Effect of fluoride-containing solutions on the surface of cast commercially pure titanium

This study evaluated the effects of fluoride-containing solutions on the surface of commercially pure titanium (CP Ti) obtained by casting. CP Ti specimens were fabricated and randomly assigned to 5 groups (n=10): group 1: stored in distilled water at 37 ± 1ºC; group 2: stored in distilled water at 37 ± 1ºC and daily immersed in 0.05% NaF for 3 min; group 3: stored in distilled water at 37 ± 1ºC and daily immersed in 0.2% NaF for 3 min; group 4: stored in distilled water at 37 ± 1ºC; and immersed in 0.05% NaF every 15 days for 3 min; and group 5: stored in distilled water at 37 ± 1ºC and immersed in 0.2% NaF every 15 days for 3 min. Surface roughness was measured with a profilometer immediately after metallographic polishing of the specimens (T0) and at 15-day intervals until completing 60 days of experiment (T15, T30, T45, T60). Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). There was no statistically significant difference (p>0.05) in surface roughness among the solutions. In conclusion, fluoride-containing solutions (pH 7.0) used as mouthwashes do not damage the surface of cast CP Ti and can be used by patients with titanium-based restorations.Este estudo avaliou o efeito de soluções para enxaguatório bucal contendo fluoreto sobre a superfície do titânio comercialmente puro (cp Ti) após fundição odontológica. As amostras (n=50) foram divididas igualmente: grupo A - armazenadas em água destilada a 37 ± 1ºC, grupo B - armazenadas em água destilada a 37 ± 1ºC e imersão diária em NaF a 0,05% durante 3 min, grupo C - armazenadas em água destilada a 37 ± 1ºC e imersão diária em NaF a 0,2% durante 3 min, grupo D - armazenadas em água destilada a 37 ± 1ºC e imersão em NaF a 0,05% a cada 15 dias por 3 min e grupo E - armazenadas em água destilada a 37 ± 1ºC e imersão em NaF a 0,2% a cada 15 dias durante 3 min. A rugosidade superficial foi medida logo após o polimento metalográfico das amostras (T0) e cada 15 dias de experiência até serem alcançados 60 dias (T15, T30, T45, T60). Os dados foram analisados usando ANOVA (α=0,05) e as diferenças não foram estatisticamente significantes (p>0,05) entre as diferentes soluções. Conclui-se que soluções contendo fluoreto (pH 7,0) não danificam a superfície do Ti cp e podem ser usadas como soluções para bochecho usadas por pacientes que possuem restaurações à base de titânio.FAPES

Sharps Accidents: Occurrence and Knowledge Level among Brazilian Dental Students

Objective: To evaluate the prevalence of sharps accidents among dental students in southwest Goiás state, Brazil, and further survey their knowledge of biosafety and post-injury management. Material and Methods: A cross-sectional analytical observational study was carried out in 2018 following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study population included dental students in the 4th and 10th course semester. A pre-formulated self-administered questionnaire containing 14 objective questions was used for data collection. Mean and standard deviation values were calculated. Results: A total of 308 responses were obtained. Overall, 15.9% of the respondents reported having previously experienced accidents with sharps. Most dental students who claimed to know the biological risks to which they are exposed were in the 5th and 8th course semesters, and 67.2% of them reported knowing how to proceed in the event of a sharp accident. Conclusion: A low prevalence of sharps accidents has been reported, and dental students are considered to have a good knowledge of biosafety

Morse taper implants at different bone levels: a finite element analysis of stress distribution

AIM: To explore the biomechanical effects of the different implantation bone levels of Morse taper implants, employing a finite element analysis (FEA). METHODS: Dental implants (TitamaxCM) with 4x13 mm and 4x11 mm, and their respective abutments with 3.5 mm height, simulating a screwed premolar metal-ceramic crown, had their design performed using the software AnsysWorkbench 10.0. They were positioned in bone blocks, covered by 2.5 mm thickness of mucosa. The cortical bone was designed with 1.5 mm thickness and the trabecular bone completed the bone block. Four groups were formed: group 11CBL (11 mm implant length on cortical bone level), group 11TBL (11 mm implant length on trabecular bone level), group 13CBL (13mm implant length on cortical bone level) and group 13TBL (13 mm implant length on trabecular bone level). Oblique 200 N loads were applied. Von Mises equivalent stresses in cortical and trabecular bones were evaluated with the same design program. RESULTS: The results were shown qualitatively and quantitatively by standard scales for each type of bone. By the results obtained, it can be suggested that positioning the implant completely in trabecular bone brings harm with respect to the generated stresses. Its implantation in the cortical bone has advantages with respect to better anchoring and locking, reflecting a better dissipation of the stresses along the implant/bone interfaces. In addition, the search for anchoring the implant in its apical region in cortical bone is of great value to improve stabilization and consequently better stress distribution. CONCLUSIONS: The implant position slightly below the bone in relation to the bone crest brings advantages as the best long-term predictability with respect to the expected neck bone loss

