La odontología digital en rehabilitación oral

El auge de la odontología digital simplificó la confección de infraestructuras, y permitió el uso de diferentes materiales (cerámicas, metal, cera, entre otros), confeccionando prótesis en menos tiempo y asegurando la precisión de la interfaz entre la corona y la preparación dental o entre el implante y la prótesis 1,2. Los sistemas CAD-CAM (Computer-aided Design and Computer-aided Manufacturing) se utilizan en rehabilitaciones extensas (prótesis híbridas, sobredentaduras, prótesis totales y removibles), parciales (prótesis fijas sobre dientes o implantes) y prótesis unitarias, así como auxiliar en la planificación de la rehabilitación y cirugía, placas oclusales, confección de modelos, entre otros. Los sistemas CAD-CAM se pueden subdividir en: intra y extraorales (escáner de mesa), o también con relación a la disponibilidad en la manipulación del archivo digital (stl.): sistemas cerrados (escaneo y fresado de la misma empresa) y sistemas abiertos (escaneo y fresado/impresión independiente)

Closed versus open reduction of facial fractures in children and adolescents : a systematic review and meta-analysis

Treatment of facial fractures in children and adolescents has always been a challenge for oral surgeon. The choice of treatment type must take into account several factors. This systematic review aimed to evaluate closed versus open reduction of facial f

Evaluation of the color stability of two techniquesfor reproducing artificial irides after microwave polymerization

The use of ocular prostheses for ophthalmic patients aims to rebuild facial aesthetics and provide an artificial substitute to the visual organ. Natural intemperate conditions promote discoloration of artificial irides and many studies have attempted to produce irides with greater chromatic paint durability using different paint materials. OBJECTIVES: The present study evaluated the color stability of artificial irides obtained with two techniques (oil painting and digital image) and submitted to microwave polymerization. MATERIAL AND METHODS: Forty samples were fabricated simulating ocular prostheses. each sample was constituted by one disc of acrylic resin N1 and one disc of colorless acrylic resin with the iris interposed between the discs. The irides in brown and blue color were obtained by oil painting or digital image. The color stability was determined by a reflection spectrophotometer and measurements were taken before and after microwave polymerization. Statistical analysis of the techniques for reproducing artificial irides was performed by applying the normal data distribution test followed by 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Chromatic alterations occurred in all specimens and statistically significant differences were observed between the oil-painted samples and those obtained by digital imaging. There was no statistical difference between the brown and blue colors. Independently of technique, all samples suffered color alterations after microwave polymerization. CONCLUSION: The digital imaging technique for reproducing irides presented better color stability after microwave polymerization

Análise dos aspectos biomecânicos e biológicos na reabilitação oral com união dente/implante

The consequences as well the criteria for the prosthetic oral rehabilitations with tooth/implant connection come in the literature, in most of the cases, with controversial results. On one side, many studies consider the connection viable, while the others studies consider impracticable because of the difference biomechanics and physiologic of the two systems. The purpose of this study was to organize, to synthesize and to select literary studies that can standardize solutions when this rehabilitation type is necessary. The study showed that the clinical follow-up result in a high survival rate in a short period and the bioengineering studies did not accept the tooth/implant connection.Os critérios bem como as conseqüências das reabilitações orais protéticas envolvendo união de dentes a implantes osseointegrados apresentam na literatura resultados controversos. Por um lado, alguns estudos consideram viável a união de elementos dentais com implantes, enquanto outros a condenam, visto a diferença biomecânica e fisiológica dos dois sistemas. Deste modo, este trabalho teve como objetivo selecionar estudos literários que possam padronizar soluções quando esse tipo de reabilitação for necessária. O levantamento mostrou que a maioria dos estudos aplicados à bioengenharia condena a união enquanto os estudos longitudinais clínicos resultam em baixo índice de fracasso, entretanto, em curto período de acompanhamento

Avaliação da distribuição de tensões em casos de prótese parcial removível de classe I mandibular convencional e associada a implante osseointegrado pelo método dos elementos finitos

