Effect of acid-etching on remineralization of enamel white spot lesions

This in vitro study aimed at investigating whether full remineralization would occur in white spot lesions when the surface porosity was increased by acid-etching. The effect of fluoride was also investigated. Enamel blocks with in vitro produced white spot lesions were used. Group A was exposed to a remineralizing solution only. In group B, the lesions were etched with 35% phosphoric acid for 30 s, then treated as in group A. Group C was treated as group A + daily treatment with a fluoride toothpaste slurry (1,000 ppm) for 5 min. Group D was treated as group B + the daily fluoride treatment of group C. The remineralization was measured weekly with Quantitative Light-induced Fluorescence during the experimental period. After 10 weeks of remineralization, mineral profiles were assessed with transverse microradiography. The enamel fluorescence was partly regained. There were significant differences in the lesion depth, mineral content at the surface layer, and integrated mineral loss between the groups. Addition of fluoride accelerated the remineralization only in the beginning; in later stages the process leveled out and even reached a plateau in all the groups. It was concluded that full remineralization was not achieved by etching, by the addition of fluoride, nor by the combination of both treatments in this in vitro study.     

Evaluation of a new bioabsorbable barrier for recession therapy: a feasibility study

BACKGROUND: The objective of this study was to evaluate the feasibility of a new polylactic acid bioabsorbable barrier in the treatment of gingival recession. METHODS: Twenty patients with buccal recession defects (Miller class I, II, and III; mean recession: 4.0 +/- 1.2 mm; range: 2.0 to 6.8 mm) participated. After thorough scaling and root surface conditioning with 10% tetracycline-HCl, a trapezoidal mucoperiosteal flap was prepared. A customized barrier was applied to cover the defect. Barriers adhered directly to tooth and bone and no sutures were used. The barrier was subsequently covered by a coronally positioned flap. Assessments of probing depths were performed by means of a controlled-force electronic probe, and recession was determined on stone models with a digital caliper at baseline and 12 months following therapy. RESULTS: Eight barriers showed limited exposure (1 to 2 mm) with minimal signs of gingival inflammation between 2 and 6 weeks following surgery. Comparing baseline measurements with outcomes at 12 months, significant root coverage and probing attachment gain were observed (P <0.0001, paired t test). Mean gingival recession was reduced to 0.4 +/- 0.5 mm, corresponding to a mean root coverage of 91.9%, and overall attachment gains amounted to 4.2 mm. A significant gain of keratinized tissue was found (2.9 +/- 0.7 mm), and mean probing depths were slightly reduced from 2.2 to 1.7 mm. CONCLUSIONS: The results of this study indicate favorable outcomes after using a new bioabsorbable barrier material for root coverage in recession-type defects.     

Prospective study on titanium bar-retained overdentures: 2-year results

Within a monometallic concept 29 patients received titanium bar‐retained mandibular overdentures on 2 IMZ implants. The study had a prospective design with 3 months recall intervals. One of 58 implants failed after 11 months. There were no significant differences of the mean plaque scores (Silness, Löe) and the mean sulcus bleeding scores (Mühlemann, Son) at the abutments between baseline, 12 months and 24 months. Less than 40% of the subjects showed plaque score zero at 24 months. However, 89% exhibited sulcus bleeding score zero indicating health of the peri‐implant soft tissues in most cases. Plaque at the basal site of the bar was scored separately at additional measuring points located at the central area and the contact areas between bar and abutments. Bar plaque scores nearly doubled between baseline and 12 months and remained high at 24 months. Median maximal vertical bone loss around the implants was 1.7 mm after 2 years. Bone loss did not exceed one quarter of the implant length in 79%. The monometallic concept in bar‐retained overdentures on 2 implants proved its clinical suitability except for the applicability of pure titanium for bar clips. Plaque formation beneath the bar seems to be one of the major clinical problems.     

Early craniofacial morphology and growth in children with nonsyndromic Robin Sequence.

