Influence of agitation methods of irrigants after methylene blue-mediated PDT on the bonding interface of a fiber post cementation system

BackgroundThis study evaluated the effects of final agitation methods of irrigants to remove methylene blue and sodium hypochlorite residues after PDT-assisted endodontic treatment on the bond strength of fiber posts cemented with etch-and-rinse adhesive and conventional resin cement.MethodsNinety bovine teeth were endodontically treated. In sequence, post space preparation followed by methylene blue-mediated PDT and sodium hypochlorite (NaOCl) irrigation were performed. Six final irrigations protocols for dye and NaOCl removal were performed prior to cementation with etch-and-rinse adhesive (Adper Scocthbond Multipurpose) and conventional dual resin cement (RelyX ARC): Conventional endodontic irrigation (CEI), passive ultrasonic irrigation (PUI), mechanical agitation with XP Endo Finisher (XPF), XP Clean (XPC) or Easy Clean (ECL) and distilled water (NCO - control). After fiber post cementation, push-out bond strength test was performed at different thirds of the post space. Failure mode was also analyzed. ANOVA and Tukey's post-hoc test was used for data analysis (α=5%).ResultsPUI, XPF e XPC protocols showed the highest bond strength values with no difference among them (p > 0.05), although they were similar to NCO, regardless of the post space third. CEI e ECL showed similar bond strength values, regardless of the third (p > 0.05). Adhesive failure was the most incident for CEI and ECL, while mixed and cohesive failures were predominant in PUI, XPF, XPC and NCO groups.ConclusionsMechanical agitation of distilled water with XPF, XPC and PUI after methylene blue-mediated PDT and irrigation with 2.5% sodium hypochlorite promoted bond strength of the resin cementation system in post space dentin comparable to control group.     

Use of enamel-dentin adhesive in the restoration of defects in the cervico-root region of teeth

The incidence of cervical defects was epidemilogically studied on a sample of 60 teeth with periodonatl disease and cervical defects which were classified in three groups. Also, the control clinical prospective study comprised 44 esthetic external restorations made of monocomponent resin (Heliosit and Visio-Disperse) and bicomponent resin (Silar and Dentosit) in the cervico-radical region of the vestibular surface od teeth with periodontal disease. Enamel-dentin adhesive was used as a bonding agent. Two parameters were followed up: 1. restoration margin staining, and 2. retentional state of restoration. The studies have shown that: a) the cervico-radical defects affecting both the dentin-coronary third of the root and the dentin-cervical third of the crown were found in 64% of subjects with periodontal disease and cervical defects requiring application of monocomposite resin in the same percentage, b) enamel-dentin adhesive+ composite restorations made of monocomposite resin showed changes in both mentioned parameters in a significantly lower percentage being of markedly smaller intensity than those made of bicomposite resins, and c) bonding capacity of enamel-dentin adhesives is an important additional factor of retention of esthetic restorations made in the cervico-radial dental region.     

Influence of the artefact reduction algorithm of Picasso Trio CBCT system on the diagnosis of vertical root fractures in teeth with metal posts

Objectives:

To assess the influence of the artefact reduction algorithm (AR) available on the Picasso Trio 3D^® imaging system (Vatech, Hwaseong, Republic of Korea) on image quality [greyscale values, contrast-to-noise ratio (CNR) and artefact formation] and diagnosis of vertical root fractures (VRFs) in the teeth with intracanal metal posts.

Methods:

30 uniradicular teeth had their crowns removed and their roots endodontically treated to receive intracanal metal posts. In 20 teeth, both complete (n = 10) and incomplete (n = 10) VRFs were created. Each tooth was scanned twice, with and without AR activation. The mean and variation of greyscale values, as well as CNR, were calculated for all images. Subsequently, an evaluator compared the amount of artefact (cupping, white streaks and dark bands) in all images. Five evaluators rated for VRF presence using a five-point scale.

Results:

Mean greyscale values and CNR were significantly decreased in images acquired with the AR. The usage of the algorithm promoted an overall reduction of image artefacts. Regarding the diagnosis of complete and incomplete VRFs, the use of the AR had an overall negative impact on specificity and accuracy.

