For deep carious lesions, less invasive carious tissue removal is recommended. The resulting residual carious lesions might benefit from remineralization by lining or restoration materials. We aimed to compare mineral gains in artificial residual lesions provided by calcium hydroxide and glass hybrid materials in combination with pulpal fluid simulation.
MethodsOn the coronal aspect of human dentin discs (n = 20), artificial carious lesions were induced using acetic acid. Median mineral loss ΔZ [25th/75th percentiles] of resulting lesions was 1643 [1301/1858] vol% μm. One third of each disc served as baseline sample. The remaining disc was divided into four groups, each being covered with one experimental material (n = 20/group): flowable composite (control (CO)), setting or non-setting calcium hydroxide liner plus flowable composite (CH-S, CH-NS), and glass hybrid (GH). Samples were mounted in a dual-chamber device. Pulpal surfaces were exposed to simulated pulpal fluid at 2.94 kPa. Coronal surfaces were exposed to artificial saliva and rinsed with 200 ppm NaF every 2 weeks. After 12 weeks, mineral loss differences (ΔΔZ) were assessed using transverse microradiography. Electron probe microscopic analysis was used to measure fluoride and strontium concentrations.
ResultsMineral gains were not significantly different between CO (ΔΔZ = 372 [115/501] vol% μm), CH-S (ΔΔZ = 317 [229/919] vol% μm), or CH-NS (ΔΔZ = 292 [130/579] vol% μm; p > 0.05/Wilcoxon test) but significantly increased in GH (ΔΔZ = 1044 [751/1264] vol% μm, p < 0.001). Samples in GH showed fluoride and strontium enrichment deep into the dentin. Such enrichment was not found in CO.
ConclusionsWithin the limitations of this study, GH, but not calcium hydroxide, provided coronal remineralization of residual carious lesions.
Clinical relevanceGlass hybrids might provide additional remineralization of residual carious lesions. The functional implications of this mineral gain need to be evaluated.
相似文献To present a digital approach to measure and compare material wear behavior of antagonistic first molar restorations made of an experimental CAD/CAM composite (COMP) and lithium disilicate ceramic (LS2) in patients with reconstructed vertical dimension of occlusion (VDO) after generalized hard tissue loss.
MethodsA total of 12 patients underwent complete full jaw rehabilitation with full occlusal coverage restorations made either of COMP or LS2. The first molar restorations (n = 48) were chosen for wear examination. At annual recall appointments, polyether impressions were taken, and resulting plaster casts were digitalized using a laboratory scanner. Mean observation period was 371 days for first and 769 days for second year. The resulting 96 datasets were analyzed by superimposition of 3-D datasets using an iterative best-fit method. Based on the superimposition data, the wear rates of the occlusal contact areas (OCAs) were calculated.
ResultsFor antagonistic restorations made of COMP, the average wear rate was 24.8 ± 13.3 μm/month, while for LS2, it was 9.5 ± 4.3 μm/month in first year, with significant differences (p < 0.0001) between the materials. In second year, monthly wear rates decreased significantly for both materials: COMP (16.2 ± 10.7 μm/month) and LS2 (5.5 ± 3.3 μm/month). Statistical comparison between wear time showed significant differences for both materials: COMP p < 0.037 and LS2 p < 0.001. A logarithmic fit (COMP R2 = 0.081; LS2 R2 = 0.038) of the data was calculated to estimate the wear progression.
SignificanceIn patients with reconstructed VDO, restorations made of LS2 show a more stable wear behavior than ones out of experimental CAD/CAM composite. In cases of complete rehabilitation, load bearing CAD/CAM-composite restorations should be critically considered for application due to their occlusal wear behavior. However, when choosing a restorative material, not only the functional occlusal stability should be taken into account but also the prospect of minimally invasive treatment with maximum preservation of natural tooth structures.
相似文献To investigate tissue health around implants with newly attached superstructures over 12 months of preventive maintenance appointments and instrumentation when necessary.
