Efeitos da ciclagem mecânica, técnica de confecção e diferentes cerâmicas sobre a adaptação marginal e resistência à fratura de próteses implantossuportadas
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Data
2020-12-03
Autores
Limírio, João Pedro Justino de Oliveira [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O objetivo desse estudo in vitro foi avaliar por meio da metodologia de ciclagem mecânica a adaptação marginal (vertical/horizontal) e resistência à fratura, verificando a decorrência e possíveis complicações protéticas de próteses parafusadas implantossuportadas (hexágono externo) confeccionadas por diferentes técnicas e materiais cerâmicos. Foram confeccionados 50 corpos de prova, pela técnica convencional e Computer aided design and Computer aided manufacturing (CAD-CAM) divididos em cinco grupos (n=10 por grupo) sendo MC (Metalocerâmica); ZrL (Coping fresado em zircônia com link mais aplicação de cerâmica feldspática); Zr (Coping fresado em zircônia mais aplicação de cerâmica feldspática); MZrL (Monolítica de zircônia com link); MZr (Monolítica de zircônia), os quais foram submetidos à ciclagem mecânica em uma angulação de 30°, a 37°C e submetidos a 5 x 10⁶ ciclos com aplicação de carga de 150N a uma frequência de 2,0Hz. No capítulo 1 foram avaliados à adaptação marginal vertical e horizontal (µm) antes e após ciclagem mecânica em Microscópio Óptico Tridimensional (3D) e no capítulo 2 os padrões de falhas das cerâmicas em Estereomicroscópio e Microscópio eletrônico de varredura (MEV) pós ciclagem mecânica. Os dados quantitativos foram analisados quanto a distribuição de normalidade e adotou-se o teste mais adequado considerando o nível de significância de 0,05. Os resultados obtidos para o capítulo 1 foram que em relação a desadaptação marginal vertical antes da ciclagem mecânica (tempo inicial-T0), houve diferença significativa com maiores valores de desadaptação para MC (93,93±22,84µm) e MZrL (66,12±11,87µm), p<0.05, quando comparados à Zr (49,92±3µm) e MZr (49,76±3,9µm), unindo os grupos com (ZrL+MZrL: 63,04±9,33µm) e sem link (Zr+MZr: 49,84±3,38µm) comparados ao grupo controle (MC) houve diferença significativa entre todos os grupos, p<0.05, com menores valores de desadaptação para o grupo sem link. Em termos de desadaptação marginal horizontal antes da ciclagem mecânica (tempo inicial - To), houve diferença significativa com maiores valores de desadaptação para o grupo MC (-130,275±34,97µm), p<0.05, e menores valores de desadaptação para o grupo MZr (- 10,35±23,14µm), p<0.05, quando comparados aos demais grupos, além disso para o grupo sem link (Zr: -70,27±22,61µ vs MZr: -10,35±23,14µ), houve diferença significativa (p<0.05) com menores valores de desadaptação para MZr. Unindo os grupos com (-75,98±14,17µm) e sem link (-40,31±37,73µm), foi identificada diferença significativa entre todos os grupos quando comparados ao controle (MC: -130,27±34,97µm), (p<0.001), com menores valores para o grupo sem link. Em relação à comparação antes e após ciclagem (Tf-T0), para análise da adaptação marginal vertical, o grupo MC (10,05±5,74µm) foi o que apresentou maiores valores de desadaptação, p<0.05, quando comparado aos demais grupos, já para análise da adaptação marginal horizontal, o grupo Zr (3±13,97µm) apresentou diferença estatística, p<0.05, na comparação com ZrL (-4,48±13,59µm) e MZrL (-2,825±11,81µm), unindo os grupos com (- 3,65±12,72µm) e sem link (0,35±10,99µm), houve menores valores de desadaptação para o grupo sem link, p<0.05. Para o capítulo 2, um total de 14 amostras falharam (lascamento/fratura de cerâmica). Os grupos MZrL e MZr apresentaram significativamente menor associação de falhas, com apenas uma falha (MZr) (p=0.035), assim como em relação ao tipo de substrato, os grupos MZrL e MZr apresentaram menos falhas (p=0,011). O uso de links e o número de ciclos não indicaram diferenças significativas entre os grupos (p≥0,05). Para área da falha, houve diferença significativa para o grupo Zr (15,55m²), p=0,029, apresentando maior extensão de área quando comparado aos demais. Em relação ao local da falha o grupo MC apresentou uma maior quantidade de falhas, com 5 falhas na região de orifício do parafuso quando comparado aos demais (p=0,043), os quais apresentaram falhas em diferentes locais. Portanto, o uso da tecnologia CAD/CAM foi o que resultou em menores valores de desadaptação marginal vertical e horizontal, assim como para resistência à fratura com destaque para as coroas monolíticas de zircônia.