Conclusions:

While indeed reducing artefact formation, the use of the AR, instead of improving the impact on the diagnosis of VRFs in teeth with intracanal metal posts, had a negative impact on the diagnosis.     

Er,Cr∶YSGG激光备洞对老年人非龋性硬化牙本质微拉伸粘接强度的影响

目的评价Er,Cr∶YSGG激光备洞对硬化牙本质微拉伸粘接强度的影响,并比较其对两种不同充填材料粘接强度的影响。方法 40颗带有楔状缺损的老年人前磨牙,表面有典型硬化牙本质,随机分成实验组和对照组。实验组用Er,Cr∶YSGG激光备洞,对照组用牙科高速涡轮手机备洞,实验组和对照组再各分两个亚组,均分别用复合树脂和玻璃离子水门汀充填。所有样本在37℃蒸馏水中放置24 h,然后制备成厚度约1 mm的哑铃型片状试件,在Instron 5848微力试验机上测定微拉伸粘接强度,在扫描电镜下观察牙本质断面的表面形态。结果实验组中复合树脂组的微拉伸粘接强度为（35.24 7.05）Mpa,玻璃离子水门汀组微粒伸粘接强度（17.71 5.74）Mpa,对照组中复合树脂组微粒伸粘接强度（27.56 4.79）Mpa,玻璃离子水门汀组微粒伸粘接强度（11.47 5.12）Mpa。实验组和对照组的微拉伸粘接强度比较差异有显著意义（P〈0.05）,两组复合树脂组和玻璃离子水门汀组的微拉伸粘接强度比较;差异有显著意义（P〈0.05）。结论 Er,Cr∶YSGG激光备洞老年人非龋性硬化牙本质后的粘接强度高于高速涡轮手机预备者,复合树脂的粘接强度优于玻璃离子水门汀。     

Barodontalgia: a review, and the influence of simulated diving on microleakage and on the retention of full cast crowns

This paper reviews the causes of barodontalgia and reports on a study that indicates a possible cause of barodontalgia in the diver. In the study, extracted teeth had full cast crowns cemented with either a zinc phosphate, a glass ionomer, or a resin cement, and simulated diving to 30 m (3.0 atmospheres) was performed. During simulated diving, the teeth were pressure cycled 15 times to 3 atmospheres and microleakage was monitored. The force required to dislodge the crown was then tested; a significant difference was found between the zinc phosphate and the glass ionomer cement groups (p < 0.01). No difference was found between the resin cement groups. Microleakage was also detected in the zinc phosphate and glass ionomer cement groups and was found to occur sooner, and to a greater extent with zinc phosphate. No microleakage was detected in the resin cement experimental group. This study showed that the retention of full cast crowns to extracted teeth is reduced after pressure cycling and that microleakage does occur if the crowns are cemented with either zinc phosphate cement or glass ionomer cement.     

外伤移位前牙两种固定方法的疗效比较

目的评估片段弓固定法与高强纤维夹板固定法在外伤移位前牙固定术中的临床效果。方法将34例因训练和运动导致上前牙移位和半脱位的门诊军人随机分成两组,分别采用片段弓固定法与高强纤维夹板固定法进行复位固定,8周后通过临床和X线检查,比较其临床应用效果。结果两组34例患者固位效果稳固、无松脱,牙龈组织健康;去除固定后检查外伤牙均无松动,无叩痛;X线检查未见牙槽骨及牙根吸收现象。在即刻效果的美观、舒适方面高强纤维夹板固定法优于片段弓固定法。结论对于外伤所致的上前牙移位和半脱位患者,两种固定法均可有效的固定松动患牙;高强纤维夹板固定法更为美观和舒适,是松动牙固定较为理想的选择。     

后路椎弓根螺钉治疗齿状突骨折伴可复性寰枢椎脱位

目的 总结后路寰枢椎椎弓根螺钉固定、复位、融合治疗齿状突骨折伴可复性寰枢椎骨折脱位的疗效.方法 对27例齿状突骨折伴可复性寰枢椎骨折脱位的患者经术前颅骨牵引,采用后路椎弓根螺钉,行寰枢椎复位、固定及植骨融合.结果 患者寰枢椎椎间稳定性得到恢复,无并发症发生;随访12-48个月(平均24个月),27例患者均获骨性融合.结论 经后路寰枢椎椎弓根螺钉固定融合术可为齿状突骨折伴可复性寰枢椎骨折脱位的患者提供牢固的三维固定,是一种更为有效的治疗方法.     

