Made available in DSpace on 2014-08-20T14:30:09Z (GMT). No. of bitstreams: 1 Dissertacao_hugo_ramalho.pdf: 1163967 bytes, checksum: 5735b7a46397cc9fceb1883f7a66141c (MD5) Previous issue date: 2013-03-18 / This study was composed by two phases that evaluated two gingival displacement (GD) techniques, conventional and cordless: 1- a in vitro study which assess cytoxicity/genotoxicity, and pH of AlCl3-based agents; and 2- a randomized clinical which evaluated the efficacy of these techniques. For in vitro phase, eluates were obtained by dilution of AlCl3-based into culture medium for 1h, 4h, and 24h. pH values were measured by digital pHmeter, cytotoxicity by MTT test and genotoxicity by Micronuclei test. A crossover, double-blind, randomized clinical trial was designed to evaluate clinical, immunologic and individual factors before and after GD by two techniques, conventional (gingival cord + astringent gel) and cordless (astringent-based paste). These factors were evaluated on incisors prepared for metal-ceramic dental crowns before, 1 day post-GD and 10 day post-GD. Interleukin 1&#946;, Interleukin 6 and Tumor Necrosis Factor &#945; concentrations were evaluated on gingival crevicular fluid collected before (control) and 1 day post-GD. In vitro data were analyzed by two-way ANOVA and Tukey test. Clinical data were analyzed by One-way Repeated Measures ANOVA and Tukey test (immunologic factor), Friedman test (periodontal parameters), and Fisher Exact or Qui-square test (pain, stress, and unpleasant flavor during GD). All test were realized considering p<0.05. Mean pH values were statistically higher for Viscostat than Expasyl. Both astringents were non-cytotoxic at 1h. Expasyl was more cytotoxic than Viscostat at 4h and 24h. Expasyl genotoxicity was not different from control group. Neither of the two evaluated techniques resulted in worse periodontal indices. Conventional technique was statistically more stressing than cordless, and similar considering pain and unpleasant taste. GD by the both 11 treatments evaluated led to statistically higher mean concentrations of the three interleukins evaluated. Conventional GD technique resulted in the highest interleukins levels. In vitro, AlCl3-based astringents presented acceptable biological activity with no genotoxic difference between Expasyl and control group. In vivo, cordless technique was less stressful and resulted in lower cytokines levels after GD / Este estudo foi composto por duas fases que avaliaram duas técnicas para afastamento gingival (AG), convencional e sem fio: 1- um estudo in vitro que avaliou acitotoxicidade/genotoxicidade, e o pH de agentes à base de AlCl3; e 2- um ensaio clínico randomizado que avaliou a eficácia destas técnicas. Na fase in vitro, eludatos foram obtidos pela diluição dos eluates agentes à base de AlCl3 em meio de cultura por 1h, 4h e 24h. Os valores de pH foram aferidos por pHmetro digital, citotoxicidade pelo teste MTT e genotoxicidade pelo teste do Micronúcleo. Um ensaio clínico randomizado, cruzado, duplo-cego foi concebido para avaliar fatores clínicos, imunológicos e individuais antes e após AG por duas técnicas, convencional (C: fio gengival + gel adstringente) e sem fio (SF: pasta à base de adstringente). Estes fatores foram avaliados em incisivos preparados para coroas metalo-cerâmicas antes, 1 dia e 10 dias após AG. As concentrações de Interleucina 1&#946;, Interleucina 6 e Fator de Necrose Tumoral &#945; foram avaliadas no fluido gengival crevicular coletado antes (controle) e 1 dia após AG. Os dados do estudo in vitro foram analisados por ANOVA 2-fatores e teste de Tukey. Os dados do ensaio clínico foram analiados por ANOVA para medidas repetidas e teste de Tukey (fator imunológico), teste de Friedman (parâmetros periodontais), e Exato de Fisher ou teste Qui-quadrado (dor, estresse e sabor desagradável). Todos os testes consideraram p<0.05. Os valores médios de pH foram estatísticamente superiores para C que para SF. As técnicas não foram citotóxicas no tempo de 1h. SF foi mais citotóxica que C em 4h e 24h. A genotoxicidade SF foi semelhante à do grupo controle. Nenhuma das técnicas avaliadas resultou em piora nos indices periodontais. Atétnica C foi mais estressante 9 que a SF, e semelhantes considerando dor e sabor desagradável. AG realizado por ambas as técnicas levou a maiores concentrações médias das três citocinas avaliadas. C resultou nos maiores níveis de interleucinas. In vitro, os adstringentes apresentaram atividade biológica aceitável, sem diferença na genotoxicidade entre as técnicas. In vivo, SF foi menos estressante e resultou em menores níveis de citocinas após AG

In the modern era of metal-free minimally-invasive dentistry, there is a growing tendency toward using metal-free restorative alternatives that provide not only excellent aesthetics but also enable superior durability. Fibre-reinforced composite (FRC) is one cost-effective alternative that fulfils the requirements of aesthetics and durability, and offers favourable physico-mechanical properties. Many FRC applications are well-documented in the literature, such as crowns and fixed partial dentures (FPD); however, their clinical implementation is still limited, owing to the lack of significant knowledge about their longevity, deterioration signs, optimum design and overall performance. This in-vitro research aimed to address these uncertainties by investigating the performance of FRC restorations, and the influence of fibre reinforcement on particular physcio-mechanical properties, including surface hardness, edge-strength, shear bond strength, fatigue and wear resistance. Basic testing models were used to investigate the effect of incorporating differently-oriented FRCs on the surface hardness, edge-strength and shear bond