , Bases de Dentadura , Reembasamento de Dentadura , Polimerização , Elastômeros de Silicone/química , Análise de Variância , Falha de Restauração Dentária , Humanos , Teste de Materiais , Estresse Mecânico , Temperatura , Fatores de TempoRESUMO
OBJECTIVE: The shear bond strengths of two hard chairside reline resin materials and an auto-polymerizing denture base resin material to cast Ti and a Co-Cr alloy treated using four conditioning methods were investigated. MATERIAL AND METHODS: Disk specimens (diameter 10 mm and thickness 2.5 mm) were cast from pure Ti and Co-Cr alloy. The specimens were wet-ground to a final surface finish of 600 grit, air-dried, and treated with the following bonding systems: 1) air-abraded with 50-70-µm grain alumina (CON); 2) 1) + conditioned with a primer, including an acidic phosphonoacetate monomer (MHPA); 3) 1) + conditioned with a primer including a diphosphate monomer (MDP); 4) treated with a tribochemical system. Three resin materials were applied to each metal specimen. Shear bond strengths were determined before and after 10,000 thermocycles. RESULTS: The strengths decreased after thermocycling for all combinations. Among the resin materials assessed, the denture base material showed significantly (p<0.05) greater shear bond strengths than the two reline materials, except for the CON condition. After 10,000 thermocycles, the bond strengths of two reline materials decreased to less than 10 MPa for both metals. The bond strengths of the denture base material with MDP were sufficient: 34.56 MPa for cast Ti and 38.30 for Co-Cr alloy. CONCLUSION: Bonding of reline resin materials to metals assessed was clinically insufficient, regardless of metal type, surface treatment, and resin composition. For the relining of metal denture frameworks, a denture base material ...
Assuntos
Resinas Acrílicas/química , Bases de Dentadura , Reembasamento de Dentadura , Ligas Dentárias/química , Colagem Dentária/métodos , Análise de Variância , Teste de Materiais , Polimerização , Resistência ao Cisalhamento , Propriedades de Superfície , Temperatura , Fatores de Tempo , Titânio/químicaRESUMO
Objective This study evaluated the fracture toughness (FT) of denture base and autopolymerizing reline resins, with and without thermocycling (T). Material and Methods Specimens of each material (denture base acrylic resin - Lucitone 550 – L; autopolymerizing reline resins - Ufi Gel Hard–UH, Tokuyama Rebase II-TR, New Truliner–NT and Kooliner-K), were produced, notched and divided into two groups (n=10): CG (control group of autopolymerizing reline resins and L): FT tests were performed after polymerization; TG (thermocycled group): FT tests were performed after T (5°C and 55°C for 5,000 cycles). Results: Results (MPa.m1/2) were analyzed by two-way ANOVA and Tukey's test (p=0.05). L exhibited the highest FT mean values in both groups (CG - 2.33; TG - 2.17). For the CG groups, NT showed the highest FT (1.64) among the autopolymerizing reline resins, and K the lowest (1.04). After T, when the autopolymerizing reline resins were compared, a statistically significant difference in FT was found only between the NT (1.46) and TR (1.00). Conclusions Thermocycling increased the FT of K and did not influence the FT of L, UH, TR and NT. .
Assuntos
Humanos , Resinas Acrílicas/química , Bases de Dentadura , Reembasamento de Dentadura , Polimerização , Elastômeros de Silicone/química , Análise de Variância , Falha de Restauração Dentária , Teste de Materiais , Estresse Mecânico , Temperatura , Fatores de TempoRESUMO
PURPOSE: Edentulism has been decreasing in the US elderly population; however, due to the increasing number of elderly, the need for prostheses has been projected to rise over the next several decades. One of the aims of the Puerto Rican Elderly Dental Health Study (PREDHS) was to assess the quality of removable prostheses (RP) in the Puerto Rican (PR) elderly (>69 years of age) population. METHODS: A cross-sectional design, using a subgroup from the Puerto Rican Elderly: Health Conditions (PREHCO) study of dentate, community-dwelling older adults from the greater San Juan area was employed. Eligible participants were administered structured questionnaires and examined in their homes by three trained and calibrated dentists using National Institute of Dental and Craniofacial Research (NIDCR) criteria. RESULTS: One hundred and eighty three (183) participants were examined (61 males, 122 females) (p < 0.001). Overall, 64% were found to have a prosthetic problem with no statistical difference between genders. Unadjusted and age-adjusted logistic models were employed. Increasing age was associated with both upper and lower clinically defined abraded prostheses, (p = 0.007; p = 0.041, respectively). Maxillary (23%) and mandibular (27%) prostheses needed replacement due to deficiencies. CONCLUSION: RP deficiencies were found in almost two-thirds of a representative sample of dentate 70+ year-old people residing in PR. There was no difference in the proportion of deficiencies between elderly who reported a dental visit in the preceding year or not having seen a dentist. A quarter of the prostheses required replacement. The findings from this and the NHANES studies demonstrate that an engaged and recognized prosthodontic dental school faculty continues to be as important now as it was a generation ago.
