The Bond Strength of Different Tray Adhesives on Vinyl Polysiloxane to Two Tray Materials: An In Vitro Study

There has been no established chemical bonding between custom tray resin and the elastomeric impression materials without the use of manufacturer’s recommended specific tray adhesive. The present study was aimed to compare the bond strength of the manufacturer recommended tray adhesives with the universal tray adhesives using the medium body consistency vinyl polysiloxane (VPS) material and custom tray made of autopolymerising resin and visible light cure (VLC) resin. A total 90 cubicle specimens of autopolymerising resin and 90 specimens of VLC resin were tested for its tensile bond strength. Effectiveness of universal tray adhesive was compared with manufactured tray adhesive. Each of these specimens was then subjected to tensile load in hounsefield universal testing machine at a cross head speed of 5 mm/min and the results were compared and evaluated using one way analysis of variance and post hoc Tuckey’s test. Analysis of bond strength revealed that the universal tray adhesive showed better strength and was statiscally significant when compared to the manufacture supplied tray adhesive. Comparison between both the groups, VLC resin showed better bond strength as compared to autopolymerizing resin. Universal tray adhesive had better tensile bond strength than the manufacturers recommended tray adhesive with the medium body viscosity VPS impression material for both autopolymerising and VLC tray resin.     

拔牙后不同移植材料牙槽窝保存术对牙槽骨吸收的影响

目的 :探究不同移植材料对拔牙后牙槽嵴保存效果的影响。方法 :选取2018-10—2019-06期间于我院口腔门诊行拔牙术、即刻牙槽嵴保存术的63例患者(135颗患牙)。根据随机数字表法分为3个研究组(A、B、C组),且各研究组拔牙后使用不同移植材料行即刻牙槽嵴保存术。其中A组为同种异体骨移植(20例,42颗牙),B组Bio-Oss Collagen骨胶原移植(26例,55颗牙),C组Bone Ceramic人工合成骨移植(17例,38颗牙);另取同期15例患者(33颗患牙)拔牙术后不填充任何骨替代材料作为对照组D组。各组在拔牙6个月后行延期种植,比较各组种植成功率、牙槽骨高度、牙槽骨宽度、牙龈乳头高度及美学效果。结果:A、B、C 3组的种植成功率及美学效果PES评分差异无统计学意义(P>0.05)。牙槽骨高度值及高度吸收值比较,B组和C组间无差异,但均高于A组且小于对照组D组(P<0.05)。牙槽骨宽度值及宽度吸收值比较,B组和C组间无差异,但均高于A组且小于对照组D组(P<0.05)。牙龈乳头高度0~Ⅰ级及Ⅳ级的病例占比,A、B和C组间无差异,但均低于对照组D组(P<0.05);牙龈乳头高度Ⅲ级的病例占比,A、B和C组间无差异,但均高于对照组D组(P<0.05)。结论:微创拔牙后牙槽嵴保存术可有助于改善骨量丢失、保存牙龈乳头高度、提高美学效果,其中同种异体植入材料在减少牙槽骨横向及纵向吸收方面的效果更佳,具有推广价值。     

Evaluation of Accuracy of Direct Transfer Snapon Impression Coping Closed Tray Impression Technique and Direct Transfer Open Tray Impression Technique: An In Vitro Study

Accuracy of the implant impression technique is one of the key factor determining the strain free fit of the prosthesis fabricated which influences the treatment success. Two implant impression techniques namely the closed tray technique with transfer coping and open tray technique were evaluated for accuracy with stone casts obtained from them. Casts were evaluated using a custom constructed bar on strain gage (SYSCOM) and abutment coordinates using Coordinate Measuring Machine (TESA micro-HITE). The statistical analysis with one way ANOVA and Mann–Whitney tests show that the casts obtained with open tray technique were accurate than the casts of closed tray technique (significance P < 0.001). Direct transfer impression technique with less number of components ensures the high accuracy of transfer of implant positions from master cast to the laboratory cast compared to the indirect transfer impression technique.     

