Objective Polymeric framework represent an innovative approach for implant-supported dental prostheses. However, the mechanical response of ultra-high performance polymers as frameworks for full-arch prostheses under the “all-on-four concept” remains unclear. The present study applied finite element analysis to examine the behavior of polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) prosthetic frameworks. Materials and Methods A three-dimensional maxillary model received four axially positioned morse-taper implants, over which a polymeric bar was simulated. The full-arch prosthesis was created from a previously reported database model, and the imported geometries were divided into a mesh composed of nodes and tetrahedral elements in the analysis software. The materials were assumed as isotropic, elastic, and homogeneous, and all contacts were considered bonded. A normal load (500 N magnitude) was applied at the occlusal surface of the first left molar after the model was fixed at the base of the cortical bone. The microstrain and von-Mises stress were selected as criteria for analysis. Results Similarities in the mechanical response were observed in both framework for the peri-implant tissue, as well as for stress generated in the implants (263–264 MPa) and abutments (274–273 MPa). The prosthetic screw and prosthetic base concentrated more stress with PEEK (211 and 58 MPa, respectively) than with PEKK (192 and 49 MPa), while the prosthetic framework showed the opposite behavior (59 MPa for PEEK and 67 MPa for PEKK). Conclusion The main differences related to the mechanical behavior of PEKK and PEEK frameworks for full-arch prostheses under the “all-on-four concept” were reflected in the prosthetic screw and the acrylic base. The superior shock absorbance of PEKK resulted in a lower stress concentration on the prosthetic screw and prosthetic base. This would clinically represent a lower fracture risk on the acrylic base and screw loosening. Conversely, lower stress concentration was observed on PEEK frameworks.

Objective: The purpose of this study is to evaluate the influence of the type of scanner and scanning direction on the accuracy of the final cast. Material and Methods: A partial master cast was used as a reference. A total of 128 scans were obtained and divided into two groups: the conventional method and the digital method. The digital group was divided into three groups: TRIOS 3, Omnicam and CS 3600. Each of these groups was subdivided according to the scanning direction, and each scan was overlaid on the digital reference cast to measure the trueness and precision of the procedures. Results: The overall precision values for the type of impression were 59.89 ± 13.08 mm for conventional and 13.42 ± 4.28 mm for digital; the values for trueness were 49.37 ± 19.13 mm for conventional and 53.53 ± 4.97 mm for digital; the scanning direction trueness values were 53.05 ± 4.36 mm for continuous and 54.03 ± 5.52 mm for segmented; and the precision values were 14.18 ± 4.67 mm for continuous and 12.67 ± 3.75 mm for segmented (p> 0.05). For the scanner type, the trueness values were 50.06 ± 2.65 mm for Trios 3, 57.45 ± 4.63 mm for Omnicam, and 52.57 ± 4.65 mm for Carestream; and those for precision were 11.7 ± 2.07 mm for Trios 3, 10.09 ± 2.24 mm for Omnicam, and 18.49 ± 2.42 mm for Carestream (p <0.05). Conclusions: The digital impression method is the most favorable method regarding precision; in terms of trueness, there are no differences between the types of impressions. KEYWORDS Conventional impression; Intra oral impression; Accuracy; Trueness.

Background The objective of this in vitro study was to evaluate the effect of the active application of self-etching ceramic primer (ME&P) on the bond strength of different dental CAD/CAM materials (Lithium Disilicate ceramic (LD), Leucite ceramic (LE), Zirconia reinforced lithium silicate ceramic (ZLS), and Hybrid ceramic (HC)) with thermocycling aging. Material and Methods The samples were randomly divided into 16 groups (n = 20). Dual resin cement cylinders were made and light cured for 10 s (1.200 mW/cm2) for the shear bond strength test. 3-way ANOVA revealed that the factors were statistically significant ( P < 0.05). Results The aging process had a negative impact on the bond strength for all groups except for Lithium Disilicate, with active application. ZLS and LE showed promising results with high bond strength values for the ME&P active application; however, after aging the bond strength value was significantly reduced. HC showed reduced bond strength values regardless the ME&P application. Conclusions In order to obtain a durable bond strength, the recommended protocol of 20 s of active application followed by 40 s of sitting time in the self-etching ceramic primer should be followed when using reinforced-glass ceramics as restorative materials. Key words: Dentistry, dental materials, silane, shear strength, computer-aided design