两种材料修复老年牙体楔状缺损临床疗效观察

目的观察并比较FX玻璃离子和光固化树脂两种材料修复老年牙体楔状缺损的临床效果。方法196例患者共502楔状缺损患牙,每个患者都随机选一侧患牙,采用FX玻璃离子充填修复,另一侧采用光固化树脂修复,连续观察1年,比较其效果。结果采用FX玻璃离子修复257颗牙,成功243颗,成功率94.5%。采用普通光固化树脂充填修复245颗患牙,成功197颗,成功率80,4%。结论FX玻璃离子修复牙体楔状缺损远期效果明显优于光固化树脂,是一种较理想的楔状牙体缺损修复材料。     

自制金属翼板修复切牙缺失

目的：探讨一种利用树脂粘结技术与金属翼板联合粘结桥修复治疗单个切牙缺失的应用价值。方法：选择合适病例,将缺牙区两侧基牙按要求进行牙体预备,用0.24mm厚度及0.16mm白合金片分别锤造出与双侧基牙舌面相密合的金属翼板,在0.24mm合金片上打出直径约为2.0mm的小孔,将该二翼板重叠点焊成一体,利用树脂粘结于基牙舌侧及邻面以修复缺失牙。结果：经过5年的观察,修复切牙缺失128例中,112例成功,8例断裂,8例缺失,成功率为87.5%。结论：自制金属翼板作为切牙缺失的固定修复方法,工艺简单,易于成功,临床效果良好,适合基层应用修复,是一种可选择的理想修复方法。     

玻璃纤维桩加全瓷冠修复前牙残根残冠的效果

目的观察玻璃纤维桩＋全瓷冠修复前牙残根残冠的效果。方法选择我科进行前牙残根、残冠修复治疗患者76例82颗患牙,采用玻璃纤维桩＋全瓷冠修复,完成后6—12个月对患者进行随访,观察有无冠桩脱落、折断、松动以及牙龈、牙冠的色泽改变情况。结果82颗患牙中,有1颗出现冠脱落,1例出现根尖叩痛。全部82颗患牙均未出现根折、桩核脱落,无继发龋坏,冠及龈边缘无变色,色泽美观。结论玻璃纤维桩＋全瓷冠修复前牙残根残冠临床效果良好。     

A comparison of modified Larson and ‘anatomic’ posterolateral corner reconstructions in knees with combined PCL and posterolateral corner deficiency

Different methods to reconstruct damaged posterolateral structures are available, but there has been little work studying their relative performance in combined PCL plus posterolateral corner (PLC) deficiency. We hypothesized that an ‘anatomic’ reconstruction with three graft bundles crossing the joint line would restore knee laxity closer to normal than a modified two-bundle Larson reconstruction. In a controlled laboratory study, the kinematics of cadaveric knees were measured electromagnetically with posterior drawer, external rotation, or varus rotation loads applied, with the knee at sequential stages: intact, PCL-deficient; PCL plus PLC-deficient; modified Larson reconstruction; anatomic PLC reconstruction. The graft bundles were tensioned sequentially to restore specific degrees of freedom to intact values of laxity at specific angles of knee flexion. A significant difference was not found between the two reconstructions. Both reconstructions restored external rotation and varus laxity to normal. Both restored posterior drawer to that caused by isolated PCL deficiency, but did not restore posterior laxity to normal. It was concluded that, with appropriate graft tensioning, both PLC reconstructions could restore both external rotation and varus laxity to normal, but not posterior drawer. The three-stranded anatomical reconstruction did not perform better than the modified two-strand Larson technique. Both of these isolated PLC reconstructions in knees with combined PCL plus PLC deficiency restored the knees to the laxity condition of an isolated PCL-deficiency, they could not reduce posterior drawer to normal.     