Effect of the Impression Margin Thickness on the Linear Accuracy of Impression and Stone Dies: An In Vitro Study

The space available for impression material in gingival sulcus immediately after the removal of retraction cord has been found to be 0.3–0.4 mm. However after 40 s only 0.2 mm of the retracted space is available. This is of concern when impression of multiple abutments is to be made. Hence a study was planned to determine the minimum width of the retracted sulcus necessary to obtain a good impression. Five metal dies were machined to accurately fit a stainless steel block with a square cavity in the center with spaces, 1 mm deep and of varying widths (0.11–0.3 mm) away from the block. Polyvinyl siloxane impressions were made and poured using a high strength stone. Using traveling microscope, length and widths of abutment, impression and die were measured and compared for linear accuracy and completeness of impression. Results showed 1.5–3 times greater mean distortion and larger coefficient of variance in the 0.11 mm group than in the wider sulcular groups. ANOVA test for distortion also showed statistically significant differences (P < 0.05). 75 % of impressions in 0.11 mm group were defective compared to less than 25 % of impressions in other width groups. It is not always possible to predictably obtain accurate impressions in sulcus width of 0.11 mm or lesser. Dimensionally accurate and defect free impressions were obtained in sulcus width of 0.15 mm and wider. Hence clinicians must choose retraction methods to obtain a width greater than 0.35 mm. Further immediate loading of the impression material after cord removal may improve accuracy.     

Microcomputed Tomographic Analysis of the Alveolar Ridge Alteration around Extraction Sites with and without Immediate Implants Placement: In Vivo Study

Background: The aim was to assess the alveolar ridge alteration around extraction sites with and without immediate implants according to extraction socket classification (ESC) using microcomputed tomography (micro‐CT). Material and Methods: Ten beagle dogs (mean age and weight: 24 ± 0.83 months and 13.8 ± 0.49 kg, respectively) were randomly divided into three groups according to the ESC. In Group 1 (ESC‐I), bilateral first and third premolars were extracted and replaced with immediate implants. In Group 2 (ESC‐II), two adjacent premolars were extracted with one immediate implant placement in the mesial socket in the maxilla and in the distal socket in the mandible. In Group 3 (ESC‐III), three adjacent teeth were extracted and an immediate implant was placed in the central socket. Primary closure was achieved using resorbable sutures. Buccal sites with dehiscence defects were excluded. After 4 months, subjects were sacrificed and alveolar ridge widths were measured at 1 mm interval in axial and sagittal views, using micro‐CT in sites with and without immediate implants. Results: In sites without immediate implant placement, alveolar ridge width was significantly higher in Group 1(6.1 ± 1.35 mm) than Group 3 (4.14 ± 1.53 mm) (p < .05). In sites with immediate implant placement, the alveolar ridge width was higher among sites in Group 1 (6.4 ± 3.8 mm) than Group 2 (4.8 ± 0.46 mm) (p < .05) and Group 3 (5.02 ± 0.84 mm) (p < .05). Overall, between each corresponding group in both sites with and without immediate implant placement at 1 mm thickness, there was no significant difference in the alveolar ridge widths. Conclusion: With the exception of Group 1 (ESC‐I), immediate implant placement did not prevent or minimize bone remodeling in extraction sites according to ESC.     

Pressure Generated on a Simulated Mandibular Oral Analog by Impression Materials in Custom Trays of Different Design

