Devido a evolução dos sistemas cerâmicos, atualmente, são permitidas inúmeras associações de materiais restauradores. Entretanto, mimetizar as características visuais das próteses livres de metal com próteses metalocerâmica permanece um desafio. Assim, o objetivo deste trabalho foi relatar o caso clínico de substituição de próteses desadaptadas, homogeneizando próteses parciais fixas livres de metal e metalocerâmicas dento e implantossuportadas, após cirurgia periodontal. O paciente de 55 anos, gênero masculino, compareceu à Clínica de Prótese Parcial Fixa, da Faculdade de Odontologia de Araçatuba – FOA/UNESP em 2017 queixando-se dos seus dentes anteriores estarem “feios” e com a “raiz aparecendo”. No exame clínico foi constatada recessão gengival nos elementos 11 e 13, os quais continham uma prótese parcial fixa de três elementos metalocerâmicas desadaptada, prótese sobre implante nos elementos 21 e 22, que apresentavam-se desadaptadas e com estética desfavorável. No exame radiográfico pôde-se observar a presença de um núcleo metálico fundido nos elementos 11 e 13. Foi proposto, então, a confecção de coroas totais livres de metal nos elementos anteriores superiores (13, 12, 11, 21 e 23) e coroa metalocerâmica para o elemento 22. Para isso, foi realizado enceramento diagnóstico inicial e, após o consentimento do paciente, foi efetuada a remoção das próteses antigas. Com a remoção, visualizamos uma depressão na vestibular do rebordo na área do 12 (ausente), solucionado com um enxerto gengival subepitelial. Após a realização dos preparos dentários e moldagem com silicone de adição as peças foram confeccionadas com sistema e.max Ceram (Ivoclar Vivadent). Após a prova estética e ajustes oclusais iniciais, as peças foram preparadas para cimentação resinosa com o sistema Variolink® N (Ivoclar Vivadent). O cimento transparente foi selecionado previamente por meio de provas com o kit Try-In. Conclui-se que, apesar da disparidade dos materiais, é possível mimetizá-los e oferecer resultados reabilitadores suficientemente estéticos e satisfatórios.Descritores: Implantação Dentária; Estética Dentária; Materiais Dentários.ReferênciasCardenas AFM, Mora CAP, Siqueira FSF, Parreiras SO, Gomes JC. Restabelecimento estético de um sorriso envelhecido: Caso clínico. Revista APCD de Estética. 2015;3(1):42-52.Strasding M, Fehmer V, Pjetursson BE, Sailer I. Extending the service life of existing dental restorations with esthetic and functional limitations. J Prosthet Dent. 2018;119(6):893-96.Koidou VP, Rosenstiel SF, Rashid RG. Celebrity smile esthetics assessment: Smile angulation. J Prosthet Dent, 2017;117(5):636-41.Levin, EI. Dental esthetics and the golden proportion. J Prosthet Dent. 1978;40(3):244-52.Flores-Mir C, Silva E, Barriga MI, Lagravere MO, Major PW. Lay person's perception of smile aesthetics in dental and facial views. J Orthod. 2004;31(3):204-9.Cotrim, ER, Vasconcelos Júnior, ÁV, Haddad, ACSS, Reis SAB. Perception of adults' smile esthetics among orthodontists, clinicians and laypeople. Dental Press J. Orthod. 2015;20(1):40-4.Chaudhari A, Bagga DK, Agrawal P, Kalra H, Sirohi D. An assessment of the self-satisfying smile among different professionals. J Int Oral Health. 2018;10(3):111-14.Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91(3):242-48.Bonfante EA, Suzuki M, Lorenzoni FC, Sena LA, Hirata R, Bonfante G et al. Probability of survival of implant-supported metal ceramic and CAD/CAM resin nanoceramic crowns. Dent Mater J. 2015;31(8):e168-77.Egilmez F, Ergun G, Cekic-Nagas I, Bozkaya S. Implant-supported hybrid prosthesis: conventional treatment method for borderline cases. Eur J Dent. 2015;9(3):442-48.Schweitzer DM, Goldstein GR, Ricci JL, Silva NR, Hittelman EL. Comparison of bond strength of a pressed ceramic fused to metal versus feldspathic porcelain fused to metal. J Prosthodont. 