strength of particulate-reinforced composite (PRC). The results revealed that the incorporation of FRC significantly enhanced surface hardness (by 12 - 19 %) and edge-strength (by 27 -75 %). However, this incorporation significantly reduced the shear bond strength (SBS) between PRC and other restorative materials, including lithium disilicate ceramic (10.9±3.1 MPa) and Co-Cr metal alloy (12.8±2.3 MPa), compared to the control (15.2±3.6 MPa, 15.0±3.7 MPa). The orientation of FRC was also found to affect the efficiency of reinforcement as bidirectional FRCs exhibited significantly higher hardness (76.8±1.2 VHN), edge-strength (67.7±8.2 N) and SBS (14.1±3.9 MPa) values than unidirectional FRCs (72.4±1.2 VHN, 56.8±5.9 N, 9.8±2.3 MPa).Clinically-relevant testing models, employing accelerated aging techniques, were performed to investigate the fatigue and wear behaviours of anatomically-shaped FRC restorations in-vitro. Direct inlay-retained FRC-FPDs with two framework designs, were tested for their fatigue behaviour and load-bearing capacity. Type-I design (with an additional bidirectional FRC layer incorporated perpendicular to the loading direction) yielded significantly higher fatigue resistance (1144.0±270.9 N) and load-bearing capacity (1598.6±361.8) than Type-II design (with a woven FRC embedded around the pontic core) (716.6±72.1 N, 1125.8±278.2 N, respectively). However, Type-19II design exhibited fewer delamination failures. Both framework design and dynamic fatigue were found to have a significant influence (p < 0.05) on the load-bearing capacity of FRC-FPDs. Additionally, the in-vitro fatigue and wear behaviours of FRC crowns, fabricated conventionally from bidirectional FRC and indirect PRC (Sinfony), were compared with those made of two CAD/CAM alternatives, namely Lava Zirconia (LZ) and Lava Ultimate (LU). A chewing simulator was employed to induce some fatigue wear in crowns, while an intraoral 3D scanner was used to quantify the resultant morphological changes. The results showed that FRC crowns had significantly lower mean cumulative wear (233.9±100.4 μm) than LU crowns (348.2±52.0 μm), but higher than LZ crowns (16.4±1.5 μm). The mean load bearing-capacity after fatigue simulation was also the highest for LZ crowns (1997.8±260.2 N) compared with FRC (1386.5±258.4 N) and LU crowns (756.5±290.9 N).Accordingly, the incorporation of FRC in resin-composite restorations is advocated since it increases surface hardness and marginal integrity, improves fatigue and wear behaviours, and enhances load-bearing capacity and overall performance.

Syfte: Syftet med denna studie är att jämföra fraktur styrkan och frakturmönster hos tre-leds broar utförda i litiumdisilikat när broarna tillverkas genom pressteknik jämfört med frästa tre-leds broar genom CAD/CAM system.Hypotes: Pressteknik är bättre lämpad med avseende till fraktur resistens då fräsning av litiumdisilikat block kan resultera i defekter och spänning i materialet, detta gör materialet mer benäget till chipping/mikroabrasioner på ytan som skulle kunna propagera och på så sätt påverka fraktur resistensen. P-värde sattes till p ≤0.05.Material och metod: 40 3-leds broar tillverkades med pressteknik jämfört med fräst teknik med CAD/CAM system i grupper. Dessa delades in i undergrupper baserat på anatomin. Broarna genomgick en artificiell åldringsprocess som utgjordes av termocykling och förbelastning. Efter den artificiella åldringsprocessen utsattes broarna för belastning fram till fraktur. Den statistiska datan samlades in och analyserades. Även fraktur mönstret analyserades. Resultat: Där fanns ingen signifikant skillnad gällande fraktur styrkan mellan de full anatomiska grupperna. Där fanns inte heller någon signifikant skillnad gällande fraktur styrkan mellan underkonstruktion grupperna. Hypotesen falsifieras därför.Slutsats: Där fanns ingen signifikant skillnad gällande hur mycket belastning det krävs för att frakturera broarna som tillverkats genom pressteknik jämfört med broarna tillverkade med hjälp av CAD/CAM teknik. Där finns ett tydligt mönster gällande fraktur mönstret men en slutsats kan inte dras med tanke på antalet broar som använts. / Aim: The aim of this study was to compare fracture load and fracture mode of three-unit fixed partial dentures, made in lithium disilicate when the FDPs are made with pressing technique versus milled with a CAD/CAM system.Hypothesis: Pressing technique is better suited with regards to fracture load since milling of lithium disilicate blocks can result in defects and tension build up in the material, leaving the material more prone to chipping/micro-abrasions on the surface that could propagate and thus affecting the fracture load. P-value set to p ≤0.05.Material and methods: 40 FDPs where manufactured with pressing technique versus milled with a CAD/CAM system in each group. Furthermore, each group where subdivided depending on the anatomy. The FDPs thereafter underwent an artificial ageing process consisting of thermocycling and preloading. After the artificial aging process the FDPs were subjected to load to fracture, where the statistical data was collected and analyzed. Also, the fracture mode was observed and analyzed.Results: There was no significant difference regarding the fracture strength between the full anatomy groups. There was also no significant difference regarding the fracture strength between the core-design groups. The hypothesis was therefore rejected.Conclusion: There is no significant difference with regards to how much load is required to fracture FDPs made through pressing technique compared to FDPs made through the use of CAD/CAM technique. There is a clear pattern regarding the fracture patterns, however a conclusion can’t be drawn considering the sample size.

