Aim To analyze the accuracy of extraoral systems (Ceramill Map400+, AutoScan-DS200+, and E2) in full implant-prosthetic rehabilitation three-dimensionally. Methods A metallic edentulous maxilla with four implants was digitalized by a contact scanner (MDX-40 - Roland, control) and used as a control image to compare with other images generated by three laboratory scanners (10 samples per group). Letters identified all the four components: A and D angled 45º, and B and C parallel. The BioCAD software exported the images (.STL) to compare and verify deviations of the analogs on the X, Y, and Z axes. The nonparametric Kruskal-Wallis test and the two-way ANOVA on ranks with a post hoc Tukey test analyzed the data with 5% significance. Results No statistical differences were observed in the accuracy between the extraoral scanners (p=0.0806). However, when analyzing only the components, component D was more accurate when scanned with Ceramill Map400+ compared with AutoScan DS200+ (p<0.001) and with E2 (p=0.002). Conclusions All extraoral systems assessed showed digitalization accuracy but with more deviations in angled implants. The Ceramill Map400+ scanner showed the best results for the digital impression of a complete arch.

Resumo Introdução A disfunção temporomandibular (DTM) é uma desordem que envolve os músculos da mastigação e da articulação temporomandibular. Pacientes desdentados totais e que utilizam protéses requerem uma avaliação criteriosa, já que o edentulismo leva a prejuízos que podem contribuir para o aparecimento de DTM. Objetivo O objetivo deste presente estudo foi avaliar o efeito da qualidade técnica das próteses totais (PTs) na incidência de DTM em pacientes portadores de PTs bi-maxilares. Material e método Foi aplicado um questionário a 154 pacientes contendo os dados pessoais, o histórico das próteses, o índice anamnésico para DTM e o índice de qualidade de prótese. Resultado Dos 154 pacientes examinados, 64 (41,6%) estavam livres de DTM, 61 (39,6%) possuíam DTM leve, 23 (14,9%), moderada e apenas 6 (3,9%) mostravam DTM severa. Quanto à qualidade da prótese total, 78 (50,6%) desdentados totais portavam PTs satisfatórias e 76 (49,4) estavam com próteses insatisfatórias. Quanto ao tempo de uso da prótese total, cerca de 50% dos indivíduos com até 10 anos de uso apresentaram algum grau de DTM e 70% dos indivíduos com mais de 10 anos acusaram a presença de DTM. Conclusão Considerando-se a metodologia empregada e a população estudada, pôde-se concluir que a qualidade das PTs não influenciou na presença de DTM.

Abstract Introduction Temporomandibular disorder (TMD) involves the mastication and temporomandibular articulation muscles. Completely toothless patients with prostheses should be thoroughly assessed since edentulism causes damage that can lead to TMD onset. Objective This study aims to assess the effect of the technical quality of total prostheses (TPs) on TMD occurrence in patients with bimaxillary TPs. Material and method 154 patients responded to a questionnaire to obtain personal data, information regarding prostheses, anamnestic index for TMD, and the prosthesis quality index. Result Of the 154 patients examined, 64 (41.6%) had no TMD, 61 (39.6%) had mild TMD, 23 (14.9%) moderate, and only 6 (3.9%) showed severe TMD. As for the quality of total prosthesis, 78 (50.6%) completely toothless individuals had satisfactory TPs while 76 (49.4) presented unsatisfactory prostheses. Regarding the time using total prosthesis, around 50% of individuals with up to 10 years use presented some degree of TMD and 70% of individuals with over 10 years presented TMD. Conclusion Considering the methodology used and the population studied, we conclude that the quality of the TPs did not influence the incidence of TMD.

