Adaptação de copings de ritânio ao implante, construídos sobre pilares UCLA por duas técnicas: fundição e fundição com soldagem de bordo laser

A reposição de um elemento dentário pode ser feita por um implante osseointegrado sendo que a adaptação passiva de sua estrutura protética é um fator relevante para o sucesso deste trabalho. Um estudo comparativo foi feito entre dois métodos de confecção de prótese unitária suportada por implante. Para tanto incluímos no centro de um bloco de resina um implante rosqueado de 3.75mm de diâmetro por 10.0mm de comprimento (3i Implant innovations, Brasil) e sobre este parafusamos com torque de 20N.cm 15 pilares UCLA torneados anti-rotacionais (137CNB, Conexão Sistemas de Próteses, Brasil) sem qualquer procedimento laboratorial (grupo controle - GC). A partir de um molde de silicone, 15 componentes tipo UCLA calcináveis (56CNB, Conexão Sistemas de Próteses, Brasil) foi parafusado (20N.cm) ao implante e receberam enceramentos padrão (face vestibular plana) os quais foram fundidos em titânio (grupo fundição - GF). 15 componentes, tipo UCLA torneados em titânio (137CNB, Conexão, Sistemas de Próteses, Brasil) receberam o mesmo enceramento padrão e estes copings foram fundidos em titânio separados e soldados a laser aos respectivos pilares em seu bordo (grupo soldagem a laser- GSL). A adaptação marginal foi observada na interface implante/componente, sob microscópio de medição, no eixo y, em 4 pontos de referência na vestibular, lingual, mesial e distal previamente marcados no bloco. As médias aritméticas foram obtidas e uma análise dos dados foi feita para determinar o teste estatístico mais apropriado. Os dados estatísticos descritivos (µm) para Controle (média ± desvio padrão:13.50 ± 21.80; mediana 0.00), for Fundição (36.20 ± 12.60; 37.00), para Laser (10.50 ± 12.90; 3.00) foram submetidos ao Kruskal-Wallis ANOVA, alfa = 5%. Resultados: Os testes mostraram que os valores médios de distorção diferem estatisticamente (kw = 17.40; df =2; p = 0.001The alternative for the reposition of a missing tooth is the osteointegrated implant being the passive adaptation between the prosthodontic structure and the implant a significant factor for the success of this experiment, a comparative study was done between the two methods for confectioning a single prosthodontic supported by an implant. To do so a screwed implant with a diameter of 3.75mm and a length of 10.0mm (3i Implant innovations, Brasil) was positioned in the middle of a resin block and over it we screwed 15 UCLA abutments shaped and anti-rotationable (137CNB, Conexão Sistemas de Próteses, Brasil) with a torque of 20N.cm without any laboratorial procedure (control group - CTRLG). From a silicon model 15 UCLA-type calcinatable compounds (56CNB, Conexão Sistemas de Próteses, Brasil) were screwed (20 N.cm), received a standard waxing (plain buccal surface) and were cast in titanium (casting group - CG) and other 15 compounds, UCLA - type shaped in titanium (137 CNB, Conexão Sistemas de Próteses, Brasil) received the same standard waxing. These last copings were cast in titanium separated from each other and were laser-welded to the respective abutments on their border (Laser-welding group - LWG). The border adaptation was observed in the implant/compound interface, under measurement microscope, on the y axis, in 4 vestibular, lingual, mesial and distal referential points previously marked on the block. The arithmetical means were obtained and an exploratory data analysis was performed to determine the most appropriate statistical test. Descriptive statistics data (µm) for Control (mean±standard deviation: 13.50 ± 21.80; median 0.00), for Casting (36.20±12.60; 37.00), for Laser (10.50 ±12.90; 3.00) were submitted to Kruskal-Wallis ANOVA, alpha = 5%. Results test showed that distorsion median values differ statistically (kw = 17.40; df =2; p = 0.00

Sobre estruturas de implantes múltiplos: fundição em monobloco versus soldagem a laser e brasagem

The linear distortion of prostheses over implants, one-piece casting and cast in sections followed by laser welding by laser and brazing was evaluated in an edentulous mandibular model with five parallel abutments, with a distance of 10mm from center to center. Seventy five gold cylinders were tightened with screws on the abutments with 10Ncm torque. The cylinder/analogue assemblies were measured by microscopic examination (0.001mm accuracy) and the obtained results were compared with the GC (control group). Fifteen metal frames were waxed and cast in a gold alloy (Stabilor, Degussa Hulls, Brazil) and divided into three groups with five elements each, as followed: GM (one-piece casting), GB (section and brazing) and GL (section and laser welding). In all groups, measurements were taken at the right, left, buccal and lingual sides of the cylinder/analogue interface and the results were submitted to analysis of variance (ANOVA) and to the Tukey test (5%). The smallest amount of distortion was seen in the laser group (GL with a mean value of 13.58), followed by the brazing group (GB with a mean value of 24.33) and one-piece (GM with a mean value of 40.00). The greatest distortion was found in the one-piece group (GM).A distorção linear das próteses sobre implantes, fundidas em monobloco e fundidas em secções e soldadas a laser e por brasagem foi avaliada em um modelo de uma mandíbula edêntula com cinco análogos de pilares de implantes, paralelos entre si com distância de 10mm medidos de centro a centro. Sobre estes foram parafusados novos cilindros de ouro, com torque de 10N/cm. Então foram executadas 15 sobre-estruturas metálicas que foram divididas: GC - Adaptação passiva dos cilindros de ouro; GM - monobloco, GB - segmentos soldados por brasagem e, GL - segmentos soldados a laser. Observaram-se as estruturas fixadas com parafusos novos sob microscópio de mensuração. A medição foi realizada na vestibular direita e esquerda e da mesma forma na lingual da interface cilindro/análogo e dados anotados em tabela apropriada. Para o eixo y, a técnica de soldagem a laser (Média=12,41 e Dp=11,12) produziu menos distorção significativamente do que a técnica de brasagem (Média=23,06 e Dp=21,88) seguida pela técnica de monobloco (Média=39,83 e Dp=21,88) p=0.05. Para o eixo x, somente o grupo Monobloco apresentou diferença significativa para as demais técnicas (Média=45,66 e Dp=21,56)

Influência da ciclagem térmica e diferente tipos de solda na resistência da interface metalo-cerâmica

O efeito da soldagem e termociclagem na união metalo-cerâmica foi avaliado pela fundição de sessenta barras metálicas em NiCr nas dimensões estabelecidas para o teste de flexão (ISO 9693:1999E). Destas, 20 barras formaram o grupo controle (GC) e 40 foram segmentadas: 20 unidas por brasagem (GB) e 20 soldadas a laser (GL). Uma camada de 1,0mm de cerâmica foi aplicada sobre as barras, as quais receberam (0,1mm de opaco e 0,9mm de dentina) na sua área central e inferior. A área total testada foi de 20mm com carga central. Os tratamentos de superfície do metal, a temperatura e tempos de queima da cerâmica foram os recomendados pelos fabricantes. A metade dos corpos-de-prova foi termociclada (GCT, GBT e GLT). Todos os corpos-de-prova foram submetidos ao teste de flexão de três pontos com célula de carga de 10Kg e velocidade 1,5±0,5mm/min em uma máquina de ensaios universal, e as cargas máximas até a falha inicial foram anotadas. Os dados foram submetidos à análise de variância e ao teste de Tukey. Não houve diferença significante estatisticamente com relação à força máxima até a falha de união metalo-cerâmica para os grupos GB (10,55±1,37N), GL (9,87±1,22N) e grupo controle GC (14,5±2,11N), que apresentou a força mais alta até falha, estatisticamente significante em relação aos demais grupos, com p=0,001. Para a termociclagem, não houve diferença significativa estatisticamente dentro de todos os grupos estudados. Após o teste, um corpo-de-prova de cada um dos grupos, foi observado por MEV associado ao EDX.Among these ones, 20 bars formed the control group (CG) and 40 were divided: 20 were attached by the use of brazing (BG) and 20 were laser welded (LG). A 1,0mm ceramic layer (0,1mm of opaque ceramics and 0,9mm of dentine ceramics) was applied over the bars, on its central and bottom area. The total area tested had 20mm 2, with central load. The metal surfaces treatments, the temperature, and the times of ceramics coccion were recommended by the manufacturers. Half of the specimens were thermocycled (CGT, BGT, LGT). All the specimens underwent the three-point bending test with a 10-kilo load cell and speed of 1,5±0,5mm/min in an universal testing machine and the maximum load up to initial failure was marked. Data underwent statistical analysis (ANOVA and Tukey Test). There was no relevant static difference concerning the maximum load to metal-ceramic failure of the groups BG (10,55±1,37N) and LG (9,87±1,22N), but CG had the highest load up to failure (14,5±2,11N), statistically relevant, of all the groups, with p=0,001. When it comes to thermocycling, there were no relevant differences statistically, among all the studied groups. After the test, one specimen of each one of the groups was observed by MEV associated to EDX

Influence of substrate design for in vitro mechanical testing

The goal of this study was to evaluate the influence of dental substrate simulator material, and the presence of root and periodontal ligament on the stress distribution in an adhesively-cemented monolithic crown. Five (5) 3D models according to the substrate simulator material and shape were modeled with CAD software for conducting non-linear finite element analysis (FEA): Tooth with and without periodontal ligament - subgroup ?pl? (groups Tooth+pl and Tooth-pl), machined tooth in epoxy-resin with and without pulp chamber - subgroup ?pc? (ER+pc and ER-pc) and simplified epoxy-resin substrate without pulp chamber and roots (SiER). Next, adhesively-cemented monolithic crowns in zirconia reinforced lithium silicate were modeled over each substrate. The solids were then imported in STEP format to the analysis software and the contact between teeth and cylinder was considered perfectly bonded; whereas, the contacts involving the resin cement were considered as non-separated. The materials were considered isotropic, linearly elastic, and homogeneous. An axial load (600 N) was applied to the occlusal surface and results of maximum principal stress (MPa) on the restoration were required. FEA revealed that all evaluated subtracts showed the crown intaglio surface as the most stressed region. The average stress and stress peaks were similar for restorations cemented onto Tooth+pl, Tooth-pl and ER+pc substrates, but, 13% higher in comparison to ER-pc and SiER substrates. Simplified substrates can be used to evaluate posterior full crown behavior without periodontal ligaments and roots, since the rigidity of the specimen is taken into account

The impact of restorative material and ceramic thickness on CAD\CAM endocrowns

Endocrown restorations as a conservative approach to restore endodontically treated teeth still need in vitro investigation under fatigue and made in different materials. This study evaluated the effect of restorative material and restoration thickness on the maximum fracture load of endocrowns subjected to cyclic loading. Sixty (60) third molar teeth received an endocrown preparation with three different heights of remaining dental tissue (1.5, 3.0 or 4.5 mm). A leucite-based ceramic (LEU) and a lithium disilicate (LD) based ceramic were selected to manufacture the CAD/CAM endocrown restorations, totaling 6 groups (n=10). The specimens were subjected to fatigue loading (200N, 2 x 106 cycles, water) and then to the single load to failure test (1 mm/min crosshead speed). Data were analyzed by using two-way ANOVA and Tukey tests (p< 0.05). All endocrowns survived the fatigue test. The thickness did not influence the restoration?s fracture load (p=0.548) instead the restorative material (p=0.003). LD showed higher mean values (1714.43 N)A than LEU (1313.47 N)B. Endocrowns manufactured with CAD/CAM lithium disilicate blocks showed superior fracture load than the leucite-based blocks after mechanical fatigue. Nevertheless, both materials presented acceptable survival and fracture load as long as the material?s minimum thickness and the enamel adhesion are respected