Material and methodsIn a randomized, split-mouth study 32 implants (8 participants with 4 implants each) received followed-up care every 3 months after superstructure attachment. Implants and superstructures were randomly assigned to four treatment groups and treated if necessary: (1) titanium curettes (TC), (2) stainless steel ultrasonic tip (PS), (3) erythritol air-polishing powder (EP), or (4) rubber cup polishing (CON). Probing depths (PDs), bleeding on probing (BOP), modified gingival (mucosal) bleeding index (GBI) around implants, and full-mouth Plaque Control Record (PCR) were measured every 3 months. Clinical attachment levels (CALs) and height of keratinized mucosa (KM)/gingival margins (GMs) for implants/teeth and PD, BOP, and GBI for teeth were documented at baseline, 6 months, and 12 months. Matrix metalloproteinase 8 (MMP-8) and periopathogens were measured at baseline and 12 months.
ResultsParticipants exhibited minimal signs of periodontal inflammation with statistically significant PD improvement (3.0 ± 0.2 to 2.8 ± 0.3 mm; p = 0.022) and overall CAL (4.3 ± 0.8 to 4.0 ± 0.7 mm; p = 0.048) after 1 year. Implants showed no statistically significant differences (p > 0.05) between or within groups at baseline or 12 months for any parameter, except MMP-8 decreased significantly for PS (14.50 ± 17.58 to 4.63 ± 7.56 ng; p = 0.044), and after 12 months, PCR showed a significant difference between TC and PS (p = 0.018).
ConclusionsTreatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements.
Clinical relevanceEarly assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.
相似文献To investigate the surface roughness of CAD/CAM materials immediately after milling and after different chairside and labside polishing procedures. A two-body wear test was performed to compare the different wear characteristics of the materials and the corresponding antagonists.
Materials and methodsSpecimens (n = 12 per series) from different CAD/CAM materials (three composites: Lava Ultimate, Cerasmart, BRILLIANT Crios; one hybrid ceramic: VITA Enamic; three ceramics: Celtra Duo, VITA Suprinity, IPS Emax.CAD) were polished according to the manufacturer’s instructions. The effect of different polishing procedures was investigated by comparing surface roughness (Ra, Rmax) after labside polishing and after chairside polishing. Wear behavior (mean, volume, and maximum wear) of specimens and antagonists as well as changes in surface roughness were determined in a pin-on-block wear test. Statistical analysis was performed with a one-way analysis of variance (ANOVA)/Bonferroni multiple-comparison post hoc test and a multifactorial ANOVA/Tukey’s significant difference post hoc test (α = 0.05). SEM micrographs were used for the qualitative evaluation of surfaces and wear traces.
ResultsAfter chairside high-gloss polishing, ceramics and composites exhibited Ra values between 0.08 and 0.10 μm and between 0.11 and 0.13 μm, respectively. After labside high-gloss polishing, values varied between 0.02 and 0.09 μm for ceramics and between 0.06 and 0.16 μm for resin composites. No significant differences were found between labside and chairside pre- and high-gloss polishing. For the ceramics, lower mean wear depths (between − 132.2 ± 19.9 and − 137.0 ± 19.0 μm) were identified compared to the resin composites (which exhibited wear depths between − 159.1 ± 19.4 and − 176.3 ± 23.9 μm). For maximum wear depth and volume, a different ranking of the materials was found. Antagonistic wear varied between 12.0 ± 6.4% and 30.6 ± 9.9% and was higher for the ceramic materials and Lava Ultimate. For all materials, a smoothing between 0.20 and 2.70 μm (Ra) was identified after wear simulation.
ConclusionsChairside polishing is as effective as labside polishing, although surfaces were directly adjusted (roughened) only before the chairside polishing. Wear was lowest for ceramics, followed by the resin-infiltrated material and the resin composites.
Clinical relevancePolishing after milling or adjustment is essential to guaranteeing optimal clinical performance. Chairside polishing after adjustment leads to comparably smooth surfaces as labside polishing after milling and grinding. Ceramics are expected to exhibit lower wear than resin composites under clinical conditions.
相似文献The aim of this study was to evaluate the influence of [2-(methacryloyloxy)ethyl] trimethylammonium chloride (METAC) in the physico-chemical properties, antibacterial activity and cytotoxicity of an experimental resin–based sealant.