The aim of this in vitro study was to evaluate, through the mechanical cycling methodology, the marginal fit (vertical / horizontal) and fracture resistance, verifying the outcome and possible prosthetic complications of screwed-retained prostheses (external hexagon) made by different techniques and ceramic materials. Fifty specimens were made using the conventional technique and Computer aided design and Computer aided manufacturing (CAD-CAM) divided into five groups (n = 10 per group) being MC (Metal-ceramics crowns); ZrL (Coping milled in zirconia with link and covered feldspar ceramic); Zr (Coping milled in zirconia with covered feldspar ceramic); MZrL (Monolithic zirconia with link); MZr (Monolithic zirconia), which were subjected to mechanical cycling at an angle of 30 °, at 37 ° C and subjected to 5 x 10⁶ cycles with a 150N load application at a frequency of 2.0Hz. In chapter 1, the vertical and horizontal marginal fit (μm) were evaluated before and after mechanical cycling under a three-dimensional optical microscope (3D) and in chapter 2 the failure modes by the stereomicroscope and scanning electron microscope (SEM) after mechanical cycling. Quantitative data were analyzed for normality distribution and the most appropriate statistical test was adopted considering the significance level of 0.05. The results obtained for chapter 1 were that in relation to vertical marginal misfit before mechanical cycling (initial time-T0), there was a significant difference with higher misfit values for MC (93.93 ± 22.84μm) and MZrL (66, 12 ± 11.87μm), p <0.05, when compared to Zr (49.92 ± 3μm) and MZr (49.76 ± 3.9μm), joining the groups with (ZrL + MZrL: 63.04 ± 9.33μm) and without link (Zr + MZr: 49.84 ± 3.38μm) compared to the control group (MC) there was a significant difference between all groups, p <0.05, with lower misfit values for the group without link. In terms of horizontal marginal misfit before to mechanical cycling (initial time - To), there was a significant difference with higher misfit values for the MC group (-130.275 ± 34.97μm), p <0.05, and lower misfit values for the group MZr (-10.35 ± 23.14μm), p <0.05, when compared to the other groups, in addition for the group without a link (Zr: -70.27 ± 22.61μm vs MZr: -10.35 ± 23, 14μm), there was a significant difference (p <0.05) with lower misfit values for MZr. Joining the groups with (-75.98 ± 14.17μm) and without link (-40.31 ± 37.73μm), a significant difference was identified between all groups when compared to the control (MC: -130.27 ± 34, 97μm), (p <0.001), with lower values for the group without a link. Regarding the comparison before and after cycling (Tf-T0), for analysis of vertical marginal fit, the MC group (10.05 ± 5.74μm) was the one with the highest misfit values, p <0.05, when compared to the others groups, already for analysis of the horizontal marginal adaptation, the Zr group (3 ± 13.97μm) showed statistical difference, p <0.05, in comparison with ZrL (-4.48 ± 13.59μm) and MZrL (-2.825 ± 11, 81μm), joining the groups with (-3.65 ± 12.72μm) and without link (0.35 ± 10.99μm), there were lower misfit values for the group without link, p <0.05. For chapter 2, a total of 14 samples failed, the groups MZrL and MZr showed significantly less association of failures, with only one failure (MZr), p = 0.035, as well as in relation to the type of substrate, the groups MZrL and MZr showed fewer failures (p = 0.011). The use of links and the number of cycles did not indicate significant differences between the groups (p≥0.05). For the chipping and/or fracture dimensions, there was a significant difference for the Zr group (p = 0.029) presenting a larger area of chipping when compared to the others. Regarding the location of the failure, the MC group showed a greater number of chipping in the screw orifice region when compared to the others (p = 0.043), which failed in different locations. Therefore, the use of the CAD / CAM system resulted in lower values of vertical and horizontal marginal maladjustment, as well as fracture resistance, with emphasis on monolithic crowns.
