全冠边缘材料与位置对人牙周组织的影响

目的 探讨全冠边缘材料和位置对人牙周组织的影响.方法 对需作全冠或双端固定桥修复并符合纳入标准的20例患者的30颗牙,在牙体预备前、全冠或双端固定桥黏固后7～8周,分别记录其颊侧牙龈的菌斑指数(PLI)、牙周探诊深度(PD)、龈沟出血指数(SBI),并测量其龈沟液(GCF)量、龈沟液的天冬氨酸转氨酶活性(AST活性).全冠或固定桥黏固前后分别测量冠边缘间隙.暂时冠和全冠黏固后对患者各行1次口腔健康教育.结果 全冠黏固后7～8周,全冠对应牙龈的PD、 SBI≥2频率、GCF量及AST活性没有明显变化, PLI≥1的频率明显下降.结论 具有良好的口腔卫生习惯、制作精良的全冠黏固后7～8周,金属边缘、烤瓷边缘、平龈冠边缘、龈下冠边缘均不会引起人牙龈的不良反应.     

Mandibular complete denture impressions with fluid wax or polysulfide rubber: A comparative study

Some authors have stated that wax cannot be used to make impressions for complete dentures, while others have found that wax has some advantages over elastomeric impression materials. The purpose of this study was to compare mandibular impressions made with a fluid wax to those made with light-body polysulfide rubber. Fifteen maxillary and mandibular complete dentures were made using fluid wax as a final impression material. For comparison, 15 maxillary and mandibular complete dentures were made using light-body polysulfide rubber. The number of adjustments required over 1 year was recorded. No statistical difference in adjustments was noted between the two groups.     

Direct and indirect effects of medication (including chemotherapy) and irradiation on the pulp

A direct or indirect effect of the intake of medication on the pulp itself has not yet been described in the literature. The effect of local anesthetics on the pulp, on the other hand, has been documented. Although local anaesthesia has been employed in dentistry for many years, most investigations of its action have only considered the effect on the nerves within the pulp using traditional methods. Recently it has become clear that the nerves and blood vessels of the pulp do not act in isolation but are closely related. In this respect it has been shown that there exists a direct relationship between the length of the flow cessation and the concentration of vasoconstrictor used. Therefore care should be taken when using vasoconstrictors especially where pulpal injury is apt to occur when dental procedures such as full crown preparations are performed immediately following a ligamental injection. The anaesthetic efficacy of intraosseous injection is well documented. The effect, however, on the dental pulpal circulation still remains subject of further investigation. Radiotherapy involving the oral cavity and salivary glands and chemotherapy (in a lesser degree) induce alterations in the oral tissues and the salivary gland functions. Some of these side effects are transient. However there are side effects such as the xerostomia which are very drastic for the dentition resulting in radiation caries and dental hypersensitivity. Tooth anomalies in the developing dentition are also described. Due to the rapid progression of the radiation caries a monitoring of the oral cavity with strict application of preventive measurements and systematic follow-up can reduce the incidence of the complications. Unfortunately most of the patients belonging to this group consult with the complications of their radiotherapy and chemotherapy. In this respect endodontic treatment of the severely decayed teeth is an important part of dental treatment. Moreover, extraction is regularly contraindicated as osteoradionecrosis is then one of the major sequels.     

Rational basis for the use of a new clinical procedure in immediately loaded implant rehabilitations: a case report

This report presents a new clinical protocol that facilitates the diagnostic, surgical, and prosthetic phases of immediately loaded implant rehabilitations. The proposed technique aims to simplify recording of the centric relation, which is usually done immediately after surgery, during the surgical impression phase. This shortens operative time while meeting requirements for an accurate impression and is thus simple and cost effective. The case report of a maxillary full-arch immediately loaded implant rehabilitation in a 45-year-old patient illustrates the clinical steps in the proposed procedure and confirms its repeatability.     