L’objectif de cette étude était d’évaluer et de comparer la force d’adhésion de deux résines de collage: le ClearfilTM Esthetic Cement & DC Bond Kit (C) et le RelyXTM Unicem (R), sur trois adhérents différents : une surface d’émail, un alliage de métaux non précieux (Np) et un alliage de métaux semi-précieux (Sp). La surface des échantillons des alliages métalliques a subi différents traitements de surface. Sur l’émail (n=15) ainsi que sur les plaquettes d’alliages Np et Sp (n=15), des cylindres de résine étaient appliqués et polymérisés. Suite au processus de collage, les échantillons ont été incubés à 37°C pendant 24 heures, puis ont subi 500 cycles de thermocyclage. Des tests de cisaillement ont été effectués, suivi par l’analyse de la surface des échantillons au microscope à balayage électronique. Une comparaison de type T-test et des comparaisons multiples post hoc, ont été effectuées pour l’analyse statistique (p 0,05). Sur l’émail, les résultats ont démontré que la résine C présentait une force d'adhésion moyenne statistiquement supérieure (33,97±17,18 MPa) à la résine R (10,48±11,23 MPa) (p 0,05). Le type d’alliage utilisé n’influençait pas la force d’adhésion, et ce, peu importe le type de résine de collage (p>0,05). Pour le groupe Sp, la résine C a démontré une adhésion statistiquement supérieure à la résine R, et ce, pour tous les traitements de surface (p 0,05). En conclusion, la résine C a démontré des résultats d’adhésion significativement supérieurs à la résine R sur l’émail ainsi que sur presque toutes les surfaces traitées des alliages de métaux. / The objective of this study was to assess and compare the shear bond strength of two types of resin cements: ClearfilTM Esthetic Cement & DC Bond Kit (C) and RelyXTM Unicem (R) when these resins cements were applied to three different surfaces: enamel, non precious metal alloy (Np) and semi-precious metal alloy (Sp). Both types of alloy surfaces were treated differently. On both enamel (n=15) and alloy plates Np and Sp (n=15) surfaces, cylinder shaped resin cements were bonded and lightpolymerized. After the adhesion process, all samples were placed into an incubator at 37°C for 24 hours and 500 thermal cycles were accomplished. Shear bond strength tests followed by electron microscopy analysis were performed. Statistical analysis was done using a T-test comparison followed by a post hoc multiple comparisons (p 0.05). The results on enamel showed that the C resin cement had a statistically significant higher bond strength (33.97±17.18 MPa) than the R resin cement (10.48±11.23 MPa) (p 0.05). The type of alloy did not influence the bond strength regardless the type of resin cement (p 0.05). For the Sp group, the bond strength was statistically higher for the C resin than for the R resin and those results are valuable for all treated surfaces (p 0.05). To conclude, the C resin cement showed a statistically significant higher bond strength than the R resin cement with enamel and most of the metal alloy treated.