后牙金铂合金全金属颈环烤瓷熔附金属全冠的应用价值

 目的 探讨后牙金铂合金全金属颈环烤瓷熔附金属全冠(porcelain fused to metal ,PFM)的应用价值。方法 选取99例进行后牙金铂合金PFM修复的患者,共修复牙体182颗,其中93颗牙体采用金铂合金PFM全金属颈环羽状肩台设计,89颗牙体采用凹面肩台设计,戴冠1年和3年后,比较两组设计边缘适应性、牙龈健康状况、继发龋发病率、牙龈染色及稳定性的差异。结果 戴冠1年后,两组设计边缘适应性、牙龈健康状况、继发龋发病率及牙龈染色无明显差异。戴冠3年后,后牙金铂合金全金属颈环PFM边缘适合性优的比例(92.47%)高于凹面肩台PFM设计(82.02%);后牙金铂合金全金属颈环PFM造成牙龈病变的比例及继发龋的比例(18.28%和3.22%)低于凹面肩台PFM(34.83%和11.24%);前者牙龈染色的程度重于后者,差异有统计学意义(P<0.05)。后牙金铂合金全金属颈环PFM随着时间推移缘适应性、牙龈健康状况、继发龋发病率无明显变化,而凹面肩台设计PFM的以上指标均向不利方向发展(P<0.05)。结论 后牙金铂合金全金属颈环PFM具有良好的边缘适应性、稳定性、较低的牙龈病变的比例及继发龋的比例,但造成牙龈染色的概率较大。后牙金铂合金全金属颈环PFM可作为后牙区修复的一种常规设计方案。
     

铸瓷与树脂嵌体颜色测量分析及临床修复效果观察

目的利用ShadeEye电脑测色仪从实验室研究和临床两方面对后牙铸瓷和树脂嵌体色彩学特性进行对比测量分析,评估其美观修复效果。方法实验室部分：选取成人离体磨牙,制备标准Ⅱ类洞型,分别制作IPS-EmpressⅡ铸瓷嵌体和BriLLint硬质复合树脂嵌体。应用ShadeEye电脑测色仪测量其L＊、a＊、b＊色度值,计算色差△E＊、明度差△L＊、红绿色品差△a＊、黄蓝色品差△b＊。结果进行统计学分析。临床部分：选择10例患者,11颗磨牙,对每一颗患牙分别制作铸瓷嵌体和树脂嵌体,测试患者的满意程度。结果铸瓷嵌体组与天然牙的L＊值差异有显著性（P〈0.05）,树脂嵌体组与天然牙的b＊值差异有显著性（P〈0.05）。两嵌体组分别与天然牙相比,△b＊、△E＊的差异均有显著性（P〈0.05）。临床应用结果显示,患者对两种嵌体明亮度的满意率和可接受率均达100%;患者对铸瓷嵌体色调的满意率高于树脂嵌体。结论两嵌体组与天然牙相比具有更高的明度;铸瓷嵌体组的a＊、b＊值更接近天然牙;铸瓷组与天然牙之间的色差主要是由于明度差△L＊造成;树脂组与天然牙之间的色差主要是由于黄蓝色品差△b＊造成,树脂组比天然牙的黄蓝色品值偏高。     

