Análise in vitro da precisão de técnicas de esplintagem na moldagem de implantes no esquema all-on-four
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In vitro analysis of the accuracy of splinting impression techniques using all-on-four systemAdvisor
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2014-10-15Type
Graduate program
Reabilitação Oral - FOAR
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Passively fitting superstructures are a prerequisite for long-lasting osseointegration of dental implants. Accurate transfer of the implant positions from the mouth to a definitive stone cast is a crucial step for ensuring the adaptation of components. Among the various techniques proposed, there is no consensus on which one is the most effective. The aim of this study was to evaluate in vitro the accuracy of different splinting methods in the impression of implants under standardized laboratory conditions. To obtain the master model, an aluminum metal matrix was developed, presenting four perforations, parallel (simulating conventional prosthesis and angled (simulating All-on-four system). Analogs were fixed and, on them, metal structures were fabricated. For straight implants, the groups were divided into GSUR: non-splinted square transfers; GUR-R: transfers splinted acrylic resin; GUM R: transfers splinted with metal rod, cyanoacrylate and acrylic resin. For angled implants, the same techniques were compared: GSU-A, GUR-A, GUM-A. The impression was performed with polyvinyl siloxane impression material and a standardized tray to control variables. The models were cast in standardized matrix with type IV plaster stone. For the measurements, a software (Leica QWin) received the images from a video camera coupled to a Leica stereomicroscope. The KruskalWallis test, associated with Dunn's test, with significance level of 5%, was applied. For straight implants, statistically significant difference between groups (KruskalWallis test; p <0.001) was observed. The difference was between GUR-R (186.71 µm) and master model (110.40 µm) and between GUR-R and the other groups (GSU-R: 108.27 µm and GUM-R: 92.98 µm). For angled implants, no statistically significant difference (p = 0.492) was found between the groups (MM-A: 68.52 µm; GSU-A: 60.80 µm; GUR-A: 56.54 µm; GUM-A: 69.33 µm. ..(Complete abstract electronic access below)
O assentamento passivo de próteses sobre implantes é fundamental para que o sucesso da reabilitação seja alcançado. A precisão na moldagem de transferência é um dos principais fatores responsáveis por assegurar a adaptação dos componentes. Dentre as várias técnicas propostas, não existe consenso sobre qual é a mais eficaz. O objetivo do presente estudo foi avaliar in vitro a precisão de diferentes métodos de união de transferentes quadrados na moldagem de implantes paralelos e angulados instalados em curva. Para a obtenção do modelo mestre, matrizes metálicas em alumínio foram confeccionadas, apresentando quatro perfurações, em forma de curva, paralelas (prótese protocolo convencional) e anguladas (esquema All-on-four). Foram fixados os análogos e, sobre eles, foram confeccionadas estruturas metálicas. Para os implantes retos, os grupos foram divididos em GSU-R: transferentes quadrados sem união; GUR-R: transferentes quadrados unidos com bastões de resina acrílica autopolimerizável pré-fabricados e GUM-R: transferentes quadrados unidos com haste metálica, cianoacrilato e resina acrílica autopolimerizável. Para os implantes angulados, as mesmas técnicas foram comparadas: GSU-A, GUR-A, GUM-A. A moldagem foi realizada com silicone de adição e moldeira rosqueada para controlar variáveis. Os modelos foram vazados em matriz padronizada com gesso pedra tipo IV. Os modelos obtidos foram armazenados à temperatura ambiente por no mínimo 120 horas até que as medidas das fendas fossem realizadas. Foi utilizada uma lupa LEICA acoplada a uma câmera de vídeo colorida e as mensurações das fendas foram realizadas no programa LEICA QWin. Foi aplicado o teste de Kruskal-Wallis, complementando pelo teste de Dunn, com nível de significância de 5%. Para os implantes retos, foi observada diferença estatisticamente significante entre os grupos...(Resumo completo, clicar acesso eletrônico abaixo)
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