2005;14(4):239-47.Venkatachalam B, Goldstein GR, Pines MS, Hittelman EL. Ceramic pressed to metal versus feldspathic porcelain fused to metal: a comparative study of bond strength. Int J Prosthodont. 2009;22(1):94-100.Holden JE, Goldstein GR, Hittelman EL, Clark EA. Comparison of the marginal fit of pressable ceramic to metal ceramic restorations. J Prosthodont. 2009;18: 645-48.Sinhori BS, de Andrada MAC, Lopes GC, Monteiro Junior S, Baratieri LN. Influence of Teeth Preparation Finishing on the Adaptation of Lithium Disilicate Crowns. Int J Biomater. 2017; ID 2078526.Hoppen LRC, Garbin CA, Rigo L, Schuh C, FederizzI L. Comparação estética entre coroas confeccionadas com os sistemas Cubo e metalocerâmico. Rev Sul-Bras Odontol. 2010;7(2):146-53.Mazur CE, Machado CT, Malheiros Pfau VJ, Augusto Pfau, E. Planejamento multidisciplinar na reconstrução do sorriso. JCDR. 2017; 14(2):62-70.Zuhr O, Bäumer D, Hürzeler M The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014;41(Suppl15):S123-42.Consolaro A. Saucerização: um mecanismo natural de adaptação peri-implantar cervical. Dental Press Implantol, 2014;8(4):8-15.Nealon FH. Acrylic restorations by the operative nonpressure procedure. J Prosthet Dent. 1952;2(4):513-27.Newman MG, Takei H, Klokkevold PR, Carranza FA. Periodontia clínica. Rio de Janeiro: Elsevier Brasil; 2007. p.926-35.Raetzke PB. Covering localized areas of root exposure employing the “envelope” technique. J Periodontol. 1985;56(7):397-402.Hannah R, Ramani P, Sherlin HJ, Ranjith G, Ramasubramanian A, Jayaraj G et al. Awareness about the use, ethics and scope of dental photography among undergraduate dental students dentist behind the lens. RJPT. 2018; 11(3):1012-16.Alberton SB, Alberton V, Carvalho RV. Providing a harmonious smile with laminate veneers for a patient with peg-shaped lateral incisors. J Conserv Dent. 2017;20(3):210-13.Vervaeke S, Matthys C, Nassar R, Christiaens V, Cosyn J, De Bruyn H. Adapting the vertical position of implants with a conical connection in relation to soft tissue thickness prevents early implant surface exposure: A 2‐year prospective intra‐subject comparison. J Clin Periodontol. 2018;45(5):605-12.Anusavice K, Shen C, Rawls HR. Dental casting and soldering alloys. In: Anusavice KJ, Phillips’ Science of Dental Material. St. Louis: Elsevier; 2003. p.563–620.Arinc H. Implant-supported fixed partial prostheses with different prosthetic materials: a three-dimensional finite element stress analysis. Implant Dent. 2018;27(3):303-10.Monnet-Corti V, Antezack A, Pignoly M. Comment parfaire l’esthétique du sourire: toujours en rose! Orthod Fr. 2018;89(1):71-80.Tonetti MS, Cortellini P, Graziani F, Cairo F, Lang NP, Abundo R et al. Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial. J Clin Periodontol. 2017;44(2):215-24.Pradeep AR, Karthikeyan BV. Peri-implant papilla reconstruction: Realities and limitations. J Periodontol. 2006; 77(3):534-44.Nariman RH, Pai UY, Soumya MK, Hegde R. A clinical assessment of the volume of interproximal papilla after definitive prosthesis around immediate and delayed loading implants placed in the maxillary esthetic zone: An in vivo study. J Indian Prosthodont Soc. 2018;18(2):168-73.Neves FDD, Silveira-Júnior CD, Coró V, Silva-Neto JP, Simamoto-Júnior PC, Prado CJD. Gingival conditioning in an implant-supported prosthesis: a clinical report. J Oral Implantol. 2013;39(4):483-85.
