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Aim: This study aimed to review the scientific literature to describe the main care and hygiene protocols for different types of maxillofacial prostheses (MFP). Methods: A bibliographic search on the PubMed / Medline database using the following keywords: ["maxillofacial prosthesis" OR "ocular prostheses" OR "palatal obturators"] AND ["Cleaning" OR "disinfection"] AND ["care"] AND ["color stability"] OR ["denture cleansers" OR "cleansing agents"]. Articles addressing materials, cleaning and disinfection protocols, and care related to MFP were included. The following exclusion criteria were applied: no adequate methodology, incompatibility with the area of interest, and unavailability for reading in full. Results: The papers were grouped into the following topics: facial prostheses, ocular prostheses, maxillofacial intraoral prostheses, and retention systems. Conclusion: Despite the MFP changes over time, its degradation decreases upon following the recommendations and post-adaptation care. The guidelines for cleaning and disinfection must be individualized to guarantee the longevity of the prosthesis and the patient health

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Alternative surface treatments have been proposed for the cementation of lithium disilicate ceramics aiming to improve adhesive and flexural strength under fatigue. This study aimed to evaluate the slow crack growth (SCG) parameters of the lithium disilicate ceramic after hydrofluoric acid (HF) etching or air abrasion (AB) as surface treatments. Ceramic discs were treated with HF (5%, 20 s) or AB (30 µm silica-modified alumina particles, 2.8 bar, 10 mm distance, 15 s), and received a layer of resin cement. The surface roughness after surface treatment was evaluated (n = 5). Samples were tested in a piston-on-three-ball assembly to evaluate the flexural strength (n = 20), inert strength (n = 25), and to determine SCG parameters n and D (n = 35). The highest roughness (p < 0.01) was observed in the AB group, with the highest reliability according to the Weibull analysis, but the lowest SCG susceptibility. Flexural (p = 0.03) and inert strength (p < 0.01) were the greatest in the HF group. Despite exhibiting lower strength than 5% HF, air abrasion may be an alternative for the surface treatment of lithium disilicate surfaces, indicating the best prognosis over time.

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Objective: To evaluate the biaxial flexural strength (BFS) of lithium disilicate (L), cemented on different substrates (epoxy resin - E and metal - M) with dual-cure resin cement (Rc) and zinc phosphate cement (Zc), not aged, thermally aged (TC) or thermo-mechanical aged (TC/MC). Material and Methods: Disks of L, E, and M were fabricated, and the cementation was performed according to the following groups: ERc (L+E+Rc); MRc (L+M+Rc); MZc (L+M+Zc); EZc (L+E+Zc). Ten samples from each described group were tested in BFS, ten more samples were subjected to TC (1×104 cycles between 5 ºC and 55 ºC water), and the last 10 samples were subjected to TC/MC (MC: 1.2×106 cycles, 50 N, 3.8 Hz). The BFS test was performed and scanning electron microscopy (SEM) was performed to evaluate the failure mode. The effect of the cementation strategy (cement/substrate) was compared in each aging method and the effect of the aging method was evaluated for each cementation strategy by one-way ANOVA and Tukey post-hoc test (α=0.05). Results: The strength values were highest to M (237.8 ~ 463.9 MPa), in comparison to the E (41.03 ~ 66.76 MPa), despite aging and luting agent. Flexural strength data decreased after TC and TC/MC in groups cemented with Zc, but was stable when cemented with Rc. SEM analysis indicated that failure origins were located at the tensile surface of the L. Conclusion: Lithium disilicate discs cemented to the metallic substrate presented the highest biaxial flexural strength. The cementation with dual-cure resin cement did not decrease BFS after aging (AU)

