Health-related quality of life of patients undergoing rehabilitation with implant-supported prostheses

The success of oral reabilitation treatment depend on the re-establishment of the masticatory function and oral comfort of the patient. Objective: To evaluate the oral health-related quality of life (OHRQoL) of patients undergoing rehabilitation with implant-supported prostheses by Oral Health Impact Profile - short form questionnaire (OHIP-14) and a questionnaire associated to the Visual Analog Scale (VAS). Material and methods: Fourteen patients requiring implant-supported prostheses on anterior region were asked to complete the OHIP-14 before, 1 and 3 months, and the VAS questionnaire, 1 and 3 months after the prosthesis installation (sample group). Moreover, fourteen complete dentate patients were asked to complete the OHIP-14 (control group). For each OHIP-14 category, the sample group’s answers were compared between the evaluation periods by the Kruskal-Wallis test, and to the control group’s answers by the U-test. The answers of the questionnaire associated to VAS were compared between the evaluation periods by t-test ( α=0.05). Results: For OHIP-14, there was no statistical difference between the answers after 1 and 3 months; however, there was difference among the answers of baseline, and 1 and 3 months after the prostheses installation, excepted for functional limitation. Comparing to the control group, before the prostheses installation, there was statistical difference for functional limitation, physical pain, psychological discomfort, physical and psychological disability; and, there was no difference after 3 months of prostheses installation. For the questionnaire associated to the VAS, there was no statistical difference between the responses for both evaluation periods, excepted for the prosthesis’ comfort and stability. Conclusion: The rehabilitated patients showed a significant improvement in function, aesthetics, self-esteem, and the quality of life.The success of oral reabilitation treatment depend on the re-establishment of the masticatory function and oral comfort of the patient. Objective: To evaluate the oral health-related quality of life (OHRQoL) of patients undergoing rehabilitation with implant-supported prostheses by Oral Health Impact Profile - short form questionnaire (OHIP-14) and a questionnaire associated to the Visual Analog Scale (VAS). Material and methods: Fourteen patients requiring implant-supported prostheses on anterior region were asked to complete the OHIP-14 before, 1 and 3 months, and the VAS questionnaire, 1 and 3 months after the prosthesis installation (sample group). Moreover, fourteen complete dentate patients were asked to complete the OHIP-14 (control group). For each OHIP-14 category, the sample group’s answers were compared between the evaluation periods by the Kruskal-Wallis test, and to the control group’s answers by the U-test. The answers of the questionnaire associated to VAS were compared between the evaluation periods by t-test ( α=0.05). Results: For OHIP-14, there was no statistical difference between the answers after 1 and 3 months; however, there was difference among the answers of baseline, and 1 and 3 months after the prostheses installation, excepted for functional limitation. Comparing to the control group, before the prostheses installation, there was statistical difference for functional limitation, physical pain, psychological discomfort, physical and psychological disability; and, there was no difference after 3 months of prostheses installation. For the questionnaire associated to the VAS, there was no statistical difference between the responses for both evaluation periods, excepted for the prosthesis’ comfort and stability. Conclusion: The rehabilitated patients showed a significant improvement in function, aesthetics, self-esteem, and the quality of life

Fracture toughness, subcritical crack growth and fatigue limit of experimental resin composites with different filler sizes.