PURPOSE: Craniofacial morphology and growth comparisons in children with untreated nonsyndromic Robin Sequence (RS) and a control group with unilateral incomplete cleft lip (UICL) in which the lip was surgically closed at 2 months of age. MATERIAL: The 52 children (7 RS and 45 UICL) included in the study were drawn from a group representing all Danish cleft children born 1976 through 1981. The ages of the children were 2 and 22 months at the time of examination 1 and 2, respectively. METHOD: The method of investigation was three-projection cephalometry. Craniofacial morphology was analyzed by means of linear, angular, and area variables. Growth at a specific anatomical location in a patient was defined as the displacement vector from the coordinate of the corresponding landmark at examination 1 to its coordinate at examination 2. RESULTS: The most striking findings in the RS group were markedly increased posterior maxillary width, increased width of the nasal cavity, short maxilla with reduced posterior height, short mandible, bimaxillary retrognathia, and severe reduction in size of the pharyngeal airway. The amount of facial growth was similar in the two groups; however, a tendency toward a more vertical growth direction was observed in the RS group. CONCLUSION: Facial morphology in children with RS differed significantly from that of children with UICL at both 2 and 22 months of age. The magnitude of facial growth was similar in the two groups, whereas a tendency toward a more vertical facial growth direction was observed in the RS group.     

Influence of environmental conditions on dentin bond strengths of one-application adhesive systems

Resin composites are considered susceptible to environmental conditions that might affect bond strength. This study investigated the influence of relative humidity and temperature on the dentin bond strength of newly developed one-application adhesive systems. Bonding systems employed in this study were five commercial one-application adhesive systems. Labial surfaces of bovine incisors were ground wet on 600-grit SiC paper. The teeth were transferred to a controlled temperature and humidity chamber and the specimens were prepared in six different environmental conditions, A) 25 +/- 0.5 degrees C, 50 +/- 5% RH, B) 25 +/- 0.5 degrees C, 80 +/- 5% RH, C) 25 +/- 0.5 degrees C, 95 +/- 5% RH, D) 37 +/- 0.5 degrees C, 50 +/- 5% RH, E) 37 +/- 0.5 degrees C, 80 +/- 5% RH, F) 37 +/- 0.5 degrees C, 95 +/- 5% RH. The dentin surfaces were treated according to each manufacturer's instructions. Resin composites of each bonding system were condensed into a mold and light irradiated. After storage in 37 degrees C water for 24 hours, 10 specimens per group were tested in a shear mode in a testing machine at a crosshead speed of 1.0 mm/minute. Statistical analysis was carried out with one-way ANOVA followed by Duncan's multiple range tests at a p-value of 0.05. The dentin bond strengths of one-application adhesive systems decreased with increasing RH. These data suggest that the relative high humidity in the oral environment needs consideration in developing clinical procedures for management of these one-application adhesive systems.     

Five-year evaluation of implants placed at extraction and with dehiscences and fenestration defects augmented with ePTFE membranes: results from a prospective multicenter study