Materials and methodsAn experimental resin-based sealant was formulated with dimethacrylates and a photoinitiator system. METAC was added at 2.5 wt.% (G2.5%) and 5 wt.% (G5%) into the experimental resin–based sealant, and one group remained without METAC as control (GCTRL). The resin-based sealants were analysed for polymerization behaviour and degree of conversion (DC), Knoop hardness (KHN) and softening in solvent (ΔKHN), ultimate tensile strength (UTS), contact angle, surface free energy (SFE), immediate and long-term micro-shear bond strength (μ-SBS) and antibacterial activity and cytotoxicity against human keratinocytes.
ResultsThe experimental resin–based sealants presented different polymerization behaviours without significant differences in the DC (p > 0.05). There was no significant difference for initial KHN (p > 0.05). The ΔKHN ranged from 51.62 (±3.70)% to 62.40 (±4.14)%, with higher values for G5% (p < 0.05). G2.5% and G5% had decreased μ-SBS between immediate and long-term tests (p < 0.05) without significant differences among groups in the immediate and long-term analyses (p > 0.05). There were no significant differences for UTS, contact angle and SFE among groups (p > 0.05). G2.5% and G5% presented immediate and long-term antibacterial activity (p < 0.05) without cytotoxicity compared to GCTRL (p > 0.05).
ConclusionThe addition of METAC provided antibacterial activity to the experimental resin–based sealant.
Clinical relevanceMETAC is an effective quaternary ammonium compound as an antibacterial agent for resin-based sealants without cytotoxic effects against human keratinocytes.
相似文献Non-invasive esthetic treatment options for stained arrested caries lesions have not been explored. This study aimed to develop laboratory models to create stained-remineralized caries-like lesions (s-RCLs) and to test the efficacy of bleaching on their esthetic treatment.
Materials and methodsOne hundred twelve enamel/dentin specimens were prepared from human molars, embedded, and had their color measured spectrophotometrically at baseline and after demineralization. They were randomly divided into four groups (n = 14) based on the staining/remineralization protocols for a total of 5 days: G1, no staining/no remineralization; G2, no staining/remineralization in artificial saliva (AS); G3, non-metallic staining/remineralization with sodium fluoride/AS; and G4, metallic staining/remineralization with silver diamine fluoride/AS. The lesion mineral loss (ΔZ) and depth (L) were measured using transverse microradiography along with color change (ΔE). Specimens were bleached and color was re-evaluated. Data were analyzed using ANOVA models followed by Fisher’s PLSD tests (α = 0.05).
Resultss-RCLs in G4 were significantly (p < 0.001) darker than G3, G2, and G1 regardless of substrate type and condition. s-RCLs in G2, G3, and G4 showed significantly lower ΔZ and L than G1 (all p < 0.001), confirming occurrence of remineralization. G4 exhibited significantly lower ΔZ and L compared to G2 (p < 0.001). Bleaching was more effective in non-metallic than in metallic stained lesions regardless of substrate type (p < 0.001).
ConclusionThe proposed models created distinct s-RCLs. Non-metallic s-RCLs were lighter and more responsive to bleaching compared to metallic s-RCLs.
Clinical relevanceThe developed experimental models allow the further investigation of the efficacy and safety of different clinical strategies for the esthetic management of s-RCLs.
相似文献The aim of this randomized controlled clinical trial was to evaluate the possible advantages of adjunctive hyaluronic acid (HA) application in the coronally advanced flap (CAF) procedure in single Miller class I/recession type 1 (RT1) gingival recession treatment.
Material and methodsThirty patients with one recession were enrolled; 15 were randomly assigned CAF + HA and 15 to CAF alone. The recession reduction (RecRed), clinical attachment level gain (CAL-gain), changes in probing pocket depth (PPD) and in the width of keratinized tissue (KT), complete root coverage (CRC), and mean root coverage (MRC) were calculated after 18 months. Post-operative morbidity (pain intensity, discomfort, and swelling) was recorded 7 days after treatment using visual analogue scale (VAS).