Assuntos
Prótese Parcial Removível/normas , Vida Independente , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Grampos Dentários/normas , Falha de Restauração Dentária/estatística & dados numéricos , Desgaste de Restauração Dentária/estatística & dados numéricos , Reembasamento de Dentadura/estatística & dados numéricos , Retenção de Dentadura/normas , Feminino , Avaliação Geriátrica , Humanos , Masculino , Porto Rico , Retratamento/estatística & dados numéricos , Saúde da População UrbanaRESUMO
BACKGROUND: Microorganisms of the genus Candida have been recovered from complete dentures made of acrylic resin, with high numbers of colony forming units and species diversity, which can act as infectious agents causing chronic atrophic candidiasis (denture stomatitis). OBJECTIVE: The objective of this paper is present a treatment protocol for chronic atrophic candidiasis (denture stomatitis). MATERIALS AND METHODS: The work describes three cases of totally edentulous patients presenting palate stomatitis who were submitted for treatment associating denture rebasing with chemically-activated acrylic resin, night immersion in 2.5% sodium hypochlorite and use of topical antifungals for two weeks. RESULTS: In all cases, remission of the inflammatory process occurred. CONCLUSION: The proposed treatment protocol proved to be to be effective.
Assuntos
Estomatite sob Prótese/terapia , Resinas Acrílicas/química , Administração Tópica , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Protocolos Clínicos , Desinfetantes de Equipamento Odontológico/uso terapêutico , Materiais Dentários/química , Reembasamento de Dentadura , Prótese Total/microbiologia , Feminino , Seguimentos , Humanos , Masculino , Metilmetacrilatos/química , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Nistatina/administração & dosagem , Nistatina/uso terapêutico , Hipoclorito de Sódio/uso terapêuticoRESUMO
In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37ºC for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.
Assuntos
Resinas Acrílicas/química , Anti-Infecciosos/química , Bases de Dentadura , Colagem Dentária/métodos , Reembasamento de Dentadura/métodos , Clorexidina/química , Falha de Restauração Dentária , Cetoconazol/química , Teste de Materiais , Miconazol/química , Nistatina/química , Reprodutibilidade dos Testes , Propriedades de Superfície , Resistência à Tração , Água/químicaRESUMO
The current study used finite element analysis to evaluate how the thickness of reline material and the area of its placement in conventional complete dentures affected the stress distribution in peri-implant bone during function in the healing period. For this study, three-dimensional models were created to simulate a severely resorbed mandible with two implants placed recently in the anterior region. Two of these models received a layer of soft liner material that covered the entire length of the denture base (1.5 mm or 3.0 mm); for the other sample models, soft liner material was placed (in thicknesses of 1.5 mm or 3.0 mm) in the implant region only. The models were exported to mechanical simulation software; two simulations were performed by placing a load in the mandibular right canine (35 N) and the mandibular right first molar (50 N). Data were quantitatively and qualitatively evaluated by means of maximum principal stress. In all cases, models that received 3.0 mm of soft liner material showed lower values of stress concentration than those receiving 1.5 mm of soft liner material. Likewise, localized application of soft liner in the implant region showed lower stress concentration compared with models in which the entire denture base was relined. These results indicate that the thickness and area of reline in conventional complete dentures has a direct effect on stress distribution in the peri-implant bone tissue during the healing period.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Reembasadores de Dentadura , Reembasamento de Dentadura , Prótese Total , Análise de Elementos Finitos , Imageamento Tridimensional , Mandíbula/fisiopatologia , Fenômenos Biomecânicos , Reabsorção Óssea/fisiopatologia , Simulação por Computador , Dente Canino , Arco Dental/fisiopatologia , Arco Dental/cirurgia , Materiais Dentários/química , Bases de Dentadura , Humanos , Arcada Edêntula/fisiopatologia , Teste de Materiais , Modelos Biológicos , Dente Molar , Estresse Mecânico , Propriedades de SuperfícieRESUMO
UNLABELLED: In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 ºC for 48 h. The drug powder concentrations (nystatin 500,000 U--G2; nystatin 1,000,000 U--G3; miconazole 125 mg--G4; miconazole 250 mg--G5; ketoconazole 100 mg - G6; ketoconazole 200 mg--G7; chlorhexidine diacetate 5%--G8; and 10% chlorhexidine diacetate--G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.
Assuntos
Resinas Acrílicas/química , Anti-Infecciosos/química , Colagem Dentária/métodos , Bases de Dentadura , Reembasamento de Dentadura/métodos , Clorexidina/química , Falha de Restauração Dentária , Cetoconazol/química , Teste de Materiais , Miconazol/química , Nistatina/química , Reprodutibilidade dos Testes , Propriedades de Superfície , Resistência à Tração , Água/químicaRESUMO
OBJECTIVE: To evaluate the weight loss and the surface roughness of acrylic resins after simulated brushing tests. MATERIAL AND METHODS: Ten specimens of each material (Tokuyama Rebase II-TR, New Truliner-NT, Ufi Gel Hard-UH and Lucitone 550-L) were made. The wear loss (mg) by weight and the surface roughness (Ra µm) of each specimen was determined before and after brushing. The specimens were placed on the brushing machine and a total of 20,000 brushing cycles was performed. The results of weight loss and roughness values were submitted to the anova followed by the Tukey's test (p = 0.05). RESULTS: The mean weight loss of material L was statistically higher (p < 0.001) than that of the relines TR, UH and NT. No significant differences were found among the roughness values of resins TR, UH and L (p > 0.05). Only for L, toothbrushing increased the surface roughness. After toothbrushing, there was no significant difference between the roughness values of materials L and NT. The highest mean weight loss during the simulated toothbrushing tests was observed for L. Before the toothbrushing tests, the NT exhibited the highest mean roughness. CONCLUSION: Brushing resulted in increase in roughness only for resin L.