PURPOSE: The purpose was to measure the pressure exerted under a simulated mandibular edentulous impression at different locations using commonly used impression materials and four impression tray configurations. MATERIALS AND METHODS: This study was performed using an oral analog that simulated an edentulous mandibular arch. Three pressure transducers were embedded in the oral analog-one pressure transducer in the anterior ridge area, and the other two in the right and left buccal shelves. Four configurations of custom trays were fabricated: trays with no relief, with and without holes; and trays with relief, with and without holes. The impression materials tested were light body polysulfide, light body vinyl polysiloxane, medium body vinyl polysiloxane, and irreversible hydrocolloid. The custom tray and the oral analog were mounted using a reline jig, and a Satec universal testing machine was used to apply a constant pressure of 1 kg/cm(2) over a period of 5 minutes on the loaded custom tray. Eighty impressions for the 16 groups (n = 5) were made, and pressures were recorded every 10 seconds. Factorial ANOVA and Tukey Multiple Comparison Test were used to analyze the results (p < 0.05). RESULTS: A significant difference was found in the pressure produced using different impression materials. Irreversible hydrocolloid and medium body vinyl polysiloxane produced significantly higher pressure than light body polysulfide and light body vinyl polysiloxane impression materials. The presence of holes and/or relief significantly altered the magnitude of pressure produced by irreversible hydrocolloid and medium body vinyl polysiloxane but not light body polysulfide and light body vinyl polysiloxane. CONCLUSION: All impression materials produced pressure during simulated mandibular edentulous impression making. For making mandibular edentulous impressions, low-viscosity impression materials-light body polysulfide and light body vinyl polysiloxane-are recommended. Tray modification was not important in changing the amount of pressure produced for the low-viscosity impression materials.     

An In Vitro Study to Compare the Accuracy of the Master Cast Fabricated by Four Different Transfer Impression Techniques for Single-Tooth Implant Replacement

Single tooth implant retained crowns have become a recognized technique for the replacement of the missing teeth. With the predictable integration of implants, the emphasis is shifted towards precise prosthesis. Minor movement of the impression coping retained inside the impression material can occur during all the procedures, leading to the three-dimensional spatial inaccuracies in the master casts. Therefore, the present study was undertaken with the purpose to evaluate the accuracy of single-tooth implant impression techniques using four different impression copings, so as to obtain a precise definitive cast for a single-unit implant restoration. A maxillary acrylic resin model with a standard single implant in the first molar region was used to simulate a clinical situation. A total of 60 impressions were made with polyvinylsiloxane impression material, which were divided into four groups of 15 impressions each. Group I used non-modified square impression coping, while in group II, III and IV square impression coping were modified differently. Master casts fabricated for all the groups were analyzed to detect rotational position change of the hexagon on the implant replicas in the master casts in reference to the resin model. The master casts obtained with the roughened and adhesive-coated impression copings showed a lower amount of rotational movement than the masters casts achieved with the non-modified impression copings. Hence, the clinician should use sandblasted and adhesive coated impression copings to achieve a more accurate and precise orientation of the implant replicas in the laboratory master casts in single-tooth implant restorations.     

An In Vitro Study of the Bond Strength of Five Adhesives Used for Vinyl Polysiloxane Impression Materials and Tray Materials

Although stock trays often provide mechanical retention for elastomeric impression materials, manufacturers typically recommend the use of an adhesive, whether a stock or custom tray is used. The mention of the bond strength on the adhesive packaging is not available, therefore the clinician has no idea whatsoever of the ideal adhesive. The aim of this study was to evaluate the bond strength of three vinyl polysiloxane (VPS) materials, one with a poly(methyl methacrylate) autopolymerizing (PMMA) specimen and another with a light-polymerizing tray material (VLC), using the adhesive recommended by the manufacturer of the impression material, and two universal adhesives. A total of ninety specimens (15 × 15 × 20 mm) were used, 45 specimens were made in PMMA and rest 45 was made in VLC. Five paint-on adhesives (Coltene, Caulk, 3M, universal Zhermack and universal GC) were applied. Three impression materials, Affinis, Reprosil, and 3M, were mixed and injected into a perforated poly vinyl chloride cylinder. Tray specimens were positioned against the open cylinder end in contact with the VPS material. Tensile strength tests were conducted until adhesive separation failure. Mean values and standard errors of the adhesive strength were recorded in MPa for each material combination. GC paint-on universal adhesive provided significantly higher adhesive strength values.     

