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Reabilitação Estética e Funcional com Pino de Fibra de Vidro / Aesthetic and Functional Rehabilitation with Fiberglass Pin
... Por outro lado, as reabilitações funcionais focam especificamente na recuperação da capacidade fonética e mastigatória do paciente. Isso é vital, pois a mastigação adequada e a fala clara são indispensáveis para a qualidade de vida, impactando diretamente na alimentação, na comunicação e nas interações sociais diárias (Lima et al., 2020Cardoso et al., 2022. ...
... Para condutos mais estreitos, brocas com diâmetro de 0,5 mm ou 1 mm são mais indicadas, enquanto condutos mais largos podem requerer brocas de 2 mm ou 3 mm, garantindo assim uma fixação segura e eficaz. Essa atenção aos detalhes na preparação do canal radicular é crucial para maximizar a eficiência do pino e minimizar o perigo de falhas no tratamento (Lima et al., 2020;Cardoso et al., 2022). ...
... Com suas inúmeras vantagens, esses pinos representam uma solução inovadora que não só melhora a funcionalidade das restaurações, mas também promove um resultado estético superior, garantindo assim a saúde oral e a confiança dos pacientes em seus sorrisos. A contínua pesquisa e desenvolvimento nesse campo são fundamentais para expandir ainda mais as possibilidades e a eficácia das soluções oferecidas aos pacientes na prática odontológica contemporânea, no Quadro 1 é possivel observar as principais características dos pinos metálicos e dos pinos de fibra de vidro (Lima et al., 2020;Cardoso et al., 2022 Fortalecer o dente sem o risco de comprometer a estrutura com materiais excessivamente rígidos Recomendados para casos clínicos em que não há um remanescente minimo de 2 mm de remanescente dental cervical Necessita de um remanescente superior a 2 mm Histórico de sucesso Fonte: Adaptado de: Alves et al.(2021), Carvalho et al.(2021), Conrado et al.(2021), Reis et al. (2021), Oliveira et al.(2021), Dhilipkumar et al.(2023) , Martins et al.(2023), Maciel et al.(2024) ...
Both metal and fiberglass posts are intraradicular components used to aid in the oral rehabilitation of patients who have suffered major coronary destruction. Each post has its own indication, presenting advantages and disadvantages that need to be taken into account when indicating each treatment plan for patients. This work aims to present metal posts and fiberglass posts, exposing their advantages and disadvantages, and can serve as an information source for both dental students and professionals who have already graduated. Scientific articles related to the proposed theme, available in the online databases BVSalud, PUBMed, Lilacs, Scielo and Google Scholar, presented in Portuguese and/or English and published between 2020 and 2024, were used to compose the bibliographic basis of this work. It is concluded that both metal posts and fiberglass posts are efficient within their indications.
... Intraradicular posts are used in dentistry for the rehabilitation of teeth that have suffered significant loss of coronal structure, usually due to deep caries, fractures, or trauma, and following endodontic treatment, which removes the dental pulp and can compromise the strength of the tooth. The rehabilitation with fiberglass posts has been widely discussed in the literature [1] emphasizing that fiberglass posts have an elastic modulus similar to the dentin, promoting better distribution of masticatory forces and reducing the risk of fractures. According to Meriç et al., glass fibers reinforced composites improve the mechanical properties of polymers and are additionally considered biocompatible and non-cytotoxic materials [2]. ...
... Nesse sentido, a prótese adesiva fixa é considerada uma alternativa mais simples para a reabilitação de dentes ausentes, ao preservar a estrutura dental sadia dos dentes adjacentes, que não precisam ser desgastados para receber a prótese. Essa técnica oferece vantagens estéticas, funcionais e biológicas (Goyatá et al., 2010;Silva et al., 2020;Felizardo et al., 2016). A técnica é de fácil e rápida execução (Goyatá et al., 2010;Raposo et al., 2013;Campanha et al., 2005), com mínima invasão dos dentes suportes (Santana et al., 2010;Felizardo et al., 2016), em relação às próteses parciais fixas convencionais. ...