Stress distribution generated by splinted or individualized implant prostheses with rehabilitation in different edges. A finite element analysis

O emprego dos implantes ósseointegráveis na odontologia moderna tem conquistado destaque nas reabilitações de forma crescente. Em casos de perda óssea vertical severa, a qual se faz bastante presente em áreas posteriores mandibulares, o uso de implantes curtos e de diâmetro reduzido se faz necessário. Para que a reabilitação mantenha o plano oclusal nivelado, utiliza-se próteses sobre implantes com proporção coroa/implante aumentada, sendo importante avaliar se há sobrecarga das estruturas de suporte, e se convém a esplintagem da infraestrutura reabilitadora. Um dos métodos utilizados atualmente para análise de distribuição de tensões na odontologia é o método dos elementos finitos. Assim, este estudo teve o objetivo geral de comparar o desempenho biomecânico de próteses, esplintadas (PSIE) ou individualizadas (PSII), sobre implantes cone Morse de comprimento regular e curto, em área posterior de mandíbula. Foram usados modelos geométricos tridimensionais de implantes regulares ∅ 4x11 mm e curtos - ∅ 4x5 mm alojados em rebordos representativos do hemi-arco mandibular esquerdo posterior envolvendo o dente 34 adjacente ao espaço anodôntico, desenhados no programa SolidWorks 2007. Os 8 grupos experimentais foram: grupo controle E (3 implantes regulares reabilitados com PSIE), grupo 1E (2 implantes regulares e 1 curto reabilitados com PSIE), grupo 2E (1 implante regular e 2 curtos reabilitados com PSIE) e grupo 3E (3 implantes curtos reabilitados com PSIE); grupo controle I (3 implantes regulares reabilitados com PSII), grupo 1I (2 implantes regulares e 1 curto reabilitados com PSII), grupo 2I (1 implante regular e 2 curtos reabilitados com PSII) e grupo 3I (3 implantes curtos reabilitados com PSII); As alturas dos pilares usados foram 3,5 mm para implantes regulares e 0,8 mm para implantes curtos. Foram simuladas forças oblíquas (45° - linguo-vestibular) de 365N em molares e 200N em prémolares. Análises qualitativas e quantitativas da distribuição de tensões máximas e mínimas principais (ossos cortical e esponjoso) e tensão equivalente de von Mises (implantes, componentes e infraestruturas) foram feitas por meio do programa AnsysWorkbench10.0. Os resultados obtidos permitiram concluir que o uso de PSIE propiciou uma série de vantagens e benefícios com relação à distribuição de tensões nos elementos envolvidos no sistema, sendo benéfica a todos os grupos experimentais do presente estudo, notoriamente ao grupo com presença apenas de implantes curtos, diminuindo as tensões no osso circunjacente aos implantes, principalmente em sua abrangência. Também diminuiu as tensões na superfície dos implantes, na área de transmucoso dos pilares/componentes, na região interna das infraestruturas e sua abrangência ao osso circunjacente aos implantes curtos nos grupos com implantes regulares e curtos. No entanto, nesse mesmo contexto, gerou maior tensão ao osso circunjacente aos implantes regulares intermediários comparativamente aos grupos individualizados. Também favoreceu a diminuição das tensões ao osso circunjacente ao dente adjacente, quando na presença de proporção coroa/implante aumentada. O uso PSII apresentou-se vantajosa na diminuição das tensões na parte superior dos pilares e na área de conexão entre coroas, além do grupo controle, apenas com