A study on stress distribution to cement layer and root dentin for post and cores made of CAD/CAM materials with different elasticity modulus in the absence of ferrule

To evaluate the stress distribution in a maxillary central incisor with different post and cores made of six CAD/CAM materials with different elastic modulus in the absence of ferrule using the finite element analysis. A three-dimensional endodontically treated maxillary central incisor restored with an all-ceramic crown was modelled in Rhinoceros (5.0 SR8, McNeel). The geometries were analyzed in ANSYS 17.2 (ANSYS Inc.) considering isotropic, homogeneous, linearly elastic materials with perfectly bonded contacts. The elastic moduli (E) of the post-and-cores defined the groups to be compared: nanoceramic resin (E=12.8GPa); composite resin (E=16GPa); hybrid ceramic (E=34.7GPa); lithium disilicate (E=95GPa); titanium (Ti-Al6-V4) (E=112GPa); and Y-TZP material (E=209.3GPa). The set was constrained in the cortical bone and loaded (45°/100 N) on the incisor palatine face. Stress distribution was analyzed by Maximum Principal Stress criteria for the crown-core cement line, Post-and-core?s cement line, Post-and-core system and Dentin. The stress distribution at the crown-core cement line (11.4 ? 13.2 MPa) was inversely proportional to the increase of the elastic modulus of the post-core approaches, while it was direct proportional on the post-and-core (4.7 ? 40 MPa) and cement line (4.1 ? 6.2 MPa). Stress distribution on the dentin was similar for all groups (24.7 - 25.3). Post-and-core made by CAD/CAM seems to be an efficient treatment alternative, since it is a conservative approach, promotes better aesthetic quality and it allows the control of the cement line thickness

Long-term fracture load of all-ceramic crowns : effects of veneering ceramic thickness, application techniques, and cooling protocol

To evaluate, in vitro, the effects of the cooling protocol, application technique, and veneering ceramic thickness on the fracture resistance of ceramic crowns with Y-TZP frameworks. 80 frameworks were made from zirconia by the CAD/CAM technique and divided into 8 groups (n = 10) according to the factors: ?application technique? (stratified-L and pressed -P), ?thickness? (1 mm and 2 mm), and ?cooling protocol? (slow-S and fast-F) of the feldspathic veneering ceramic. After, all crowns were cemented over G10 preparations with resin cement (Panavia F, Kuraray), mechanically cycled (2x106 cycles, 200 N, 3Hz), and subjected to the axial compression resistance test (0.5 mm/min, 10 kN). The data (N) underwent descriptive statistical analysis by 3-way ANOVA and Tukey?s test (5%). Fracture analysis was performed to determine the possible origin of failure. The factors ?cooling protocol? (P=0.0058) and ?application? technique (P=0.0001) influenced the fracture resistance of the crowns. For pressed veneer technique, the P2S (4608.9±464.5). A presented significantly higher results than that P2F(3621.1±523.0)BCD (Tukey?s test). For the stratified technique, this difference was not observed (P>0.05). The thickness of the veneering ceramic was not significant regardless of the cooling protocol and technique (P>0.05). The predominant failure mode was chipping of the ceramic veneer originating in the subsurface. The pressed technique, used with a slow-cooling protocol, leads to the best outcome for the veneering of all-ceramic crowns

Influence of different restorative materials on the stress distribution in dental implants

