Banca de QUALIFICAÇÃO: ANA LARISSE CARNEIRO PEREIRA
Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.STUDENT : ANA LARISSE CARNEIRO PEREIRA
DATE: 07/02/2023
TIME: 14:30
LOCAL: Departamento de Odontologia
TITLE:
KEY WORDS:
Protheses supported-implant. CAD-CAM. Edentulous. Dental Impression Technique. Dental marginal adaptation. Occlusal Adjustment.
PAGES: 198
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUMMARY:
Rehabilitation with complete-arch implant-supported fixed prostheses (IFP), using conventional methods, involves a series of clinical and laboratory procedures. With the introduction of digital resources, new possibilities for workflows and materials emerged, allowing the simplification of the conventional technique. As a result, new problems associated with the applicability of digital technology to total edentulous arches rehabilitated with multiple implants made the creation of digital IFP challenging. Therefore, the objective of this work is to evaluate the accuracy of a new workflow, as well as the effect of associating different materials for the manufacture of IFP. A device for intraoral scanning of multiple implants (BR 10 2019 026265 6) was developed, which allows direct and precision scanning of the position of implants for the virtual environment. However, numerous factors involving the accuracy of implant position transfer from the real to the virtual environment were described in a systematic review (CRD42020171021). In this, it was evidenced that the choice of scanner and its technology, characteristics of the arch, quantity, distribution, distance and angulation of the implants, in addition to the environmental conditions during the scanning, can influence the quality of the virtual images and, consequently, in prosthetic work. Based on these results, a study was developed to evaluate and compare the effect of the type of impression (conventional - CI versus digital - DI) and the number of implants over time, from impressions to the generation of working models for IFP, as well as patient satisfaction. It was observed that the DI time was shorter than the IC (DI, x̃=02:58; IC, x̃=31:48) (p<0.0001). The arches rehabilitated with 3 implants required less digital impression time (3: x̃=05:36; 4: x̃=09:16) (p<0.0001). Regarding satisfaction, the DI was more comfortable and painless than the IC (p<0.005). Then, the accuracy of the device in the construction of implant-supported infrastructures was evaluated, through the analysis of clinical passivity and vertical marginal misfit (single screw test, all screws tightened and alternating) in the conventional (CI) and printed (DI) models. Clinically, it was observed absence of retention, presence of stability, absence of empty spaces between the framework/abutments. In the laboratory, greater misfits were observed in the DI model compared to the CI, when the single screw test was applied. In the comparison between the three tests, the single screw provided the greatest misfits in the frameworks in the CI model, with a significant difference between single and alternate screws (p<0.001), single screw and all tightened (p<0.001) and no difference between alternate and all tight (p=0.368). In the DI model, greater misfits were observed when the single screw test was applied, with a significant difference between the three tests used (p<0.001). These findings supported the development of the new technique for making digital IFP, which was tested through a study whose objective was to evaluate the accuracy of the digital maxillomandibular registration (DMR) compared to the conventional one (CMR) for making IFP, through the distribution and quantity of occlusal contact points, registration time and occlusal adjustment. The DMR method showed better accuracy for the distribution of occlusal contact points between clinically “excellent (30%) and good (70%)”. A greater number of occlusal contact points were observed in CMR for anterior teeth (p=.439) and posterior teeth (premolars – p=.009) for DMR (p=.227). No relationship was observed between the distribution and amount of occlusal contact points (CMR – p=.288/DMR – p=.183). The CMR requires less working time and the prostheses obtained by the CMR method took more occlusal adjustment time (p=.008). With these PTF installed, the accuracy and reproducibility of the real (CR) and virtual (CV) occlusal contact points were investigated. Of the methods, 100% (CR) and 73.6% (CV) presented real and virtual occlusal contact points considered clinically excellent. There was no significant difference regarding the reproducibility of the methods by the number of occlusal contact points (CR: x̅13.32; CV: x̅13.68; p=0.715). In order to evaluate the effectiveness of the bonding between framework/base/CAD/CAM tooth, different bonding protocols will be evaluated, as well as the effect of glaze on staining at the base/tooth interface, and the impact of glaze on base materials. prosthesis on biofilm adhesion, hardness and flexion. Therefore, in the end, it is expected that some of the bonding protocols tested will increase the bond strength between the parts of the prosthesis, that the glaze will reduce biofilm adhesion, increase the hardness and flexion of the base materials of CAD/CAM dentures.
COMMITTEE MEMBERS:
Presidente - 1459400 - ADRIANA DA FONTE PORTO CARREIRO
Interna - 1678126 - PATRICIA DOS SANTOS CALDERON
Interno - 1640419 - RODRIGO OTHAVIO DE ASSUNCAO E SOUZA