A associação das próteses parciais removíveis (PPRs) e implantes osseointegrados tem sido relatada na literatura, mas ainda não existem relatos sobre a melhor forma de conexão com o último dente suporte nos casos de extremidade livre. Assim, o objetivo deste trabalho foi estudar, através do MEF bidimensional, o comportamento das estruturas de suporte de uma PPR convencional e associada a implante osseointegrado, agindo apenas como suporte, variando-se os sistemas de conexão com o último dente suporte entre apoio distal e placa distal. Foram confeccionados 4 modelos hemi-mandibulares, com presença apenas do dente 33, sendo: Mod A, PPR convencional e apoio distal; Mod B, PPR convencional e placa distal; Mod C, PPR associada a implante de 3,75 x 10,0 mm e apoio distal; Mod D, PPR associada a implante de 3,75 x 10,0 mm e placa distal. O programa de elementos finitos utilizados foi o ANSYS 9.0 com carregamento de 50N em cada ponta de cúspide, estritamente vertical. Os resultados foram obtidos através de mapas de deslocamento e tensão de Von Mises. Os resultados mostraram alívo do ligamento periodontal e dente suporte quando da presença da placa distal, tanto nos mapas de deslocamento quanto nos mapas de tensão. Por esta metodologia foi possível concluir que: 1. A placa distal diminuiu a tendência de movimento do dente suporte, tanto dos modelos com PPR convencional, quanto nos associados a implante; 2. Os modelos que incorporaram a placa distal melhoraram a distribuição interna de tensões de von Mises, principalmente pelo alívio do dente suporte.The association of the removable partial dentures (RPDs) and osseointegrated implants it has been mentioned in the literature, but reports don’t still exist on the best connection form with the last support tooth in the cases of distal extension. Like this, the objective of this work was to study, through the bidimensional FEA, the behavior of the support structures of a conventional RPD and associated with implants, just acting as support, by variation in the connection systems with the last support tooth between distal incisal rest or and distal plate. 4 hemi-mandibular models were made, with presence just of the tooth 33: Model A: conventional RPD and distal incisal rest; Model B: conventional RPD and distal plate; Model C: RPD associated with implant (3,75 x 10,0 mm) and distal incisal rest; Model D: RPD associated with implant (3,75 x 10,0 mm) and distal plate. The finite element program used was ANSYS 9.0 with loading of 50N in each cusp tip, strictly vertical. The results were obtained through displacement maps and tension maps. The results showed decrease of the ligament and support tooth tension when distal plate were present, as in the displacement maps or in the tension maps. For this methodology it was possible conclude: 1. The distal plate reduced the tendency of movement of the support tooth in all models; 2. the models that incorporated the distal plate improved the internal distribution of von Mises tensions, mainly for the relief of the support tooth

Polymorphisms of the serotonin receptors genes in patients with bruxism: a systematic review

This study aimed to investigate if SNP rs6313, SNP rs2770304, SNP rs4941573, and SNP rs1923884 of the 5-HT2A receptor gene and SNP rs6295 of the 5-HT1A receptor gene are associated with bruxism etiology. Methodology: This systematic review was registered in PROSPERO (CRD42018094561). A search was conducted for articles published in or before May 2021. To qualify for eligibility in this review, the studies had to be case-controls, cohort or cross-sectional. The inclusion criteria were the articles with a group of patients with bruxism and a control group in which the presence of these SNPs was evaluated. The exclusion criteria were the investigations of other polymorphisms, the studies that did not consider a control group for comparison, case reports, and reviews. The NOS and JBI were used to evaluate the methodological quality of studies. Results: We conducted this study with databases, such as Web of Science, Scopus, Embase, PubMed/MEDLINE, and ProQuest. We considered four studies eligible. A total of 672 participants were included,187 with sleep bruxism, 105 with awake bruxism, 89 with sleep and awake bruxism, and 291 controls. One study found a strong association between the SNPs rs6313, rs2770304 and rs4941573 of the 5-HT2A receptor gene and sleep bruxism. In one study, we considered the C allele of the SNP rs2770304 a risk factor for sleep bruxism. We found no significant results of other SNPs in sleep bruxers compared to controls. We found no positive association concerning the SNPs and groups of awake bruxism and sleep and awake bruxism. Conclusion: The different results regarding the SNPs in sleep bruxers could be explained by the genetic distinction between Chilean, Mexican, Japanese, and Polish population. More clinical trials and prospective studies must be conducted with larger sample size and in different ethnicities to confirm the results of this review

Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation