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Orientadores: Wander José da Silva, Altair Antoninha Del Bel Cury / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T01:05:41Z (GMT). No. of bitstreams: 1 Bergamo_EdmaraTatielyPedroso_M.pdf: 7968983 bytes, checksum: ebd79c42e62e1085b97f070b982adcce (MD5) Previous issue date: 2015 / Resumo: Os sistemas cerâmicos representam na odontologia uma alternativa aos metais na reabilitação protética, sendo que a zircônia é o material com melhores propriedades mecânicas. Coroas confeccionadas em zircônia sem aplicação de cerâmica de cobertura, chamadas monolíticas, têm se mostrado uma alternativa favorável para reabilitação oral, pois associam alta resistência à fratura e estética satisfatória, assim como evitam a complicação mais evidente em infraestruturas de zircônia que é a fratura da cerâmica de cobertura. A zircônia pura pode assumir 3 formas cristalográficas: monoclínica, tetragonal e cúbica, dependendo da temperatura. A união da zircônia com óxidos estabilizadores, como o óxido de ítrio (Y-TZP) faz com que a zircônia se mantenha na fase tetragonal. No entanto, a zircônia permanece metaestável e mediante relativamente baixas temperaturas, umidade e estresse uma progressiva transformação de fase de tetragonal para monoclínica pode ocorrer e afetar a resistência da mesma. Assim sendo, o presente estudo avaliou a carga à fratura e a transformação de fases da zircônia em coroas monolíticas submetidas ao envelhecimento através de testes térmicos e mecânicos. Setenta coroas monolíticas de zircônia (Y-TZP) foram cimentadas em réplicas de resina composta e separadas aleatoriamente em 5 grupos (n=14): Controle (C), sem tratamento; Envelhecimento hidrotérmico (EH), 122°C, 2 bar de pressão por 1 hora; Fadiga térmica (FT), 104 ciclos, de 5 a 55°C por 30 segundos; Fadiga Mecânica (FM), 106 ciclos, 70 N de carga, deslizamento de 1,5 mm da cúspide mesiopalatina com frequência de 1,4 Hz; e Fadiga Mecânica associada com tratamento térmico (FMT). Ao final de cada tratamento, a carga à fratura foi determinada em máquina de testes universal com célula de carga de 10KN e velocidade de 1mm/min (n=12/grupo). Avaliação de alterações de superfície e o modo e a origem da fratura foram realizadas no microscópio eletrônico de varredura. A transformação de fases foi analisada através da difração de raios X (n=2/grupo). Os dados de resistência à compressão foram analisados por Análise de variância a um fator e o nível de significância foi de 5%. Também foi realizada a distribuição de Weibull. Todas as restaurações sobreviveram aos testes de envelhecimento e não foram observadas diferenças significantes entre os tratamentos para a carga à fratura (p>0,05). O módulo de Weibull variou de 6,2 a 16,6, com diferença significativa para o grupo envelhecido pelo tratamento hidrotérmico. Falhas catastróficas com origem na superfície foram evidenciadas. Na análise da difração de raios X foi observado que houve transformação de fases, para todos os grupos, nas diferentes faces da coroa, variando entre 1,9 a 8,9%. Com base nos dados concluí-se que coroas monolíticas de zircônia evidenciam uma alta carga à fratura, confiabilidade estrutural e apresentaram baixa transformação de fase / Abstract: Nowadays, in dentistry, zirconia ceramic systems represent an alternative to metals in prosthetic treatment due to the excellent mechanical properties. Zirconia crowns made without porcelain veneering, called monolithic, have proven to be a favorable alternative to oral rehabilitation, as they associate high strength and satisfactory aesthetic, while avoiding the most known complications in zirconia prosthesis, chipping and delamination. Pure zirconia can assume three crystallographic forms: monoclinic, tetragonal and cubic depending on the temperature. The zirconia association with stabilizing oxides, such as yttrium oxide (Y-TZP), maintains the zirconia in the tetragonal phase at room temperature. Therefore, zirconia remains metastable and at low temperatures, with moisture and stress a progressive transformation of tetragonal to monoclinic phase can occur and affect its strength. The present study evaluated the fracture load and phase transformation of zirconia monolithic crowns submitted to thermal and mechanical aging tests. Seventy monolithic zirconia crowns (Y-TZP) were cemented in resin-based replica and randomly divided into 5 groups (n = 14): Control (C), no treatment; Hydrothermal aging (HA), 122°C, 2 bar for 1 hour; Thermal Fatigue (TF), 104 cycles between 5 and 55°C for 30 seconds; Mechanical Fatigue (FM) 106 cycles, with a load of 70 N sliding of 1.5 mm in mesiopalatal cusp at 1.4 Hz; Mechanical and Thermal Fatigue associated (MTF). After each treatment, the fracture load was determined in a universal testing machine with 10KN load and speed of 1mm/min (n=12/group). Surface modifications and fracture origin and mode were evaluated by scanning electron microscope. The phase transformation was analyzed by x-ray diffraction (n=2/group). The fracture load data were analyzed by one-way ANOVA at a level of 5%. Also, the Weibull distribution was performed. All restorations survived the aging tests and no significant differences were observed in between treatments (p> 0.05). There was no statistically significant difference in the mean fracture load and characteristic fracture load among the groups (p>.05). The Weibull modulus ranged from 6.2 to 16.6, with significant difference between control and hydrothermal aging groups. Catastrophic failures were observed. Phase transformation was shown at the different surfaces of the crown in all groups (1.8-8.9%). In conclusion, monolithic zirconia crowns showed high fracture load, structural reliability and low phase transformation / Mestrado / Protese Dental / Mestra em Clínica Odontológica

Hipótese do trabalho: Avaliar a presença de um orifício de acesso ao parafuso do intermediário do implante em infra-estruturas cimentadas sobre o pilar de titânio. Objetivo: O presente estudo visou comparar resistência a compressão de infra-estruturas em zircônia estabilizada por ítrio e em dissilicato de lítio cimentadas sobre pilar em titânio, com e sem acesso ao parafuso. Método: Foram confeccionados quarenta corpos-de-prova compostos por análogos de implantes hexágono externo de plataforma 4,1mm, intermediários de titânio pré-fabricado para próteses cimentadas e infra-estruturas para coroas totais. Os corpos-de-prova foram divididos em quatro grupos experimentais, sendo vinte, em cerâmica de zircônia estabilizada por ítrio(G1 e G2) e vinte em cerâmica de dissilicato de lítio(G3 e G4), todas confeccionadas com a mesma anatomia, ambas para próteses cimentadas sobre implante. Das vinte infra-estruturas de cada tipo de cerâmica, dez foram infra-estruturas convencionais para coroas cimentadas, constituindo o grupo controle e dez apresentavam um orifício de acesso ao parafuso, transpassando a cerâmica, constituindo o grupo experimental. As cimentações foram efetuadas com agente de fixação RelyX U200, de acordo com as especificações do fabricante, e o grupo experimental (com acesso ao parafuso) teve o orifício de acesso ao canal restaurado com resina composta foto ativada Z350 Filtek Supreme XT. Os corpos-de-prova foram submetidos a teste de compressão com velocidade de 0,5mm/minuto em máquina de ensaio universal. Resultados: Não foram encontradas diferenças estatísticas significativas entre infra-estruturas de cerâmicas convencionais e as infra-estruturas confeccionadas com orifício de acesso oclusal(G2 1.675 N/cm., G3 1.931 N/cm e G4 1.447 N/cm), exceto as infra-estruturas convencionais de zircônia estabilizada por ítrio que se apresentou superior aos demais(G1 3.372 N/cm). Com base nos resultados todas as modalidades de infra-estruturas testadas são viáveis para o uso clínico. / Hypothesis of work: To evaluate the presence of an access hole to screw the intermediate cemented implant in infrastructure over the titanium abutment. Objective: This study aimed to compare the compressive strength of infrastructure in yttrium stabilized zirconia and lithium disilicate cemented to abutment in titanium, with and without access to the screw. Method: Forty bodies-specimens consisting of similar external hex implants platform 4.1mm, intermediate titanium prefabricated for cemented prostheses and infrastructures for crowns were fabricated. The bodies-specimens were divided into four experimental groups, twenty, ceramic yttrium stabilized zirconia (G1 and G2) and twenty in ceramic lithium disilicate (G3 and G4), all made with the same anatomy, both for cemented prostheses on implants. Infrastructure of twenty of each type of tile ten were conventional infrastructure for cemented crowns, constituting the control group and ten had an access hole to the screw, trespassing ceramics, constituting the experimental group. The cementation were performed with RelyX U200 fixing agent, according to the manufacturers specifications, and the experimental group (with access to the screw) had the access hole channel restored with composite resin Z350 photo activated Filtek Supreme XT. The bodies-specimens were subjected to compression test speed of 0.5 mm / min in a universal testing machine. Results: No statistically significant differences between conventional ceramic infrastructure and infrastructure made with port access were found occlusal (G2 1675 N / cm, G3 1931 N / cm and G4 1447 N / cm.) Except conventional infrastructure stabilized zirconia yttrium who introduced himself superior to the others (G1 3300 N / cm). Based on the results of all modalities tested infrastructure are feasible for clinical use.

Objetivo: Comparar in vitro la adaptación marginal de coronas unitarias de porcelana vitrocerámica elaboradas con tres sistemas de procesado. Materiales y métodos: El presente estudio fue de tipo experimental in vitro. La muestra estuvo conformada por 69 coronas de porcelana vitrocerámica fabricadas con los sistemas: CAD-CAM, inyección de porcelana y condensación sobre muñón refractario. Para la evaluación de la discrepancia marginal vertical se realizó un registro fotográfico con una cámara digital y un lente macroscópico de 100 milímetros. Las imágenes fueron medidas digitalmente (ImageJ) y se utilizaron 52 puntos aleatorios de discrepancia marginal vertical alrededor de las coronas para obtener el promedio de cada una de ellas. Se utilizó la prueba de Kruskal-Wallis para realizar la comparación entre los grupos de estudio con un nivel de significancia estadística de p<0.05. Resultados: El presente estudio encontró diferencias estadísticamente significativas al comparar los tres sistemas de procesado (<0.001). El sistema CAD-CAM tuvo una discrepancia marginal vertical menor (53 µm) en comparación con el sistema de inyección de porcelana (85 µm) y el de condensación sobre muñón refractario (113 µm). Conclusiones: Se encontraron diferencias estadísticamente significativas entre los tres grupos de estudio. Asimismo, el sistema CAD-CAM tuvo una mayor adaptación marginal en comparación con los otros dos métodos de fabricación. Finalmente, los tres sistemas de confección utilizados tuvieron una discrepancia marginal vertical por debajo del límite establecido por la Asociación Americana de Odontología (<120 µm). / Objective: To compare in vitro the marginal adaptation of ceramic glass porcelain single crowns made with three processing systems. Materials and methods: The present study was experimental in vitro. The sample consisted of 69 glass ceramic porcelain crowns manufactured with the following three systems: CAD-CAM, porcelain injection and powder condensation. For de measurement of the vertical marginal discrepancy, the crowns were photographed using a digital camera with a macroscopic lens of 100 millimeters. The images were imported into image processing software (ImageJ) and 52 points were randomly selected around the crown to measure the vertical marginal discrepancy. For each crown, the 52 measurements were combined into a single average marginal discrepancy. Kruskal-Wallis was used to test differences in the observed marginal discrepancies between the study groups. (p <0.05) Results: This study found statistically significant differences when comparing the three different processing systems (<0.001). The CAD-CAM system had a smaller vertical marginal discrepancy (53 µm) compared to the porcelain injection (85 µm) and the powder condensation techniques (113 µm). Conclusions: Statistically significant differences were found between the three study groups. Also, the CAD-CAM system had a greater marginal adaptation compared to the other two manufacturing techniques. Finally, the three fabrication methods used in this study had a vertical marginal discrepancy within the limit established by the American Dental Association (<120 µm). / Tesis

Indiana University-Purdue University Indianapolis (IUPUI) / The objectives: 1. To compare the flexural strength, flexural modulus, and fracture toughness of specimens fabricated from recently marketed translucent full-contour zirconia, traditional zirconia, and lithium disilicate glass ceramic. 2. To compare the load-to-failure of crowns fabricated from recently marketed translucent full-contour zirconia, traditional zirconia, and lithium disilicate glass ceramic at their recommended tooth-reduction thickness. Methodology: Four groups of translucent zirconia (BruxZir, KDZ Bruxer, CAP FZ, Suntech zirconia), one group of traditional zirconia (CAP QZ) and IPS e.maxCAD) were tested. Twelve bars of each material were made and tested for flexural strength, and fracture toughness. Fracture patterns were imaged under SEM. Forty-eight crowns (8 from each group) were fabricated with CAD/CAM technique following manufacturers’ recommendations for the amount of tooth reduction. All the crowns were cemented to prepared epoxy resin dies with RelyX Unicem and tested for static load to failure in a universal machine. Result: In bar-shape samples, CAP QZ (traditional zirconia) showed the highest flexural strength (788.12 MPa), fracture toughness (6.85 MPa.m1/2), and fracture resistance (2489.8 N). All translucent zirconia groups show lower mechanical properties than QZ. However, there were no differences between translucent and traditional zirconia in the fracture resistance of the crown-shape samples. There was no significant difference in fracture resistance between IPS e.max crowns at recommended thickness and other zirconia crowns at recommended thickness. Conclusion: With less reduction of tooth structure, a high inherent strength and chip resistance make full-zirconia crowns a good alternative to porcelain-fused-to-metal crowns and all other ceramic crowns.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: New glass ceramics and Computer-Aided Design/Computer Assisted Manufacture (CAD/CAM) have become common aspects of modern dentistry. The use of posterior ceramic crowns with a high level of esthetics, fabricated using the CAD/CAM technology is a current treatment modality. Several materials have been used to fabricate these crowns, including lithium disilicate glass-ceramics, which have not been fully investigated in the literature. Objective: to investigate the load to fracture of lithium disilicate glass ceramic posterior crowns fabricated by CAD/CAM technology with different material thicknesses adhesively cemented on epoxy resin. Methods: Four groups of different ceramic thicknesses (0.5 mm, 1 mm, 1.5 mm, and 2 mm) were fabricated by milling CAD/CAM lithium disilicate IPS emax CAD blocks. A total of 68 posterior crowns were surface treated and luted with a resin adhesive cement on an epoxy resin model. Samples were fatigued then loaded to fracture using a universal testing machine to test the fracture strength. Statistical comparisons between various crown thicknesses were performed using one-way ANOVA followed by Fisher's Protected Least Significant Differences. Results: There was a significant difference in the load-to-fracture (N) value for all comparisons of the four thickness groups (p < 0.0001), except 2 mm vs. 1.5 mm (p = 0.325). The mean load-to-fracture (N) was significantly higher for 2 mm than for 1 mm or 0.5 mm. Additionally, the mean load-to-fracture was significantly higher for 1.5 mm than for 1 mm or 0.5 mm. Furthermore, the mean load-to-fracture was significantly higher for 1 mm than for 0.5 mm. Conclusion: Within the limitation of this study, it is advisable for clinical applications to consider a crown thickness of 1.5 mm or greater of milled lithium disilicate for posterior single teeth.

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Aim: To investigate the clinical survival and success, including both function and aesthetics, of tooth supported crowns in the anterior region after a minimum of 5 years after installation in the student as well as teacher clinic of the Faculty of Odontology, Malm. University, Sweden. Materials &amp; method: Eligible patients were identified through screening of dental technician invoices stretching back to 2012. 78 patients were invited to participate in the study and 39 patients were examined, 28 and 11 from student and teacher clinics respectively. A modified examination protocol based on the CDA protocol was used by two examiners to score the crowns. Moreover, patients’ own views on aesthetics and function of their crowns were collected through a questionnaire. Results: Patient satisfaction with function and aesthetics was equally high in teacher and student clinic as well as for the different crown materials. Examiner ratings found overall successful results across the investigated categories “surface and colour”, “anatomic form” and “margin integrity”. No significant differences were found with regards to the operator or the different materials. The 5-year survival rate among the examined patients was 89% resp. 91% in the student and teacher clinic. Conclusion: Patients at the Faculty of Odontology in Malm. can expect to receive satisfying crown treatments in the anterior region of the mouth regardless of whether the operator is a teacher or a student and regardless of the chosen material. / Syfte: Att undersöka klinisk överlevnad och lyckandefrekvens, med hänsyn till funktion och estetik, av tandstödda kronor i framtandsregionen som installerades för minst 5 år sedan på student och lärarklinik vid Odontologiska fakulteten, Malmö Universitet, Sverige. Material och metod: 78 lämpliga patienter identifierades genom granskning av  tandtekniska fakturor från 2012 och framåt, och bjöds in att delta i studien. 39 patienter undersöktes, 28 respektive 11 från student- och lärarklinik. Två granskare använde ett modifierat granskningsprotokoll baserat på CDA protokollet för att betygsätta kronornas utseende och funktion. Utöver detta användes ett frågeformulär för att få patientens syn på estetik och funktion av kronan. Resultat: Patienternas omdömen av kronans funktion och estetik var lika hög i lärar- och studentkliniken liksom för de olika kronmaterialen. Granskarnas bedömning visade hög lyckandefrekvens för de undersökta kategorierna ”yta och färg”, ”anatomisk form” och ”kantanslutning”. Inga signifikanta skillnader kunde ses med avseende på vem som var operatör eller vilket material som valts. 5-års överlevnaden bland de undersökta patienterna var 89% resp. 91% p. student- och lärarkliniken. Slutsats: Patienter som behandlas vid Odontologiska fakulteten i Malmö kan förvänta sig ett tillfredsställande resultat vid kronterapi i framtandsregionen oavsett om operatören är en lärare eller en student och oavsett vilket material som väljs.

This dissertation comprises several studies addressing supervised learning problems where the supervision is imperfect. Firstly, we investigate the margin conditions in active learning. Active learning is characterized by its special mechanism where the learner can sample freely over the feature space and exploit mostly the limited labeling budget by querying the most informative labels. Our primary focus is to discern critical conditions under which certain active learning algorithms can outperform the optimal passive learning minimax rate. Within a non-parametric multi-class classification framework,our results reveal that the uniqueness of Bayes labels across the feature space serves as the pivotal determinant for the superiority of active learning over passive learning. Secondly, we study the estimation of central mean subspace (CMS), and its application in transfer learning. We show that a fast parametric convergence rate is achievable via estimating the expected smoothed gradient outer product, for a general class of covariate distribution that admits Gaussian or heavier distributions. When the link function is a polynomial with a degree of at most r and the covariates follow the standard Gaussian, we show that the prefactor depends on the ambient dimension d as d^r. Furthermore, we show that under a transfer learning setting, an oracle rate of prediction error as if the CMS is known is achievable, when the source training data is abundant. Finally, we present an innovative application involving the utilization of weak (noisy) labels for addressing an Individual Tree Crown (ITC) segmentation challenge. Here, the objective is to delineate individual tree crowns within a 3D LiDAR scan of tropical forests, with only 2D noisy manual delineations of crowns on RGB images available as a source of weak supervision. We propose a refinement algorithm designed to enhance the performance of existing unsupervised learning methodologies for the ITC segmentation problem.

Implantes osseointegrados vêm sendo utilizados com sucesso para restaurar a função e a estética de pacientes desdentados totais e parciais, no entanto, apesar do alto índice de sucesso, a literatura apresenta uma série de complicações da técnica. Apesar da falta de consenso sobre qual a melhor maneira de se restaurar implantes múltiplos adjacentes, a confecção de próteses unitárias vem sendo sugerida e praticada por muitos profissionais. O objetivo deste trabalho foi verificar, pela técnica fotoelástica (qualitativa e quantitativa), o comportamento biomecânico de coroas unitárias sobre implantes hexágono interno com pilar UCLA. Foram confeccionadas coroas cimentadas e parafusadas, simulando a reabilitação da área posterior da mandíbula com e sem a presença de elemento dental distal aos implantes. Foram analisados, também, a liga metálica da infraestrutura (Ni-Cr-Ti ou Ni-Cr) e o tipo de material para revestimento estético (cerâmica ou resina). Foram confeccionados modelos fotoelásticos simulando espaço protético com ausência de segundo pré-molar e primeiro molar, reabilitado com coroas sobre implantes. Três modelos de pontas de aplicação de carga foram utilizados para produzir quatro diferentes condições de carregamento na superfície oclusal das coroas: 1 -puntiforme obtido com uma ponta simples para carregamento no pré-molar ou no molar com 5kgf; 2 puntiforme simultânea obtido por uma ponta dupla para carregamento das duas coroas ao mesmo tempo com 10kgf; 3 - oclusal distribuído obtido com uma ponta que simulou a oclusão antagonista com 10kgf. Após a aplicação das cargas, foram obtidos registros fotográficos para análise qualitativa e posteriormente foi realizada a análise quantitativa em três pontos na região cervical e um ponto na região apical de cada implante. De acordo com os resultados obtidos pode-se concluir que o uso de ligas de Ni-Cr-Ti ou Ni-Cr não interferiu na transmissão de tensões. Coroas revestidas em resina, de modo geral, geraram maior concentração de tensões em torno dos implantes quando comparadas às coroas revestidas em cerâmica. As coroas parafusadas provocaram maior tensão em torno dos implantes quando comparadas às coroas cimentadas. A presença do dente com ponto de contato efetivo à distal das coroas sobre implantes favoreceu a distribuição de tensões. / Osseointegrated implants have been successfully used to restore function and esthetic to fully and partially edentulous patients; however, regardless of the high success, the literature reveals some complications of the technique. Despite the lack of consensus about what is the better way to restore multiple adjacent implants, the use of single crowns have been suggested and practiced by many professionals. The purpose of the present study was to verify, using photoelastic analysis (qualitative and quantitative), the biomechanical behavior of single crowns on internal hexagon implants with UCLA abutment. Cement and screw-retained crowns was fabricated simulating the rehabilitation of posterior mandible area with or without the presence of a dental element distal to the implants. The metal framework alloys (Ni-Cr-Ti or Ni- Cr) and the esthetic veneering materials (ceramic or resin) was, also, analyzed. Photoelastic models were made simulating the missing of the second pre-molar and the first molar, rehabilitated with implant-supported crowns. Three models of loading application tips were used to produce different conditions of loading on crowns occlusal surface: 1 punctiform obtained with a simple tip for loading over premolar or molar with 5 Kgf; 2 simultaneous punctiform obtained with a Double tip for loading over both crowns in the same time with 10 Kgf; 3 distributed occlusal obtained with a tip simulating the antagonist occlusion with 10 Kgf. After loading application photographic records were obtained for qualitative analysis, and in sequence, quantitative analysis was realized in three cervical points and one point in the apical area of each implant. According to the obtained results, it was concluded that the use of Ni-Cr-Ti or Ni-Cr alloys did not interfere in stress transmission. Resin veneered crowns, generally generated higher concentration of stress around the implants when compared to ceramic veneered crowns. Screw-retained crowns promoted higher stress around the implants when compared to cement-retained crowns. The presence of teeth with effective interproximal contact distal to implantsupported crowns improved the stress distribution.