Nesta pesquisa, foi realizada uma análise comparativa, por meio do método dos elementos finitos bidimensional linear, das deformações e tensões geradas a partir da aplicação de uma carga de 100N, nas estruturas de suporte (fibromucosa,ligamento periodontal, osso cortical e osso esponjoso) de dois modelos que simulam um hemiarco mandibular associada a uma prótese parcial removível de extremidade livre dista inferiorl, quando da variação da inclinação do rebordo residual no plano sagital. O modelo A (MA) foi desenhado com um rebordo ascendente distal com 15 graus de inclinação e o modelo B (MB) com um rebordo descendente distal com 15 graus negativos, ambos em relação ao plano oclusal. Nos dois modelos aplicou-se uma carga primeiramente na cúspide médio-vestibular do primeiro molar inferior artificial (C1) e depois na cúspide vestibular do segundo pré-molar inferior (C2), por meio do programa I-deas (software de elementos finitos) onde foram feitas as análises de deformações e tensões e processamento das imagens. Fez-se então uma análise comparativa dos carregamentos (C1 e C2) em cada modelo individualmente e entre os dois modelos(MA e MB). Os resultados permitiram concluir que: 1) A inclinação do rebordo residual no plano sagital influenciou na distribuição e na intensidade das tensões das estruturas de suporte; 2) No osso cortical as tensões foram mais localizadas e de maior intensidade que no osso esponjoso; 3) A diferença de deformação entre fibromucosa e ligamento periodontal foi maior quando a carga foi aplicada no primeiro molar, de ambos os modelos, sendo a mais expressiva no rebordo ascendente distal; 4) As tensões de compressão foram maiores em intensidade e melhor distribuídas no osso esponjoso e no osso cortical, quando comparadas as tensões de tração; 5) O rebordo ascendente distal se mostrou mais favorável à distribuição das tensões nas estruturas de suporte quando comparado ao rebordo descendente distal; 6) Nos dois modelos a aplicação da carga no primeiro molar gerou um maior torque sobre o dente suporte para a distal do que quando aplicado no segundo pré-molar, principalmente no rebordo descendente distal; 7) As estruturas de suporte do rebordo residual foram mais solicitadas em C1 que em C2, em ambos os modelos, principalmente no rebordo ascendente distal; 8) No dente suporte as tensões nas estruturas de suporte foram mais axiais quando o carregamento ocorreu no segundo pré-molar inferior, em ambos os modelos. / In this study, a two-dimensional finite element comparative analysis of the stress distribution and of displacement in the supporting structures – oral mucosa,periodontal ligament, compact and cancellous bone – was carried out for a distal extension base removable partial denture (RPD), modeled on two mandibular dental archs with different types of residual ridge when aplaying loads of 100N. The A model (MA) was developed to include a distal ascending alveolar ridge with a 15-degrees positive inclination, while the B model (MB) was prepared with a distal descending alveolar ridge with a 15-degrees negative inclination. Both models had a load applied inicially on the lower first molar median cusp (C1) and then on the lower second premolar buccal cusp (C2). Using the FEA software (I-DEAS, USA) for the stress distribution and displacement analysis of the generated images. A comparative analysis was them performed on the C1 and C2 loads for which and both models (MA and MB).The results showed that: 1 – The alveolar ridge inclination showed some degree of on the stress distribution and intensity generated by the RPD; 2 –The compact bone showed greater stress concentration and intensity than the cancellous bone; 3 – The ratio between oral mucosa and periodontal ligament displacement showed greater values when load was applied on the lower first molar for both models. The ratio was higher for the distal ascending alveolar ridge; 4- The compressive stress showed greater intensity and better range of distribution than the tensile stress for both the compact and cancellous bone; 5 – The distal ascending residual ridge had a more favourable stress distribution than distal descending conterpart ; 6 – The load applied on the lower first molar produced more distal torquing on the supporting tooth than that on the lower second premolar ,specially on the distal descending residual ridge; 7 – the load applied on the lower firt molar generated greater amount of stress on the residual ridge supporting structures for both models, but specially for the distal ascending residual ridge; 8 – The load applied on the lower second premolar produced more vertical forces on the supporting structures of the tooth for both models.