ResultsAfter 18 months, RecRed was statistically significantly higher in the test group (2.7 mm [1.0]) than in the control group (1.9 mm [1.0]; p = 0.007). PPD were found to be slightly but statistically significantly increased in both groups. No statistically significant difference was found for KT gain between treatments. CRC was 80% for test and 33.3% for control sites (p < 0.05). A MRC of 93.8 ± 13.0% for test and 73.1 ± 20.8% for control sites was calculated (p < 0.05). The test group reported lower swelling and discomfort values 7-days post-surgery (p < 0.05). Statistically significant difference was not found for pain intensity.
ConclusionsThe adjunctive use of HA was effective in obtaining CRC for single Miller class I/RT1 gingival recession sites.
Clinical relevanceAdjunctive application of HA in the coronally advanced flap procedure may improve the reduction of the recessions and increase the probability of CRC in Miller class I recessions.
相似文献To evaluate the potential of conventional glass ionomer cement (GIC), Biodentine™, MTA, and Portland cement to induce mineral density changes in carious dentin compared to zinc oxide eugenol control cement (ZOE).
Materials and methodsFifty blocks of bovine root dentin were prepared and a biofilm model using ATCC strains of S.mutans, S.sobrinus, and L.casei was used to promote artificial dentin lesions. After demineralization, the blocks were randomly divided into the five cement groups. Half of the surface of each specimen received the tested material and the other half was covered with wax (control). Samples were stored in phosphate buffered saline solution for 30 days and after that were scanned in a micro-CT with standardized parameters. Dentin mineral density changes were calculated using differences in plot profiles of the exposed and control carious dentin. Friedman’s test, followed by Wilcoxon signed-rank test was used with 5% significance.
ResultsMean ΔZ values for the cements were 48.63 ± 19.09 for the control (ZOE), 63.31 ± 32.59 for Biodentine™, 114.63 ± 72.92 for GIC, 109.56 ± 66.28 for MTA, and 106.88 ± 66.02 for Portland cement. All cements showed a statistically significant increase in ΔZ values compared to the control, but Biodentine™ values were statistically significantly lower compared to GIC and the other calcium silicate cements.
ConclusionsTested materials present potential to induce mineral density changes in carious bovine dentin. MTA, Portland, and GIC showed higher bioactivity potential than Biodentine™.
Clinical relevanceBased on minimally invasive concept, materials with remineralization potential can be used to preserve diseased but still repairable dental tissue.
相似文献The aim of this study is to investigate the use of a porcine-derived acellular dermal matrix (MD) in root coverage procedures combined with extended coronally positioned flap (eCAF), in comparison to the subepithelial connective tissue graft (SCTG) associated with the eCAF.
Material and methodsEighteen adult patients presenting bilateral type 1 gingival recession were randomly assigned to SCTG or MD groups. Clinical and patient-based outcomes were recorded at 3 and 6 months after the surgical procedure.
ResultsBoth groups showed a significant reduction in the mean recession height of 3.33 ± 0.89 mm to 1.24 ± 1.10 mm (MD) and 3.21 ± 0.8 mm to 0.83 ± 0.86 mm (SCTG) without difference between groups. Six patients in the test group and eight in the control group obtained complete root coverage. The keratinized tissue height and thickness (KTT) showed a significant increase after 3 and 6 months in both groups. The average KTT gains were 0.39 ± 0.4 mm (MD) and 0.51 ± 0.5 mm (SCTG) (p < 0.05). Performing multivariate analysis suggests that MD addition to coronally advanced flaps may be similar to SCTG.
ConclusionThe MD had similar results in comparison to SCTG and in the context of reducing patient morbidity it can be used as an alternative for the treatment of gingival recessions.
Clinical relevanceThe SCTG is the gold standard therapy for root coverage. The MD has been widely used in mucogingival surgery as a substitute for SCTG and proposed similar results. A substitute is very important for clinicians and patients. It will give a better postoperative and possibilities to treat multiples recession. (Clinicaltrials.gov Identifier: NCT03675334).
相似文献The study was aimed at comparing implants installed with guided and conventional surgery.
Material and methodsTwenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens.