implantes regulares e próteses de proporção normal, sendo viável sua utilização neste contexto frente às vantagens clínicas não oferecidas pelas próteses esplintadas.The use of dental implants in modern dentistry has gained prominence in oral rehabilitations. In cases of severe vertical bone loss, which is very much present in mandibular posterior areas, the use of short implants and reduced diameter is necessary. To maintain the occlusal plane level rehabilitation it is necessary the use of prostheses with increased crown/implant ratio , and it is important assess whether there is overhead of supporting structures, and befits splinting the rehabilitating infrastructure. One of the methods currently used to analyze the stress distribution in dentistry is the finite element method. Thus , this study has the overall objective to compare the biomechanical performance of prostheses, splinted (PSIE) or individualized (PSII) over Morse taper implants of regular and short length in the posterior area of the mandible. It were used three-dimensional geometric models of regular implants - ∅ 4x11 mm and short implants - ∅ 4x5 mm housed in representative edges of the posterior left mandibular hemi-arch tooth involving 34 teeth, designed in SolidWorks 2007 program. The 8 experimental groups were: control group E (3 regular implants rehabilitated with PSIE ), group 1E (2 regular and 1 short implants rehabilitated with PSIE) , 2E group (1 regular implant and 2 short implants rehabilitated with PSIE) and 3E group (3 short implants rehabilitated with PSIE); control group I (3 regular implants rehabilitated with PSII), group 1I (2 regular and 1 short implants rehabilitated with PSII), 2I group (1 regular implant and 2 short implants rehabilitated with PSII) and 3I Group (3 short implants rehabilitated with PSII); The pillars heights used for regular implants were of 3.5 mm and 0.8 mm for the short implants. Oblique forces (45° linguo-vestibular) were simulated in molars (365N) and premolars (200N). Qualitative and quantitative analysis of the distribution of maximum and minimum principal stresses (cortical and cancellous bone) and von Mises equivalent stress (implants, components and infrastructure) were made through the software AnsysWorkbench10.0. The results showed that the use of PSIE provided advantages and benefits regarding the stresses distribution in the elements involved in the system, being beneficial to all experimental groups of this study notoriously in the group with only short implants, reducing stresses in the surrounding bone to implants, especially in coverage. Also decreased the stresses on the implants surface, in the transmucosal abutments area, in the inner region of the infrastructure and its reach to the surrounding bone to short implants in groups with regular and short implants. However, in that respect, generated higher stresses to the surrounding bone of intermediate implants compared to the individualized groups. Also favoring a decrease of the stresses to surrounding bone adjacent to the tooth, in the presence of increased crown/implant ratio. The use PSII showed to be advantageous in reducing stresses on top of the abutments and the area of connection between crowns, and in the control group, only with regular implants and prostheses of normal crown/implant ratio, so it can be used in this context facing the clinical advantages not offered by splinted prostheses

Qualitative and quantitative analysis by finite element method of the stress distribution at different bony edges rehabilitated with Morse taper implant- supported metalloceramic prostheses, of different lengths

O emprego dos implantes osseointegráveis na odontologia moderna tem sido crescente. Dentre os tipos de conexões existentes, o cone Morse tem se mostrado com vantagens e atrativos interessantes. Com relação ao comprimento, a aplicabilidade de implantes curtos para casos de perda óssea vertical intensa se faz muito presente, principalmente em áreas mandibulares posteriores, a fim de se evitar procedimentos cirúrgicos mais complexos que envolvam maior morbidade. Juntamente com a perda óssea, a necessidade da manutenção do plano oclusal nivelado é inquestionável, sendo necessário o uso de próteses sobre implantes curtos com dimensões maiores, podendo haver sobrecarga sobre tais implantes e estruturas de suporte. O método dos elementos finitos (MEF) possibilitou avaliar as tensões na superfície dos implantes e componentes, e na interface entre implantes e rebordo ósseo. Neste estudo foram usados modelos de implantes cone Morse e próteses sobre implantes do tipo metalocerâmicas, individualizadas, de diferentes dimensões, alojados em diferentes rebordos com reabsorção óssea vertical. Todas as estruturas foram desenhadas por meio do programa SolidWorks (SolidWorks Corporation, Massachusetts, USA), e análises qualitativas e quantitativas das tensões equivalentes de Von Mises foram realizadas nos rebordos ósseos e implantes por meio do programa AnsysWorkbench10.0 (Swanson, Analysis Systems, Inc., Houston, USA). Os grupos foram: grupo controle (3 implantes de 11mm comprimento), grupo 1 (implantes de 13mm, 11mm e 5mm comprimento), grupo 2 (1 implante de 11mm e 2 implantes de 5mm comprimento) e grupo 3 (3 implantes de 5mm comprimento). As alturas dos pilares usados foram 3.5mm para implantes de 13mm e 11mm (regulares) e 0.8mm para implantes de 5mm (curtos). Foram simuladas forças oblíquas de 365N em molares e 200N em pré-molares. Os resultados mostraram que, com relação aos implantes e componentes, os pilares com 0.8mm de altura geraram menores tensões equivalentes de Von Mises comparativamente aos de 3.5mm de altura. A associação de implantes curtos com coroas de maiores dimensões concentrou maiores valores e distribuição de tensões na superfície destes implantes, principalmente na face vestibular (direção das cargas oblíquas). O implante mais distal sempre concentrou maiores tensões. Já com relação ao osso, houve 50% mais tensão no osso cortical para os implantes de 5mm do que os de 13mm e 11mm de comprimento. Houve 80% mais tensão no osso esponjoso para os implantes de 5mm do que os de 13mm e 11mm de comprimento. Houve maior concentração de tensão na região óssea cervical aos implantes curtos. No entanto, tais implantes foram capazes de realizar boa dissipação das tensões aos ossos frente às cargas aplicadas, apesar de atingir seu limiar próximo entre deformação elástica e plástica para o osso trabecular. Implantes mais distais e/ou com maior mesa oclusal geraram regiões de maior tensão no osso circunjacente. Concluiu-se que pacientes que se faz necessária a instalação de implantes curtos associados a próteses sobre implantes de dimensões aumentadas necessitam de cuidadosa avaliação e ajuste oclusal, já que uma eventual sobrecarga nestes implantes curtos, e até mesmo nos de comprimento regular, podem gerar tensões que vão além do limiar fisiológico do osso circunjacente, podendo acarretar danos a todo o sistema.The use of dental implants is increasing in dentistry. Among the different types of connections existent, the Morse taper has been highlighted on several positive features. Regarding to the length, the use of short implants in cases of severe vertical bone loss are becoming frequent, especially in mandibular posterior areas, avoiding more complex surgical procedures and greater morbidity. As a consequence of bone loss, the need for rehabilitation to maintain the occlusal plane level is unquestionable, leading to the use of implants prostheses with larger dimensions, which may cause overload on these short implants and the supporting structure. This finite element analysis (FEA) compared stress distribution on external surface of Morse taper implants, their abutments and at bone/implant interface of different bone ridges, varying implants length and dimensions of each metal-ceramic crowns. All structures were designed using the SolidWorks software (SolidWorks Corporation, Massachusetts, USA), and qualitative and quantitative analysis of the equivalent Von Mises stresses were ran on AnsysWorkbench10.0 (Swanson Analysis Systems, Inc., Houston, USA). Three-dimensional FE models were designed representing a posterior left side segment of the mandible: group control, 3 implants of 11mm length; group 1, implants of 13mm, 11mm and 5mm length; group 2, 1 implant of 11mm and 2 implants of 5mm length; group 3, 3 implants of 5mm length. The abutments heights were 3.5mm for 13mm and 11mm implants (regular) and 0.8mm for 5mm implants (short). Evaluation was performed on Ansys software, with oblique loads of 365N for molars and 200N for premolars. The results, for implants and abutments, showed that abutments with 0.8mm height generated less von Mises stresses compared with 3.5mm height. The use of short implants associated with bigger crowns concentrated higher stress distribution and stress values on the surface implants, mainly on the vestibular side (oblique loads). The more distal implants had the higher stress mesures. The results for the bone showed that there was 50% higher stress on cortical bone on the 5mm implants length than 13mm and 11mm implants. There was 80% higher stress on trabecular bone for the 5mm implants length than 13mm and 11mm implants. There was higher stress concentration on the bone region of the short implants neck. However, these implants were capable to dissipate the stress to the bones, given the applied loads, but achieving near the threshold between elastic and plastic deformation to the trabecular bone. Distal implants and/or with biggest occlusal table generated greatest stress regions on surrounding bone. It was concluded that patients requiring short implants associated with increased proportions implant prostheses need careful evaluation and occlusal adjustment, as a possible overload in these short implants, and even in regular ones, can generate stress beyond the physiological threshold of the surrounding bone, which may compromise the whole system

Three-Dimensional Finite Element Analysis of Stress Distribution on Different Bony Ridges With Different Lengths of Morse Taper Implants and Prosthesis Dimensions