A técnica de prótese adesiva consiste em utilizar materiais que se aderem aos dentes para substituir dentes ausentes, sem necessidade de desgastar muito os dentes que servem de apoio. Um desses materiais é a resina composta reforçada por fibra de vidro, que se adapta e se fixa bem à prótese adesiva. Neste caso clínico, foi realizada uma prótese parcial fixa adesiva, usando os dentes vizinhos como suporte para uma prótese unitária feita de resina composta reforçada por fibra de vidro. O propósito foi devolver a função e a estética do dente 25, sem gerar desconforto ao paciente. Os procedimentos foram feitos assegurando que a prótese ficasse bem ajustada na boca da paciente, e a técnica consistiu em colocar resina composta no dente preparado, com uma fibra de vidro entrelaçada em forma de X sobre a resina. A polimerização prendeu a fibra de vidro ao dente, aumentando a resistência da prótese adesiva, o que possibilitou evitar preparos invasivos e reduzir riscos de fraturas e deslocamentos das próteses adesivas. Os resultados obtidos através do tratamento, consistem na melhoria da capacidade de mastigação e a confiança da paciente. No caso, a fibra de vidro reforçou a prótese adesiva, devolvendo a estética e função dos dentes, com boa adaptação e estabilidade, e as vantagens incluíram a preservação da estrutura dental saudável e a restauração da função estética.
A colaboração multidisciplinar desempenha um papel crucial na busca por resultados excelentes, visando restabelecer tanto a saúde quanto a estética, considerando as particularidades de cada paciente, especialmente em casos de fratura dental com pouco remanescente. Este caso clínico tem como objetivo relatar a abordagem integrada no tratamento reabilitador estético da unidade 22 após traumatismo dentário em um adolescente. O plano de tratamento envolveu uma avaliação detalhada e a decisão por uma intervenção multidisciplinar, com a recomendação de uma cirurgia periodontal para restabelecer as distâncias biológicas e permitir a realização da terapia endodôntica. Posteriormente, efetuou-se a reconstrução da porção coronária com pino de fibra de vidro, seguida pela confecção de uma coroa provisória para a proteção e estética do dente. O processo foi concluído com a avaliação e o tratamento ortodôntico. O cuidadoso e meticuloso plano de tratamento foi essencial para o sucesso do caso clínico, proporcionando resultados satisfatórios e atendendo plenamente às expectativas da paciente.
O programa ‘Farmácia Solidária’ foi implementado em Maringá (PR) no ano de 2019, com objetivo de receber fármacos doados pela população e redistribuí-los por meio das UBS para quem necessite. O presente trabalho teve como objetivo avaliar por meio de testes físico-químicos oficiais, a qualidade de alguns comprimidos distribuídos no programa Farmácia Solidária. Foram analisados comprimidos gené ricos de hidroclorotiazida 25mg e comparados com a referência Clorana® 25mg, este adquirido em far mácia comercial de Maringá. Os testes realizados foram peso médio, dureza, friabilidade, desintegração, dissolução e doseamento. Os comprimidos testados apresentam valores dentro dos parâmetros descritos na Farmacopeia Brasileira 6.a edição.
The aim of this study was to assess the influence of mechanical cycling and cement thickness on the bond strength between fiber posts and root dentin. Forty bovine teeth were sectioned (16 mm) and randomly assigned to four groups (n = 10). Specimens in Groups 1 and 2 were cemented using a thinner cement layer, while specimens in Groups 3 and 4 were cemented using a thicker cement layer. Groups 2 and 4 were submitted to mechanical cycling. Four slices per specimen were produced and submitted to push-out testing. Bond strength values were not affected by mechanical cycling (P = 0.2893), although the thickness of the cement layer did affect bond strengths (P = 0.0059, thinner > thicker). Tukey's test showed that Group 1 (19.27 MPa) had a higher mean bond strength value than Group 3 (12.4 MPa) and Group 4 (13.6 MPa), while Group 2 (15.0 MPa) was statistically similar to all groups. These results indicate that a thicker cement layer negatively affected the push-out bond strength between a fiber post and root dentin, regardless of whether the specimens were subjected to mechanical cycling.
Objective
This study aimed to evaluate the fracture load and displacement of roots restored with posts of different elastic modulus.
Material and method
Thirty-six replicas of epoxy resin mixed with glass microfibers were made from an endodontically-treated human premolar root prepared to a length of 12 mm with a custom drill, leaving the apical 4 mm unprepared. Replicas were randomly restored with (n = 12): FP-LM (fiber post with low elastic modulus– 50 GPa), FP-HM (fiber post with high elastic modulus – 67 GPa) and MP (metallic post – 208 GPa), using self-curing adhesive and dual resin cement. Cores were built up with composite resin and metallic crowns were cemented in all the roots with self-adhesive resin cement with self-curing mode. Specimens were subjected to a fracture load test (45° inclination/0.5 mm/min) and displacement was registered at 100 N.