ResultsS-CAIS showed less linear deviation at the apical point and the midpoint and less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers and Tf presented higher levels in CS (p < 0.05). Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique.
ConclusionHowever, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic levels and bone markers.
Clinical relevanceEvaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level.
Trial registrationReBEC-RBR-8556fzp.
相似文献The identification of predictors of supragingival biofilm accumulation may improve the results of therapeutic strategies for dental caries and periodontal diseases in general clinical practice. This study aimed to determine predictors of changes in visible plaque (VP) and gingival bleeding (GB) during integrated dental care.
Materials and methodsA retrospective longitudinal study was conducted by a census of patients receiving integrated dental care in a general clinical practice ambulatory at the Federal University of Rio Grande do Sul (Brazil). The sample comprised 91 charts of patients attended over a 6-months period. Gender, age, patient’s main complaint, oral hygiene pattern, and clinical data were recorded from charts for the last two dental visits in the ambulatory. Changes in VP and GB were modeled by multiple linear regression and beta coefficients (b) were reported.
ResultsThe mean follow-up time was 13 months. Significant reductions in VP (32.8 ± 27.9 to 17.4 ± 19.4%; p < 0.001) and GB (27.1 ± 23.8 to 18.5 ± 17.3%; p < 0.001) were observed. Higher plaque reductions were predicted by higher baseline VP levels (p = 0.02), shorter time (< 12 months) elapsed between VP recordings (b = 14.1%, p = 0.02), interproximal cleansing (b = 11.9%, p = 0.03), lower number of sessions for oral hygiene instruction (b = 13.7%, p = 0.02), and presence of pockets ≥ 6 mm (b = − 12.4%, p = 0.02). GB was predicted by time of follow-up > 12 months and baseline VP.
ConclusionsPlaque and gingivitis improved in patients under integrated dental care. Factors related to motivation, oral hygiene practices, and baseline periodontal status might be used as predictors of VP and GB changes.
Clinical relevanceVisible plaque and gingivitis reduced in a sample of patients treated under integrated dental care. Some predictors may determine for which patients the treatment may be maximize and those who will need greater efforts to achieve the therapeutic goal for oral hygiene.
相似文献To obtain radicular measurements of two separate mesiobuccal (MB) root canals in maxillary first molars using micro-computed tomography (μCT) with customized software.
Materials and methodsHuman maxillary first molar MB roots (N = 36) with two separate canals (MB1, MB2) and apical foramina were scanned by μCT and analyzed with Kappa2 software to reconstruct three-dimensional (3D) surface models of roots and canals. These models were sectioned at 0.1 mm intervals perpendicular to the central axis of each canal. Canal widths, 3D curvatures, and surrounding dentine thicknesses were measured concurrently on each section. Dentine thicknesses were analyzed statistically for differences between each direction and the different levels of both canals.
ResultsDentine walls around MB1 were thicker than MB2 (p < 0.05). Thinnest dentine was most often located at disto-inside direction in both canals. Canal widths were significantly smaller in MB2 than MB1 (p < 0.01). Apical constrictions were smaller (p < 0.05) and further (p < 0.05) from the apex in MB2 than MB1. Canal curvatures were greatest in the apical third of both canals (p < 0.001), and they were greater in MB2 than MB1 (p < 0.05).
ConclusionsMB2 canals had shorter lengths, smaller widths, and more severe curvatures and were surrounded by thinner dentine walls. In MB2, apical constrictions were between 1 and 2 mm from the apex, compared to about 1 mm for MB1.
Clinical relevanceThese detailed measurements and in-depth 3D analyses of maxillary first molar MB roots with two separate canals and apical foramina provide morphologic references for root canal therapy.
相似文献The objective was to evaluate a visible-light-transillumination (using Digital Imaging Fiber-Optic Transillumination machine: DIFOTI) method using occlusal view (DIFOTI-occl), axial view (buccal and lingual: DIFOTI-axial), and combination of all views (DIFOTI-all) for detecting non-cavitated approximal caries and to compare its performance to visual examination (International Caries Detection and Assessment System: ICDAS).