Preferences for oral health states: effect on prescribing periapical radiographs

OBJECTIVES: To elicit preferences for the outcomes of radiographic endodontic diagnosis and subsequent therapy, and to test for differences in these preferences between three types of dental specialists. METHODS: Using the "standard gamble" method, dentists involved in teaching oral diagnosis (n=26) were asked to rank on a scale of 0.0-1.0 their preferences (utilities) for four treatment outcomes, "composite filling in vital tooth", "composite restoration and root filled", "root filled and post crown" and "extraction and bridge", from a previously analysed diagnostic testing and therapeutic strategy for managing damaged anterior teeth. Respondents consisted of oral radiologists (n=9), specialized treatment planners (n=11) and specialist endodontists (n=6). Using the derived utilities, a decision analysis was subsequently carried out on the expected health value of taking periapical radiographs of patients with otherwise symptomless fractured incisors. RESULTS: "Composite restoration and root filled" (mean utility 0.83, SD 0.15) was the option preferred above that of "root filled and post crown" (mean utility 0.77, SD 0.16) by the entire sample of oral diagnosticians (P=0.007). Radiologists and endodontists had higher utilities for "composite restoration and root filled" than treatment planners. According to the decision analysis, for the preferred option of "composite restoration and root filled", taking a radiograph was the best strategy only when the prevalence of pathology exceeds 10%, 12% and 50% for radiologists, endodontists and treatment planners, respectively. CONCLUSIONS: The expected utility of using radiographs as a diagnostic test varies among groups of dental specialists. We conclude that variation in utilities among dentists could in part explain variation in the diagnostic use of dental radiographs.     

两种桩核系统在严重缺损前牙残根修复中的临床研究

目的：探讨玻璃纤维桩系统和铸造金属桩系统在修复严重缺损前牙中的临床效果。方法本研究是在2008年～2009年,对257例,共324颗具有保留价值的前牙严重缺损残根在根管治疗的基础上,根据患者意愿,分别使用铸造金属桩核和纤维桩核两种桩核,后全冠修复。随访36个月,观察两组患牙的成功率,进行χ2检验。结果造成失败的主要原因是牙根折断、桩折断,其他包括冠脱落、桩脱落、根尖阴影等。结论在适当的适应症选择条件下,纤维桩可广泛的应用于严重缺损前牙残根。     

The role of PCL reconstruction in knees with combined PCL and posterolateral corner deficiency

Although many PCL injuries are in combination with posterolateral corner (PLC) injuries, there has been little work done on combined injury reconstruction; the literature includes differing recommendations. It was hypothesised that a double-bundle PCL reconstruction would restore both posterior drawer and external rotation laxities closer to normal than an isolated single-bundle reconstruction in combined PCL plus PLC-deficient knees. However, it was also hypothesised that an isolated PCL reconstruction would still leave abnormal rotation laxity. In this controlled laboratory study, cadaver knee kinematics were measured electromagnetically with posterior drawer, external rotation, varus rotation loads applied, at sequential stages: intact; PCL-deficient; PCL plus PLC-deficient; double-bundle PCL reconstruction; single-bundle PCL reconstruction. The grafts were tensed using a posterior drawer laxity matching protocol. There was no significant difference between single- and double-bundle PCL reconstructions at any angle of flexion: both reconstructions restored posterior drawer to normal; neither reconstruction restored external rotation or varus laxity to normal. We concluded that, in combined PCL plus PLC deficiency, isolated PCL reconstruction only controls tibial posterior drawer, but is not sufficient to restore rotational laxity to normal. Double-bundle PCL reconstruction was not better than single-bundle, so the added complexity of double-bundle reconstruction does not seem to be justified by these results.     

前牙重度磨耗伴游离端牙列缺损固定-活动联合修复的临床应用

目的评价采用固定-活动联合修复前牙重度磨耗伴游离端牙列缺损重建咬合关系的临床效果。方法对28例前牙重度磨耗伴游离端牙列缺损的患者,前牙进行完善根管治疗,后牙先以活动可摘局部义齿重建后牙咬合关系和牙合间距离,经过不断调整、观察2～3个月后,采用前牙桩核烤瓷连冠修复,后牙根据最后确定的垂直高度采用附着体义齿修复。结果 28例前牙重度磨耗伴游离端牙列缺损经过咬合重建序列治疗,采用固定-活动联合修复后,患者面下1/3高度均得到恢复,面部丰满美观,关节无疼痛和弹响,前牙烤瓷冠牢固、美观,游离端附着体义齿固位良好,咀嚼效能高,无卡环,义齿美观舒适,恢复了垂直距离,确定了咬合关系。结论固定-活动联合修复是治疗前牙重度磨耗伴游离牙列缺损患者的一种有效可行的修复方法。     

Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study

Purpose

To biomechanically compare Bankart lesion repair alone and Bankart lesion repair associated with infraspinatus capsulotenodesis described as «remplissage», in the treatment of combined Bankart and Hill-Sachs lesions.