The aim of this in vitro study was to evaluate, through the mechanical cycling methodology, the marginal fit (vertical / horizontal) and fracture resistance, verifying the outcome and possible prosthetic complications of screwed-retained prostheses (external hexagon) made by different techniques and ceramic materials. Fifty specimens were made using the conventional technique and Computer aided design and Computer aided manufacturing (CAD-CAM) divided into five groups (n = 10 per group) being MC (Metal-ceramics crowns); ZrL (Coping milled in zirconia with link and covered feldspar ceramic); Zr (Coping milled in zirconia with covered feldspar ceramic); MZrL (Monolithic zirconia with link); MZr (Monolithic zirconia), which were subjected to mechanical cycling at an angle of 30 °, at 37 ° C and subjected to 5 x 10⁶ cycles with a 150N load application at a frequency of 2.0Hz. In chapter 1, the vertical and horizontal marginal fit (μm) were evaluated before and after mechanical cycling under a three-dimensional optical microscope (3D) and in chapter 2 the failure modes by the stereomicroscope and scanning electron microscope (SEM) after mechanical cycling. Quantitative data were analyzed for normality distribution and the most appropriate statistical test was adopted considering the significance level of 0.05. The results obtained for chapter 1 were that in relation to vertical marginal misfit before mechanical cycling (initial time-T0), there was a significant difference with higher misfit values for MC (93.93 ± 22.84μm) and MZrL (66, 12 ± 11.87μm), p <0.05, when compared to Zr (49.92 ± 3μm) and MZr (49.76 ± 3.9μm), joining the groups with (ZrL + MZrL: 63.04 ± 9.33μm) and without link (Zr + MZr: 49.84 ± 3.38μm) compared to the control group (MC) there was a significant difference between all groups, p <0.05, with lower misfit values for the group without link. In terms of horizontal marginal misfit before to mechanical cycling (initial time - To), there was a significant difference with higher misfit values for the MC group (-130.275 ± 34.97μm), p <0.05, and lower misfit values for the group MZr (-10.35 ± 23.14μm), p <0.05, when compared to the other groups, in addition for the group without a link (Zr: -70.27 ± 22.61μm vs MZr: -10.35 ± 23, 14μm), there was a significant difference (p <0.05) with lower misfit values for MZr. Joining the groups with (-75.98 ± 14.17μm) and without link (-40.31 ± 37.73μm), a significant difference was identified between all groups when compared to the control (MC: -130.27 ± 34, 97μm), (p <0.001), with lower values for the group without a link. Regarding the comparison before and after cycling (Tf-T0), for analysis of vertical marginal fit, the MC group (10.05 ± 5.74μm) was the one with the highest misfit values, p <0.05, when compared to the others groups, already for analysis of the horizontal marginal adaptation, the Zr group (3 ± 13.97μm) showed statistical difference, p <0.05, in comparison with ZrL (-4.48 ± 13.59μm) and MZrL (-2.825 ± 11, 81μm), joining the groups with (-3.65 ± 12.72μm) and without link (0.35 ± 10.99μm), there were lower misfit values for the group without link, p <0.05. For chapter 2, a total of 14 samples failed, the groups MZrL and MZr showed significantly less association of failures, with only one failure (MZr), p = 0.035, as well as in relation to the type of substrate, the groups MZrL and MZr showed fewer failures (p = 0.011). The use of links and the number of cycles did not indicate significant differences between the groups (p≥0.05). For the chipping and/or fracture dimensions, there was a significant difference for the Zr group (p = 0.029) presenting a larger area of chipping when compared to the others. Regarding the location of the failure, the MC group showed a greater number of chipping in the screw orifice region when compared to the others (p = 0.043), which failed in different locations. Therefore, the use of the CAD / CAM system resulted in lower values of vertical and horizontal marginal maladjustment, as well as fracture resistance, with emphasis on monolithic crowns.
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Palavras-chave
Prótese dentária fixada por implante, Cerâmicas, Desenho assistido por computador, Dental prosthesis