Structural conformation and leaching from in vitro aged and retrieved Invisalign appliances

The objectives of this study were to investigate the structure of Invisalign appliances (Align Technology, Santa Clara, Calif) after intraoral exposure, and to qualitatively and quantitatively characterize the substances leached from the aligners after accelerated in vitro aging. Samples of Invisalign appliances were randomly selected from 10 patients before intraoral placement and after retrieval, and the prepared specimens were subjected to (1) bright-field optical reflection microscopy to study the surface morphology; (2) Fourier transform infrared microspectroscopy to characterize the in vivo changes in molecular composition induced on appliance surfaces, (3) scanning electron microscopy and energy dispersive X-ray microanalysis to identify the elemental composition of integuments formed on the surface, and (4) Vickers hardness (HV 200) testing. Another set of reference and retrieved appliances was subjected to artificial aging for 2 weeks, and the extracts were subjected to gas chromatography-mass spectroscopy. The retrieved appliances demonstrated substantial morphological variation relative to the as-received specimens involving abrasion at the cusp tips, adsorption of integuments, and localized calcification of the precipitated biofilm at stagnation sites. Buccal segments of retrieved appliances showed an increase in hardness, which might be attributed to mastication-induced cold work; however, the clinical implication of this effect on mechanotherapy is unknown. In vitro aged and retrieved appliances were found to leach no traceable amount of substances in an ethanol aging solution.     

Finite element analysis of effect of prosthesis height, angle of force application, and implant offset on supporting bone

PURPOSE: This finite element analysis was conducted to determine the magnitude of stress in the supporting bone when implants were arranged in either a straight-line or an offset configuration. In addition, the effects of axial and nonaxial loading and changes in prosthesis height were assessed. MATERIALS AND METHODS: An 8-node hexahedral solid-element 3-dimensional finite element analysis model of the mandible was created using PATRAN software. Three titanium endosseous implants were placed in the model 7 mm apart. The center implant was placed on the line from the centers of the terminal implants (no offset), 1.5 mm lateral to this line (1.5-mm offset), or 3.0 mm lateral to this line (3.0-mm offset). Forces of 200 N were applied to a point corresponding to the center of the middle implant when the implants were in a straight-line configuration. Forces were applied in a straight vertical direction or in 15-degree increments to the vertical to a maximum of 60 degrees. Simulated type IV gold prostheses were made to simulate heights of 6 and 12 mm. RESULTS: The least stress in the supporting bone was found with vertical loading of the no-offset implants with the 6-mm prosthesis (3.12 MPa) followed by the same alignment with the 12-mm prosthesis (3.86 MPa). Changing the angle of force application by 15 degrees resulted in increased stress to the underlying bone, and the creation of an offset did not fully compensate for this increased stress. DISCUSSION: In contrast to previous studies, this study examined 3 elements not previously studied together in a single finite element analysis, using the maximum offset defined by normal anatomic contours of mandibular premolar and molar teeth, thereby describing the relative importance of clinically relevant methods for stress reduction. CONCLUSIONS: Vertical loading of an implant-supported prosthesis produced the lowest stress to the supporting bone. Changes in the angle of force application resulted in greater stress to supporting bone. Reduction in prosthesis height or use of an offset implant location for the middle implant reduced stress, but the reduction did not compensate for the increase found with off-axis loading.     

Evaluation of radiographic predictors to assess the rate of mandibular residual ridge resorption.

Sixty healthy clinical edentulous patients (thirty male and thirty female) were chosen for the study. Panoramic and lateral cephalometric radiographs were taken of each patient. The amount of bone loss was estimated from the panoramic radiographs as per the formula proposed by Wical and Scoop. The rate of mandibular residual resorbed ridge (RRR) expressed as percentage of bone loss per year was then computed. The correlation between the mandibular RRR and gonial cortical thickness and the percentage of cortical bone at the symphysis was tested. These parameters were also compared between the male and female patients. The rate of mandibular RRR, expressed as percentage of bone loss per year, was found to be indirectly correlated with the cortical thickness at gonion as measured from the panaromic and the lateral cephalometric radiographs. The values of students 't' test for mean differences between the female and the male patients with respect to the rate of mandibular RRR and the cortical thickness at the gonion were found to be statistically significant.     

Adjustment of the occlusal vertical dimension in the bite-raised guinea pig

In humans, the inappropriate occlusal vertical dimension (OVD) causes several orofacial disorders, such as bruxism and pain in the masticatory muscles and temporomandibular joint. However, it is still unclear how strictly the OVD is adjusted. To answer this question, we studied the temporal change of the OVD in bite-raised young guinea pigs. The OVD was raised by fixation of a bite-raising appliance to the lower incisors, and increased by either 3 or 1.5 mm at the first molars. After the space produced between the upper and lower molars was filled within 10 days due to eruption of the molars, the appliance was removed. In the bite-raised animals, the raised OVD was reduced until it attained that observed in the control animals, after which the OVD increased according to cranial growth. These results show that the OVD is developmentally changed and strictly controlled.     

