Próteses parciais fixas reforçadas por fibras: um estudo clínico retrospectivo preliminar

The aim of this study was to evaluate the clinical performance (retention rate) of fiber-reinforced composite fixed partial dentures (FPDs). Polyethylene fiber (Ribbond®) was used combined with restorative composite during FPDs fabrication. FPDs were placed in thirteen patients in a private clinic. Nineteen FPDs were evaluated. The prosthetic space was filled with only one pontic using extracted teeth (2 cases), acrylic resin teeth (11 cases), or with composite resin (6 cases), combined with Polyethylene fiber. The clinical criterion used was based on retention rate of FPDs. If FPDs were in function in the mouth at the time of examination without previous repair they were classified as Complete Survival (CS) restorations. A classification of Survival with Rebonding (SR) was assigned in the event of an adhesive failure, but after rebonding the FPD still remained under evaluation. Treatment was classified as a Failure (F) if the FPD restoration was lost. The time of evaluation was 41.15 months (±15.13). The FPDs evaluated were retained (CS=94.75%), and no failure was found except for in one situation which required rebonding (SR=5.25%). According to the survival estimation method of Kaplan-Meyer the mean survival time was 42.3 months. At the time of evaluation investigated, polyethylene-reinforced FPDs showed a favorable retention rate in preliminary data.O objetivo deste estudo foi avaliar a performance clínica (percentagem de retenção) de próteses parciais fixas reforçadas por fibras. Fibras de polietileno (Ribbond®) foram usadas em combinação com resina composta durante a confecção das próteses. Os tratamentos foram realizadas em 13 pacientes, em uma clínica privada., sendo que 19 próteses foram reavaliadas. O espaço protético era preenchido com um pôntico usando o próprio dente extraído (2 casos), dentes de acrílico (11 casos) ou confeccionados com resina composta (6 casos), em todas as situações eram empregadas fibras de polietileno. Os critérios clínicos usados foram baseados na percentagem de retenção das próteses parciais fixas. As próteses que estavam em função no momento da avaliação, sem nunca necessitar de qualquer reparo prévio, foram classificadas como sobrevivência completa (SC). A classificação de sobrevivência com nova colagem (SR) foi utilizada para os casos de falha adesiva, com posterior cimentação da peça, a qual permanecia em função. O tratamento era classificado como falha (F) quando a restauração era perdida. O tempo médio de avaliação foi de 41,15 meses (±15,13). Nenhum caso de falha foi detectado, em apenas um caso houve falha adesiva com posterior colagem da peça (SR=5,25%) e em 94.75% dos casos as próteses permaneciam em função.. De acordo com o método de sobrevida de Kaplan-Meyer o tempo médio de sobrevida foi de 42,3 meses. As próteses parciais fixas reforçadas por fibras mostraram uma percentagem de retenção favorável neste estudo preliminar

Fiber reinforcement of a resin modified glass ionomer cement

Objectives: Understand how discontinuous short glass fibers and braided long fibers can be effectively used to reinforce a resin modified glass ionomer cement (RMGIC) for carious lesion restorations. Methods: Two control groups (powder/liquid kit and capsule) were prepared from a light cured RMGIC. Either discontinuous short glass fibers or braided polyethylene fiber ribbons were used as a reinforcement both with and without pre-impregnation with resin. For the former case, the matrix was the powder/liquid kit RMGIC, and for the latter case the matrix was the capsule form. Flexural strength was evaluated by three-point beam bending and fracture toughness was evaluated by the single-edge V-notch beam method. Compressive strength tests were performed on cylindrical samples. Results were compared by analysis of variances and Tukey's post-hoc test. Flexural strength data were analyzed using Weibull statistical analysis. Results: The short fiber reinforced RMGIC both with and without pre-impregnation showed a significant increase of ∼50% in the mean flexural strength and 160–220% higher fracture toughness compared with the powder/liquid RMGIC control. Reinforcement with continuous braided fibers gave more than a 150% increase in flexural strength, and pre-impregnation of the braided fibers with resin resulted in a significant flexural strength increase of more than 300% relative to the capsule control. However, for the short fiber reinforced RMGIC there was no significant benefit of resin pre-impregnation of the fibers. The Weibull modulus for the flexural strength approximately doubled for the fiber reinforced groups compared to the control groups. Finally, compressive strength was similar for all the groups tested. Significance: By using a RMGIC as a matrix, higher flexural strength was achieved compared to reported values for short fiber reinforced GICs. Additionally, the short fibers provided effective toughening of the RMGIC matrix by a fiber bridging mechanism. Finally, continuous braided polyethylene fibers gave much higher flexural strength than discontinuous glass fibers, and their effectiveness was enhanced by pre-impregnation of the fibers with resin

Effect of cooling protocol on mechanical properties and microstructure of dental veneering ceramics

Objectives: Understand how cooling protocols control the microstructure and mechanical properties of veneering porcelains. Methods: Two porcelain powders were selected, one used to veneer metallic frameworks (VM13) and one for zirconia frameworks (VM9). After the last firing cycle, the monolithic specimens were subjected to two cooling protocols: slow and fast. Flexural strength (FS) was evaluated by three-point beam bending and fracture toughness (KIC) was evaluated by the single-edge V-notch beam (SEVNB) method. Scanning electron microscopy (SEM) was performed to determine the leucite crystal volume fraction (%), particle size, and matrix microcrack density. The results were compared by analysis of variances (ANOVA) and Tukey's multiple comparison test. Results: The mechanical properties were significantly (p < 0.05) higher for the VM13 porcelain (FS = 111.0 MPa, KIC = 1.01 MPa.√m) compared to VM9 (FS = 79.6 MPa, KIC =0.87 MPa.√m) regardless of cooling protocol due to ∼250% higher volume fraction of leucite crystals. The slow cooled VM13 and fast cooled VM9 resulted in the highest and lowest mechanical properties, respectively, while the VM9 slow cooled properties were similar to the VM13 fast cooled. The SEM revealed that the slow cooling significantly increased the volume fraction of leucite crystals by 33–41 %. Across both porcelains, a significant linear correlation between both mechanical properties (strength and toughness) and leucite crystal content was found. Slow cooling was also associated with increased crystal growth resulting in more matrix microcracking. Significance: Controlled crystallization using slow cooling can be applied as a means of strengthening dental porcelains. However, the benefits of slow cooling may be partially offset by increasing the microcrack density in the glass matrix. To achieve the maximum benefit of slow cooling, it is recommending to develop heat treatments to produce porcelain with fine-grained and homogenously dispersed leucite crystals to achieve minimal glass matrix microcracking