Remodeling of gingival contour in the rehabilitation with fixed partial dentures – case report / Remodelação do contorno gengival em reabilitação com prótese parcial fixa – relato de caso

One of the most challenging aspects in rehabilitations is the correct manipulation of gingival tissues, aiming to achieve a natural contour, with interdental papillae and emergence profile, compatible with a natural tooth. The rehabilitation is impaired when there is loss of the interproximal papilla. To solve this problem, it is possible to use the gingival conditioning technique, which comprises relining the provisional crown with acrylic resin, applying gradual pressure, leading to formation of a gingival papilla. This paper presents a case of esthetic and functional recovery in a fixed partial denture by remodeling of the gingival contour by the gradual pressure technique, by gradual relining of the provisional crown. It is concluded that this gingival conditioning technique is simple, easy to accomplish and very effective for esthetic-functional reestablishment in rehabilitations with fixed partial dentures, provided the patient maintains correct hygiene and plaque control. 

Ritmo de base e atividade paroxística no EEG de pacientes com AIDS: relação com as concentrações séricas de uréia e creatinina

The HIV is responsible for important metabolic and structural alterations of the brain. This affected brain must react to continuous systemic metabolic fluctuations. We search for possibly resulting cerebral electric disturbance that could be found by EEG exploration. Sixty-three AIDS patients ranked as CDC group IV had their EEG background rhythm measured, and were appointed to mutually exclusiding groups delimited by medians' values of urea (24 mg/dl) and creatinine (0.9 mg/dl) seric concentrations. These groups were independently formed for each of the parameters utilized, and each data pair generated therefrom were compared between themselves to verify whether there were differences in background rhythm and the occurrence of paroxysmal activity. Background rhythm and paroxysmal activities have not statistically differed between the group whose creatinine values were lower than 0.9 mg/dl and the group whose creatinine values were equal or higher than 0.9 mg/dl. Background rhythm has not statistically differed between the group whose ures values were <24 mg/dl and the group whose urea values were =24 mg/dl; contrariwise, the occurrence of paroxysmal activities in these groups has significatively differed, being higher in the patient group whose otherwise normal urea values exceeded 24 mg/dl (p=0.02).Sendo o HIV responsável por alterações estruturais e metabólicas do encéfalo, procuramos verificar se pequenas alterações metabólicas sistêmicas poderiam determinar alterações encefálicas detectáveis através do EEG. Medimos o ritmo de base no EEG de 63 pacientes aidéticos no grupo IV da classificação do CDC e, utilizando os valores das medianas das taxas de uréia e creatinina séricas, constituímos dois grupos para cada um dos referidos parâmetros. Verificamos se os EEGs dos pacientes com uréia abaixo do valor mediano (24 mg/dl), diferiam em relação ao ritmo de base e presença de atividade paroxística, daqueles com uréia = 24 mg/dl. Procedemos da mesma forma para estudar o ritmo de base e atividade paroxística em relação à mediana das concentrações de creatinina (0,9 mg/dl). O ritmo de base e a ocorrência de atividade paroxística não foram diferentes em relação à concentração de creatinina. O mesmo ocorreu em relação ao ritmo de base e concentração de uréia. Observamos, entretanto, maior número de EEGs de pacientes com uréia normal acima de 24 mg/dl com atividade paroxística (p=0,02).Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Clínica MédicaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de NeurologiaInstituto de Infectologia Emílio RibasUNIFESP, EPM, Disciplina de Clínica MédicaUNIFESP, EPM, Disciplina de NeurologiaSciEL

Reverse Cast Metallic Core Based on the Original Prosthetic Crown

The dental crown can be restored using the root in clinical situations where the dental remnant allows adequate anchorage by the use of an intraradicular retainer. After endodontic treatment, reconstruction of the dental anatomy depends on correct planning and the type of restoration to be used. This requires reestablishment of form and function with creation of anchoring features, avoiding detachment and favoring the distribution of forces, thus preventing fracture of the remnant due to functional and parafunctional forces applied on the tooth. This paper reports the clinical case of a patient who sought dental care for a full metal-ceramic crown with a cast metallic core with reduced length that had been detached from tooth 24. After clinical and radiographic examination, root integrity was verified. The patient was offered reconstruction with a cast metallic core of satisfactory length, providing adequate retention and support, with reutilization of the original prosthetic crown, serving as a reverse template of the coronal portion of this new core, providing reduction in costs and operational time