Result
One-way ANOVA showed that elastic modulus of the post did not affect the fracture load means (p = 0.203) (FP-LM: 237.4 ± 65.11 N; FP-HM: 236.7 ± 92.85 N; MP: 295.8 ± 108.7 N) but was statistically significant for the displacement (p < 0.00): Tukey’s test showed that FP-LM displacement mean (0.81 ± 0.15 mm) was significantly higher than those for FP-HM (0.46 ± 0.26 mm; p = 0.00) and MP (0.62 ± 0.07 mm; p = 0.04).
Conclusion
Posts with different elastic modulus exhibit similar fracture loads, but a lower displacement is achieved when fiber posts with a high elastic modulus and metallic posts are used.
Introdução
Os pinos de fibra de vidro são uma alternativa aos núcleos metálicos e apresentam vantagens, tais como: estética, módulo de elasticidade semelhante à dentina e cimentação imediata após o término do tratamento endodôntico. Ainda, apresentam a capacidade de aderir ao cimento resinoso e este, à dentina, por meio de técnicas adesivas.
Objetivo
Comparar a adesão de um cimento resinoso convencional e um autoadesivo a pinos de fibra de vidro, e os efeitos de diferentes tratamentos de superfície na resistência adesiva dos pinos.
Material e método
Trinta pinos foram divididos em três grupos: Controle: sem tratamento na superfície; Jateamento: jateamento com óxido de alumínio por 30 segundos, e Peróxido: imersão em peróxido de hidrogênio 24% por um minuto. Em seguida, corpos de prova foram obtidos a partir de cilindros de cimento resinoso contendo o pino de fibra posicionado no centro de seu longo eixo. Em cada grupo, cinco pinos foram associados ao adesivo Âmbar + cimento convencional AllCem Core e os outros cinco pinos, ao cimento autoadesivo RelyX U200. O conjunto pino/cimento foi segmentado e avaliado em relação à resistência de união (RU) por push-out. Os dados foram analisados estatisticamente pelos testes de ANOVA e Tukey (p<0,05).
Resultado
Os cimentos avaliados exibiram valores de RU semelhantes. Em relação aos tratamentos de superfície, os maiores valores de RU foram encontrados no grupo Jateamento.
Conclusão
O cimento convencional, AllCem Core, e o cimento autoadesivo, RelyX U200, mostraram valores de resistência de união semelhantes. Ainda, o jateamento com óxido de alumínio favoreceu a adesão dos pinos aos cimentos.
This study evaluated the influence of the surface treatments of fiberglass posts on bond strength to root dentin using push-out test. Forty bovine incisor roots were endodontically treated. The surface of the fiberglass posts (Exacto #2, Angelus) were treated using 4 different protocols (n=10): Control - 70% ethanol for 1 min; 37% phosphoric acid for 1 min; 10% hydrofluoric acid for 1 min; and 24% hydrogen peroxide for 1 min. After a silane coupling agent was applied for 1 min and all posts were cemented using self-adhesive resin cement (RelyX Unicem, 3M-ESPE). The roots were sectioned and two 1-mm-thick slices were obtained from each third: cervical, middle and apical. The specimens were subjected to the push-out test with a crosshead speed of 0.5 mm/min. Data were analyzed by repeated measures ANOVA followed by Tukey's HSD tests (=0.05). The surface treatment (p<0.001) and root third region (p=0.007) factors were significant. The retention to root canal was affected by surface treatment type. The post surface treatment with 24% hydrogen peroxide for 1 min yielded significantly higher bond strength when the fiberglass posts were cemented with RelyX Unicem.
Dentes tratados endodonticamente que possuem grande perda de estrutura coronária necessitam de ancoragem intrarradicular para que posteriormente seja restabelecida forma e função. Dentre os retentores intrarradiculares, o pino de fibra de vidro tem se destacado por ser um material biocompatível que apresenta módulo de elasticidade semelhante a dentina e constitui um material estético que exige menor tempo clínico e de fácil aplicação. Os pinos de fibra de vidro apresentam uma alternativa clínica aos núcleos metálicos fundidos por representarem uma opção de pinos intrarradiculares com características mecânicas ideais ao remanescente dentário, além de permitir estética superior. Sendo assim, este trabalho propõe uma revisão de literatura sobre as características inerentes a este tipo de pino e sua aplicabilidade clínica.