Objetivo: Avaliar a resistência à flexão biaxial (BFS) do dissilicato de lítio (L), cimentado sobre diferentes substratos (resina epóxi - E e metal - M) com cimento resinoso dual (Rc) e cimento de fosfato de zinco (Zc), não envelhecido, submetido ao envelhecido térmico (TC) ou ao envelhecido térmico-mecânico (TC/MC). Material e Métodos: Foram confeccionados discos de L, E e M, e a cimentação foi realizada de acordo com os seguintes grupos: ERc (L+E+Rc); MRc (L+M+Rc); MZc (L+M+Zc); EZc (L+E+Zc). Dez amostras de cada grupo descrito foram testadas em BFS, mais dez amostras foram submetidas à TC (1×104 ciclos de imersão em água entre 5 ºC e 55 ºC), e as últimas 10 amostras foram submetidas à TC/MC (MC: 1.2 ×106 ciclos, 50 N, 3.8 Hz). Foram realizados os testes de BFS e a microscopia eletrônica de varredura (MEV) para avaliar o modo de falha. O efeito da estratégia de cimentação (cimento/substrato) foi comparado em cada método de envelhecimento e o efeito do método de envelhecimento foi avaliado para cada estratégia de cimentação por ANOVA a um fator e teste post-hoc de Tukey (α=0,05). Resultados: Os valores de resistência foram maiores para M (237.8 ~ 463.9 MPa), em comparação com E (41.03 ~ 66.76 MPa), independentemente do envelhecimento e do agente cimentante utilizado. Os dados de resistência à flexão diminuíram após TC e TC/MC nos grupos cimentados com Zc, mas se mantiveram estáveis quando cimentados com Rc. A análise MEV indicou que a origem das falhas estava localizada na superfície de tração do L. Conclusão: Os discos de dissilicato de lítio cimentados ao substrato metálico apresentaram maior resistência à flexão biaxial. A cimentação com cimento resinoso dual não diminuiu o BFS após o envelhecimento (AU)

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Aim: To evaluate the resistance of the union between a glass fiber post and radicular dentine after cleaning the root with 17% EDTA and filling with different endodontic cements. Methods: Forty uniradicular bovine incisors were removed to obtain root lengths of 18 mm. Endodontic treatment was performed on all roots using different filling cements (zinc oxide and eugenol-based, OZE; cement based on epoxy resin, AH) and cleaning solutions (saline, SA or EDTA), which made it possible to obtain four groups: OZESA, OZEEDTA, AHSA and AHEDTA. Subsequently, 12 mm of filling material was removed from the roots, and they were prepared to receive fiber posts luted with resin cement. To execute the mechanical cycles (2x106 cycles, 90 N, 4 Hz), coronal reconstruction was performed with a silicon matrix. The roots were then sliced (2-mm thick) to perform the push-out test. The results were analyzed using analysis of variance (one factor and two factors) and Tukey's test (α=0,05). Results: Bond strength (Mpa) was significantly higher for OZEEDTA (9,18) and AHEDTA (8,70) than for OZESA (6,06) AHSA (8,7). OZEEDTA also presented the highest values in the cervical region (15,18) but was significantly lower in the apical region (2,99). However, AHEDTA had a homogeneous bond strength in all thirds. Conclusion: Regardless of the endodontic cement used, EDTA was used as an irrigating solution, culminating in a higher bond strength between the glass fiber post and dentin

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ABSTRACT COVID-19 outbreak may lead to major impacts in applied oral sciences. Remarkably, it could be expected that factors associated to pandemic may lead to a greater risk of developing, worsening and perpetuating TMD and its associated risk factors. This non systematic literature review aims to discuss how the COVID-19 pandemic can influence the emergence, maintenance or worsening of TMD worldwide. During epidemics: the number of people whose mental health is affected tends to be greater than the number affected by the infection, and fear increases anxiety and stress levels in healthy individuals; chronic pain patients probably not receipt important treatments; overuse of medications becomes frequent; there are manifestation of unconscious oral parafunctional habits and poor sleep quality. All these facts represent risk factors common to TMD. Dentists should be aware of these issues and adapt their practices to properly diagnose and treat these patients within a multifactorial approach, increasing the quality of life of these individuals.

