A slow release calcium delivery system for the study of reparative dentine formation

Abstract— Several liquid, semi-solid and solid delivery systems were formulated and tested to devise a method of reproducibly administering accurate micro-doses of calcium into a 700 μm diameter cakity in a rat maxillary incisor tooth, in the absence of hydroxyl ions. Development of this delivery system was necessary to facilitate studies of the mechanisms of pulpal repair and odontoblast differentiation. The principal requirements for the delivery system were that it should be easily administered into a small pulp exposure in the rat incisor and that a greater than 1000-fold range in calcium ion concentrations could be incorporated and delivered for a period of 2–3 days, preferably in an acidic environment to minimize the effect of non-specific nucleation under alkaline conditions. Poly ethylene) glycol microspheres were found to be an ideal vehicle. Under the in vivo dissolution conditions used, complete release of all calcium salts occurred within 12–15 hours, except for the very water-insoluble calcium stearate. It was anticipated that the re lease of calcium ions would be significantly more prolonged in vivo because of the physical constraints of the prepared cavity as well as the restricted access to fluid flow.     

Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog

Aim: To evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri‐implant tissue dimensions in a dog model. Material and methods: Mandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough surface, were installed on each side of the mandible in the premolar region. On the right side of the mandible, implants with a tapered and enlarged platform were used, while standard cylindrical implants were installed in the left side of the mandible. Abutments with the diameter of the cylindrical implants were used resulting in a mismatch of 0.25 mm at the tapered implant sites. The flaps were sutured to allow a non‐submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment. Results: All implants were completely osseointegrated. A minimal buccal bone resorption was observed for both implant configurations and surface topographies. Considering the animals as the statistical unit, no significant differences were found at the buccal aspect in relation to bone levels and soft tissue dimensions. The surface topographies did not influence the outcomes either. Conclusions: The present study failed to show differences in peri‐implant tissue dimensions when a mismatch of 0.25 mm from a tapered platform to an abutment was applied. The surface topographies influence a neither marginal bone resorption or peri‐implant soft tissue dimension. To cite this article:
Baffone GM, Botticelli D, Pantani F, Cardoso LC, Schweikert MT, Lang NP. Influence of various implant platform configurations on peri‐implant tissue dimensions: an experimental study in dog.
Clin. Oral Impl. Res. 22 , 2011; 438–444.     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Effect of interimplant distance (2 and 3 mm) on the height of interimplant bone crest: a histomorphometric evaluation

Background: Implants restored according to a platform‐switching concept (implant abutment interface with a reduced diameter relative to the implant platform diameter) present less crestal bone loss than implants restored with a standard protocol. When implants are placed adjacent to one another, this bone loss may combine through overlapping, thereby causing loss of the interproximal height of bone and papilla. The present study compares the effects of two interimplant distances (2 and 3 mm) on bone maintenance when bone‐level implants with platform‐switching are used. Methods: This study evaluates marginal bone level preservation and soft tissue quality around a bone‐level implant after 2 months of healing in minipig mandibles. The primary objective is to evaluate histologically and histomorphometrically the affect that an implant design with a horizontally displaced implant–abutment junction has on the height of the crest of bone, between adjacent implants separated by two different distances. Results: Results show that the interproximal bone loss measured from the edge of the implant platform to the bone crest was not different for interimplant distances of 2 or 3 mm. The horizontal position of the bone relative to the microgap on platform level (horizontal component of crestal bone loss) was 0.31 ± 0.3 mm for the 2‐mm interimplant distance and 0.57 ± 0.51 mm above the platform 8 weeks after implantation for the 3‐mm interimplant distance. Conclusions: This study shows that interimplant bone levels can be maintained at similar levels for 2‐ and 3‐mm distances. The horizontally displaced implant–abutment junction provided for a more coronal position of the first point of bone–implant contact. The study reveals a smaller horizontal component at the crest of bone than has been reported for non‐horizontally displaced implant–abutment junctions.     