A Comparative Analysis of the Effect of Three Types of Denture Adhesives on the Retention of Maxillary Denture Bases: An In Vivo Study

There are many factors involved in the success of a good quality complete dentures, one of them is retention. There are some forcing situations where providing optimal retention may be a problem, in which use of denture adhesives is recommended. In the present study, primary and secondary impressions were made on 20 completely edentulous patients, master cast was fabricated. Master cast was duplicated; heat-cured denture base was fabricated. The retention test for control group, powder group, wafer group, paste group was done using a customized force sensor device. Readings was subjected to ANOVA followed by post hoc test. Results show that the retention force value of the paste group was the maximum, followed by powder group, wafer group and the least retention force value was observed with control group. Within the limitations of the study it can be concluded that the paste form of denture adhesive has the best retentive property compared to the powder and wafer.     

A Comparative Analysis of the Effect of Various Denture Adhesives Available in Market on the Retentive Ability of the Maxillary Denture: An In Vivo Study

"Every human being has a divine right to enjoy the health to its fullest." Oral and Dental health is not an exception to this dictum. The speciality of Prosthodontics has emerged as a science to provide replacement of missing dentition for its form and functions along with associated structures. Any successful complete denture treatment combines exemplary technique, effective patient rapport, patient education, and familiarity with all possible management options in order to provide maximum satisfaction to patient. There are some forcing situations where providing desirable (optimal) retention may be a problem. In such types of patients use of denture adhesives is recommended for enhancing the quality of retention. The use of denture adhesive provides comfort and additional confidence not only by increasing the adhesive and cohesive but also eliminating voids between the denture base and the basal seat. This study is undertaken to evaluate the enhancement of retentive quality of complete denture with the use of denture adhesives available in Indian markets for the use by denture wearers.     

Evaluation of Effect of Tray Space on the Accuracy of Condensation Silicone, Addition Silicone and Polyether Impression Materials: An In Vitro Study

Optimal thickness of impression materials in the custom tray in order to get the most accurate impression. To investigate the effect of different tray spacer thickness on the accuracy and the dimensional stability of impressions made from monophasic condensation silicone, addition silicone and polyether impression materials. Three different types of elastomeric monophasic impression materials were used for making the impression of a master die with tray having tray spacer thickness of 2, 4 and 6 mm. Each type of impression was poured in die stone after 1 h. Each cast was analyzed by a travelling microscope and compared with the master die. The data was tabulated and subjected to statistical evaluation. The results of the study indicated that the impressions made from 2 to 4 mm spaced trays produced more accurate stone casts when compared to 6 mm spaced tray. No statistical significant differences were observed between the accuracy and dimensional stability of the three materials tested. Minimum changes were observed when the cast was poured after 1 h and the tray space was 2 mm for all the materials tested. It is therefore advisable not to exceed tray space of 2 mm.     

Effectiveness of Mouthrinses and Oral Prophylaxis on Reduction of Microorganisms Count in Irreversible Hydrocolloid Impression: An In Vivo Study

Dental impressions, contaminated with saliva, blood, plaque, are potential source of infection. All impressions should be disinfected after their removal from mouth to prevent cross contamination. Different methods have been tried to disinfect the commonly used irreversible hydrocolloid impression material, but they have been shown to influence the dimensional stability and surface detail of the impression which ultimately affects the precision of the final prosthesis. The aim of this study was to evaluate the efficacy of pre-procedural oral prophylaxis and mouthrinses in reducing the overall microbial load intraorally as well as on alginate impression surface. A total of 60 positive cases selected from 100 subjects who were partially edentulous and above 18 years of age and without medical or pharmacotherapy histories were studied over a period of 18 months, from outpatient clinic of Department of Prosthodontics, GNIDSR. Alginate impressions, before and after prophylaxis were examined microbiologically for the persistence of test microorganisms on the untreated (control group) and the impressions made after treatment. The data were statistically analyzed by the Student t test to assess the effectiveness of the procedure and also the comparative effectiveness of oral prophylaxis and commonly used mouthrinses. The results showed that the impressions were safer when made after oral prophylaxis and/or mouthrinses     