Methods

Seven pairs (right and left) of cadaveric shoulders have been tested, first without any lesion and then after performing a combined Bankart and Hill-Sachs lesions. For each pair, the specimens were then randomly assigned for Bankart lesion repair alone on one side or for Bankart lesion repair associated with remplissage on the other side. During tests, the shoulder was placed at 90° of abduction and at maximal external rotation, which value was recorded. A 50 N postero-anterior load was then applied to the proximal humerus, and the stiffness was calculated from the obtained load–displacement curve.

Results

Bankart and Hill-Sachs lesions significantly (p < 0.05) decreased joint stiffness compared with intact joint. Bankart lesion repair alone did not restore stiffness to the level of intact, while adding the remplissage to the Bankart lesion repair did. External rotation was significantly increased after creation of the Bankart and Hill-Sachs lesion; Bankart repair restored the external rotation to the level of intact, while Bankart lesion repair associated with remplissage significantly decreased external rotation compared with intact and to Bankart lesion repair alone.

Conclusion

In cadaveric shoulders with combined Bankart and Hill-Sachs lesions, Bankart lesion repair associated with remplissage restored intact joint stiffness contrary to Bankart lesion repair alone. This increase in stiffness was associated with a decrease in external rotation.

     

激光在乳牙牙髓治疗中的应用进展

乳牙牙髓治疗是儿童口腔医师最常进行的治疗之一。由于儿童的配合度和乳牙特殊的解剖结构,乳牙牙髓治疗在临床中有很多难以解决的技术难点,特别是乳牙的根管治疗。激光治疗的微创性、舒适性。可降低儿童对牙科治疗的恐惧。近年来,激光被儿童口腔医师和学者关注,很多研究表明激光在乳牙牙髓治疗应用中取得了良好的效果,有望进一步提高乳牙牙髓治疗的成功率。本文就激光在乳牙牙髓治疗中的应用进展做一综述。     

The in vitro effect of antimicrobial photodynamic therapy with toluidine blue and indocyanine green on microleakage of class V cavities

IntroductionConsidering the importance of disinfecting dentin and enamel after cavity preparation and the possible effect of disinfection methods on induction of various reactions in the tooth structure the aim of the present study was to evaluate microleakage of composite resin restoration after disinfecting the prepared dentin and enamel surface with antimicrobial photodynamic therapy (aPDT) with toluidine blue (TBO) and indocyanine green (ICG).Materials and methodsStandard class V cavities were prepared on buccal surface of 71 human premolar teeth. The samples were randomly divided into 3 groups based on disinfection method: Group 1: conventional disinfection method with Phosphoric acid 37% as the control; Group 2: aPDT with TBO and diode laser with wavelength of 635 nm; Group 3: aPDT with ICG and diode laser with wavelength of 808 nm. All the cavities were restored with composite resin (3M™ Filtek™ Z250). After thermocycling and immersing in 0.5% basic fuchsin, the samples were prepared for microleakage evaluation under a stereomicroscope. Data was analyzed with Kruskal-Wallis and Wilcoxon signed-rank tests at P < 0.05.ResultsThere were no significant differences in the microleakage of occlusal and gingival margins between the TBO and control groups (P > 0.05). Also, the microleackage of occlusal margins between groups was not significantly different (P > 0.05) but microleackage of gingival margins of ICG group was lower than two other groups in a meaningful way (P < 0.05).ConclusionPhotodynamic therapy with ICG as disinfecting agent in cavity preparations before composite resin restorations decreases the microleackage of gingival margins.