Clinical and histologic evaluation of submerged and nonsubmerged hydroxyapatite-coated implants: a preliminary study in dogs

A clinical and histologic study was performed to evaluate the differences in the healing of submerged and nonsubmerged hydroxyapatite-coated 2-piece implants. Three foxhounds were used for this evaluation. Mandibular premolars 1, 2, 3, and 4 were extracted. Three months later, 2 submerged implants were placed on one side of the mandible, and 2 nonsubmerged implants were placed on the other side of the mandible. After 3 months of healing, the submerged implants were exposed, and a third implant was placed on each side of the mandible in a nonsubmerged procedure. Clinical parameters were recorded, the animals were sacrificed 6 months after placement of the first implants, and histologic and histometric analyses were performed. Results of the evaluation of the clinical parameters showed only minor differences among the different treatment groups. Regarding the percentage of bone-to-implant contact of the different treatment groups, the submerged implants showed a bone-to-implant contact of 63.4%, the nonsubmerged implants showed 70.3% contact, and the late nonsubmerged implants demonstrated a bone-to-implant contact of 58.7%. The average distance from the implant neck to the first bone-to-implant contact (fBIC) for submerged implants was 0.58 mm, for nonsubmerged implants it was 1.09 mm, and it was 1.13 mm for late nonsubmerged implants. The vertical distance between the gingival margin and the apical extent of the junctional epithelium (aJE) varied from 1.14 mm to 1.28 mm in the different groups. The distance from the aJE to fBIC was 1.00 mm for the submerged group, 1.08 mm for the nonsubmerged group, and 1.00 mm for the late nonsubmerged group. Generally, it can be concluded that the clinical and the histologic behavior of submerged or nonsubmerged 2-piece implants utilized in this experiment do not differ.     

Influence of fiber-reinforced composites on the resistance to fracture of vertically fractured and reattached fragments

Introduction

The aim of this in vitro study was to evaluate the fracture type and test the effects of 2 different fibers on fracture strength of roots with reattached fragments. The null hypothesis was that adding suitable fibers to the content of dual-cure adhesive resin cement increases the fracture resistance of reattached fragments under vertical forces.

Methods

Root canals of 45 teeth were prepared, and the teeth were intentionally fractured into 2 separate fragments. Control groups (n = 7 each) consisted of unfractured teeth with instrumented and obturated or only instrumented root canals. The fractured teeth were divided into 3 groups (n = 15 each), and separated fragments were reattached by using (1) dual-cured resin cement (Clearfil SA), (2) dual-cured resin cement + polyethylene fiber (Construct), or (3) dual-cured resin cement + glass fiber (Stick-Net). Force was applied at a constant speed of 0.5 mm/min to the root until fracture. Mean load was recorded and analyzed statistically by using Kruskal-Wallis and Dunn tests (P = .05). Fracture types were analyzed by using χ² analysis with Yates correction.

Results

Stick-Net demonstrated the lowest fracture resistance (P < .05), whereas Construct and Clearfil SA had similar fracture strengths (P > .05). The roots in the control group showed the highest fracture resistance. However, there was no statistically significant difference between the Construct, Clearfil SA, and control groups (P > .05).

Conclusions

Separated fragments of vertically fractured teeth can be reattached by using a dual-cured resin or by adding polyethylene fiber (Construct).     

Assessment of the distraction regenerate using three-dimensional quantitative computer tomography

This study presents a new method for objective assessment of the distraction regenerate using three-dimensional quantitative computer tomography (3D-QCT). The distraction specimens of 16 sheep that underwent bifocal cranial distraction osteogenesis to reconstruct a critical size defect were used to evaluate this method. To analyse the validity of this method the results were compared to conventional quantitative computer tomography (QCT). Squared correlation coefficients (r(2)) according to Sackett showed a high reliability (r(2) > 70% for the total DO regenerate, DO Regions 2-4). Method comparison according to Bland-Altman (< or =6.25% of measurements out of 95% limits of agreement) showed that three-dimensional computer tomography based bone densitometry is valid for future DO research.     

Three-dimensional, non-destructive visualization of vertical root fractures using flat panel volume detector computer tomography: an ex vivo in vitro case report

AIM: To detect and to visualize radiographically vertical root fractures in extracted teeth with a prototype of a novel, high resolution, three-dimensional flat panel volume detector computer tomograph (FD-VCT) system. SUMMARY: Five teeth with root fillings and clinical symptoms such as fistulas and isolated periodontal pockets of 8 mm or more were extracted after dental radiography indicating lateral or periapical lesions. Vertical root fractures or cracks were suspected because of the symptoms and clinical findings were evident after extraction in all cases but fracture lines were not visible on routine dental radiographs acquired before extraction. The extracted teeth were explored with a prototype of a FD-VCT. Using the FD-VCT, in all cases vertical root fractures or crack lines could be detected clearly in different views, depiction-modes and cross-sections at a spatial resolution of 140 microm. The evaluation of the fracture lines and teeth could be performed in three-dimensional views. The FD-VCT findings were confirmed by detailed inspection of the extracted teeth. KEY LEARNING POINTS: The FD-VCT is an innovative diagnostic tool for non-destructive, three-dimensional evaluation of extracted teeth in pre-clinical and experimental studies. The FD-VCT allows precise visualization and evaluation of vertical root fractures or cracks in extracted teeth. Clinical application of the system may be possible if technical modifications reduce the exposure dose: the high resolution detector systems of the FD-VCT should be combined with radiation systems that focus the radiation to the area of interest.     

