This study aimed to present a literature review with data obtained in vitro and in vivo on metal free partial fixed protheses (PFP) in the posterior region, considering the following variables: ceramic material to be used; prosthesis extension; survival or longevity; main failures found, and comparison with the longevity of conventional metaloceramic PFP. A bibliographical survey was carried out using the databases: United States National Library of Medicine (PubMed) and Scientific Electronic Library Online (Sciello) for articles in English and Portuguese from 1998 to 2019. Articles should meet the inclusion criteria, which were articles that contained information that enabled the calculation of PFPs survival and success, articles with a minimum observation period of 3 years, articles that identified the reason of failures, and studies reported since 1998. Sixteen studies met the inclusion criteria and were evaluated comparatively. The survival rate of the PFP’s varies depending on the ceramic material used and the prostheses extension, no significant difference was observed in the relation between the ceramic material used and the connectors size; however, the greater the extension of the prosthesis, the higher must be the connector size. It was concluded that ceramic materials based on zirconia are the ones that have the longest survival. In addition, the main reasons that lead to decreased survival of PFP’s are secondary caries and connector fracture, however, more studies are needed to determine safely which materials and the extent of PFP’s are the most indicated.
One of the theories that contribute to explaining the evolution of non-carious cervical lesions (NCCLs) refers to fatigue wear, in which the concentration of stresses in the cervical region leads to the formation of microfractures in the dental tissues and progressive structure loss. However, due to a combination of factors that may cause wear, there is still uncertainty about the role of the occlusal factor as a risk factor that causes NCCLs. Objectives: The purpose of this case-control study was to investigate the association between the presence of NCCLs with occlusal force and other potential risk factors. Materials and Methods: Thirty-nine participants with NCCLs (cases) and 39 non-carrier patients (control), aged between 20 and 59 years old, were enrolled in the dental clinic of the Faculdade Integradas São Pedro (FAESA), located in Vitória, Espírito Santo State, Brazil. Information was collected through anamnesis, clinical examination, and a questionnaire addressing aspects related to tooth brushing, dentifrice, and mouthwash use. In clinical examination, patients were submitted to four measurements of occlusal force in the maxillary first premolars and maxillary first molars, using a strain gauge sensor of medium intensity, the Flexiforce (Tekscan, South Boston, MA, USA). The sensor was calibrated for the unit of measurement in Newtons (N). Results: Data was analyzed using a Student's t-test and multiple logistic regression, adopting the significance level of 5%. There was no statistically significant difference between the case and control groups regarding the bite force in the four measured regions. Logistic regression identified sex as a factor significantly associated with non-carious cervical lesions (p = 0.020). For the calculation of the odds ratio, the female sex presented a six-fold chance (OR = 6.082; CI = 1.332 - 27.765) higher than non-carious cervical lesions. Conclusions: It was concluded that females presented a higher risk factor for non-carious cervical lesions than men, whereas there was no association of occlusal strength, as well as aspects related to brushing and deleterious habits.Clinical Relevance: NCCLs are highly prevalent in daily clinical practices and can impact aesthetics and function, leading to hypersensitivity and impairment of oral-health-related quality of life. Gingival recession is an important clinical indicator for the presence of NCCLs.
The aim of this study was to identify the protocols used for indirect anterior and posterior restorations on dental substrate, used in Dental Prosthesis Specialization Courses and by professionals already specialists in the area. Two groups participated of this study, the first composed of 40 dental surgeons specialized in Dental Prosthesis and the second by 7 Specialization Courses of the same area. Both answered the same questionnaire about ceramic systems and cementation used for unitary indirect restorations of posterior and anterior teeth, on dental substrate in color A2 of the VITA scale (Vita Zahnfabrik). It was observed that among the prosthodontists, the majority (82.5%) opted for lithium disilicate for indirect restorations of anterior teeth and metalloceramics (32.5%) for posterior teeth. Alumina and felspathic were the least used materials in anterior and posterior regions. Dual resin cement was the most used for anterior teeth (57.5%) and posterior teeth (45%). Among the schools of Specialization and Updating courses, lithium disilicate (86%) was the first choice for anterior teeth and, for posterior teeth, zirconia (72%). Regarding cementation, both in the posterior and in the anterior regions, dual resin cement was the most used. From this survey of the protocols used, it was possible to identify that the two realities are similar, especially in the anterior region with preference for lithium disilicate, emphasizing the importance of knowledge of the materials available in the market.
This work aims to verify the effectiveness of the semi-adjustable articulator (SAA) when compared to a clinical examination of samples in individuals comparing the number of occlusal interferences. The research was carried out at FAESA (Integrated University of São Pedro), in which two independent researchers compared occlusal interferences in protrusion and laterality movements in the clinical examination and in models mounted on a semi-adjustable articulator, with carbon from Baush, in 77 patients who attended to the graduation clinic. Data were tabulated and evaluated by the Mann-Whitney statistical test and data normality was verified by the Kolmogorov-Smirnov test. When analyzing the interference of protrusion on central incisors, it was found that the mean was higher for the SAA on clinical examination. As for the right laterality in the canine guides, it was observed that the clinical examination had a higher interference average in relation to the SAA. The same was true for left laterality, where the mean interference was also higher for the clinical examination. That is, by increasing the values of occlusions in the SAA, the values of occlusions in the clinical examination also increase. As central incisor protrusions between the SAA and clinical examination were moderately positive, there was a strong positive relationship for the right sides and a moderate positive relationship for the left sides. It is concluded that a semi-adjustable articulator is an effective tool for the diagnosis and planning of the dentist, due to its ability to simulate mandibular movements. However, such a tool requires prior knowledge for an ideal assembly for treatment success.
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