Para alcançar a estética em dentes anteriores deve-se ter conhecimento de diversas técnicas e principalmente fazer a escolha correta dos materiais. As cerâmicas odontológicas estão cada vez mais presentes nas restaurações, visto que possuem ótimas propriedades ópticas e mecânicas. Assim, o objetivo deste estudo foi proporcionar a estética em dentes anteriores com diferentes subtratos através de uma prótese fixa metal-free. Paciente do gênero masculino, 38 anos, procurou atendimento queixando-se da estética do seu sorriso. No exame clínico foi observada uma coroa total metalocerâmica no elemento 21 e facetas de resina composta nos elementos 11,12 e 22, todas com estética insatisfatória. O dente 21 apresentava um núcleo metálico fundido adequado e os dentes 12 e 22 com tratamentos endodônticos. Foi proposta a instalação de pinos de fibra de vidro nos dentes 12 e 22. Além, da confecção de coroas totais metais-free em dissilicato de lítio nos quatro incisivos superiores com o sistema e-max ceram. O resultado final estético e funcional foi aprovado pelo paciente e pelos profissionais envolvidos.Descritores: Estética Dentária; Cerâmica; Reabilitação Bucal.ReferênciasOkida RC, De Moura AP, Franco LM, Salomão FM, Rahal S, Machado LS, Okida DSS. A utilização do DSD (Digital Smile Design) para a otimização da estética dental. Rev Odontol Araçatuba 2017;38(3):9-14.Sabatini C. Color stability behavior of methacrylate-based resin composites polymerized with light-emitting diodes and quartz-tungsten-halogen. Oper Dent. 2015;40(3):71-81.Wang X, Huyang G, Palagummi SV, Liu X, Skrtic D, Beauchamp C et al. High performance dental resin composites withhydrolytically stable monomers. Dent Mater. 2018;34(2):228-37.Yazici AR, Celik C, Dayangaç B, Ozgünaltay G. The effect of curing units and staining solutions on the color stability of resin composites. Oper Dent. 2007; 32(6):616-22.Aguiar EMG, Rodrigues RB, Lopes CCA, Silveira Júnior CD, Soares CJ, Novais VR. Diferentes sistemas cerâmicos na reabilitação oral: relato de caso clínico. Rev Odontol Bras Central. 2016;25(72):31-6.Mazaro JVQ, Zavanelli AC, Pellizzer EP, Verri FR, Falcón-Antennucci RM. Considerações clínicas para a restauração da região anterior com facetas laminadas. Rev Odontol Araçatuba. 2009;30(1):51-4.Vichi A, Louca C, Corciolani G, Ferrari M. Color related to ceramic and zirconia restorations: a review. Dent Mater. 2011;27(1):97-108.Rossato DM, Saade EG, Saad JRC, Porto-Neto ST. Coroas estéticas anteriores em cerâmica metal-free: relato de caso clínico. Rev Sul-Bras Odontol. 2010;7(4):494-98.Lanza MDS, Andreeta MRB, Pegoraro TA, Pegoraro LF, Carvalho RM. Influence of curing protocol and ceramic composition on the degree of conversion of resin cement. J Appl Oral Sci. 2017;25(6):700-7.Soares PFB, Siqueira JM, Carvalho VF, Bicalho AA, Soares CJ. Contenção interdentária empregando fibra de vidro e resina composta: Relato de caso e acompanhamento de 14 anos. Rev Odontol Bras Central. 2016;25(73):80-3.Martinez-Insua A, da Silva L, Rilo B, Santana U. Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon-fiber post with a composite core. J Prosthet Dent. 1998;80(5):527-32.Rocha IJPB, Silva LDR, de Santa Maria SL, Oliveira DP, Porfírio Z. Análise de dois métodos de desinfecção de condutos radiculares após preparo para pinos: proposta de protocolo protético: estudo in vitro. Rev Odontol UNESP. 2017;46(4):189-95.Dede DÖ, Ceylan G, Yilmaz B. Effect of brand and shade of resin cements on the final color of lithium disilicate ceramic. J Prosthet Dent. 2017;117(4):539-44.Lopes Cde C, Rodrigues RB, Silva AL, Simamoto Júnior PC, Soares CJ, Novais VR. Degree of conversion and mechanical properties of resin cements cured through different all-ceramic systems. Braz Dent J. 2015;26(5):484-89.Martins FV, Vasques WF, Fonseca EM. How the variations of the thickness in ceramic restorations of lithium disilicate and the use of different photopolymerizers influence the degree of conversion of the resin cements: a systematic review and meta‐analysis. J Prosthodont. 