Introduction: Gingival Recessions (GR) are understood as processes of apical migration of periodontal tissues in relation to the cement-enamel junction, that is, they result in an inadequate positioning of the periodontium of protection, causing the consequent root exposure of the dental elements involved. Objective: The present study aims to report a case of Miller class III root coverage with coronary tissue repositioning associate with conjunctive graft. Case Report: A 50-year-old male, leucoderma, normossemic, sought care in a private clinic and presented as the main complaint the root exposition in element 41. After anamnesis, and before an accurate clinical examination and panoramic radiographic the presence of Miller's class III gingival recession, located on the buccal surface of the dental element 41, was diagnosed. The etiological factor includes a chronic periodontitis associated with bacterial plaque. Discussion: Regarding the collection of palatal connective tissue to be used as an autogenous graft material, the surgical technique adopted in this present case report provides a flap of adequate blood supply, whose nutrition will occur through the connective tissue and periosteum remnant of the surgical site of the recipient. Conclusion: The adopted therapeutic approach comprises a surgical technique of relative ease of execution, which seeks to minimize the postoperative discomfort of the patient and the existence of postoperative complications.Descriptors: Periodontics; Guided Tissue Regeneration; Dentistry; Surgery Oral.ReferencesJenabian N, Motallebnejad M, Zahedi E, Sarmast ND, Angelov N. Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession. J Clin Exp Dent. 2018;10(5):e431-38. Rehan M, Khatri M, Bansal M, Puri K, Kumar A. Comparative Evaluation of Coronally Advanced Flap Using Amniotic Membrane and Platelet-rich Fibrin Membrane in Gingival Recession: An 18-Month Clinical Study. Contemp Clin Dent. 2018;9(2):188-94.Pini Prato GP, Franceschi D, Cortellini P, Chambrone L. Long-term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession-type defects. J Periodontol. 2018;89(11):1290-1299.Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985;5(2):8-13.Guttiganur N, Aspalli S, Sanikop MV, Desai A, Gaddale R, Devanoorkar A. Classification systems for gingival recession and suggestion of a new classification system. Indian J Dent Res. 2018;29(2):233-37.Rasperini G, Acunzo R, Pellegrini G, Pagni G, Tonetti M, Pini Prato GP et al. Predictor factors for long-term outcomes stability of coronally advanced flap with or without connective tissue graft in the treatment of single maxillary gingival recessions: 9 years results of a randomized controlled clinical trial. J Clin Periodontol. 2018;45(9):1107-17.Trombelli L, Simonelli A, Minenna L, Rasperini G, Farina R. Effect of a Connective Tissue Graft in Combination With a Single Flap Approach in the Regenerative Treatment of Intraosseous Defects. J Periodontol. 2017;88(4):348-56.Tavelli L, Barootchi S, Nguyen TVN, Tattan M, Ravidà A, Wang HL. Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: A systematic review and meta-analysis. J Periodontol. 2018;89(9):1075-1090. George SG, Kanakamedala AK, Mahendra J, Kareem N, Mahendra L, Jerry JJ. Treatment of gingival recession using a coronally-advanced flap procedure with or without placental membrane. J Investig Clin Dent. 2018;9(3):e12340. Ramireddy S, Mahendra J, Rajaram V, Ari G, Kanakamedala AK, Krishnakumar D. Treatment of gingival recession by coronally advanced flap in conjunction with platelet-rich fibrin or resin-modified glass-ionomer restoration: A clinical study. J Indian Soc Periodontol. 2018;22(1):45-49.Akram Z, Vohra F, Javed F. Low-level laser therapy as an adjunct to connective tissue graft procedure in the treatment of gingival recession defects: A systematic review and meta-analysis. J Esthet Restor Dent. 2018;30(4):299-306. Francetti L, Taschieri S, Cavalli N, Corbella S. Fifteen-Year Follow-Up of a Case of Surgical Retreatment of a Single Gingival Recession. Case Rep Dent. 2018;2018:3735162. Cairo F, Cortellini P, Tonetti M, Nieri M, Mervelt J, Pagavino G et al. Stability of root coverage outcomes at single maxillary gingival recession with loss of interdental attachment: 3-year extension results from a randomized, controlled, clinical trial. J Clin Periodontol. 2015;42(6):575-81.Deepa D, Arun Kumar KV. Clinical evaluation of Class II and Class III gingival recession defects of maxillary posterior teeth treated with pedicled buccal fat pad: A pilot study. Dent Res J (Isfahan). 2018;15(1):11-6.Culhaoglu R, Taner L, Guler B. Evaluation of the effect of dose-dependent platelet-rich fibrin membrane on treatment of gingival recession: a randomized, controlled clinical trial. J Appl Oral Sci. 2018;26:e20170278. Reino DM, Novaes AB Jr, Grisi MF, Maia LP, de Souza SL. Palatal harvesting technique modification for better control of the connective tissue graft dimensions. Braz Dent J. 2013;24(6):565-68. Apicella A, Heunemann P, Bolisetty S, Marascio M, Graf AG, Garamszegi L et al. The Influence of Arginine on the Response of Enamel Matrix Derivative (EMD) Proteins to Thermal Stress: Towards Improving the Stability of EMD-Based Products. PLoS One. 2015;10(12):e0144641. da Silva Neves FL, Silveira CA, Dias SB, Santamaria Junior M, de Marco AC, Kerbauy WD et al. Comparison of two power densities on the healing of palatal wounds after connective tissue graft removal: randomized clinical trial. Lasers Med Sci. 2016;31(7):1371-78.Schmidlin P, Zobrist K, Attin T, Wegehaupt F. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides. J Appl Oral Sci. 2016;24(1):31-6.Aguirre-Zorzano LA, García-De La Fuente AM, Estefanía-Fresco R, Marichalar-Mendía X. Complications of harvesting a connective tissue graft from the palate. A retrospective study and description of a new technique. J Clin Exp Dent. 2017;9(12):e1439-e45.Arweiler NB, Auschill TM, Donos N, Sculean A. Antibacterial effect of an enamel matrix protein derivative on in vivo dental biofilm vitality. Clin Oral Investig. 2002;6(4):205-9.Bhutda G, Deo V. Five years clinical results following treatment of human intra-bony defects with an enamel matrix derivative: a randomized controlled trial. Acta Odontol Scand. 2013;71(3-4):764-70.Bajić MP, Danilović V, Prokić B, Prokić BB, Manojlović M, Živković S. Histological Effects of Enamel Matrix Derivative on Exposed Dental Pulp. Srp Arh Celok Lek. 2015;143(7-8):397-403.Jaiswal GR, Kumar R, Khatri PM, Jaiswal SG, Bhongade ML. The effectiveness of enamel matrix protein (Emdogain(®)) in combination with coronally advanced flap in the treatment of multiple marginal tissue recession: A clinical study. J Indian Soc Periodontol. 2012;16(2):224-30.