RESUMO O surto de COVID-19 pode causar grandes impactos nas ciências relacionadas a odontologia. Notavelmente, pode-se esperar que os fatores associados à pandemia possam levar a um maior risco de desenvolver, agravar e perpetuar a DTM e seus fatores associados. Esta revisão não sistemática da literatura tem como objetivo discutir como a pandemia de COVID-19 pode influenciar no surgimento, manutenção ou agravamento da DTM em todo o mundo. Durante as epidemias: o número de pessoas cuja saúde mental é afetada tende a ser maior do que o número afetado pela infecção, e o medo aumenta os níveis de ansiedade e estresse em indivíduos saudáveis; pacientes com dor crônica provavelmente não recebem tratamentos importantes; o uso excessivo de medicamentos torna-se frequente; há manifestação de hábitos parafuncionais orais inconscientes e má qualidade do sono. Todos esses fatos representam fatores de risco comuns à DTM. O dentista deve estar atento a essas questões e adaptar sua prática para diagnosticar e tratar adequadamente esses pacientes dentro de uma abordagem multifatorial, aumentando a qualidade de vida desses indivíduos.

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OBJECTIVE: To evaluate the composition, flexural strength and fatigue behaviour of lithium disilicate ceramic (LD) after repeated firings and different staining techniques. METHODS: LD discs were fabricated and divided according to number of firing cycles and staining technique: CO - control, discs were crystallized (850°C/10min); SC - single-step characterization - crystallization and staining (applied with a thin brush) were performed in a single step with one firing cycle (850°C/10min); and DC - double-step characterization - crystallization firing cycle was performed first (850°C/10min), followed by staining firing cycle (770°C/90s). Specimens were fired two, four or six times (one crystallization firing cycle and one, three or five staining firing cycles), resulting into 9 groups (n=30): COII, COIV, COVI, SCII, SCIV, SCVI, DCII, DCIV and DCVI. The composition of the specimens was investigated (EDS, XRD, Raman spectroscopy), and the biaxial flexural strength (n=10) and staircase tests (n=20, 5×104 cycles, 5Hz) were performed. Data were subjected to one-way ANOVA and Tukey's test (α=0.05). RESULTS: EDS and XRD revealed amorphous content for stained groups. Biaxial flexural strength was not affected by repeated firings in any group, but stained groups presented lower flexural strength than control groups (p=0.001). The fatigue limit results decreased in all groups compared to flexural strength. SC groups showed similar (SCII and SCIV) or even higher fatigue limits (SCVI) than the control groups, and DC showed the lowest fatigue limit values. SEM and Raman suggested that the interfaces between staining and the LD showed only an overlap for the DC groups, whereas for the SC it was suggested an interaction between the stain and the LD. SIGNIFICANCE: Repeated firings did not result in decreased lithium disilicate flexural strength.Staining affected flexural strength and also resulted in increased amorphous content in the characterized specimens. Single-step staining resulted in the highest fatigue limit.

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Aim: To evaluate the influence of lengths and different luting agents on the bond strength of fiberglass posts' adhesion to dentin.Methods: Sixty single-root bovine teeth were endodontically treated and included in polyether and acrilyc resin to simulate a periodontal ligament. These were divided into 6 groups according to the post lengths (6, 10 or 14 mm) and luting agents (self-adhesive dual resin cement ­ U; or etch-and-rinse dual resin cement ­ A): U6, U10, U14, A6, A19, and A14. All fiberglass posts were cemented according to manufacturer instructions. After this, mechanical aging was performed (1.2x106 cycles; 4 Hz, 90 N). The push-out specimens were then conducted (2.0 ± 0.1 mm), with the test executed in a universal machine (10 kgf at 0.5 mm/min). Data obtained were submitted to the Kruskal-Wallis and Dunn's test. Results: No statistically significant difference was observed in bond strength between the groups due to the type of luting agent (p > 0.05). However, the isolated post-length factor showed significantly different results for the U groups (p < 0.05). The U10 group showed similar union values to U6 but statistically inferior to U14. Conclusion: bond strength of fiberglass posts of the same length as the dentin presented no differences according to the luting agent, but the post-length property influenced the bond strength when self-adhesive resin cement was used.