Materials and methodsThirty extracted human premolars were selected (sound to lesions into the outer one-third of the dentine) based on micro-computed tomography (μ-CT). Teeth were mounted in a custom-made device to simulate approximal contact. DIFOTI (Electro-Optical Sciences Inc., Irvington, NY, USA) images were obtained from the occlusal, buccal, and lingual views. DIFOTI image and ICDAS examinations were performed and repeated by three trained/calibrated examiners. Sensitivity, specificity, area under receiver operating characteristics curve (Az), inter- and intra-class correlation coefficients (ICCs), and correlation were determined.
ResultsSensitivity/specificity was for DIFOTI-occl: 0.42/0.75, DIFOTI-axial: 0.86/0.93, DIFOTI-all: 0.91/0.69, and for ICDAS: 0.89/0.83. Az for DIFOTI-occl was significantly lower than that of DIFOTI-axial (p < 0.001), DIFOTI-all (p = 0.002), and ICDAS (p = 0.005). Spearman correlation coefficients with μ-CT for DIFOTI-occl (r = 0.39) showed weak association, while DIFOTI-axial (r = 0.80), DIFOTI-all (r = 0.91), and ICDAS (r = 0.90) showed moderate association. ICCs for intra-examiner repeatability/inter-examiner agreement were for DIFOTI-occl (0.64/0.58), DIFOTI-axial (0.92/0.89), DIFOTI-all (0.85/0.83), and ICDAS (0.79/0.72).
ConclusionsThe results of the current in vitro study suggest that, for detection of non-cavitated approximal caries lesions, DIFOTI performs better using axial than occlusal view.
Clinical relevanceApproximal non-cavitated caries detection is challenging. DIFOTI can observe images from occlusal-, buccal-, and lingual views. DIFOTI and visual (ICDAS) examinations of buccal- and lingual- and all-views are more suitable than those of occlusal view for a detection of non-cavitated approximal caries.
相似文献The aim of this study was to investigate in vitro the effect of clodronate on interleukin-1ß (IL-1ß)–stimulated human periodontal ligament fibroblasts (HPdLFs) with the focus on inflammatory factors of orthodontic tooth movement with and without compressive force.
Materials and methodsHPdLFs were incubated with 5 μM clodronate and 10 ng/mL IL-1ß. After 48 h, cells were exposed to 3 h of compressive force using a centrifuge. The gene expression of cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), matrix metalloproteinase 8 (MMP-8), and the tissue inhibitor of MMP (TIMP-1) was analyzed using RT-PCR. Prostaglandin E2 (PGE-2), IL-6, and TIMP-1 protein syntheses were quantified via ELISA.
ResultsCompressive force and IL-1ß induced an overexpression of COX-2 gene expression (61.8-fold; p < 0.05 compared with control), diminished by clodronate (41.1-fold; p < 0.05 compared with control). Clodronate slowed down the compression and IL-1ß induced IL-6 gene expression (161-fold vs. 85.6-fold; p < 0.05 compared with control). TNF-α was only slightly affected without statistical significance. Clodronate reduced IL-1ß-stimulated MMP-8 expression with and without compressive force. TIMP-1 on gene and protein level was downregulated in all groups. Analyzing the MMP-8/TIMP-1 ratio, the highest ratio was detected in IL-1ß-stimulated HPdLFs with compressive force (21.2-fold; p < 0.05 compared with control). Clodronate diminished IL-1ß-induced upregulation of MMP-8/TIMP-1 ratio with (11.5-fold; p < 0.05 compared with control) and without (12.5-fold; p < 0.05 compared with control) compressive force.
ConclusionOur study demonstrates a slightly anti-inflammatory effect by clodronate under compressive force in vitro. Additionally, the periodontal remodeling presented by the MMP-8/TIMP-1 ratio seems to be diminished by clodronate.
Clinical relevanceReduction of pro-inflammatory factors and reduction of periodontal remodeling might explain reduced orthodontic tooth movement under clodronate intake.
相似文献The aim of this study was to evaluate the fracture resistance of simulated immature roots using Biodentine (BD) and fiber post (FP) compared with different root canal-filling materials under aging conditions.