Introduction: In cases where there is an association of two or more diseases, it’s complex to improve individual’s well-being and quality of life, especially when these diseases have a bidirectional relation, as observed between diabetes mellitus and periodontal disease. Aim: The present study aims to review the literature on the relation between Diabetes Mellitus and Periodontal Disease, identifying the main aspects and pathognomonic characteristics.Conclusion:Due to the exposed in the literature on the interrelation of diabetes mellitus and periodontal disease, further studies are needed for a better understanding of the subject, knowing that the interdisciplinary approach is very important for the patient to have a better quality of life.

Gorlin-Goltz Syndrome, also known as Nevoid Basal Cell Carcinoma Syndrome, is a rare genetic disorder characterized by the presence of multiple keratocysts in the jaw and basal cell carcinomas, at young age, of palmar and/or plantar depressions, of calcification of the sickle cerebral and skeletal malformations. This syndrome is caused by a mutation of the PTCH1 (patched homolog 1 from Drosophila) gene, a tumor suppressor gene. In this work, the systemic and maxillofacial characteristics of the Gorlin-Goltz syndrome, as well as some neurological, dermatological, musculoskeletal and endocrine alterations, are reviewed. In addition, a case report was added for the purpose of support this study.

Objective: The aim of this study was to evaluate the pterygoid canal (PC) by Cone Beam Computed Tomography (CBCT), establishing its configuration and proximity with anatomical structures. Material and Methods: We evaluated 398 CBCT exams, all from a public University radiology clinic archive. Four parameters were evaluated: single or double PC, distance between PC and the inferior part of the sphenoid sinus (SS), ratio of PC and SS and the distance between the PC and the foramen rotundum. Results: It was observed that most of the PC of the sample presented simple morphology, the most frequent type of relationship between the PC and the SS on both sides was the close contact with the wall. Among the cases that there were some distances between the PC and the inferior wall of the SS, the mean of this distance did not exceed 3.20 mm, being the left side (3.03 mm) slightly closer than the right (3.20 mm). Finally, the distances between the PC and the corresponding Foramen Rotundum are presented with mean values of 5.87 mm for the right side and 6.31 mm for the left side. Conclusion: CBCT examination is of paramount importance for PC identification; once in the studied sample, the mean values found evidence the close relation between the PC and the SS.KeywordsCone beam computed tomography; Endonasal approach; Vidian canal.

Introduction: The aim of this study is to describe, via literature review, the use of bone grafts and the types most commonly used to rebuild following alveolar bone loss. Methodology: This literature review was conducted using the following databases: Pubmed (https://www.ncbi.nlm.nih.gov/pubmed), Scielo (http://www.scielo.org/php/index.php). The keywords for the textual search were: Bone Regeneration; Alveolar Bone Grafting; Dental Research; Dentistry. The inclusion criteria were: Literature that covers the subject under study, Literature of the last five years (from 2014 until 2019), English Language, systematic review, laboratory and clinical studies. The exclusion criteria were: literature review, letter to the editor, opinion article, literature duplicated in databases and literature that did not address the variables under study. Literature Review: 186 articles were found, but according to the inclusion criteria, only 30 were selected for this study. Bone is a specialized, vascularized and dynamic connective tissue that changes over the life of the organism. When injured, it has a unique capacity for regeneration and repair without the presence of scars, but in some situations due to the defect size, the bone tissue does not regenerate completely; thus, it is necessary to perform bone grafting procedures. Conclusion: The use of bone grafts in dentistry is shown to be a very effective and useful resource considering its great applicability in bone reconstructions in various areas of dentistry. However, greater knowledge about the viability and influence of biomaterials, whether associated to autogenous grafts or not, on bone repair is necessary.