This finite element analysis (FEA) compared stress distribution on different bony ridges rehabilitated with different lengths of morse taper implants, varying dimensions of metal-ceramic crowns to maintain the occlusal alignment. Three-dimensional FE models were designed representing a posterior left side segment of the mandible: group control, 3 implants of 11 mm length; group 1, implants of 13 mm, 11 mm and 5 mm length; group 2, 1 implant of 11 mm and 2 implants of 5 mm length; and group 3, 3 implants of 5 mm length. The abutments heights were 3.5 mm for 13- and 11-mm implants (regular), and 0.8 mm for 5-mm implants (short). Evaluation was performed on Ansys software, oblique loads of 365N for molars and 200N for premolars. There was 50% higher stress on cortical bone for the short implants than regular implants. There was 80% higher stress on trabecular bone for the short implants than regular implants. There was higher stress concentration on the bone region of the short implants neck. However, these implants were capable of dissipating the stress to the bones, given the applied loads, but achieving near the threshold between elastic and plastic deformation to the trabecular bone. Distal implants and/or with biggest occlusal table generated greatest stress regions on the surrounding bone. It was concluded that patients requiring short implants associated with increased proportions implant prostheses need careful evaluation and occlusal adjustment, as a possible overload in these short implants, and even in regular ones, can generate stress beyond the physiological threshold of the surrounding bone, compromising the whole system.NeodentNeoden

Effect of fluoride sodium mouthwash solutions on cpTI: evaluation of physicochemical properties

The effects of fluoride, which is present in different oral hygiene products, deserve more investigation because little is known about their impact on the surface of titanium, which is largely used in Implantology. This study evaluated the surface of commercially pure titanium (cpTi) after exposure to different concentrations of sodium fluoride (NaF). The hypothesis tested in this study was that different concentrations of NaF applied at different time intervals can affect the titanium surface in different ways. The treatments resulted in the following groups: GA (control): immersion in distilled water; GB: immersion in 0.05% NaF for 3 min daily; GC: immersion in 0.2% NaF for 3 min daily; GD: immersion in 0.05% NaF for 3 min every 2 weeks; and GE: immersion in 0.2% NaF for 3 min every 2 weeks. The experiment lasted 60 days. Roughness was measured initially and every 15 days subsequently up to 60 days. After 60 days, corrosion analysis and anodic polarization were done. The samples were examined by scanning electron microscopy (SEM). The roughness data were analyzed by ANOVA and there was no significant difference among groups and among time intervals. The corrosion data (i corr) were analyzed by the Mann-Whitney test, and significant differences were found between GA and GC, GB and GC, GC and GD, GC and GE. SEM micrographs showed that the titanium surface exposed to NaF presented corrosion that varied with the different concentrations. This study suggests that the use of 0.05% NaF solution on cpTi is safe, whereas the 0.2% NaF solution should be carefully evaluated with regard to its daily use

Morse taper implants at different bone levels: a finite element analysis of stress distribution

explore the biomechanical effects of the different implantation bone levels of Morse taper implants, employing a finite element analysis (FEA). Methods: Dental implants (TitamaxCM) with 4x13 mm and 4x11 mm, and their respective abutments with 3.5 mm height, simulating a screwed premolar metal-ceramic crown, had their design performed using the software AnsysWorkbench10.0. They were positioned in bone blocks, covered by 2.5 mm thickness of mucosa. The cortical bone was designed with 1.5 mm thickness and the trabecular bone completed the bone block. Four groups were formed: group 11CBL (11 mm implant length on cortical bone level), group 11TBL (11 mm implant length on trabecular bone level), group 13CBL (13mm implant length on cortical bone level) and group 13TBL (13 mm implant length on trabecular bone level). Oblique 200 N loads were applied. Von Mises equivalent stresses in cortical and trabecular bones were evaluated with the same design program. Results: The results were shown qualitatively and quantitatively by standard scales for each type of bone. By the results obtained, it can be suggested that positioning the implant completely in trabecular bone brings harm with respect to the generated stresses. Its implantation in the cortical bone has advantages with respect to better anchoring and locking, reflecting a better dissipation of the stresses along the implant/bone interfaces. In addition, the search for anchoring the implant in its apical region in cortical bone is of great value to improve stabilization and consequently better stress distribution. Conclusions: The implant position slightly below the bone in relation to the bone crest brings advantages as the best long-term predictability with respect to the expected neck bone loss