Materials and methodsOne hundred and forty maxillary central anterior teeth were randomly divided into seven groups (n = 20/group). Negative control received no treatment. In the other groups, the root canals were prepared to simulate immature teeth. The root canals were filled with a 4-mm apical plug of BD and restored intraradicular with BD, BD + FP, composite resin (CR), CR + FP, and gutta-percha (GP). Positive controls were instrumented but without restoration. Teeth were subjected to thermocycling and received cyclic loading before fracture resistance test. Fracture resistance was conducted using a universal testing machine with a crosshead speed of 0.5 mm/min until fracture. Load to fracture was recorded in newtons (N). Data were statistically analyzed using one-way analysis of variance and Tukey’s test at P < 0.05.
ResultsRoot canals restored intraradicular with BD + FP and CR + FP showed the highest fracture resistance compared with the other experimental groups (P < 0.001). There was no significant difference in the fracture resistance between CR and BD groups (P = 0.998). GP and positive control groups were significantly lower resistance to fracture than the other groups (P < 0.001).
ConclusionsIntraradicular reinforcement with BD + FP and CR + FP enhanced the fracture resistance of simulated immature teeth than the other experimental groups.
Clinical relevanceBiodentine or composite resin combined with fiber post could be used to reinforce immature teeth with an apical Biodentine plug.
相似文献Oral behaviors are activities, like gum chewing, teeth clenching, and biting of objects, that go beyond normal functioning demands and contribute to the onset of temporomandibular disorders (TMD). Somatosensory amplification refers to the tendency to experience somatic sensations as intense, noxious, and disturbing and is related to bodily hypervigilance. Clinical experience suggests that individuals with bodily hypervigilance also present with occlusal hypervigilance and continuously check their occlusion. This study aimed at investigating whether somatosensory amplification and trait anxiety, a characteristic correlated with hypervigilance, are associated with a greater incidence of oral behaviors, and verifying how self-reported facial TMD pain affect this relationship.
Materials and methodsThe State-Trait Anxiety Inventory, the Somatosensory Amplification Scale, the Oral Behavior Checklist (OBC), and the TMD-Pain Screener Questionnaire were filled out by 255 University students with self-reported facial TMD pain (PAIN group; 47 subjects, 24.8 ± 4.2 years) and without pain (CTR group; 208 subjects, 26.0 ± 4.8 years) using a web survey.
ResultsTrait anxiety, somatosensory amplification, and OBC scores were greater in the PAIN than CTR group (all p < 0.05). Trait anxiety and somatosensory amplification were positively associated with the frequency of oral behaviors, as measured with the OBC (all p < 0.05). A significant effect of the interaction study group*trait anxiety (p = 0.028) on OBC scores was found.
ConclusionsIndividuals with greater trait anxiety and somatosensory amplification report more frequent oral behaviors. The relationship between anxiety and oral behaviors is affected by concurrent facial pain.
Clinical relevanceIndividuals with increased trait anxiety and concurrent facial pain report more frequent oral behaviors than those without pain. Clinicians should evaluate patients’ anxiety and somatosensory amplification before starting dental treatment.
相似文献Limited evidence suggests a putative inhibitory effect of dietary proteins on demineralization during the carious process. The aim was to explore a potential anticaries activity of the egg protein ovalbumin on a relevant in vitro approach.
Materials and methodsBiofilms of Streptococcus mutans UA159 were formed on saliva-coated enamel and dentin bovine slabs. Biofilms were challenged with 10% sucrose followed by either a 200 μg/mL solution of ovalbumin or 1:10, 1:100, and 1:1000 (v/v) serial dilutions of that ovalbumin solution, for the entire length of the experiment. Biofilms exposed to 10% sucrose followed only by 0.9% NaCl served as caries-positive control. Once completed the experimental phase, biofilms were analyzed for biomass, viable bacteria, and polysaccharide formation. Final surface hardness (SH) was obtained to calculate %SH loss (demineralization). Two independent experiments were conducted, in triplicate. Data were analyzed by ANOVA and a post hoc test at the 95% confidence level.