A longevidade da prótese e a saúde bucal de usuário de Prótese Parcial Removível (PPR) são muito dependentes de higiene apropriada. O objetivo deste estudo foi comparar o efeito de soluções de Ricinus communis, em diferentes concentrações, com soluções de peróxido alcalino e cloreto de cetilpiridínio, em relação à liga metálica de Cobalto Cromo (Co-Cr) que compõe a estrutura de PPR. A amostra do experimento foi composta por 55 espécimes de Co-Cr, confeccionados a partir de padrões de cera circulares (12 mm x 3 mm) obtidos a partir de uma matriz metálica. Os padrões foram fundidos, numerados aleatoriamente e divididos em 5 grupos de imersão: H2O- água deionizada (controle) (15 minutos); Rc 2%- Ricinus communis 2% (20 minutos), Rc 10% -Ricinus communis 10% (20 minutos), PA- peróxido alcalino (15 minutos) e CCP- cloreto de cetilpiridínio 0,500 mg (10 minutos). Os espécimes foram avaliados quanto à rugosidade de superfície (n=10) no início e após a simulação de 6 meses, 1, 2, 3, 4 e 5 anos tanto pelo microscópio confocal a laser (Sa, &micro;m), como também pelo rugosímetro de superfície (Ra, &micro;m). Um espécime de cada grupo foi analisado quanto à topografia de superfície (Microscopia Eletrônica de Varredura, MEV) e Espectrometria de Energia Dispersiva de Raios-X (EDS) antes e após simulação de uso por 5 anos. De acordo com os resultados obtidos (&alpha;=0,05) pela microscopia confocal (Sa), não houve diferença para o fator solução (Kruskal-Wallis); para o fator tempo (Friedman) houve diferença estatística em Rc 2% entre T0 e T1, T3, T4 e T6 (p<0,001) e em Rc 10% de T2 para T3 (p=0,007), com diminuição da rugosidade. Com o rugosímetro (Ra), houve diferença estatística (Kruskal- Wallis) para CCP que apresentou menor rugosidade em relação à Rc 10% em T1 (p=0,048) e T6 (p=0,013). Em relação ao tempo (Friedman), a água propiciou diminuição da rugosidade superficial (Ra) de T0 para T2 (p=0,013). Na análise de MEV e EDS podese verificar que as soluções não apresentaram efeitos deletérios sobre as superfícies. Conclui-se que embora tenha sido encontrada diferença estatística para a rugosidade, os resultados são clínicamentes aceitáveis. Deste modo, todas as soluções podem ser utilizadas com segurança pelo período de 5 anos. / Denture longevity and oral health of Removable Partial Denture (RPD) user are highly dependent on proper hygiene. The aim of this study was to compare the effect of solutions of Ricinus communis, in different concentrations, with solutions of alkaline peroxide and cetylpyridinium chloride 0.500 mg, in relation to the Cobalt Chromium (Co-Cr) alloy that composes the structure of RPD. The sample of the experiment consisted of 55 specimens of Co-Cr, made from circular wax patterns (12 mm x 3 mm) obtained in a metal matrix. The patterns were cast, randomly enumerated and divided into 5 immersion groups: H2Odeionized water (control) (15 minutes); Rc 2%- Ricinus communis 2% (20 minutes), Rc 10% -Ricinus communis 10% (20 minutes), PA-alkaline peroxide (15 minutes) and CCPcetylpyridinium chloride 0.500 mg (10 minutes). The specimens were evaluated for surface roughness (n = 10) at the beginning and after the simulation of 6 months, 1, 2, 3, 4 and 5 years by the laser confocal microscope (Sa, &micro;m) and by the rugosimeter of surface (Ra, &micro;m). One specimen from each group was analyzed for surface topography (Scanning Electron Microscopy, SEM) and Energy-dispersive X-ray spectroscopy (EDS) befofe and after simulation of use for 5 years. According to the results obtained (&alpha;= 0.05) by confocal microscopy (Sa), there was no difference for the solution factor (Kruskal- Wallis); For the time factor (Friedman) there was a statistical difference in Rc 2% in T0 to T1, T3, T4 and T6 (p <0.001) and Rc 10% in T2 to T3 (p = 0.007), with decrease in roughness. With the the rugosimeter (Ra), there was a statistical difference (Kruskal- Wallis) for CCP that presented less roughness in relation to the Rc 10% in T1 (p = 0.048) and T6 (p = 0.013). In relation to the time, (Friedman) the water caused a reduction of surface roughness (Ra) between T0 and T2 (p = 0.013). In the analysis of SEM and EDS it can be verified that the solutions did not present deleterious effects on the surfaces. It was concluded that although a statistical difference was found for roughness, the results are clinically acceptable. Thus, all solutions can be safely used for a period of 5 years.

O objetivo deste estudo foi avaliar, pelo método dos elementos finitos bidimensional, a distribuição das tensões geradas nas estruturas de suporte das próteses parciais removíveis (PPR) - osso cortical, osso esponjoso, fibromucosa e ligamento periodontal, em modelos de arcos parcialmente dentados de extremidade livre inferior, em rebordo horizontal (MA) e descendente-ascendente (MB). Foram confeccionados dois modelos de quadrante de mandíbula em AUTOCAD 2004 (Autodesk Inc., USA), contendo apenas o primeiro pré-molar e rebordo residual, sendo repostos o segundo pré-molar e primeiro molar pela PPR, tendo como dente suporte o primeiro pré-molar com apoio oclusal distal. Posteriormente, foi aplicada carga axial de 100 N nas cúspides dos dentes artificiais da PPR (somente sobre o 1 o molar - C1 e somente sobre o 2 o pré-molar - C2). Os modelos confeccionados em AUTOCAD foram transferidos para o programa I-DEAS (software de elementosfinitos), que discretizou-os e realizou a distribuição das tensões sob as condições de aplicação de carga citadas. Pôde–se observar que no osso esponjoso, a maior deformação e tensão de compressão foram observadas ao redor do dente suporte, principalmente no terço cervical distal para a deformação e no ápice do dente para a tensão de compressão durante a aplicação de carga sobre o segundo pré-molar no rebordo horizontal (0,003 mm e 0,621 N/mm 2 , respectivamente). Já no rebordo descendente-ascendente, as áreas solicitadas foram as mesmas, apresentando deformação e tensão de compressão máximas de 0,003 mm e 0,609 N/mm 2 . Para a fibromucosa, pode-se notar que no rebordo horizontal, a maior deformação e tensão de compressão ocorreram abaixo do ponto de aplicação