Submitted by PPG Odontologia (odontologia-pg@pucrs.br) on 2018-03-09T17:16:59Z No. of bitstreams: 1 THAISA_BARIZAN_BORDIN_TES.pdf: 20201047 bytes, checksum: 55c2ba5219f534c63b5c41a38764d58f (MD5) / Rejected by Tatiana Lopes (tatiana.lopes@pucrs.br), reason: Devolvido devido ? falta da capa institucional no arquivo pdf. on 2018-03-15T12:45:57Z (GMT) / Submitted by PPG Odontologia (odontologia-pg@pucrs.br) on 2018-03-15T15:28:20Z No. of bitstreams: 1 THAISA_BARIZAN_BORDIN_TES.pdf: 20512384 bytes, checksum: 548341879f639810273a963a54d05c8c (MD5) / Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-03-16T13:40:48Z (GMT) No. of bitstreams: 1 THAISA_BARIZAN_BORDIN_TES.pdf: 20512384 bytes, checksum: 548341879f639810273a963a54d05c8c (MD5) / Made available in DSpace on 2018-03-16T13:50:16Z (GMT). No. of bitstreams: 1 THAISA_BARIZAN_BORDIN_TES.pdf: 20512384 bytes, checksum: 548341879f639810273a963a54d05c8c (MD5) Previous issue date: 2017-12-14 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The high prevalence of edentulous patients associated to the poor retention of the conventional complete dentures, combined to the high survival rate of dental implants and an increased demand for aesthetic dentistry, resulted in a higher number of fixed restorations provided to the patients. However, as any technique, this one is also not free from failures and these can occur due to problems related to the biomechanics of the implant/prosthesis. These complications may be from biologic or technical origin, the first being related to processes affecting the peri-implant hard and soft tissues, and the second to mechanical damage of the implant, implant components and prostheses. Due to the paucity of clinical studies reporting complications in implant fixed complete denture prostheses (IFCDPs), this thesis aimed to evaluate implants and prostheses survival rates, as well as the main complications observed in patients rehabilitated with IFCDPs after at least one year of follow-up. The secondary goal was to evaluate patient satisfaction. Through the electronic records, based on the inclusion criteria, edentulous patients who were rehabilitated with prostheses supported by at least four rough surface dental implants between January 2000 and December 2015 in the Departent of Postgraduate Prosthodontics at Tufts University School of Dental Medicine (Boston, MA, USA) were selected. A comprehensive multidisciplinary examination composed of medical and dental history, clinical examination involving periodontal and prosthetic examination, radiographic analysis and photographs was performed. Comparison was made as well between porcelain IFCDPs (Group 1) and metalresin IFCDPs (Group 2). A questionnaire to assess patient satisfaction regarding the treatment in general, aesthetics, chewing ability, taste, and speaking ability was also applied. For data analysis, Kaplan-Meier estimation curves were used to predict the survival of implants and prostheses. The chi-square test and Fisher's exact test where appropriate and logistic regression analysis were performed. Four hundred fifty-seven implants (Nobel Biocare, Biomet 3i, Straumann) supporting a total of 71 PDTFIs in 52 patients (mean age 65.5 years) were evaluated, with a mean follow-up time of 5.2 years (range 1 to 12 years). Of these prostheses, 38 were in the maxilla and 33 in the mandible (19 edentulous maxillae, 14 edentulous mandibles, 19 both arches); 55 were made of porcelain (porcelain-fused-to-metal or metal-free) (Group 1) and 16 were metal-resin (MR) (Group 2); 36 were cement retained and 35 were retained by screws. Only 6 implants had to be removed, resulting in a survival rate of 98.7%. Of the 71 prostheses, 6 failed (1 porcelain and 5 MR), presenting a survival rate of 91.5%. A total of 274 biologic complications were recorded in 63 prostheses (47 porcelain and 16 MR), being soft tissue recession around the implants (7.7%) the most frequently observed, followed by soft tissue inflammation underneath the prostheses (7.4%), and peri-implant mucositis (6.3%). Soft tissue recession was the most frequent complication in both groups, and no statistical significant difference was observed for any biologic complication between Group 1 and Group 2. A total of 274 technical complications were observed in 57 prostheses (42 porcelain and 15 MR). Wear of the prosthetic material (9.8%) was the most frequent, followed by decementation of the cement-retained IFCDPs (2.9%), and loss of screw access filing material of the screw-retained IFCDPs (2.7%). The rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (Group 1) and 19.4% for metal-resin IFCDPs (Group 2), yielding a statistically significant difference between the two groups (p < 0.05). Regarding the patient satisfaction evaluation, the greatest dissatisfaction was in relation to the ability to chew (12%). However, in general, 94% of the patients were satisfied with the treatment rendered. With a mean exposure time of 5.2 years, high implants and prosthetic survival rates can be expected in rehabilitations with implanted-fixed complete denture prostheses, presence of biologic and technical complications, and a high level of patient satisfaction. / A alta preval?ncia de pacientes ed?ntulos associada a pobre reten??o das pr?teses totais convencionais, combinada com as altas taxas de sobreviv?ncia de implantes dent?rios e uma maior da demanda por odontologia est?tica, resultou em um aumento no n?mero de restaura??es fixas fornecidas aos pacientes. Entretanto, como toda t?cnica, esta tamb?m n?o ? ausente de falhas e essas podem ocorrer devido a problemas relacionados com a biomec?nica do conjunto pr?tese/implante. Essas complica??es podem ser de origem biol?gica ou t?cnica, sendo a primeira relacionada a processos que afetam os tecidos de suporte peri-implantar e a segunda a danos mec?nicos do implante, componentes de implantes e pr?teses. Devido ? escassez de estudos cl?nicos relatando complica??es em pr?teses dent?rias totais fixas implantossuportadas (PDTFIs), essa tese teve como objetivo avaliar taxas de sobreviv?ncia de implantes e pr?teses, assim como as principais complica??es observadas em pacientes reabilitados com PDTFIs ap?s terem sido acompanhados pelo per?odo de, pelo menos, um ano. Tamb?m teve como objetivo avaliar o grau de satisfa??o dos pacientes. Atrav?s dos registros eletr?nicos, a partir de crit?rios de inclus?o, foram selecionados pacientes ed?ntulos que foram reabilitados com pr?teses suportadas por pelo menos quatro implantes dent?rios de superf?cie tratada entre janeiro de 2000 e dezembro de 2015 na Divis?o de P?s- Gradua??o em Pr?tese da Faculdade de Medicina Dent?ria da Universidade Tufts (Boston, MA, USA). Nestes pacientes, um exame compreensivo multidisciplinar composto de hist?ria m?dica e dent?ria, exame cl?nico envolvendo exame periodontal e exame das pr?teses, an?lise radiogr?fica e fotografias foi realizado. Tamb?m foi feito a compara??o entre PDTFIs fabricadas com cer?mica (metalocer?micas ou livres de metal) (Grupo 1) e PDTFIs metalopl?sticas (Grupo 2). Al?m disso foi aplicado um question?rio sobre a satisfa??o do paciente de forma geral, em rela??o a est?tica, a mastiga??o, ao paladar, e a fona??o ap?s o tratamento. Para a an?lise dos dados, as curvas de estimativas de Kaplan-Meier foram utilizadas para prever a sobreviv?ncia dos implantes e das pr?teses. Foi feito o teste quiquadrado e o teste exato de Fisher quando apropriado e ainda a an?lise de regress?o log?stica. Foram analisados 457 implantes (Nobel Biocare, Biomet 3i, Straumann) suportando um total de 71 PDTFIs em 52 pacientes (m?dia de idade de 65,5 anos), com um per?odo m?dio de acompanhamento de 5,2 anos (intervalo de 1 a 12 anos). Destas pr?teses, 38 eram em maxila e 33 em mand?bula (19 maxilas ed?ntulas, 14 mand?bulas ed?ntulas, 19 ambas as arcadas); 55 eram fabricadas em cer?mica (metalocer?micas ou livres de metal) (Grupo 1) e 16 eram metalopl?sticas (MP) (Grupo 2); 36 eram cimentadas e 35 eram retidas atrav?s de parafusos. Apenas 6 implantes tiveram que ser removidos, resultando uma taxa de sobreviv?ncia de 98,7%. De 71 pr?teses, 6 falharam (1 cer?mica e 5 MP), apresentando uma taxa de sobreviv?ncia de 91,5%. Um total de 274 complica??es biol?gicas foram registradas em 63 pr?teses (47 cer?micas e 16 MP), sendo a grande maioria recess?o do tecido gengival ao redor do implantes (7,7%), seguida de inflama??o nos tecidos moles abaixo das pr?teses (7,4%), e mucosite peri-implantar (6,3%). Recess?o de tecido mole foi a complica??o mais frequente em ambos os grupos, n?o sendo observadas diferen?as estatisticamente significativas para qualquer complica??o biol?gica entre o Grupo 1 e o Grupo 2. Foram observadas 274 complica??es t?cnicas em 57 pr?teses (42 cer?micas e 15 MP), sendo as mais frequentes o desgaste do material prot?tico (9,8%), a decementa??o da pe?a prot?tica das PDTFIs retidas atrav?s de cimento (2,9%), e perda do material de recobrimento do parafuso prot?tico das PDTFIs retidas por parafusos (2,7%). A taxa de desgaste do material prot?tico foi de 7,3% para PDTFIs cer?micas (Grupo 1) e 19,4% para PDTFIs metalopl?sticas (Grupo 2), resultando em uma diferen?a estatisiticamente significativa entre os dois grupos (p < 0,05). Na avalia??o de satisfa??o do tratamento recebido, a maior insatisfa??o foi em rela??o a capacidade de mastigar (12%). Contudo, de uma forma geral, 94% dos pacientes demonstraram-se satisfeitos. Com um tempo m?dio de exposi??o de 5,2 anos, pode-se esperar elevadas taxas de sobreviv?ncia de implantes e de reconstru??es com pr?teses dent?rias totais fixas implantossuportadas, presen?a de complica??es biol?gicas e t?cnicas, e um elevado grau de satisfa??o dos pacientes.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:56:18Z No. of bitstreams: 1 DIS_ROBERTA_ALENCASTRO_AVILA_PARCIAL.pdf: 118749 bytes, checksum: dc5aeca744ebbdf64a56379812249ac5 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:56:27Z (GMT) No. of bitstreams: 1 DIS_ROBERTA_ALENCASTRO_AVILA_PARCIAL.pdf: 118749 bytes, checksum: dc5aeca744ebbdf64a56379812249ac5 (MD5) / Made available in DSpace on 2017-06-30T17:56:37Z (GMT). No. of bitstreams: 1 DIS_ROBERTA_ALENCASTRO_AVILA_PARCIAL.pdf: 118749 bytes, checksum: dc5aeca744ebbdf64a56379812249ac5 (MD5) Previous issue date: 2017-01-20 / Introduction: The objective of this work was through a prospective cohort analysis evaluate possible correlations between periimplantar bone loss of lower fixed implants (PTFIs) and their respective distribution of bilateral occlusal contacts, maximum bite force (FMM), area occlusal contacts of left and right lateral movements, their relation with the antagonist arch and the presence or absence of provisional fixed prosthesis. Materials and Methods: This convenience sample consisted of 20 (twenty) patients with lower PTFIs who were followed for one year, after the installation of the prosthesis. In the two data collections the FMM measurement was performed, the occlusal contacts distribution was measured through the T-Scan III device and a Cone Beam computed tomography was ordered to evaluate the periimplant bone loss. For the measurement of bone loss, a comparison was made between the initial and second moments. After this process the results of periimplant bone loss were correlated and compared with the other data obtained. The statistical analysis performed to evaluate bone loss of implants was the Friedman test and Wilcoxon test, Mann-Whitney comparisons test, the Spearman correlations test and Student's T-test. Results: The main results were: 1) the implants do not differentiate in relation to periimplant bone loss; 2) there was no significant correlation of bone loss with FMM, right and left laterality and the distribution of contacts in maximum intercuspal position; 3) in comparison between bone loss of patients with full dentures and partially edentulous, they showed no statistically significant difference, as well as in patients who received provisional full prosthesis and those who did not receive. Conclusion: Bone loss appears to occur similarly between all implants, sides, and regions. FMM, R and L laterality, MIH contact distribution, and the antagonist arcade do not appear to interfere with periimplant bone remodeling. The preliminary results of this study suggest that there is no need for provisioning in inferior restorations, since there were no differences in bone loss between patients who received and did not receive fixed provisional. / Introdu??o: O objetivo deste trabalho foi atrav?s de uma an?lise tipo coorte prospectivo, avaliar as poss?veis rela??es existentes entre a perda ?ssea periimplantar de pr?teses totais fixas implantossuportadas inferiores (PTFIs) e sua respectiva distribui??o de contatos oclusais bilaterias, for?a m?xima de mordida (FMM), ?rea de contatos oclusais nos movimentos de lateralidade esquerda e direita, sua rela??o com arcada antagonista e presen?a ou n?o de pr?tese fixa provis?ria. Materiais e M?todos: A amostra de conveni?ncia foi constitu?da por 20 pacientes portadores PTFIs inferiores, e foram acompanhados por um per?odo de um ano, ap?s a instala??o da pr?tese. Nas duas coletas de dados foi realizada a medi??o da FMM, medi??o da distribui??o dos contatos oclusais atrav?s do aparelho T-Scan III e solicitado uma tomografia computadorizada Cone Beam para avalia??o da perda ?ssea periimplantar. Para mensura??o da perda ?ssea, foi realizada a compara??o entre as tomadas iniciais e no segundo momento. Ap?s, os resultados de perda ?ssea periimplantar foram correlacionados e comparados com os demais dados obtidos. A an?lise estat?stica realizada para avaliar perda ?ssea dos implantes, lados e regi?es foi o teste de Friedman e teste de Wilcoxon, para compara??es teste de Mann-Whitney e para as correla??es teste de Spearman e teste T de Student. Resultados: Os principais resultados foram: 1) os implantes n?o se diferenciam em rela??o a perda ?ssea periimplantar; 2) n?o houve correla??o significativa de perda ?ssea com FMM, lateralidade D e E e a distribui??o de contatos em MIH; 3) na compara??o entre perda ?ssea de pacientes com antagonista PT e parcialmente ed?ntulos, n?o mostrou diferen?a estatisticamente significativa, assim como em pacientes que receberam protocolo provis?rio e os que n?o receberam. Conclus?o: A perda ?ssea parece ocorrer de forma semelhante entre todos os implantes, lados e regi?es. A FMM, a lateralidade D e E, a distribui??o de contatos em MIH e a arcada antagonista n?o parecem interferir na remodela??o ?ssea periimplantar. Os resultados preliminares deste estudo sugerem que n?o h? necessidade de provisionaliza??o em protocolos inferiores, visto que n?o houve diferen?as de perda ?ssea entre os pacientes que receberam e n?o receberam provis?rio fixo.

Made available in DSpace on 2014-12-17T15:43:52Z (GMT). No. of bitstreams: 1 PolianaMCD_DISSERT.pdf: 1792247 bytes, checksum: 7f68d2f3ec1dcc9a4fd54fc8a9e991be (MD5) Previous issue date: 2012-12-13 / The evaluation criteria of the cases treated with dental implants are based on clinical and radiographic tests. In this context it is important to conduct research to determine prognosis of different types of prosthetic rehabilitation and determination of the main problems affecting this type of treatment. Thus, the objective of this study was to assess the prosthetic conditions of individuals rehabilitated with implant-supported prosthesis. In this cross-sectional study 153 patients were treated, accounting for a sample of 509 implants. The failures were observed by clinical and radiographic examination. The results showed that the fracture (0.2%) loss (0.4%) and loosening of the screws (3.3%) were failures are less frequent. The fracture structures as the resin (12.4%), porcelain (5.5%) and metallic (1.5%), loss of resin that covers the screw (23.8%) and loss of retention overdentures on implants (18.6%) had a higher occurrence. The failure of adaptation between the abutment and the implant (6.9%) and especially between the prosthesis and the abutment (25.4%) had a high prevalence and, when related to other parameters showed a significant association, particularly with the cemented prosthesis (OR = 6.79). It can be concluded that to minimize the appearance of failures, protocols must be observed from diagnosis to the settlement and control of prostheses on implants, particularly with respect to technical steps of the making of the prosthesis and care in radiographic evaluating the fit between their components / Os crit?rios de avalia??o dos casos tratados com implantes osseointegrados s?o baseados em testes cl?nicos e exames radiogr?ficos. Nesse contexto, ? importante a realiza??o de pesquisas na determina??o do progn?stico dos diferentes tipos de reabilita??es prot?ticas e na determina??o dos principais problemas que atingem este tipo de tratamento. Desta forma, o objetivo deste trabalho foi avaliar as condi??es prot?ticas de indiv?duos reabilitados com implantes osseointegrados e pr?teses sobre implantes. Neste estudo transversal foram atendidos 153 pacientes, contabilizando uma amostra de 509 implantes. As falhas foram observadas atrav?s do exame cl?nico e radiogr?fico. Os resultados demonstraram que a fratura (0,2%), a perda (0,4%) e o afrouxamento dos parafusos (3,3%) foram as falhas menos frequentes. A fratura das estruturas como a resina (12,4%), porcelana (5,5%) e met?lica (1,5%), a perda da resina que recobre o parafuso de fixa??o (23,8%) e a perda de reten??o nas pr?teses overdentures (18,6%), tiveram uma ocorr?ncia maior. A falha de adapta??o, entre o pilar e o implante (6,9%) e principalmente entre a pr?tese e o pilar (25,4%) teve uma alta preval?ncia e, quando relacionada com outros par?metros, demonstrou uma associa??o significativa, principalmente com a fixa??o do tipo cimentada (OR= 5,39). Pode-se concluir que para minimizar o aparecimento de falhas, protocolos devem ser observados desde o diagn?stico at? o assentamento e controle das pr?teses sobre implantes, principalmente com rela??o aos passos t?cnicos da confec??o da pr?tese e com o cuidado em avaliar radiograficamente a adapta??o entre seus componentes

Made available in DSpace on 2014-12-17T15:43:52Z (GMT). No. of bitstreams: 1 DaniloGBF_DISSERT.pdf: 1485726 bytes, checksum: 4640fbe2db551567fc003e0585ff8950 (MD5) Previous issue date: 2013-03-22 / The aim of this study was to compare the misfit vertical, horizontal and passivity of zirconia and cobalt-chromium frameworks fabricated for CAD / CAM technology and conventional method of casting. Sixteen frameworks in one-piece, were obtained from a metallic matrix containing three Br?nemark compatible implants with regular platform (Titamax Cortical Ti, Neodent). Eight frameworks were fabricated by CAD / CAM system (NeoShape, Neodent): four in zirconia (ZirCAD) and four cobalt-chromium (CoCrcad). Eight other frameworks were obtained by conventional casting method: four cobalt-chromium with UCLA abutment premachined Co-Cr (CoCrUCci) and four cobalt-chromium with UCLA abutment castable (CoCrUCc). The fit vertical, horizontal and passivity by one-screw test were measured using scanning electron microscopy with magnification of 250x. Initially evaluated the passivity by one-screw test and subsequently to assess the vertical and horizontal misfit, tightened all the screws with a torque of 20 Ncm. Mean, standard deviation, minimum and maximum values were calculated for each group. Measurements of horizontal misfit were transformed into cumulative frequency for categorization of the variable and the group later comparison groups. To evaluate the existence of quantitative differences between the groups tested for vertical misfit and passivity, we used the Kruskal-Wallis test. The Mann-Whitney test was used to compare group to group statistical differences (p <0.05). Were observed the respective mean and standard deviation for vertical misfit and passivity in micrometers: ZirCAD (5.9 ? 3.6, 107.2 ? 36), CoCrcad (1.2 ? 2.2, 107.5 ? 26 ), CoCrUCci (11.8 ? 9.8, 124.7 ? 74), CoCrUCc (12.9 ? 11.0, 108.8 ? 85). There were statistical differences in measures of vertical misfit (p = 0.000). The Mann-Whitney test revealed statistical differences (p <0.05) between all groups except between CoCrUCci and CoCrUCc (p = 0.619). No statistical difference was observed for the passivity. In relation to the horizontal misfit groups ZirCAD and CoCrcad did not show best values in relation to CoCrUCci and CoCrUCc. Based on the results it can be concluded that frameworks fabricated by CAD / CAM technology had better values of vertical fit than those manufactured by the casting method, nevertheless, the passivity was not influenced by manufacturing technique and material used. The horizontal fit obtained by frameworks manufactured by CAD / CAM was not superior to those manufactured by casting. A lower variability in vertical adjustment and passivity was observed when frameworks were fabricated by CAD / CAM technology / O objetivo deste estudo foi comparar o desajuste vertical, horizontal e a passividade de infraestruturas fabricadas em zirc?nia e cobalto-cromo por tecnologia CAD/CAM e pelo m?todo da fundi??o convencional. Dezesseis infraestruturas em monobloco, foram obtidas a partir de uma matriz met?lica contendo tr?s implantes Br?nemark compat?veis de plataforma regular (Titamax Cortical Ti, Neodent). Oito infraestruturas foram confeccionadas pelo sistema CAD/CAM (NeoShape, Neodent): quatro em zirc?nia (Zircad) e quatro em cobalto-cromo (CoCrcad). Outras oito infraestruturas foram obtidas pelo m?todo da fundi??o convencional: quatro em cobalto-cromo com pilar UCLA cinta Co-Cr (CoCrUCci) e quatro em cobalto-cromo com pilar UCLA calcin?vel (CoCrUCc). O ajuste vertical, horizontal e a passividade pelo teste do parafuso ?nico foram mensurados usando microscopia eletr?nica de varredura com aumento de 250x. Inicialmente avaliou-se a passividade pelo teste do parafuso ?nico e posteriormente para avaliar o desajuste vertical e horizontal, apertou-se todos os parafusos, com torque de 20Ncm. M?dia, desvio padr?o, valor m?nimo e m?ximo foram calculados para cada grupo. As medidas de desajuste horizontal foram transformadas em frequ?ncia cumulativa para categoriza??o da vari?vel e posterior compara??o grupos a grupo. Para avaliar a exist?ncia de diferen?as quantitativas entre os grupos testados para desajuste vertical e passividade, foi usado o teste Kruskal-Wallis. O teste Mann-Whitney foi usado para comparar as diferen?as estat?sticas grupo a grupo (p<0,05). Foram observados os respectivos valores de m?dia e desvio padr?o em micr?metros para desajuste vertical e passividade: Zircad (5,9 ? 3,6; 107,2? 36), CoCrcad (1,2 ? 2,2; 107,5? 26), CoCrUCci (11,8 ? 9,8; 124,7? 74), CoCrUCc (12,9 ? 11,0; 108,8? 85). Observaram-se diferen?as estat?sticas para medidas de desajuste vertical (p=0,000). O teste Mann-Whitney revelou diferen?as estat?sticas (p<0,05) entre todos os grupos, exceto entre CoCrUCci e CoCrUCc (p=0,619). Nenhuma diferen?a estat?stica foi observada para a passividade das infraestruturas. Em rela??o ao desajuste horizontal, os grupos ZirCAD e CoCrcad n?o apresentaram melhores valores em rela??o a CoCrUCci e CoCrUCc. Baseado nos resultados pode-se concluir que infraestruturas confeccionadas por tecnologia CAD/CAM obtiveram melhores valores de ajuste vertical que aquelas fabricadas pelo m?todo da fundi??o, apesar disso, a passividade das infraestruturas n?o foi influenciada pela t?cnica de fabrica??o e material utilizado. O ajuste horizontal obtido pelas infraestruturas fabricadas por CAD/CAM n?o foi superior ?quelas fabricadas por fundi??o. Uma menor variabilidade no ajuste vertical e na passividade foi observada quando infraestruturas foram fabricadas por tecnologia CAD/CAM