Effect of access cavity location and design on degree and distribution of instrumented root canal surface in maxillary anterior teeth

AIM: The null hypothesis tested in this study was that in single-rooted anterior teeth with simple root canal anatomy, different access cavity designs ('lingual cingulum', 'lingual conventional', 'incisal straight-line') do not influence the ability of endodontic files to plane the walls of the root canals. METHODOLOGY: Thirty extracted human maxillary anterior teeth were divided randomly into three groups for each access cavity. The access cavities were prepared according to predefined criteria and the roots embedded in individual polyvinyl-siloxane putty matrices. The matrices allowed these teeth to be split into buccal and palatal halves and to be reassembled. The split teeth enabled removal of pulpal remnants from the root canal system and the walls to be stained with an even layer of permanent black ink. Once dried, the split roots were reassembled in the putty matrices and a step-back filing technique was used to prepare the canals with water irrigation. The canal walls were examined for residual ink staining and scored by three independent assessors using an index devised for the purpose. RESULTS: There was good agreement between the assessors. None of the access cavities allowed file contact with the entire root canal wall. The overall (palatal and buccal sections) scores showed significant differences (P < 0.01) between the access cavity groups in the extent to which the canal walls could be filed. The straight-line incisal access cavity had the greatest proportion of instrumented root canal surface. The lingual cingulum access cavity was the worst in this respect. The differences in residual ink scores between the access cavity types were significant for the buccal halves (P < 0.01) but not for the palatal halves (P > 0.05). CONCLUSIONS: The null hypothesis was proven. Regardless of access cavity design, mechanical preparation did not allow instrumentation of the entire root canal wall. Straight-line access allowed the greatest proportion of the root canal wall to be instrumented and the lingual cingulum access the least.     

Effect of platform switching on peri-implant bone levels: a randomized clinical trial

Objective: The concept of platform switching has been introduced to implant dentistry based on observations of reduced peri‐implant bone loss. However, randomized clinical trials are still lacking. This study aimed to test the hypothesis that platform switching has a positive impact on crestal bone‐level changes. Material and methods: Two implants with diameters of 4 mm were inserted epicrestally into one side of the posterior mandibles of 25 subjects. After 3 months of submerged healing, the reentry surgery was performed. On the randomly placed test implant, an abutment 3.3 mm in diameter was mounted, resulting in a horizontal circular step of 0.35 mm (platform switching). The control implant was straight, with an abutment 4 mm in diameter. Single‐tooth crowns were cemented provisionally. All patients were monitored at short intervals over the course of 1 year. Standardized radiographs and microbiological samples from the implants' inner spaces were obtained at baseline (implant surgery), and after 3, 4, and 12 months. Results: After 1 year, the mean radiographic vertical bone loss at the test implants was 0.53±0.35 mm and at the control implants, it was 0.58±0.55 mm. The mean intraindividual difference was 0.05±0.56 mm, which is significantly <0.35 mm (P=0.0093, post hoc power 79.9%). The crestal bone‐level changes depended on time (P<0.001), but not on platform switching (P=0.4). The implants' internal spaces were contaminated by bacteria, with no significant differences in the total counts between the test and the control at any time point (P=0.98). Conclusions: The present randomized clinical trial could not confirm the hypothesis of a reduced peri‐implant bone loss at implants restored according to the concept of platform switching. To cite this article:
Enkling N, Jöhren P, Klimberg V, Bayer S, Mericske‐Stern R, Jepsen S. Effect of platform switching on peri‐implant bone levels: a randomized clinical trial.
Clin. Oral Impl. Res. 22 , 2011; 1185–1192.
doi: 10.1111/j.1600‐0501.2010.02090.x     

特殊颌关系患者种植修复的临床进展

种植义齿设计中，修复体的排列关系和咬合关系是考虑的重点。但对于上下颌关系失调的患者，种植体的位置和基台的结构常与咬合关系相抵触。本文就种植义齿修复中遇到的颌关系不调的分类及其临床处理方法作一综述。     