ABSTRACT Introduction: The passivity of prosthetic components is one of the most important prerequisites in oral implant rehabilitation for maintenance of osseointegration. Objective: Thus, the present study analyzed in vitro the accuracy of different molding techniques in prosthetic rehabilitation on angled implants installed in an anatomical model of a metallic edentulous maxilla. Methods: Laboratory experiment study. A reference metal model of an edentulous maxilla was used. A metal framework was used for the misadaptation assessment. Three groups (n= 10) were compared and impressions were made with vinyl-polysiloxane and casts were obtained with type IV stone: (1) Impression with a metallic open-tray without splinted transfers; (2) Impression with a metallic open-tray and metal splinted transfers; (3) Impression with a multifunctional guide and metal splinted transfers. Misadaptation was assessed with the aid of a stereomicroscope and measuring software. Data were submitted to ANOVA with Welch correction and the Games-Howell post-hoc test with the significance set at 5 %. Results: Misadaptation (µm) was 110,23 ± 30,94, 37,53 ± 3,92, and 37,69 ± 2,79 for the the groups. Statistically significant differences between impression with a metallic open-tray with and without splinted transfers were observed (p < 0,001). No significant differences between the other types of impression. Conclusions: Impression with a metallic open-tray without splinted transfers and with a multifunctional guide splinted with metal transfers were the most precise methods resulting in higher accuracy in transferred implants.

RESUMEN Introducción: La pasividad de los componentes protésicos es uno de los prerrequisitos más importantes para el mantenimiento de la osteointegración en la rehabilitación oral sobre implantes. Objetivo: Evaluar in vitro la precisión de diferentes técnicas de impresión en rehabilitación sobre implantes inclinados instalados en un modelo anatómico de un maxilar metálico desdentado. Métodos: Estudio de laboratorio de tipo experimental. Se utilizó un modelo metálico de referencia de un maxilar desdentado. Fue utilizada una barra metálica para la evaluación de la desadaptación. Se compararon tres grupos (n = 10), se realizaron impresiones con polivinilsiloxano y se obtuvieron modelos con yeso piedra tipo IV: (1) impresión con una cubeta metálica abierta sin unión de los transferentes; (2) impresión con una cubeta metálica abierta y unión de los transferentes con cilindros metálicos; (3) impresión con una guía multifuncional y unión de los transferentes con cilindros metálicos. La desadaptación se evaluó con la ayuda de un microscopio estereoscópico y un software de medición. Los datos se enviaron a ANOVA con la corrección de Welch y la prueba post-hoc de Games-Howell con la significación establecida en 5 %. Resultados: La desadaptación (µm) fue de 110,23 ± 30,94; 37,53 ± 3,92 y 37,69 ± 2,79 para los grupos, respectivamente. Se observaron diferencias estadísticamente significativas entre la impresión con cubeta abierta metálica con y sin unión de los transferentes (p <0,001). No hubo diferencias significativas entre los otros tipos de impresiones. Conclusiones: La impresión con cubeta abierta metálica sin unión de los transferentes y con una guía multifuncional con unión de los transferentes con cilindros metálicos fueron los métodos más precisos que dieron como resultado una mayor precisión en la transferencia de la posición de los implantes.

Denture fractures are common in daily practice, causing inconvenience to the patient and to the dentists. Denture repairs should have adequate strength, dimensional stability and color match, and should be easily and quickly performed as well as relatively inexpensive. OBJECTIVE: The aim of this study was to evaluate the flexural strength of acrylic resin repairs processed by different methods: warm water-bath, microwave energy, and chemical polymerization. MATERIAL AND METHODS: Sixty rectangular specimens (31x10x2.5 mm) were made with warm water-bath acrylic resin (Lucitone 550) and grouped (15 specimens per group) according to the resin type used to make repair procedure: 1) specimens of warm water-bath resin (Lucitone 550) without repair (control group); 2) specimens of warm water-bath resin repaired with warm water-bath; 3) specimens of warm water-bath resin repaired with microwave resin (Acron MC); 4) specimens of warm water-bath resin repaired with autopolymerized acrylic resin (Simplex). Flexural strength was measured with the three-point bending in a universal testing machine (MTS 810 Material Test System) with load cell of 100 kgf under constant speed of 5 mm/min. Data were analyzed statistically by Kruskal-Wallis test (p<0.05). RESULTS: The control group showed the best result (156.04±1.82 MPa). Significant differences were found among repaired specimens and the results were decreasing as follows: group 3 (43.02±2.25 MPa), group 2 (36.21±1.20 MPa) and group 4 (6.74±0.85 MPa). CONCLUSION: All repaired specimens demonstrated lower flexural strength than the control group. Repairs with autopolymerized acrylic resin showed the lowest flexural strength.