As a dangerous factor in vertical root fracture, dentinal crack formation is often associated with root canal instruments. We conducted this meta-analysis to compare the influence of two types of nickel titanium (NiTi) instruments that have different movements (reciprocating single-file versus full-sequence rotary file systems) on dentinal cracks formation during root canal preparation. Searches were conducted in PubMed, ISI Web of Knowledge, Embase and Cochrane Library using a combination of keywords. Titles and abstracts of all articles were independently assessed by two reviewers in accordance with the predefined inclusion criteria. Relevant studies were acquired in full-text form. Data in these articles were independently extracted. A meta-analysis was conducted using Review Manager 5.3. The results showed that the WaveOne and Reciproc files with a reciprocating motion produced significantly fewer dentinal cracks than the conventional rotational ProTaper technique.
Statement of problem:
Endodontically treated teeth with Class III restorations show reduced fracture resistance. The placement of glass fiber posts may affect fracture resistance and should be further evaluated.
Purpose:
The purpose of this in vitro study was to evaluate the effect of fiber posts on the fracture resistance of endodontically treated maxillary central incisors with Class III restorations.
Material and methods:
Forty extracted human maxillary central incisors were selected and divided into 4 test groups (n=10 each) according to the restoration strategy: control group; endodontically treated teeth without endodontic posts (GHT); endodontically treated teeth with 2 Class III restorations simulating coronal destruction (GCT); endodontically treated teeth with 2 Class III restorations and a carbon fiber post (GCF); and endodontically treated teeth with 2 Class III restorations and a glass-fiber post (GGF). The fiber posts were adhesively cemented with composite resin cement, and the cavities were restored with composite resin. After 3 months of water storage, all specimens were loaded at 45 degrees in a universal testing machine until fracture and evaluated for fracture mode. The data were analyzed using 1-way ANOVA, followed by the Tukey honest significant difference multiple comparisons test (α=.05).
Results:
Mean ±SD failure loads ranged from 687.5 ±84.0 N to 943.8 ±93.1 N. One-way ANOVA revealed a statistically significant difference among the groups (P≤.05). The control group (GHT) had significantly higher resistance to fracture than the other groups (P≤.05).
Conclusions:
Within the limitations of this in vitro study, placement of a fiber post did not affect the fracture resistance of endodontically treated maxillary central incisors with 2 Class III restorations.
Objectives
This study compared the influence of cement film thickness (CFT) on bond strength (BS) and fracture resistance (FR) of fiber-reinforced composite (FRC) posts to root canal.
Materials and methods
One hundred bovine incisors were used for BS and FR analysis (n = 10) and distributed into five experimental groups according to FRC post diameters (WhitePost DC no. 0.5, no. 1, no. 2, no. 3, no. 4), leading to five different CFTs. The canals were prepared using drill no. 4 provided by the post manufacturer and irrigated with 2.5 % NaOCl. After conditioning (24 % H2O2/5 min) and silanization, posts were cemented with resin cement. BS was evaluated using push-out test and FR using the compression test at 45°. A stereomicroscope was used to measure CFT and to analyze failure pattern. BS data were subjected to two-way ANOVA and Scheffé test for contrast (α = 0.05); FR data were subjected to one-way ANOVA.
Results
BS was significantly affected by CFT, as the most well-adapted post achieved the highest values (p < 0.05). BS was similar for all root thirds. CFT did not affect fracture resistance. No root fractures were observed.
Conclusions
A FRC post well adapted to the root canal results in higher BS values. Different CFTs did not influence the FR of teeth restored with FRC posts.
Clinical relevance
The results indicate that post retention is improved when a well-adapted post is used, although this has not been critical to fracture resistance.
Influence of luting agent, design of tooth preparation for cast posts on tooth resistance to fracture.
To evaluate fracture resistance of teeth restored with cast posts and cores with or without cervical ferrule and cemented with zinc phosphate, glass ionomer, or resin cement.