To assist clinicians in deciding the most suitable restorative materials to be used in the crowns and abutment in implant rehabilitation. For finite element analysis (FEA), a regular morse taper implant was created using a computer aided design software. The implant was inserted at the bone model with 3 mm of exposed threads. An anatomic prosthesis representing a first maxillary molar was modeled and cemented on the solid abutment. Considering the crown material (zirconia, chromium-cobalt, lithium disilicate and hybrid ceramic) and abutment (Titanium and zirconia), the geometries were multiplied, totaling eight groups. In order to perform the static analysis, the contacts were considered bonded and each material was assigned as isotropic. An axial load (200 N) was applied on the crown and fixation occurred on the base of the bone. Results using Von-Mises criteria and micro strain values were obtained. A sample identical to the CAD model was made for the Strain Gauge (SG) analysis; four SGs were bonded around the implant to obtain micro strain results in bone tissue. FEA results were 3.83% lower than SG. According to the crown material, it is possible to note that the increase of elastic modulus reduces the stress concentration in all system without difference for bone. Crown materials with high elastic modulus are able to decrease the stress values in the abutments while concentrates the stress in its structure. Zirconia abutments tend to concentrate more stress throughout the prosthetic system and may be more susceptible to mechanical problems than titanium

Effect of glazing application side and mechanical cycling on the biaxial flexural strength and Weibull characteristics of a Y-TZP ceramic

Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Objective: Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. Methodology: Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors “glazing side” (control – no glazing; GT – glaze on tensile side; GC – glaze on compression side; GTC – glaze on both sides) and “mechanical aging” (non-aged and aged, A – mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh’s rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey’s test (5%), and Weibull analysis were performed. Results: The “glazing side”, “mechanical aging” and the interaction of the factors were significant (p&lt;0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh’s rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p&lt;0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. Conclusion: Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging

Avaliação da resistência ao cisalhamento da união entre duas ligas a base de CoCr e uma cerâmica

INTRODUCTION: Based on the importance of the integrity of the metal/ceramic interface, the purpose of this work was to evaluate the shear bond strength of the metal-ceramic union of two Co-Cr alloys (Wirobond C, Bego; Remanium 2000, Dentaurum) combined with Omega 900 ceramic (Vita Zahnfabrik). MATERIAL and METHOD: Eleven cylindrical matrixes were made for each alloy, and the metallic portion was obtained with the lost wax casting technique with standardized waxing of 4mm of height and of 4mm of diameter. The ceramic was applied according to the manufacturer’s recommendations with the aid of a teflon matrix that allowed its dimension to be standardized in the same size as the metallic portion. The specimens were submitted to the shear bond test in an universal testing machine (EMIC), with the aid of a device developed for such intention, and constant speed of 0.5mm/min. RESULTS and CONCLUSIONS: The mean resistance was 48.387MPa for Wirobond C alloy, with standard deviation of 17.718, and 55.956MPa for Remanium 2000, with standard deviation of 17.198. No statistically significant difference was observed between the shear strength of the two metal-ceramic alloys. ______________________________________________________________________________________________________________ RESUMOINTRODUÇÃO: Baseados na importância da integridade da interface metal-cerâmica, este trabalho tem como objetivo avaliar a resistência ao cisalhamento da união metal-cerâmica de duas ligas de Co-Cr (Wirobond C, Bego; Remanium 2000, Dentaurum) combinadas com a cerâmica Omega 900 (Vita Zahnfabrik). MATERIAIS E MÉTODOS: Foram confeccionados 11 corpos-de-prova cilíndricos para cada liga utilizada, sendo que a porção metálica foi obtida por fundição pela técnica da cera perdida, através de enceramentos padronizados com 4mm de altura por 4mm de diâmetro. A aplicação da cerâmica foi realizada segundo recomendações do fabricante, com auxílio de uma matriz de teflon que permitia sua padronização com as mesmas dimensões da porção metálica. Os corpos-de-prova foram submetidos ao ensaio de resistência ao cisalhamento em máquina de ensaios universal (EMIC), com auxílio de dispositivo desenvolvido para tal propósito, sob velocidade constante de 0,5mm/ min. RESULTADOS E CONCLUSÕES: As médias de resistência obtidas foram 48,387 MPa para a liga Wirobond C, com desvio padrão de 17,718, e 55,956 MPa para a Remanium 2000, com desvio padrão de 17,198. Após análise de variância foi possível observar que não há diferença estatisticamente significante entre os valores de resistência ao cisalhamento das duas ligas metalocerâmicas