Objetivo: avaliar a influência dos agentes cimentantes e dos diferentes comprimentos de pinos na resistência de união de pinos de fibra de vidro a dentina. Métodos: Sessenta dentes bovinos uniradiculares tiveram a raiz endodonticamente tratada, e foram incluídos em poliéter e resina acrílica para simular o ligamento periodontal. Os espécimes foram divididos em seis grupos de acordo com o comprimento dos pinos (6, 10 ou 14mm) e dos agentes de cimentantes (cimento resinoso dual autoadesivo (RelyX U200, 3M ESPE) - U; ou cimento resinoso dual convencional (AllCem Core, FGM) - A: U6, U10, U14, A6, A19 e A14. Todos os pinos de fibra de vidro foram cimentados conforme as recomendações do fabricante. Após, o envelhecimento mecânico (1,2x106 ciclos; 4 Hz, 90 N) as amostras foram fatiadas para o teste de push-out (2,0 ± 0,1 mm) executado em uma máquina de ensaio universal (10 kgf a 0,5 mm/min). Os dados foram submetidos ao teste de Kruskal-Wallis e Dunn. Resultados: não houve diferença estatística na resistência de união entre os grupos devido ao tipo de agente cimentante (p > 0,05), mas houve para o comprimento dos pinos dos grupos U (p < 0,05). O grupo U10 apresentou valores de união semelhantes a U6, mas estatisticamente inferiores ao U14. Conclusão: a resistência de união dos pinos de fibra de vidro de um mesmo comprimento não apresentou diferenças mesmo quando cimentados com cimentos diferentes, mas o comprimento dos pinos isoladamente influenciou quando o cimento resinoso autoadesivo foi utilizado.

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ABSTRACT Objective Evaluate the influence of silane heat treatment in bond durability between two resin cements and CAD/CAM feldspathic ceramic. Methods 40 feldspathic ceramic blocks were obtained, and were duplicated in microhybrid composite. All ceramic blocks were etched with 10% hydrofluoric acid for 20 s and received application of silane agent. The blocks were randomizedinto eight groups (n=5) according to the surface treatments and luting agents: P- Panavia F; PAg- Panavia F + Aging; HP- Heat Treatment + Panavia F; HPAg- Heat Treatment + Panavia F + Aging; R- RelyX ARC; Rag- RelyX ARC + Aging; HR- Heat Treatment + RelyX ARC; HRAg- Heat Treatment + RelyX ARC + Aging. The heat treatment was performed in furnace at 100 °C for 2 min. All blocks were cemented and cut to obtain samples with adhesive area of 1 mm2. Aging was performed with 10000 thermal cycles. The samples were subjected to microtensile bond strength test. Results The three-way ANOVA test revealed a significant interaction between cement versus heat treatment (p=0.001) and heat treatment versus thermal cycling (p=0.001) indicating that there was a change in bond strength due to surface treatment and aging. Conclusion Therefore, the heat treatment of the silane at 100 ºC for 2 minutes obtained higher values of bond strength between the resin cement and a feldspathic ceramicafter aging.

RESUMO Objetivo Avaliar a influência do tratamento térmico do silano na resistência de união entre dois cimentos resinosos e uma cerâmica feldspática CAD/CAM. Métodos Quarenta blocos cerâmicos foram duplicados em resina micro-híbrida. Todas as cerâmicas foram condicionadas com ácido fluorídrico 10% por 20 s e receberam aplicação do silano. Os blocos foram randomizados em oito grupos (n = 5): P-Panavia F; PAg- Panavia F + Envelhecimento; HP-Tratamento térmico + Panavia F;HPAg-Tratamento térmico + Panavia F + Envelhecimento; R-RelyX ARC; RAg-RelyX ARC; HR-Tratamento térmico + RelyX ARC; HRAg - Tratamento térmico + RelyX ARC + Envelhecimento. O tratamento térmico foi realizado em forno a 100 °C durante2 min. Todos os blocos foram cimentados e cortados para obter amostras para microtração. Foram feitos 10000 ciclos térmicos. As amostras foram submetidas a teste de micro-tração. Resultados O teste ANOVA revelou uma interação significativa entre cimento/tratamento térmico (p=0,001) e tratamento térmico/ciclo térmico (p=0,001). Conclusão Dessa maneira, o tratamentotérmico do silano a 100ºC por 2 minutos foi capaz de aumentar a resistência de união entre o cimento resinoso e uma cerâmica feldspática mesmo após o envelhecimento.