Anesthetic Success Using Nitrous Oxide and a Combination of Lidocaine/Clonidine for the Inferior Alveolar Nerve Block and the Effects on Blood Pressure and Pulse in Patients with Symptomatic Irreversible Pulpitis: A Prospective,Randomized, Double-blind Study

IntroductionThe pulpal anesthetic success rates for an inferior alveolar nerve block (IANB) alone in patients presenting with symptomatic irreversible pulpitis are less than adequate. Nitrous oxide and clonidine have shown increases in IANB success when administered individually, but their success has not been evaluated when used together. The purpose of this prospective, randomized, double-blind study was to determine the effect of nitrous oxide/oxygen plus an IANB using lidocaine/clonidine on the success of the IANB in patients with symptomatic irreversible pulpitis and to evaluate the effect of clonidine on blood pressure and pulse.MethodsSixty-two emergency patients experiencing moderate to severe pain and a diagnosis of symptomatic irreversible pulpitis were enrolled. Subjects were randomly divided into 2 groups and received nitrous oxide/oxygen and an IANB using 2% lidocaine with either 27 μg clonidine or 18 μg epinephrine as vasoconstrictors. Blood pressure and pulse were recorded before and during the emergency endodontic treatment. Anesthetic success was defined as no or mild pain upon access and instrumentation of the canals.ResultsThe pulpal anesthetic success rate in both treatments was 58%, with no significant difference between the groups. There was no statistically significant difference in pulse or systolic blood pressure with the use of clonidine compared with epinephrine. Diastolic blood pressure was significant.ConclusionsThe use of nitrous/oxide plus the addition of lidocaine/clonidine for the IANB in teeth with symptomatic irreversible pulpitis resulted in no statistically significant difference in anesthetic success of the IANB. There were no statistically significant differences in pulse or systolic blood pressure with the use of clonidine compared with epinephrine; diastolic blood pressure was significant.     

Effects of Implant Design and Surface on Bone Regeneration and Implant Stability: An Experimental Study in the Dog Mandible

Background: Previous experimental studies have shown a higher degree of bone‐implant contact for surface‐enlarged implants compared with machined implants. Yet, there is insufficient evidence that such implants show higher stability and an increased survival rate. Purpose: The purpose of this investigation was to study the integration and stability of grit‐blasted implants with retention elements on the implant neck, with and without marginal bone defects, compared with machined implants without retention elements. Materials and Methods: After tooth extraction of the mandibular premolars in six dogs, two grit‐blasted, partly microthreaded Astra Tech implants and one standard Branemark implant were bilaterally placed in each dog. On one side, 3 ± 3 mm large buccal defects were created, to expose three to four implant threads. The contralateral side served as control, and no defects were made. The animals were sacrificed after 4 months of healing. Implant stability was measured using resonance frequency analysis at implant installation and after 4 months of healing. Histologic and histomorpho‐metric evaluation was made after 4 months of healing. Results: Resonance frequency analysis indicated that all implants in the test and control groups were osseointegrated after 4 months, with a tendency toward higher implant stability for the Astra Tech implants. There was a statistically significant higher increase in resonance frequency for the Astra test implants compared with their corresponding controls. Histology and histomorphometry showed well‐integrated implants with varying degrees of bone repair at the defect sites. The greater bone‐implant contact for the Astra implants was statistically significant. No significant difference between the implants in amount of bone filling the threads was recorded. Conclusions: The Astra Tech implants tested showed a higher degree of bone—implant contact and higher level of bone regenerated at defect sites compared with the Brånemark implants. Resonance frequency analysis demonstrated a significantly higher increase in the Astra test implants compared with their control groups than did the Brånemark test implants versus their controls.