de carga, ou seja, no primeiro molar, com valores de 0,137 mm e 0,144 N/mm 2 . No rebordo descendente-ascendente, a área de maior deformação e tensão de compressão localizaram-se na porção ascendente do rebordo em direção do trígono retromolar, com valores de 0,131 mm e 0,122 N/mm 2 , respectivamente. Diante dos limites do presente estudo pode-se concluir que: 1 - O osso cortical apresenta uma concentração de tensões maior que o osso esponjoso; 2 – O osso cortical apresenta uma deformação mais restrita em área que o osso esponjoso; 3 - O rebordo descendente-ascendente com a aplicação de carga sobre o primeiro molar (MB-C1) apresenta a maior deformação da fibromucosa quando comparada à deformação sofrida pelo ligamento periodontal, na proporção de 10:1; 4 - O rebordo descendente-ascendente apresenta uma distribuição de tensões menos favorável que o rebordo horizontal; 5 - A aplicação de carga no primeiro molar gera mais torque sobre o dente para distal do que a aplicação de carga sobre o segundo pré-molar. / This study is a two-dimensional finite element analysis (FEA) of the stress distributionin the supporting structures – compact and cancellous bone; periodontal ligament and oral mucosa – for a distal extension base removable partial denture (RPD) modeled on mandibular dental archs with two residual ridge forms: horizontal and descending-ascending. The two experimental quadrant models were developed in the AUTOCAD 2004 (Autodesk Inc., USA), software to include the first premolar asthe dental support with a distal occlusal rest; the second premolar and first molar as the artificial teeth inserted on the base over an RPD framework and the residual ridge. These models were discretized on the FEA software (I-DEAS, USA) and an axial load of 100 N was applied to the mesh on the artificial teeth cusps either on the first mola r (C1) or on the second premolar (C2). It was noticed that, in the cancellous bone, the maximum strain was around the supporting tooth, mainly in the distalcervical third (0.003 mm) while the largest compression tension (CT) was at the tooth apex when the load was applied over the second premolar, with a horizontal residual ridge (0,621 N/mm 2 ). When the ridge was descending-ascending, the areas affected were the same, showing 0,003 mm and 0,609 N/mm 2 , respectively as the maximum displacement and CT. In the oral mucosa, the largest results occurred when the load application point was over the first molar and the residual ridge was horizontal: 0,137 mm and 0,144 N/mm 2 . The descending-ascending alveolar ridge showed the maximum displacement and CT in the ascending segment of the residual ridge, toward the retromolar trigon, with 0,131 mm and 0,122 N/mm 2 , respectively. Within the constraints of this study, it was concluded that: 1 – The compact bone shows greater stress concentration than the cancellous bone; 2 – The compact bone shows greater area displacement concentration than the cancellous bone; 3 – The descending-ascending residual ridge with the load application on the first molar showed the largest displacement of the oral mucosa when compared to the periodontal ligament displacement with a 10:1 ratio; 4 – The descending-ascending residual ridge had a less favourable stress distribution than its horizontal counterpart; 5 – The load applied on the first molar produced more distal torquing on the supporting tooth than that on the second premolar.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Para reabilitar a ausência de um elemento dentário posterior, as próteses parciais fixas (PPF) com retentores intracoronários são uma alternativa aos implantes osseointegrados. O objetivo deste estudo foi avaliar a distribuição de tensões nessas próteses com três combinações de materiais: cerâmica de zircônia parcialmente estabilizada por ítria (ZPEI) revestida por cerâmica de fluorapatita (&#945;), cerâmica de dissilicato de lítio (&#946;) ou compósito fibrorreforçado (&#947;). Na composição &#945;, foram analisadas a presença ou ausência da cerâmica de revestimento na parede cervical das caixas proximais e três variações na área total da seção transversal dos conectores (4 mm de largura x 3,2, 4,2 ou 5,2 mm de altura). Em 8 modelos bidimensionais de elementos finitos, uma carga vertical de 500 N foi aplicada na fossa central do pôntico e as tensões principais máximas (tração) e mínimas (compressão) foram apontadas em MPa. Inicialmente foram avaliados os 6 modelos com PPF de ZPEI e suas variações. Os maiores valores das tensões de tração foram encontrados no terço cervical dos conectores. Quando presente nestas regiões, a cerâmica de revestimento recebeu tensões acima do limite de sua resistência à flexão. Na comparação entre os modelos sem cerâmica de revestimento na parede cervical das caixas proximais, mesmo aquele com conectores de 3,2 x 4 mm, cuja infraestrutura apresentava 2,5 x 3 mm, poderia ser recomendado para uso clínico. Altos valores de tensões de compressão foram registrados entre o terço oclusal e médio dos conectores, correspondente à união entre as cerâmicas, o que poderia ocasionar, devido à flexão, falhas adesivas. Posteriormente, o modelo de ZPEI com a cerâmica de fluorapatita ausente da parede cervical das caixas proximais e área total dos conectores de 4,2 x 4 mm foi comparado aos dois outros materiais com conectores de mesma área. Na PPF de dissilicato de lítio, os valores representaram