2019;28(1):e395-403.Turp V, Turkoglu P, Sen D. Influence of monolithic lithium disilicate and zirconia thickness on polymerization efficiency of dual‐cure resin cements. J Esthet Restor Dent. 2018;30(4):360-68.Tavarez RR, Gonçalves LM, Dias AP, Dias AC, Malheiros AS, Silva AC. An harmonic smile resulted from the use of ceramic prosthesis with zirconia structure: a case report. J Int Oral Health. 2014;6(3):90-2.Vaz EC, Vaz MM, de Torres ÉM, de Souza JB, Barata TDJE, Lopes LG. Resin cement: correspondence with try in paste and influence on the immediate final color of veneers. J Prosthodont. 2019;28(1):e74-81.Ladha K, Verma M. Conventional and contemporary luting cements: an overview. J Indian Prosthodont Soc. 2010;10(2):79-88.
Introduction: The lack of an eye has an immediate and long-term impact on a patient's life. Aim: The aim of this study is to show a case of prosthetic rehabilitation of an eyeball. Case report: Male patient, 60 years old, sought care at the Oral Oncology Center of the São Paulo State University "Júlio de Mesquita Filho", for the rehabilitation of the orbital cavity with an acrylic eye prosthesis. This prosthesis was made with thermopolymerizable acrylic resin and hand painted iris with oil paint on cardboard. The prosthesis was installed after finishing and polishing and the hygiene and general care instructions were explained. Conclusion: In the present case, the patient was satisfied with the aesthetics and comfort of the prosthesis, which demonstrates the success of the treatment.
Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson’s correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa).
Aim:This study aimed to report the clinical case of an immediate implant-supported rehabilitation in infected alveolar socket with buccal bone resorption and apical periodontitis in the teeth 42 and 43. Case Report: The patient was rehabilitated with implants associated with guided bone regeneration and immediate provisionalization. After 4 months, the custom molding was made in order to receive the metal-ceramic prosthesis. The follow-up lasted 24 months and there was no painful symptomatology, infection, implant mobility or marked peri-implant bone loss in this period. Conclusion: Therefore, the placement of immediate implants on fresh infected alveolar sockets is viable for the implant-supported rehabilitation.
Paciente masculino, de 32 años, acudió a la Clínica de Prótesis Parcial Fija (PPF), de la Facultad de Odontología de Araçatuba-Universidad Estadual Paulista, manifestando como queja principal que sus dientes anteriores estaban “feos y rotos”. Después del examen clínico, el paciente fue diagnosticado con desorden temporomandibular, bruxismo y presencia de erosiones dentarias (intrínsecas y extrínsecas). Se propuso el acompañamiento de un médico gastroenterólogo y la rehabilitación con prótesis libres de metal (11, 12, 21 y 22) confeccionadas en silicato de litio reforzado con zirconio por el sistema CAD/CAM. Después de la endodoncia de los incisivos antero-superiores, fueron instalados los pernos de fibra de vidrio anatomizados con resina compuesta; la impresión fue realizada con hilo retractor y silicona de adición. Después de la prueba estética y ajustes oclusales, las PPFs de e-max Ceram, fueron preparadas para cementación resinosa con el sistema Variolink II color Light. Después de 1 semana, se tomó la impresión de la arcada superior y posteriormente se le instaló una placa miorrelajante. El paciente y los profesionales involucrados aprobaron el resultado final, comprobando la eficacia estética asociada al uso de prótesis libre de metal, a pesar de que el paciente presenta compromiso gastroesofágico y desorden temporomandibular.
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