Influence of enamel thickness on quantification of mineral loss in enamel using laser-induced fluorescence

The objective of this study was to evaluate the effect of enamel thickness on the quantification of white-spot lesions with laser fluorescence. One hundred and twenty 3-mm-diameter human ground and polished enamel specimens were used. Specimens were illuminated by a 488-nm argon laser, images were acquired through a 540-nm high-pass filter and stored on the Quantitative Light-Induced Fluorescence (QLF) program. Specimens were divided into two groups and demineralized for 48 or 96 h and QLF images were again acquired. Fluorescence radiance (FR) of both sound (FR(s)) and demineralized (FR(d)) enamel was determined using the QLF program. Change in fluorescence radiance (Delta FR, %) was determined as follows: Delta FR = FR(d)/FR(s) x 100. One thin section was obtained for transverse microradiography analysis. Enamel and dentin thickness of the thin sections were measured. There was a good correlation between QLF parameters and enamel thickness. It can be concluded that the FR observed for similar lesions depends on the actual enamel thickness.     

Tourette's syndrome with rapid deterioration by self-mutilation of the upper lip

A case of Tourette's syndrome is presented in a thirteen-year-old boy with obsessive-compulsive symptoms including self-mutilation of the upper lip. His upper lip injury was caused by complication of picking with fingernail, and self-biting with the lower anterior teeth. It became rapidly worse and the median part of the upper lip collapsed. But the placement of an acrylic splint was able to prevent further damage of the upper lip.     

Evaluation of stress patterns generated by reduction forceps within a photoelastic mandibular model.

INTRODUCTION: Little attention has been paid to the mechanical effects of fracture reduction forceps. AIM: This study aims to evaluate the stress patterns within the fractured mandible generated by reduction forceps. MATERIAL AND METHODS: Thirty-six mandibular models were fabricated using a photoelastic resin. Each of the three sets of mandibular models was osteotomized according to one of three different fracture types. After reducing the cut segments, reduction forceps were placed into different engagement holes to compress the segments. Photoelastic stress analysis was used to visualize the stress patterns within the fractured mandibular models as generated by the reduction forceps. RESULTS: In the case of symphyseal or parasymphyseal fractures, an optimum distribution of stresses over the fracture site was achieved when placing the reduction forceps more than 12mm away from either side of the fracture line, between the midway level of the mandibular height (bisecting the mandible) and 5mm below this level. In the case of body fractures, optimum stress distribution was achieved when the reduction forceps were placed more than 16mm from the fracture line at the midway level. CONCLUSION: Correct use of the reduction forceps helps to provide a precise three-dimensional reduction for mandibular fractures.     

Helicobacter pylori and Campylobacter rectus share a common antigen

AIM: The aim of this study was to investigate the presence of antigens with immunological cross-reactivity in periodontopathogenic bacteria and Helicobacter pylori, the pathogen associated with gastritis and peptic ulcers in human. MATERIALS AND METHODS/RESULTS: Among the putative periodontopathogens tested (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola), cross-reactive bands were only detected in C. rectus by SDS-PAGE/Western immunoblotting analysis using a polyclonal antibody directed to H. pylori cells. One of these cross-reactive antigens, a 64-kDa band antigen, also reacted with a monoclonal antibody directed to the human heat shock protein (HSP) 60. The N-terminal amino acid sequence of this C. rectus protein revealed a high degree of homology with corresponding regions of other HSPs belonging to the HSP60 family, indicating that the 64-kDa antigen was a GroEL protein. The nucleotide sequence of the C. rectus GroEL protein coded for a 547 amino acid protein with a predicted size of 57.8 kDa. Comparison of the alignment of the deduced amino acid sequence of the GroEL protein of C. rectus with that of H. pylori showed a high degree of similarity throughout its length (76.8%). GroEL protein from C. rectus possessed the ability to stimulate production of IL-6 by a confluent monolayer of human gingival epithelial cells and was cytotoxic when used at a high concentration. CONCLUSIONS: This study reveals an immunological relationship between H. pylori and C. rectus, and clearly indicates that one of the shared antigens is a GroEL protein possessing a biological activity that might play a role in the initiation and progression of periodontal disease.     

Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report

AIM: To compare mineral trioxide aggregate (MTA) with calcium hydroxide when used as pulp-capping materials in human teeth. METHODOLOGY: Eleven pairs of maxillary third molars in subjects between 20 and 25 years of age were subjected to mechanical pulp exposure. The exposed pulps were capped with MTA or calcium hydroxide, covered with ZOE and restored with amalgam. A total of 14 teeth were extracted after periods of 1 week (two molars) 2 months (three molars), 3 months (five molars), 4 months (two molars) and 6 months (two molars). RESULTS: Histological evaluation demonstrated less inflammation, hyperaemia and necrosis plus thicker dentinal bridge and more frequent odontoblastic layer formation with MTA than calcium hydroxide. CONCLUSIONS: Although the results favour the use of MTA, more studies with larger samples and a longer follow up are suggested.