Clinical effects after subgingival polishing with a non-aggressive ultrasonic device in initial therapy

OBJECTIVES: The Vector ultrasonic system provides root debridement supported by different abrasive irrigation fluids. The aim of this study was to investigate the clinical outcome of initial therapy with subgingival low-abrasive debridement. MATERIAL AND METHODS: Twenty patients, who had at least two teeth with pocket depths >5 mm in each quadrant, took part in this prospective randomized clinical study. Patients were treated in a split-mouth design as one test quadrant (1) subgingivally with Vector fluid polish (VU-H) and as three control quadrants, (2) with only supragingival polishing (PO-H), (3) with hand instruments (HI-H) performed by a hygienist and (4) with hand instruments (HI-D) performed by a dentist. At baseline, 3 and 6 months after treatment, pocket depths and attachment levels (ALs) were measured and bleeding on probing (BOP) was recorded. RESULTS: At 6-month evaluation, all groups showed an improvement in clinical parameters. No statistically significant differences in any of the investigated parameters could be observed between the Vector group and the hand scaling groups, or when comparing the results of the two different operators. CONCLUSION: This study demonstrates that Vector treatment with polishing fluid was able to reduce pocket depths and the prevalence of BOP and improve clinical AL in a similar way as scaling with curettes.     

Effects of low power red laser on induced-dental caries in rats

OBJECTIVE: The purpose of this study was to investigate the effects of low power red laser associated with acidulated phosphate fluoride on the development of induced-dental caries in rats. DESIGN: Dental caries were induced in molars of 40 rats divided into five groups: control group (CG), the teeth were not submitted to any treatment; laser group (LG), teeth were irradiated with a low power red laser (LPRL), power of 30 mW and dose of 5 J/cm(2); fluoride group (FG), teeth were treated with topical acidulated phosphate fluoride (APF) 1.23% applied for 4 min; laser+fluoride group (LFG), teeth were irradiated with LPRL followed by APF; fluoride+laser group (FLG), teeth were treated with APF followed by LPRL. The animals were killed after 48 days, and the first and second molars were extracted to analyze the caries lesion area, microhardness, and calcium and phosphorus ratio. RESULTS: There were no statistical differences among FG, LFG, and FLG regarding to caries area and microhardness, although the caries area were smaller in LFG. Ca/P ratio did not show significant differences among all groups. CONCLUSIONS: Although LPRL before APF application appeared to diminish the caries progression, LPRL did not present any additional benefit compared with acidulated phosphate fluoride on the prevention of induced-dental caries in rats.     

Effects of surface-conditioning methods on shear bond strength of brackets bonded to different all-ceramic materials

The aims of this study were to investigate the effects of two surface-conditioning methods on the shear bond strength (SBS) of metal brackets bonded to three different all-ceramic materials, and to evaluate the mode of failure after debonding. Twenty feldspathic, 20 fluoro-apatite, and 20 leucite-reinforced ceramic specimens were examined following two surface-conditioning methods: air-particle abrasion (APA) with 25 μm Al(2)O(3) and silica coating with 30 μm Al(2)O(3) particles modified by silica. After silane application, metal brackets were bonded with light cure composite and then stored in distilled water for 1 week and thermocycled (×1000 at 5-55°C for 30 seconds). The SBS of the brackets was measured on a universal testing machine. The ceramic surfaces were examined with a stereomicroscope to determine the amount of composite resin remaining using the adhesive remnant index. Two-way analysis of variance, Tukey's multiple comparison test, and Weibull analysis were used for evaluation of SBS. The lowest SBS was with APA for the fluoro-apatite ceramic (11.82 MPa), which was not significantly different from APA for the feldspathic ceramic (13.58 MPa). The SBS for the fluoro-apatite ceramic was significantly lower than that of leucite-reinforced ceramic with APA (14.82 MPa). The highest SBS value was obtained with silica coating of the leucite-reinforced ceramic (24.17 MPa), but this was not significantly different from the SBS for feldspathic and fluoro-apatite ceramic (23.51 and 22.18 MPa, respectively). The SBS values with silica coating showed significant differences from those of APA. For all samples, the adhesive failures were between the ceramic and composite resin. No ceramic fractures or cracks were observed. Chairside tribochemical silica coating significantly increased the mean bond strength values.     

Nanoleakage inhibition within hybrid layer using new protective chemicals and their effect on adhesion

Hybrid-layer degradation occurs because of acidic properties of currently used adhesive systems. Titanium tetrafluoride couples with tooth surface, and titanium compounds are not substituted. Caffeic acid phenethyl esther inhibits endogenous matrix metalloproteinases that cause hybrid-layer degradation. It was hypothesized that titanium tetrafluoride and caffeic acid phenethyl esther application on exposed dentine surfaces before adhesive applications would inhibit nanoleakage and hybrid-layer degradation without compromising the bond strength of the adhesives. In ultracut thin sections, human dentine-chemical agent-adhesive composite interfaces were observed under transmission electron microscope with complementary scanning electron microscopy. Microtensile bond strength tests were also accomplished. Titanium tetrafluoride and titanium tetrafluoride + caffeic acid phenethyl esther applications decreased bond strength values. Caffeic acid phenethyl esther showed decreased silver nitrate penetration for cements based on Bisphenol glycydilmethacrylate and methyl methacrylate, whereas cement based on 4-methacryloyloxyethyl trimellitate anhydride methyl methacrylate showed almost no infiltration. Caffeic acid phenethyl esther application before cementation could inhibit nanoleakage and biodegradation of the hybrid layer.