Análise pelo método dos elementos finitos da distribuição de tensões em tecido ósseo periimplantar, componentes protéticos e implantes com conexão cono morse e hexágono externo reabilitados com diferentes desenhos protéticos na região anterior da maxila

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Florianópolis, 2017.O objetivo desse estudo foi analisar pelo método dos elementos finitos a distribuição e picos de tensão em prótese parcial fixa (12-22) e prótese parcial fixa com cantiléver distal bilateral (11-21) suportadas por implantes de hexágono externo e cone morse na região anterior da maxila. As duas situações clínicas foram simuladas em terceira dimensão, analisadas e comparadas qualitativamente segundo o mapa de cores e quantitativamente por meio dos Critérios de Rankine para infraestrutura e cerâmica, o Critério equivalente Von Mises para os implantes, pilares e parafusos passantes e o Critério Mohr Coulomb para o tecido ósseo periimplantar. O teste foi realizado com aplicações de carga de 400 N com angulação de 45º em relação ao longo eixo da prótese. Foi observado que as tensões na cerâmica diminuíram 103% e 110% para próteses sem cantiléver sendo o pico de maior tensão na região da extensão distal. Independentemente do tipo de desenho protético os pilares cone morse diminuíram 38% dos picos de tensão em relação ao hexágono externo. Em contrapartida a conexão hexágono externo reduziu os valores dos picos de tensão em 20% na região ossea periimplantar em relação à conexão cone morse. De acordo com as limitações deste estudo, evindenciou-se que independentemente da conexão protética, a prótese parcial fixa com cantiléver distal bilateral aumentou os picos de tensão na cerâmica. Independentemente do tipo de desenho protético, a conexão cone morse aumentou os picos de tensão no osso periimplantar e o hexágono externo no pilar. A plotagem gráfica da distribuição de tensões evidenciou que os picos de tensão na infraestrutura, parafuso protético e implante foram similares entre os grupos analisados.Abstract : The aim of the present study was to analyze the mechanics of the distribution and stress peaks in fixed partial prostheses (12-22) and fixed partial protheses with a bilateral distal cantilever (11-21) supported by external hexagon and morse taper in the anterior region of the maxilla. The two clinical situations were simulated in three dimension, analyzed and compared qualitatively according to the color map and quantitatively using the Rankine criteria for the infrastructure and ceramics, the Von Mises equivalent criterion for implants, abutments and screws and the Mohr Coulomb criterion for the peri-implant bone tissue. The test was performed with load applications of 400 N with an angle of 45º in relation to the long axis of the prosthesis. It was observed that the ceramic stress decreased 103% and 110% for the non-cantilevered prostheses with the peak of greater stress in the distal exstress region. Regardless of the type of prosthetic design, the morse taper abutments decreased 38% of the stress peaks in relation to the external hexagon, and external hexagon reduced the values of the stress peaks 20% in the peri-implantar osseous region in relation to the cone morse connection. According to the limitations of the present study, it was shown that, independently of the prosthetic connection, the fixed partial prosthesis with a bilateral distal cantilever increased the stress peaks in the ceramics. Regardless of the type of prosthetic design, the cone morse connection increased the stress peaks in the peri-implantar bone and the external hexagon in the abutment. The graphical plot of the stress distribution showed that the stress peaks in the infrastructure, prosthetic screw and implant were similar between the analyzed groups

The use of the digital smile design concept as an auxiliary tool in periodontal plastic surgery

Periodontal surgery associated with prior waxing, mock-up, and the use of digital tools to design the smile is the current trend of reverse planning in periodontal plastic surgery. The objective of this study is to report a surgical resolution of the gummy smile using a prior esthetic design with the use of digital tools. A digital smile design and mock-up were used for performing gingival recontouring surgery. The relationship between the facial and dental measures and the incisal plane with the horizontal facial plane of reference were evaluated. The relative dental height x width was measured, and the dental contour drawing was inserted. Complementary lines are drawn such as the gingival zenith, joining lines of the gingival and incisal battlements. The periodontal esthetic was improved according to the established design digital smile pattern. These results demonstrate the importance of surgical techniques and are well accepted by patients and are easy to perform for the professional. When properly planned, they provide the desired expectations. Periodontal Surgical procedures associated with the design digital smile facilitate the communication between the patient and the professional. It is, therefore, essential to demonstrate the reverse planning of the smile and periodontal parameters with approval by the patient to solve the esthetic problem