O objetivo desta pesquisa foi verificar a influência de diferentes tamanhos de partículas de carga na tenacidade à fratura (KIc), nos parâmetros do crescimento subcrítico de trinca (n e f0) e de Weibull (m e 0), na longevidade estimada pelo diagrama tensão-probabilidade-tempo (SPT) e no limite de fadiga cíclica (LFC) de compósitos resinosos experimentais. Quatro compósitos foram preparados contendo 78% em massa (59% em volume) de conteúdo inorgânico, constituído por 67% de pó de vidro com diferentes tamanhos de partículas (d50 = 0,5; 0,9; 1,2 e 1,9 µm) e 11% de sílica pirogênica. Dados de KIc obtidos pelo método single-edge notched beam (25x5x2,8 mm; n=15) foram submetidos a ANOVA/teste de Tukey (p < 0,05). n e f0 foram determinados através do ensaio de fadiga dinâmica (10-2 a 102 MPa/s) utilizando um dispositivo de flexão biaxial (12x1,2 mm; n=10). Para determinar m e 0, mais 20 espécimes de cada compósito foram testados na taxa de 100 MPa/s. Os diagramas SPT foram obtidos a partir dos dados da fadiga dinâmica e análise de Weibull. No ensaio de fadiga cíclica, um dispositivo de flexão biaxial (12x1,2 mm) foi utilizado para se obter a resistência à flexão inicial (RFI; n=14) e o LFC (n=20). LFC foi obtido pelo método escada após 105 ciclos. Para todos os testes, os espécimes foram armazenados em água destilada a 37oC por 24h. Foi realizada a fractografia dos espécimes fraturados nas taxas 10-2 e 10-1 MPa/s da fadiga dinâmica e nos ensaios para determinação da RFI e LFC. Houve relação direta entre d50 e KIc (C0,5: 1,2±0,1b; C0,9: 1,3±0,1ab; C1,2: 1,3±0,1ab; C1,9: 1,4±0,2a, em MPa.m0,5). C0,5 (31,2±6,2a) e C1,9 (34,7±7,4a) apresentaram valores de n superiores a C0,9 (20,3±3,0b) e C1,2 (17,3±1,8b). C1,2 (166,42±0,01a) apresentou o maior valor de f0 (em MPa), seguido pelo C1,9 (159,82±0,02b), C0,9 (159,59±0,02c) e C0,5 (158,40±0,02d). Não houve diferença estatística entre os valores de m (6,6 a 10,6) e 0 (170,6 a 176,4 MPa) dos compósitos. As reduções na tensão de fratura para uma probabilidade de falha de 5% após 10 anos estimadas pelo diagramas SPT foram de aproximadamente 22% para C0,5 e C1,9 e 36% para C0,9 e C1,2. Não houve diferença estatística entre as médias de RFI (155,4 a 170,7 MPa). C0,5 (93,0±18,6a) apresentou o maior LFC (em MPa), seguido pelo C1,2 (91,8±11,1ab), C1,9 (87,2±3,0b) e C0,9 (82,5±8,0c). Defeitos sub-superficiais e superficiais foram as principais origens de fratura. A trinca se propagou pela matriz polimérica ao redor das partículas (deflexão de trinca) e todas as superfícies apresentaram características de fratura frágil. Como conclusão, compósitos com partículas maiores apresentaram maior KIC, enquanto que partículas menores contribuíram para um maior LFC. Compósitos com distribuição granulométrica mais ampla, independentemente do d50, apresentaram maior resistência ao SCG. Nos demais parâmetros e propriedades avaliados (m, 0 e RFI) não houve influência do tamanho das partículas.The aim of this study was to verify the influence of different filler sizes in the fracture toughness (KIc), subcritical crack growth (n e f0) and Weibull (m e 0) parameters, longevity estimated by the strength-probability-time (SPT) diagram and cyclic fatigue limit (CFL) of experimental resin composites. Four composites were prepared, each one containing 78 w% (59 vol%) of inorganic content, in which 67 w% were glass powder with different filler sizes (d50 = 0.5; 0.9; 1.2 e 1.9 µm) and 11 w% were pyrogenic silica. KIc data was obtained by the single-edge notched beam test and submitted to ANOVA/Tukey tests (p < 0.05). n and f0 were determined by the dynamic fatigue test (10-2 a 102 MPa/s) using a biaxial flexural device (12x1.2 mm; n=10). 20 specimens of each composite were tested at 100 MPa/s to determine Weibull parameters. SPT diagrams were constructed using the dynamic fatigue and Weibull data. For the cyclic fatigue test, a biaxial flexural device (12x1.2 mm) was used to obtain the initial flexural strength (IFS; n=14) and CFL (n=20). CFL was determined by staircase method after 105 cycles. For all tests, the specimens were stored in distilled water at 37oC for 24h. It was done the fractography of the fractured specimens that was subjected to the 10-2 e 10-1 MPa/s rates of the dynamic fatigue and to the IFS and CFL tests. There was a direct relation between d50 e KIc (C0.5: 1.2±0.1b; C0.9: 1.3±0.1ab; C1.2: 1.3±0.1ab; C1.9: 1.4±0,2a, in MPa.m0,5). C0.5 (31.2±6.2a) and C1.9 (34.7±7.4a) presented higher n values than C0.9 (20.3±3.0b) and C1.2 (17.3±1.8b). C1.2 (166.42±0.01a) showed the highest f0 value (in MPa), followed by C1.9 (159.82±0.02b), C0.9 (159.59±0.02c) and C0.5 (158.40±0.02d). There were no statistical differences among the m (6.6 to 10.6) and 0 (170.6 to 176.4 MPa) values of the composites. The reductions in fracture stress at 5% failure probability for a lifetime of 10 years estimated by the SPT diagrams were approximately 22% for C0.5 and C1.9 and 36% for C0.9 and C1.2. There were no statistical differences among the IFS means (155.4 to 170.7 MPa). C0.5 (93.0±18.6a) showed the highest CFL (in MPa), followed by C1.2 (91.8±11.1ab), C1.9 (87.2±3.0b) and C0.9 (82.5±8.0c). Near-surface and surface flaws were the main fracture origins. The crack propagated by the polymeric matrix around the fillers (crack deflection) and all the fracture surfaces showed brittle fracture features. As conclusion, composites with large fillers presented the highest KIC, while the small fillers contributed to increase the CFL. Composites with broader granulometric size distribution, regardless of d50, showed higher resistance to SCG. There was no influence of the composites filler sizes in the others parameters and properties evaluated (m, 0 and IFS)