uma provável violação do limite de sua resistência à flexão. A PPF de compósito fibrorreforçado apresentou tensões bem abaixo do limite de resistência à flexão de sua infraestrutura, mas, como no modelo de ZPEI, tensões compressivas se concentraram com alto valor entre o terço oclusal e médio dos conectores, local de união entre a resina composta e a infraestrutura de fibras. Os resultados mostraram que a cerâmica de dissilicato de lítio e a presença da cerâmica de fluorapatita na parede cervical das caixas proximais deveriam ser contraindicadas para a condição proposta. Parece viável uma área de conectores na infraestrutura de ZPEI com no mínimo 2,5 x 3 mm. A PPF de compósito fibrorreforçado apresenta resistência estrutural para a situação estudada, mas, como também aquelas compostas de ZPEI, aparenta ter como pontos fracos a adesão entre a infraestrutura e o material de cobertura e a própria resistência deste último. / Inlay-retained fixed partial dentures (IRFPD) are an alternative to osseointegrated implants to replace a single missing posterior tooth. The aim of this study was to evaluate the stress distribution within these prostheses with three material combinations: yttria-tetragonal zirconia polycrystal (Y-TZP) ceramic veneered with fluorapatite ceramic (&#945;), lithium-disilicate ceramic (&#946;) or fiber-reinforced composite (&#947;). In composition &#945;, an analysis was conducted on the presence or absence of the veneering ceramic on the cervical wall of the proximal boxes and three variations in the total area of the connectors cross-section (4 mm in width x 3.2, 4.2 or 5.2 mm in height). In 8 two-dimensional finite element models, a vertical load of 500 N was applied on the central fossa of the pontic. Maximum (tension) and minimum (compression) principal stresses were then shown in MPa. First, the 6 models with Y-TZP fixed partial dentures (FPD) and their variations were evaluated. The highest values of tensile stresses were found at the cervical third of the connectors. When present in these regions, the veneering ceramic received stresses beyond its flexural strength limit. In the comparison among models without veneering ceramic on the cervical wall of the proximal boxes, even the model with connectors of 3.2 x 4 mm, whose framework presented 2.5 x 3 mm, could be recommended for clinical use. High values of compressive stresses were recorded between the middle and occlusal thirds of the connectors, corresponding to the juncture of the ceramics. Owing to flexure, these stresses might lead to adhesive failures. Then, the Y-TZP model without fluorapatite ceramic on the cervical wall of the proximal boxes and total connector area of 4.2 x 4 mm was compared to the other two materials with connectors of the same area. For the lithium-disilicate FPD, the observed values would probably exceed its flexural strength limit. The fiber-reinforced composite FPD presented stresses far below the flexural strength limit of its framework, but, as observed in the Y-TZP model, high values of compressive stresses were concentrated between the middle and occlusal thirds of the connectors, where the juncture of the composite and the fiber framework is located. The results showed that the use of lithium-disilicate ceramics and the presence of fluorapatite ceramics on the cervical wall of the proximal boxes should be contraindicated for the condition proposed. A minimum of 2.5 x 3 mm for the connector area of the Y-TZP framework seems viable. The fiber-reinforced composite FPD presented structural resistance for the situation studied but, as was also the case of the Y-TZP fixed partial dentures, its weak points seem to be the adhesion between the framework and the veneering material, as well as the resistance of the veneering material itself.

Made available in DSpace on 2014-12-17T15:43:46Z (GMT). No. of bitstreams: 1 KassiaCD_DISSERT.pdf: 3074934 bytes, checksum: e11accf83a218e88932f4699f7d8e3bd (MD5) Previous issue date: 2012-12-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / There is a lack of clinical studies evaluating techniques of functional impression for partially edentulous arches. The aim of this double-blind non-randomized controlled clinical trial was to compare the efficacy of altered cast impression (ACI) and direct functional impression (DFI) techniques. The efficacy was evaluated regarding the number of occlusal units on denture teeth, mucosa integrity at 24-hour follow-up and denture base extension. The sample included 51 patients (female and male) with mean age of 58.96 years treated at Dental Department of UFRN. The patients, exhibiting edentulous maxilla and mandibular Kennedy class I, were divided into two groups (group ACI, n=29; group DFI, n=22). Clinical evaluation was based on the number of occlusal units on natural and/or artificial teeth, mucosa integrity at 24-hour follow-up, and denture base extension. Statistical analysis was conducted using the software SPSS 17.0? (SPSS Inc., Chicago, Illinois). Student T-test was used to reveal association between number of occlusal units and impression technique while chi-square test showed association between mucosa integrity and impression technique. Fischer s exact test was applied for association between denture base extension and impression technique at 95% level of significance. No significant difference was observed between the groups regarding number of