The influence of plaque and/or excessive loading on marginal soft and hard tissue reactions around Brånemark implants: a review of literature and experience

High implant survival rates are published with more than 15 years of observation time. Failures over time are often caused by ongoing marginal bone loss. Therefore, the need for reliable monitoring of the stability of periimplant attachment and/or bone level is extremely important. Marginal bone loss around osseointegrated implants has often been associated with periimplantitis, but clinical observations cannot prove this relationship. Otherwise, the impact of excessive loading on periimplant bone has been shown in animal studies and has been positively related to implant failure in terms of implant mobility and marginal bone loss. Some clinical observations support this hypothesis.     

Effect of application technique of luting agent on the retention of three types of fiber-reinforced post systems

The aim of this study was to evaluate retentive strengths of three adhesive/resin cement/fiber post systems to the apical third of post-space dentin varying the application method of the luting agent. ENA post (Micerium, Avegno, Genova, Italy), FRC Postec Plus (Ivoclar Vivadent, Schaan, Liechtenstein), and Anatomical Post (Dentalica, Milano, Italy) were luted in prepared root canals using the adhesive system and resin cement provided by the respective manufacturer. Each group was randomly divided into three subgroups (n = 10) according to the technique used to place the luting agent into post space: using a lentulo spiral, applying the cement onto the post surface, and injecting the material with a specific syringe. A push-out test was performed on sections from the post-space apical part of each specimen. All fractured specimens were observed using a stereomicroscope. Bond strength values were not significantly affected by the application technique of the luting agent (p > 0.05). The ENA post system showed the highest retentive strengths. The other two post groups exhibited similar bond strengths to each other. Microscopic analysis revealed a prevalence of post/cement and mixed failures.     

Bonding to ground versus unground enamel in fluorosed teeth.

OBJECTIVES: To determine the effect of grinding on the bonding effectiveness of a self-etch and an etch-and-rinse adhesive to fluorosed enamel. METHODS: The teeth were classified using the Thylstrup and Fejerskov index (TFI). Fluorosed teeth (TFI=5) obtained from Isparta (Turkey) and control teeth (TFI=0) obtained from Leuven (Belgium) were used. Using a depth-marking diamond bur, 0.3mm of enamel was removed from mid-buccal and mid-palatal/lingual surfaces of the teeth, whereas the area adjacent to the ground area was left unprepared. A two-step self-etch (Clearfil Protect Bond, Kuraray) and a three-step etch-and-rinse adhesive (Optibond FL, Kerr) were used to bond the resin composite to the ground and unground enamel. Rectangular micro-specimens were prepared using the slow-speed diamond saw and tested in tensile to determine the micro-tensile bond strength (microTBS). RESULTS: The microTBS to unground fluorosed enamel was significantly lower than to ground fluorosed enamel for Clearfil Protect Bond (15.8+/-15.2 and 45.0+/-12.4MPa, p<0.0001) and for Optibond FL (35.5+/-21.4 and 50.5+/-12.3MPa, p<0.05), respectively. In control teeth, Clearfil Protect Bond bonded better to ground enamel (p<0.01), whereas OptiBond FL exhibited a similar bonding effectiveness to ground and unground enamel (p=0.0634). SIGNIFICANCE: Preparation of enamel improved the resin-enamel bond strength in fluorosed teeth. The bonding effectiveness to unground enamel was lower in fluorosed teeth than in control teeth for the self-etch adhesive tested.     

Clinical evaluation of an implant maintenance protocol for the prevention of peri-implant diseases in patients treated with immediately loaded full-arch rehabilitations

To cite this article:
Int J Dent Hygiene 9 , 2011; 216–222
DOI: 10.1111/j.1601‐5037.2010.00489.x
Corbella S, Del Fabbro M, Taschieri S, De Siena F, Francetti L. Clinical evaluation of an implant maintenance protocol for the prevention of peri‐implant diseases in patients treated with immediately loaded full‐arch rehabilitations. Abstract: Objective: The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full‐arch rehabilitation. Materials and methods: Sixty‐one patients (28 women and 33 men) treated with immediately loaded full‐arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow‐up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri‐implant tissue inflammation was also evaluated. Results: Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to peri‐implantitis (1.4% at 12 months), whereas the incidence of peri‐implant mucositis was less than 10% in each considered period. Conclusions: The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri‐implant mucositis as well as in controlling plaque accumulation and clinical attachment loss.