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OBJECTIVE: To evaluate the influence of extrinsic pigmentation on the biaxial flexural strength and surface topographic of translucent Y-TZP (InCoris TZI - Sirona - USA) subjected to several surface treatments. METHODS: Sintered zirconia discs-shaped specimens (n=120) (ø:12mm; thickness:1.2mm; ISO 6872) were prepared and divided (n=15) according to various factors: "extrinsic pigmentation" (n: without; p: with) and "surface treatments" (C: control - as sintered; A: abraded with silica-coated alumina particles (30µm); G: glazed with a thin film of low-fusing porcelain glaze; GH: glazed and etched with 10% hydrofluoridric acid for 60s. Mechanical cycling (1.2×106 cycles, 200N, 3.8Hz) and flexural strength test (1mm/min - 1000kg cell) were performed. Two-way ANOVA and Tukey's were used for statistical test (α=0.05). Weibull analysis was used to evaluate the strength reliability. Samples were analyzed via (1) an optical profilometer to determine the surface roughness (Ra); (2) an X-ray diffraction (XRD) to evaluate phase transformations; and (3) a SEM equipped with an energy dispersive X-ray spectroscopy (EDX) to elucidate morphological properties and chemical compositions. RESULTS: Regardless of the surface treatment (p=0.5459) (Cn: 560.16MPa; Gn: 573.36MPa; An: 643.51MPa; GHn: 542.94MPa; Cp: 628.04MPa; Gp: 641.90MPa; Ap: 554.47MPa; GHp :602.84MPa) and extrinsic pigmentation (p=0.1280) there was no difference in the flexural strength among the experimental groups. According to the XRD analysis, phase transformations occurred in the An group (t→m) and in Ap group (t→c). Surface roughness was affected by surface treatments (An - p=0.001) and extrinsic pigmentation (Gp - p=0.001). SIGNIFICANCE: The biaxial flexural strength of the tested samples was not affected neither by surface treatments nor by pigmentation, although it can cause phase transformation and promote surface roughness.

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PURPOSE: This study evaluated the effect of different loading pistons, made of various materials and with different elastic moduli acting as antagonist material, on stress distribution and fatigue behavior of a CAD/CAM silica-based ceramic. MATERIALS AND METHODS: Discs of CAD/CAM made silica-based ceramic (N = 60) (VITA MARK II) were divided into six groups (n = 10 per group), according to the test method (M: Monotonic; F: Fatigue) and the antagonist piston material (T: Tungsten; S: Steel; G: Epoxy resin). FT, FS and FG combinations were submitted to mechanical cycling (2 × 106 cycles, 4 Hz, 45 N). The bending stress after fatigue were also valuated using Weibull analysis and the parameters η (eta), ß (beta) and the mean time to failure (MTTF) were calculated. Fractographic analysis and Finite Element Analysis (FEA) were performed. Data were analyzed using ANOVA and Tukey's tests (alpha=0.05). RESULTS: MG presented significantly less bending strength (MPa) (75.6) compared to MT (87.8) and MS (84.4) (p < 0.05). Six specimens from FT (MMTF: 8.3 × 106; ß:0.60; η:5.6 × 106), four from FS (MMTF: 1.9 × 106; ß:1.2; η:2.0 × 106) and one from FG (MMTF: 1.3 × 106; ß:0.48; η:0.64 × 106) survived the fatigue test. The stress peak on the tensile surface of S was similar to that of T and both were less than that of G. The failure origins were on the tensile surface. CONCLUSION: The epoxy resin pistons were able to decrease the bending stress, and life expectancy (faster failure) of a silica-based ceramic compared to tungsten and steel.

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