occlusal units, mucosa integrity and denture base extension. The altered cast technique did not provide significant improvement in comparison to the direct technique when the number of occlusal units, mucosa integrity and denture base extension / A literatura cient?fica ? carente de estudos cl?nicos que avaliem a efici?ncia de t?cnicas de moldagem funcional para arcos parcialmente desdentados. Objetivou-se realizar um ensaio cl?nico controlado, n?o randomizado e duplo-cego, para comparar a efici?ncia da t?cnica de moldagem funcional do modelo alterado (TMMA) com a t?cnica de moldagem funcional direta (TMD), em rela??o ao n?mero de pontos de contato oclusais por unidade oclusal na instala??o de novas pr?teses, a integridade da fibromucosa na sess?o de controle de 24 horas e a extens?o da base de pr?tese. A amostra foi constitu?da por 51 pacientes, com m?dia de idade de 58,96 anos, portadores de arco maxilar totalmente desdentado e Classe I de Kennedy mandibular, de ambos os sexos, reabilitados nas cl?nicas do Departamento de Odontologia da Universidade Federal do Rio Grande do Norte. Os pacientes foram divididos em dois grupos: grupo TMMA (n=29) e Grupo TMD (n=22). As seguintes vari?veis foram utilizadas para as medidas cl?nicas: n?mero de pontos de contato oclusais por unidade oclusal, a integridade da fibromucosa no retorno programado de 24 horas e a extens?o da base da pr?tese. Para an?lise estat?stica, utilizou-se o programa SPSS 17.0? (SPSS Inc., Chicago, Illinois) e aplicou-se o teste t de Student para verificar a associa??o do n?mero de pontos de contato oclusais por unidade oclusal em dentes naturais e artificiais e a t?cnica de moldagem. Para verificar a associa??o entre a integridade da fibromucosa e a t?cnica, foi utilizado o teste quiquadrado. O teste exato de Fisher foi usado para verificar a associa??o entre a extens?o da base da pr?tese e a t?cnica, com confian?a estat?stica de 95%. N?o existiu diferen?a estatisticamente significativa entre os dois grupos quanto ? t?cnica de moldagem em rela??o ao n?mero de pontos de contato oclusais, ? integridade da fibromucosa e ? extens?o da base da pr?tese. A t?cnica de moldagem funcional do modelo alterado n?o oferece vantagens significativas, quando comparada ? t?cnica direta, em rela??o ? quantidade de n?mero de pontos de contato oclusais por unidade oclusal, ? integridade da fibromucosa e ? extens?o da base da pr?tese

L’objectif de cette étude était d’évaluer et de comparer la force d’adhésion de deux résines de collage: le ClearfilTM Esthetic Cement & DC Bond Kit (C) et le RelyXTM Unicem (R), sur trois adhérents différents : une surface d’émail, un alliage de métaux non précieux (Np) et un alliage de métaux semi-précieux (Sp). La surface des échantillons des alliages métalliques a subi différents traitements de surface. Sur l’émail (n=15) ainsi que sur les plaquettes d’alliages Np et Sp (n=15), des cylindres de résine étaient appliqués et polymérisés. Suite au processus de collage, les échantillons ont été incubés à 37°C pendant 24 heures, puis ont subi 500 cycles de thermocyclage. Des tests de cisaillement ont été effectués, suivi par l’analyse de la surface des échantillons au microscope à balayage électronique. Une comparaison de type T-test et des comparaisons multiples post hoc, ont été effectuées pour l’analyse statistique (p 0,05). Sur l’émail, les résultats ont démontré que la résine C présentait une force d'adhésion moyenne statistiquement supérieure (33,97±17,18 MPa) à la résine R (10,48±11,23 MPa) (p 0,05). Le type d’alliage utilisé n’influençait pas la force d’adhésion, et ce, peu importe le type de résine de collage (p>0,05). Pour le groupe Sp, la résine C a démontré une adhésion statistiquement supérieure à la résine R, et ce, pour tous les traitements de surface (p 0,05). En conclusion, la résine C a démontré des résultats d’adhésion significativement supérieurs à la résine R sur l’émail ainsi que sur presque toutes les surfaces traitées des alliages de métaux. / The objective of this study was to assess and compare the shear bond strength of two types of resin cements: ClearfilTM Esthetic Cement & DC Bond Kit (C) and RelyXTM Unicem (R) when these resins cements were applied to three different surfaces: enamel, non precious metal alloy (Np) and semi-precious metal alloy (Sp). Both types of alloy surfaces were treated differently. On both enamel (n=15) and alloy plates Np and Sp (n=15) surfaces, cylinder shaped resin cements were bonded and lightpolymerized. After the adhesion process, all samples were placed into an incubator at 37°C for 24 hours and 500 thermal cycles were accomplished. Shear bond strength tests followed by electron microscopy analysis were performed. Statistical analysis was done using a T-test comparison followed by a post hoc multiple comparisons (p 0.05). The results on enamel showed that the C resin cement had a statistically significant higher bond strength (33.97±17.18 MPa) than the R resin cement (10.48±11.23 MPa) (p 0.05). The type of alloy did not influence the bond strength regardless the type of resin cement (p 0.05). For the Sp group, the bond strength was statistically higher for the C resin than for the R resin and those results are valuable for all treated surfaces (p 0.05). To conclude, the C resin cement showed a statistically significant higher bond strength than the R resin cement with enamel and most of the metal alloy treated.