Sixty single-rooted maxillary first premolars of similar sizes were selected. Biomechanical preparation and post space preparation for cast post was done for all samples and then they were divided into two groups (n=30). Cervical ferrule preparation was done for Group A, and Group B was prepared without any cervical ferrule. Both groups were further divided into three subgroups (1, 2, and 3; n=10) Cast posts for subgroups 1, 2, and 3 were cemented with zinc phosphate, glass ionomer, and resin cement, respectively. A shearing load was applied to indented buccal cusp of specimens at an angle of 45° in universal testing machine at a cross-head speed of 1 mm/min until fracture.
Specimens with ferrule (Group A) had significantly higher shear bond strength values (mean 1503.37 N) than specimens without ferrule (Group B) (mean 1052.09 N).
Inclusion of ferrule in tooth preparations for posts increased the fracture resistance regardless of the luting agent.
Resin composites have become the first choice for direct posterior restorations and are increasingly popular among clinicians and patients. Meanwhile, a number of clinical reports in the literature have discussed the durability of these restorations over long periods. In this review, we have searched the dental literature looking for clinical trials investigating posterior composite restorations over periods of at least 5 years of follow-up published between 1996 and 2011. The search resulted in 34 selected studies. 90% of the clinical studies indicated that annual failure rates between 1% and 3% can be achieved with Class I and II posterior composite restorations depending on several factors such as tooth type and location, operator, and socioeconomic, demographic, and behavioral elements. The material properties showed a minor effect on longevity. The main reasons for failure in the long term are secondary caries, related to the individual caries risk, and fracture, related to the presence of a lining or the strength of the material used as well as patient factors such as bruxism. Repair is a viable alternative to replacement, and it can increase significantly the lifetime of restorations. As observed in the literature reviewed, a long survival rate for posterior composite restorations can be expected provided that patient, operator and materials factors are taken into account when the restorations are performed.
Santana FR, Castro CG, Simamoto-Júnior PC, Soares PV, Quagliatto PS, Estrela C, Soares CJ. Influence of post system and remaining coronal tooth tissue on biomechanical behaviour of root filled molar teeth. International Endodontic Journal, 44, 386–394, 2011.
Aim To investigate ex vivo the influence of post system and amount of remaining coronal tooth tissue on the fracture resistance, fracture mode and strain of root filled molar teeth.
Methodology Seventy mandibular human molar teeth were divided into seven groups (n = 10), one control (sound teeth) and six experimental groups resulting from the interaction between the two study factors: post system (Pa, post absence; Gfp, glass fibre post; Cmp, cast Ni–Cr alloy post and core) and amount of remaining coronal tooth tissue (Fe, 2 mm of ferrule; NFe, no ferrule). Teeth in the experimental groups were restored with metal crowns. For the strain gauge test, two strain gauges per sample were attached on the buccal and proximal root surfaces, and the samples of each group (n = 5) were submitted to a load of 0–100 N. Fracture resistance (N) was assessed in a mechanical testing device (n = 10). Strain gauge and fracture resistance data were analysed by two-way anova (3 × 2) followed by the Tukey’s HSD and Duncan’s test (α = 0.05). The failure mode was evaluated using an optical stereomicroscope and classified according to the location of the failure.
Results The absence of ferrule was associated with lower fracture resistance regardless of the post system. Groups restored with glass fibre post and cast Ni–Cr alloy post and core had similar fracture resistance and higher values than groups without posts, regardless of the remaining coronal tooth tissue. Teeth with no ferrule and cast Ni–Cr alloy post and core resulted in catastrophic fractures and those with no ferrule and glass fibre post or no ferrule and post absence resulted in restorable failures. Buccal strain was higher in sound teeth and lower in teeth without posts. Glass fibre post insertion decreased the buccal strain compared to the teeth with ferrule and absence of post.
Conclusions Two millimetre of ferrule had a significant influence on cusp strain, fracture resistance and failure mode. The glass fibre post was as effective as the cast Ni–Cr alloy post and core in the restoration of root filled molars regardless of the remaining tooth tissue. Absence of a post decreased the fracture resistance and increased the cusp strain.
Abordagem restauradora de dentes tratados endodônticamente pinos/núcleos e restaurações unitárias
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Avaliação da resistência ao cisalhamento do pino pré-fabricado pelo teste push-out, utilizando dois sistemas cimentantesautocondicionantes. Revista Odontológica de Araçatuba
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Endodontia passo a passo: Evidências clínicas/ Organizador Francisco José de Souza Filho
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