Marginal and internal fit of zirconia copings obtained using different digital scanning methods

Abstract The objective of this study was to evaluate the marginal and internal fit of zirconia copings obtained with different digital scanning methods. A human mandibular first molar was set in a typodont with its adjacent and antagonist teeth and prepared for an all-ceramic crown. Digital impressions were made using an intraoral scanner (3Shape). Polyvinyl siloxane impressions and Type IV gypsum models were also obtained and scanned with a benchtop laboratory scanner (3Shape D700). Ten zirconia copings were fabricated for each group using CAD-CAM technology. The marginal and internal fit of the zirconia copings was assessed by the silicone replica technique. Four sections of each replica were obtained, and each section was evaluated at four points: marginal gap (MG), axial wall (AW), axio-occlusal edge (AO) and centro-occlusal wall (CO), using an image analyzing software. The data were submitted to one-way ANOVA and Tukey’s test (α = 0.05). They showed statistically significant differences for MG, AO and CO. Regarding MG, intraoral scanning showed lower gap values, whereas gypsum model scanning showed higher gap values. Regarding AO and CO, intraoral digital scanning showed lower gap values. Polyvinyl siloxane impression scanning and gypsum model scanning showed higher gap values and were statistically similar. It can be concluded that intraoral digital scanning provided a lower mean gap value, in comparison with conventional impressions and gypsum casts scanned with a standard benchtop laboratory scanner

Influence of the base and diluent methacrylate monomers on the polymerization stress and its determinants

The aim of this study was to evaluate the effect of the association between bisphenol-A diglycidyl dimethacrylate (BisGMA) or its ethoxylated version (BisEMA) with diluents derived from the ethylene glycol dimethacrylate (EGDMA), with increasing number of ethylene glycol units (1: EGDMA, 2: DEGDMA, 3: TEGDMA, or 4: TETGDMA), or trimethylol propane trimethacrylate (TMPTMA) or 1,10-decanediol dimethacrylate (D3MA) on polymerization stress, volumetric shrinkage, degree of conversion, maximum rate of polymerization (Rpmax), and elastic modulus of experimental composites. BisGMA containing formulations presented lower shrinkage and stress but higher modulus and Rpmax than those containing BisEMA. TMPTMA presented the lowest stress among all diluents, as a result of lower conversion. EGDMA, DEGDMA, TEGDMA, and TETGDMA presented similar polymerization stress which was higher than the stress presented by D3MA and TMPTMA. D3MA presented similar conversion when copolymerized with both base monomers. The other diluents presented higher conversion when associated with BisEMA. EGDMA showed similar shrinkage compared with DEGDMA and higher than the other diluents. The lower conversion achieved by TMPTMA did not jeopardize its elastic modulus, similar to the other diluents. Despite the similar conversion presented by D3MA in comparison with EGDMA and DEGDMA, its lower elastic modulus may limit its use. Rather than proposing new materials, this study provides a systematic evaluation of off the shelf monomers and their effects on stress development, as highlighted by the analysis of conversion, shrinkage and modulus, to aid the optimization of commercially available materials. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012PNPD-CAPES [02436/09-4]PNPDCAPE

Marginal and Internal Adaptation of Zirconia Crowns: A Comparative Study of Assessment Methods

<div><p>Abstract Marginal and internal adaptation is critical for the success of indirect restorations. New imaging systems make it possible to evaluate these parameters with precision and non-destructively. This study evaluated the marginal and internal adaptation of zirconia copings fabricated with two different systems using both silicone replica and microcomputed tomography (micro-CT) assessment methods. A metal master model, representing a preparation for an all-ceramic full crown, was digitally scanned and polycrystalline zirconia copings were fabricated with either Ceramill Zi (Amann-Girrbach) or inCoris Zi (Dentslpy-Sirona), n=10. For each coping, marginal and internal gaps were evaluated by silicone replica and micro-CT assessment methods. Four assessment points of each replica cross-section and micro-CT image were evaluated using imaging software: marginal gap (MG), axial wall (AW), axio-occlusal angle (AO) and mid-occlusal wall (MO). Data were statistically analyzed by factorial ANOVA and Tukey test (a=0.05). There was no statistically significant difference between the methods for MG and AW. For AO, there were significant differences between methods for Amann copings, while for Dentsply-Sirona copings similar values were observed. For MO, both methods presented statistically significant differences. A positive correlation was observed determined by the two assessment methods for MG values. In conclusion, the assessment method influenced the evaluation of marginal and internal adaptation of zirconia copings. Micro-CT showed lower marginal and internal gap values when compared to the silicone replica technique, although the difference was not always statistically significant. Marginal gap and axial wall assessment points showed the lower gap values, regardless of ceramic system and assessment method used.</p></div