Avaliação da adaptação marginal de infra-estruturas implanto-suportadas pre-fabricadas ou fundidas em titanio, submetidas a eletroerosão

Orientador : Mauro Antonio de Arruda NobiloTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaDoutorad

Evaluation of spatial and functional roughness parameters on air-abraded zirconia as a function of particle type and deposition pressure

Purpose: This study evaluated the spatial and functional roughness parameters on air-abraded zirconia as a function of particle type and deposition pressure. Materials and Methods: Polished zirconia blocks (Cercon, Degussa/Dentsply) (N=30) with dimensions of 5 × 4 × 4 mm3 were air abraded according to 2 factors: a) particle type – 30-μm silica-coated alumina (CoJet) or alumina particles (45 μm); b) deposition pressure (1.5, 2.5 and 4.5 bar). Roughness parameters (Sdr, Vi, Sci and Svi) were measured in an optical profilometer (Wyko NT 1100) at the center of the air-abraded area (301.3 × 229.2 μm). Two measurements were made for each parameter from each surface. The means of each group were analyzed by 2-way ANOVA followed by Tukey’s adjustment test and Student’s t-test (alpha = 0.05). Results: Both the particle type (p 0.05) in these parameters for either particle type. Conclusion: Considering roughness parameters for micromechanical retention and parameters for adsorption mechanisms of adhesion, zirconia surfaces presented better morphological features when air abraded with silica-coated alumina than alumina particles at pressures higher than 1.5 bar. Particle deposition at 2.5 bar may be preferable to 4.5 bar pressure for avoiding possible deposition-related damage on zirconia, as there were no significant differences for the functional parameters

Evaluation of patients undergoing placement of zygomatic implants using sinus slot technique

Background: This study aimed to evaluate patients undergoing placement of zygomatic implants by Stella and Warner’s technique, considering the survival rate of conventional and zygomatic implants, and assess the health of the maxillary sinuses and the level of patient satisfaction. Methods: In this retrospective cohort study, 28 patients had received a combination of conventional and zygomatic implants (group I) and 14 were rehabilitated with only conventional implants (group II). Results: The results showed that Stella and Warner’s technique, thought to minimize the presence of the implant into the maxillary sinus, improving the emergence of the implant, proved to be effective, allowing a high survival rate of conventional and zygomatic implants (100 %). The follow-up period ranged from a minimum of 15 months to a maximum of 53 months after prosthetic rehabilitation (average of 34 months). No pathological changes were found on the periimplant tissues. Radiographs showed satisfactory bone levels in conventional implants of oral rehabilitation with zygomatic implants and a good positioning of the apex of the zygomatic implants in relation to the zygomaticbone. The tomographic findings revealed no characteristics of sinus disease. There were no cases of obstruction of the maxillary sinus ostium. Conclusions: The placement of zygomatic implants by Stella and Warner’s technique proved to be a predictable technique with high implant survival rate in patients with atrophic maxilla and was not associated with sinus disease in the sample analyzed. However, a long-term follow-up is necessary to confirm the initial findings of this study