ResultsA reduction (p < 0.05) in biomass and extracellular polysaccharide formation, but not in the number of viable cells, was observed for both dental substrates. All ovalbumin concentrations tested showed lower demineralization than the positive control (p < 0.05), in a dose-dependent manner. The highest concentration showed a reduction in the %SH loss of about 30% for both enamel and dentin.
ConclusionEgg ovalbumin presented to sucrose-challenged biofilms of Streptococcus mutans seems to reduce cariogenicity of a biofilm-caries model.
Clinical relevanceOvalbumin may counteract the cariogenic effect of sugars. If these findings are clinically confirmed, novel preventive approaches for caries are warranted.
相似文献The aim of this study is to evaluate the long-term clinical performance of a glass ionomer (GI) restorative system in the restoration of posterior teeth compared with a micro-filled hybrid posterior composite.
Materials and methodsA total of 140 (80 Cl1 and 60 Cl2) lesions in 59 patients were restored with a GI system (Equia) or a micro hybrid composite (Gradia Direct). Restorations were evaluated at baseline and yearly during 6 years according to the modified-USPHS criteria. Negative replicas at each recall were observed under SEM to evaluate surface characteristics. Data were analyzed with Cohcran’s Q and McNemar’s tests (p < 0.05).
ResultsOne hundred fifteen (70 Cl1 and 45 Cl2) restorations were evaluated in 47 patients with a recall rate of 79.6% at 6 years. Significant differences were found in marginal adaptation and marginal discoloration for both restorative materials for Cl1 and Cl2 restorations (p < 0.05). However, none of the materials were superior to the other (p > 0.05). A significant decrease in color match was observed in Equia restorations (p < 0.05). Only one Cl2 Equia restoration was missing at 3 years and another one at 4 years. No failures were observed at 5 and 6 years. Both materials exhibited clinically successful performance after 6 years. SEM evaluations were in accordance with the clinical findings.
ConclusionsBoth materials showed a good clinical performance for the restoration of posterior teeth during the 6-year evaluation.
Clinical relevanceThe clinical effectiveness of Equia and Gradia Direct Posterior was acceptable in Cl1 and Cl2 cavities subsequent to 6-year evaluation.
相似文献This ex vivo study was performed to investigate the effect of radiotherapy (RT) delivery time on fracture resistance of mandibular premolars filled with Biodentine or gutta-percha/sealer (GPS).
Materials and methodsSeventy-two mandibular premolars were used in this study. Randomly selected 24 teeth were kept intact for the control groups (with and without irradiation). Then, the remaining 48 teeth were randomly assigned into 4 groups (n = 12) according to RT delivery time (irradiated before or after root canal treatment) and obturation materials as follows: Group RT + GPS, Group: GPS + RT, Group RT + Biodentine and Group Biodentine + RT. The samples were either initially endodontically treated and then irradiated or initially irradiated and then endodontically treated with one of the abovementioned materials. The samples were irradiated at 2 Gy per fraction, 5 times a week for a total dose of 60 Gy in 30 fractions over 6 weeks. The roots were embedded in self-polymerizing acrylic resin. The fracture resistance was evaluated in a universal testing machine. Data was analyzed by one-way ANOVA and Games-Howell post hoc test at p < 0.05.
ResultsRadiation therapy significantly reduced fracture resistance of intact teeth (p < 0.05). The highest fracture resistance was observed in intact/non-irradiated teeth and the lowest fracture resistance in Biodentine + RT group (p < 0.05). The effect of RT delivery time was insignificant when GPS was preferred as the root canal filling material (p > 0.05); it was significant when preferring Biodentine (p < 0.05). When RT was applied to the teeth after Biodentine obturation, the fracture resistance decreased significantly compared to the teeth that were obturated with GPS after or before RT application (p < 0.05).
ConclusionBoth RT time and obturation materials (Biodentine or gutta-percha/sealer) affect the fracture resistance of the endodontically treated teeth.
Clinical relevanceEndodontic treatment could be completed with both materials after RT; however, when the endodontic treatment was initially completed and the teeth were subsequently exposed to RT, it was shown that the reinforcement effect of Biodentine decreased.
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