铸造桩核修复重度缺损上颌第一磨牙三维有限元模型的建立

目的探讨铸造桩核修复重度缺损上颌第一磨牙三维有限元模型的建立方法。方法对上颌第一磨牙样本模型进行两方位多层CT扫描，采用Mimics软件和Ansvs软件，结合Freeform触觉设计系统之自由造型软件建立铸造桩核冠修复重度缺损上颌第一磨牙的三维有限元模型。结果成功建立形态逼真、结构层次清晰的三根铸造桩及核修复重度缺损上颌第一磨牙三维有限元模型。结论改进CT扫描方式可增加样本图像信息量的获取：Mimics和Ansys建模软件结合应用可提高三维有限元模型的精确度：Freeform自由造型软件可用于建立复杂桩核修复系统的三维模型。     

Marginal fit of 14-unit zirconia fixed dental prosthesis retainers

Summary  The marginal fit of 14-unit fixed dental prosthesis retainers and single-crown copings fabricated by the same computer-aided design (CAD)/computer-aided manufacturing (CAM) system were evaluated in vitro hypothesizing that the marginal opening might be independent of the type of restoration. Eight ivorine maxillary teeth (FDI locations 27, 25, 23, 21, 11, 13, 15 and 17) were prepared to accommodate a 14-unit prosthesis. Ten fixed dental prosthesis retainers and 40 single-crown-copings were fabricated using Zeno CAD/CAM on 20 master dies. Four cross-sections were made from each tooth and the marginal gap dimensions were measured. One-way anova was used to test the difference between the experimental groups and two-way anova and a post hoc test (Student–Newman–Keuls) were carried out to determine the influence of the location of the abutment tooth and the measurement location within the abutment tooth in the experimental groups ( P  < 0·05). Mean marginal gap dimensions and standard deviations for fixed dental prosthesis retainers and single-crown copings were 25 ± 29 and 13 ± 12 μm, respectively. The type of restoration showed a significant influence ( P  < 0·001) on the marginal gap. The location of the abutment tooth ( P  < 0·001) and the measurement location ( P  < 0·001) exhibited significant influence on marginal gaps of fixed dental prosthesis retainers while no influence on single-crown copings could be detected. The highest marginal gaps were found at the palatal surface of the incisor and canine of the 14-unit fixed dental prosthesis retainers. Fourteen-unit fixed dental prosthesis showed significantly higher marginal openings than single crowns fabricated under the same conditions. However, both restorations showed clinically acceptable marginal openings.     

Quality of written communication and master impressions for fabrication of removable partial prostheses in the Kingdom of Bahrain

The aim of this study was to examine the quality of written instructions and choice of impression trays and materials for removable partial dentures (RPDs) in the Kingdom of Bahrain. All six private dental laboratories in Bahrain were contacted and invited to participate in the study. Five laboratories participated, and submitted written instructions received by them for fabrication of both acrylic (A-RPDs) and cobalt-chromium (CC-RPDs) RPDs. These were examined for evidence of selected design variables. Types of impression trays and materials used were also recorded. One hundred and thirty-one written instructions were examined. Eleven percent (n = 14) were for CC-RPDs, 89% (n = 117) for A-RPDs. All treatments were provided on a private basis. Fifty-seven percent (n =1 8) of CC-RPD instructions requested the technician to design the prosthesis, 43% (n = 6) contained a diagram and 43% (n = 6) mentioned all design variables. Seventy-nine percent (n = 92) of A-RPDs requested the technician to design the denture, and only 1% (n = 1) mentioned all design variables. Alginate impression material was most commonly used for master impressions (83% of impressions (n = 109); 85% (n = 99) of A-RPDs, and 71% (n = 10) of CC-RPDs). Master casts were poured after a minimum of 24 h. Acrylic custom trays were used in 14% (n = 19) of cases (43% (n = 6) of CC-RPDs; 13% (n = 15) of A-RPDs). The quality of written instructions to dental laboratories for the fabrication of RPDs was found to be inadequate in Kingdom of Bahrain. There was widespread use of inappropriate impression trays and materials.