ASSISTÊNCIA DE ENFERMAGEM AO PACIENTE GRANDE QUEIMADO: UM ESTUDO DE REVISÃO INTEGRATIVA

O estudo tem como objetivo descrever a assistência realizada pelos profissionais de enfermagem frente ao paciente grande queimado. Trata-se de uma revisão de literatura do tipo integrativa, realizada entre o período de 10 de novembro a 28 de dezembro de 2023 nas bases de dados LILACS, Periódico CAPES, e SCIELO, utilizando os descritores “Unidades de Queimados” AND “Enfermagem”, “Enfermagem” AND “Queimaduras”, registrados nos Descritores em Ciências da Saúde. Os critérios de inclusão foram os artigos originais na íntegra disponíveis nas bases de dados indexadas, escritos em língua portuguesa, e que foram publicados recentemente nos últimos seis anos, entre o período de 2018 a 2023. Inicialmente foram encontrados 66 estudos no LILACS, 40 no CAPES e 14 artigos no SCIELO. Após a análise, leitura dos estudos e aplicação dos critérios de inclusão e exclusão, foram selecionados um quantitativo de 7 artigos para compor a revisão integrativa, visto que esses abrangeram a temática proposta. Os estudos selecionados nas bases indexadas foram expostos em um quadro de dados contendo as seguintes informações: título, autor, ano, objetivo, metodologia do estudo e base de dados. Foi possível observar que os profissionais de enfermagem são imprescindíveis frente aos casos de queimaduras, visto que realizam uma assistência humanizada e eficaz, com a adoção de condutas que reduzem a dor e o sofrimento do paciente. Além disso, estes profissionais realizam condutas iniciais de estabilização da vítima, curativos das lesões, administração de analgésicos e antibióticos, e estratégias por meio da tecnologia leve, como o dialógo, incentivo e esclarecimento de dúvidas aos familiares e ao paciente.O estudo tem como objetivo descrever a assistência realizada pelos profissionais de enfermagem frente ao paciente grande queimado. Trata-se de uma revisão de literatura do tipo integrativa, realizada entre o período de 10 de novembro a 28 de dezembro de 2023 nas bases de dados LILACS, Periódico CAPES, e SCIELO, utilizando os descritores “Unidades de Queimados” AND “Enfermagem”, “Enfermagem” AND “Queimaduras”, registrados nos Descritores em Ciências da Saúde. Os critérios de inclusão foram os artigos originais na íntegra disponíveis nas bases de dados indexadas, escritos em língua portuguesa, e que foram publicados recentemente nos últimos seis anos, entre o período de 2018 a 2023. Inicialmente foram encontrados 66 estudos no LILACS, 40 no CAPES e 14 artigos no SCIELO. Após a análise, leitura dos estudos e aplicação dos critérios de inclusão e exclusão, foram selecionados um quantitativo de 7 artigos para compor a revisão integrativa, visto que esses abrangeram a temática proposta. Os estudos selecionados nas bases indexadas foram expostos em um quadro de dados contendo as seguintes informações: título, autor, ano, objetivo, metodologia do estudo e base de dados. Foi possível observar que os profissionais de enfermagem são imprescindíveis frente aos casos de queimaduras, visto que realizam uma assistência humanizada e eficaz, com a adoção de condutas que reduzem a dor e o sofrimento do paciente. Além disso, estes profissionais realizam condutas iniciais de estabilização da vítima, curativos das lesões, administração de analgésicos e antibióticos, e estratégias por meio da tecnologia leve, como o dialógo, incentivo e esclarecimento de dúvidas aos familiares e ao paciente

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Analise do assentamento passivo de infra-estruturas em titanio e liga de paladio-prata, fundidas em monobloco e submetidas a soldagem a laser