According to the possible influence of systemic diseases and of drugs used for its treatment in buccal cavity, the aim of present study is to carry out a review of literature on this topic, emphasizing on influence of these factors on use of the total prostheses (PTs), allowing to surgeon-dentist a better scientific knowledge to creation of this type of rehabilitation treatment.

Considerando la posible influencia de las enfermedades sistémicas y de los medicamentos utilizados para su tratamiento en la cavidad bucal, el presente estudio se propone realizar una revisión de la literatura sobre el tema, enfatizando la influencia de estos factores en el uso de las prótesis totales (PTs), con el fin de proporcionar al cirujano-dentista un mejor conocimiento científico para la realización de ese tipo de tratamiento rehabilitador.

Permlastic® is a polysulfide-based impression material widely used by dentists in Brazil. It is composed of a base paste and a catalyzer containing lead dioxide. The high toxicity of lead to humans is ground for much concern, since it can attack various systems and organs. The present study involved a quantitative analysis of the concentration of lead in the material Permlastic®. The lead was determined by plasma-induced optical emission spectrometry (Varian model Vista). The percentages of lead found in the two analyzed lots were 38.1 and 40.8%. The lead concentrations in the material under study were high, but the product’s packaging contained no information about these concentrations.

The oral rehabilitation of the patients toothless totals presents large difficulties, because diverse factors act limiting the treatment with complete dentures conventional, as severe reabsorption of the alveolar process, generating for the phonetic patient difficulties and of mastication, annoyance, retention lack and stability of the prosthesis. With the emergence of you implant them osseointegratin idealized by Profº Branemark, these aspects were improved by means of the possibility of new treatment options, as the overdentures tissue-implant-supported. However, the protocol of Branemark demanded a period of scaring from three to six months, owing the patients to await this time for the placement of the final prosthesis. This way, the surgical technique of immediate load was proposed to abbreviate this period, improving the transition phase, at the same time that it reduces the problems psychological associates. This way, the objective of the present study is to carry out a literature revision about the works that used overdentures comparing immediate and late load, the best alternative and factors wrapped in the success of the procedure discussing.

La rehabilitación oral de los pacientes desdentados totales presenta grandes dificultades, pues diversos factores actúan limitando el tratamiento con prótesis totales convencionales como la severa reabsorción del proceso alveolar, que genera para los pacientes dificultades fonéticas y de masticación, incomodidad, falta de retención y estabilidad de las prótesis. Con el surgimiento de los implantes osteointegrados ideados por el Profesor Branemark, estos aspectos fueron mejorados, por la posibilidad de nuevas opciones de tratamiento como las sobredentaruras muco-implantosoportadas. Sin embargo, el protocolo de Branemark exigía un período de cicatrización de 3 a 6 meses, tiempo que los pacientes deben esperar para la colocación de la prótesis final. De esta forma, la técnica quirúrgica de carga inmediata fue propuesta para abreviar este período, mejorando la fase de transición, al mismo tiempo que reduce los problemas psicológicos asociados. El objetivo del presente estudio es realizar una revisión de literatura acerca de los trabajos que utilizaron sobredentaduras comparando carga inmediata y tardía, discutir la mejor alternativa, así como los factores envueltos en el éxito del procedimiento.

The study of techniques to reach aesthetics in the anterior region when using osseointegrated implants is of great importance. A literature review was made to compare effivciency and suitability of immediate provisionalization in re-opening of osseointegrated implants with respect to the set time (use of standardized cicatrizants and emergency profile cicatrizants). Immediate provisional denture in the phase of re-opening makes the restoration of the gingival contourn quicker when compared to the use of cicatrizants without intermediate phases required.

El estudio de las técnicas para alcamzar una estética en el seguimiento anterior cuando se utilizan implantes osteointegrados es de gran importancia. Se realizó una revisión de la literatura con el objetivo de comparar la eficiencia y conveniencia de la instalación de prótesis provisionales inmediatamente en la reapertura de los implantes osteointegrados en relación con el tiempo establecido (uso de cicatrizadores estandarizados y cicatrizadores con perfil de emergencia arbitrado). La prótesis provisional inmediata en la fase de reapertura propicia la restauración del contorno de la encía más rápidamente cuando se compara con el uso de cicatrizadores sin necesidad de fases intermediarias.