Orientador: Mauro Antonio de Arruda NobiloDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Este estudo se propôs avaliar o assentamento passivo de infra estruturas fundidas em titânio e liga de paládio-prata, confeccionadas pela técnica monobloco e soldagem à laser. A partir de uma matriz metálica com cinco implantes (3,75 X 13mm), obteve-se um modelo mestre onde foram incorporadas réplicas de implantes em aço inoxidável, e então foram realizados os procedimentos de enceramento, inclusão e acabamento das estruturas metálicas. Foram enceradas 20 amostras, padronizadas em forma e tamanho, sendo 10 fundidas em titânio comercialmente puro (Rematitan-Dentaurum, Pforzhein-Germany) e 10 em liga de paládio-prata (Pors-on 4-Degussa). As amostras foram divididas em 04 grupos, sendo: Grupo I: 05 estruturas fundidas em peça única em liga de paládio-prata; Grupo II: 05 estruturas fundidas em liga de paládio-prata, previamente seccionadas e submetidas à soldagem a laser; Grupo III: 05 estruturas fundidas em peça única de titânio e Grupo IV: 05 estruturas fundidas em titânio, previamente seccionadas e submetidas à soldagem a laser. As análises e mensurações das interfaces foram efetuadas tanto nas peças em monobloco quanto nas soldadas a laser, utilizando microscópio mensurador (STM Digital - OLYMPUS - Japan). Sendo as mesmas efetuadas na região vestibular (V) e lingual (L) da interface implante/prótese dos três implantes previamente denominados com letras A, C e E. Os dados foram submetidos análise de variância e ao teste de Tukey (p<0,05). Os resultados indicaram que: as estruturas fundidas em monobloco nos cilindros centrais apresentaram maior interface (desajuste médio de 151,392 mm) que as soldadas a laser (34,739 mm). Também foram encontradas diferenças estatisticamente significantes entre os materiais utilizados, sendo que a liga de paládio-prata (66,301 mm) apresentou melhores resultados que o titânio (119,831 mm). Nos cilindros distais, os resultados mostraram não haver diferenças estatisticamente significantes entre as estruturas fundidas em titânio e paládio-prata, na técnica monobloco. No entanto, foram encontradas diferenças estatisticamente significantes entre os dois materiais, após a soldagem a laser, sendo que o titânio (31,37 mm) apresentou melhores resultados que a liga de paládio-prata (106,59 mm). Houve também diferenças estatisticamente significantes entre as técnicas monobloco e soldagem a laser para ambos os materiais, sendo os melhores resultados para a técnica de soldagem à laserAbstract: The aim of this study was to evaluate passive fit in titanium and palladium-silver, made by the one-piece casting technique and laser welding. By means of a metallic matrix containing five implants (3.75 X 13mm), a master model was obtained and implant replies were incorporated into it, then, wax up, inclusion and polishing was performed in the metallic structures. Twenty standardized samples, in shape and size, were waxed up; ten samples were cast in commercially pure titanium (Rematitan Dentaurum, Pforzhein-Germany), the other ten specimens were cast in palladium-silver alloy (Pors-on 4-Degussa). The samples were separated in four groups: Group I: five single structures cast in palladium-silver alloy; Group II: five structures, that were previously sectioned and underwent to laser welding, were cast in palladium-silver alloy; Group III: five single structures that were cast in titanium; and Group IV: five structures, that were previously sectioned and underwent to laser welding, were cast in titanium. The interfaces evaluations and measurements were performed both in one-piece castings and the laser welded structures, using a microscope. Data were submitted to ANOVA and Tukey's test (p<0.05). According to the results, one-piece casting structures showed higher interface (mean desajustment of 151.392 mm) in comparison to the structures welded in laser (34.739 mm). Concerning the materials, it was also found statistically significant difference, palladium-silver alloy (66.301 mm) showed better results than titanium (119.831 mm). In relation to the distal cylinders, the structures cast in titanium and palladium-silver alloy didn't present statistically significant differences, for the one-piece casting technique. However, statistically significant differences between these materials were found after laser welding. Titanium presented better results (31.37 mm) compared to palladium-silver alloy (106.59 mm). With respect to the one piece casting and laser welding techniques, there were also statistically significant differences between this two materialsMestradoProtese DentalMestre em Clínica Odontológic

Clinical assessment of masticatory efficiency in the rehabilitation of edentulous patients

Introduction: Rehabilitation of edentulous patients has been a constant concern in dentistry. Several studies have reported a reduction in the masticatory function in these patients. Osseointegrated implants have been used in order to obtain better masticatory efficiency, but more studies are needed to confirm these results. Aim: To evaluate the masticatory function of patients with conventional dentures and implant-supported dentures. Methods: A double-blinded controlled clinical study was conducted. The sample was composed of 60 patients divided into three groups: G1 with 20 patients with conventional upper (maxillary) and lower (mandibular) complete dentures, G2 with 20 patients with mandibular overdentures and upper (maxillary) complete dentures, and G3 with 20 patients with lower fixed implant-supported complete dentures (protocol). Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Results: A statistically significant difference was found for masticatory efficiency between groups G1 and G2 (pd”0.05) and between G1 and G3 (pd”0.05), and there was no statistically significant difference between G2 and G3 (pe”0.05). Conclusions: The results suggest that placement of osseointegrated implants in complete denture wearers improves their masticatory efficiency

Clinical assessment of masticatory efficiency in the rehabilitation of edentulous patients

itation of edentulous patients has been a constant concern in dentistry. Several studies have reported a reduction in the masticatory function in these patients. Osseointegrated implants have been used in order to obtain better masticatory efficiency, but more studies are needed to confirm these results. Aim: To evaluate the masticatory function of patients with conventional dentures and implant-supported dentures. Methods: A double-blinded controlled clinical study was conducted. The sample was composed of 60 patients divided into three groups: G1 with 20 patients with conventional upper (maxillary) and lower (mandibular) complete dentures, G2 with 20 patients with mandibular overdentures and upper (maxillary) complete dentures, and G3 with 20 patients with lower fixed implant-supported complete dentures (protocol). Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Results: A statistically significant difference was found for masticatory efficiency between groups G1 and G2 (pd0.05) and between G1 and G3 (pd0.05), and there was no statistically significant difference between G2 and G3 (pe0.05). Conclusions: The results suggest that placement of osseointegrated implants in complete denture wearers improves their masticatory efficiency