Background: Barrier membranes have been used to promote bone ingrowth on implants with dehiscences and fenestrations. Membranes also have been used to protect defects adjacent to implants placed at the time of extraction. The concept of guided bone regeneration relates to preferentially allowing cells from bone to migrate into various defects while excluding fibrous tissue and epithelium. The purpose of these procedures is to enhance bone-to-implant contact at the treated sites and to prevent mucosal complications. Purpose: The purpose of this article is to report clinical outcomes for implants placed at the time of extraction and augmented with expanded polytetrafluoroethylene (ePTFE) and followed for 5 years. The outcomes for implants with dehiscences and fenestrations augmented with ePTFE barriers and followed up to 5 years also are reported. Methods and Materials: Four treatment centers participated in this study (Tucson, Gothenburg, Spokane, and Leuven). In the extraction group, teeth were removed for varying reasons, and Brånemark implants were placed and stabilized within the host bone. Defects present at the coronal implant aspect were covered with ePTFE barrier membranes. Flaps were rotated to cover the membrane-treated sites. If exposure of the material occurred prior to second-stage surgery, the membranes were removed. Barriers remaining unexposed were removed at second-stage surgery. The implants were followed up to 5 years. In the fenestration and dehiscence group, implants with exposed threads were augmented with ePTFE barrier membranes. The barriers were removed at appropriate intervals, and the patients were followed up to 5 years. Radiographic measurements were made from nonstandardized periapical radiographs at abutment connection and 1, 3, and 5-year follow-up visits. Results: Forty patients participated in the extraction group. They received a total of 49 implants. Three implants failed prior to loading. The 5-year cumulative survival rates for implants placed at the time of extraction were 93.9% and 93.8%, respectively, for maxillary and mandibular implants. The average maxillary mesial and distal marginal bone loss (1–5 yr) was 0.3 mm (standard deviation [SD] = 1.5) and 0.3 mm (SD = 1.0). In mandibles, the average mesial and distal bone loss (1–5 yr) was -0.2 mm (SD = 0.5) and -0.05 mm (SD = 0.6), respectively. The dehiscence and fenestration group included 44 patients. Twenty-six were followed for up to 5 years. Eight patients experienced total implant failure. For dehiscences and fenestrations, the cumulative survival rates were 76.8% and 83.8% for maxillary and mandibular implants, respectively. The average maxillary mesial and distal bone loss (1–5 yr) was 0.4 mm (SD = 0.8) and 0.2 mm (SD = 0.9), respectively. In mandibles, the average mesial and distal marginal bone loss was 0.3 mm (SD = 0.9) and 0.3 mm (SD = 0.8), respectively. Conclusions: Implants placed at the time of extraction and augmented with ePTFE barrier membranes have favorable long-term predictability. On the other hand, long-term evaluation of implant dehiscences and fenestrations augmented with barrier membranes indicates that they have less favorable 5-year survival rates. Membrane augmentation of these may be questioned.     

Histochemical characterization of masseter muscle fibres in a biopsy study of normal young women.

Muscle fibres from biopsies of the anterior part of the masseter muscle (pars superficialis) were histochemically characterized in 13 healthy female students. They were 21-28 yr old with a full complement of teeth, and normal facial and occlusal relations. Before surgery, normal masseter muscle function was demonstrated by bite-force measurements and recordings of electromyographic activity. After staining for myosin ATPase activity, the relative mean areas of muscle fibres were: type I 82.9%, type IM 9.5% and type II 8.3%. The intraindividual (18-155% of mean) and interindividual (0-216% of mean) variation of the fibre size was large. The type I fibres had the largest diameter (10-80 microns, mean: 39 microns), the type II fibres (6-47 microns, mean: 21 microns) and the IM fibres (8-54 microns, mean: 28 microns) the smallest. The biopsy technique and the histochemical characterization will be suitable for reference in women with functional changes or diseases of the masseter muscle.     

Flexible casts used in making indirect interim restorations.

This article describes a procedure for making indirect interim restorations from a cast and dies made of polyvinyl siloxane impression material. The use of these flexible casts and dies facilitates the removal of the polymerized resin from the cast and the rapid set of the polyvinyl materials reduces the time involved in making the indirect interim restorations.     

Studies on the occurrence of systemic manifestations during first eruption of teeth in children

The aim of the study was establishing whether systemic symptoms and signs appearing in children during first eruption of teeth are connected with this process, and what is the correlation between the studied features and eruption of individual milk teeth. The study involved 55 generally healthy infants aged 3-4 months, and the observation was continued up to the age of 36 months. The study on the development of teeth was carried out in two Regional Paediatric Dental Clinics in Warsaw, at 6-week intervals in the first year of life, and at 10-week intervals in the 2nd and 3rd years. The systemic symptoms and signs were recorded by mothers, and the obtained data were stored on computer cards. The results were subjected to statistical analysis considering finally these systemic manifestations which were present in at least 25% of children. The manifestations connected with teeth eruption included: profuse salivation, biting of hard, things, restlessness, appetite loss and sleep disturbances. These symptoms were most pronounced at the time of milk incisors eruption, less evident during eruption of first molars, and were absent during eruption of second molars. Canine teeth eruption was connected particularly with restlessness and sleep disturbances. Such signs as raised body temperature, skin changes, gastrointestinal disturbances were only weakly connected with teeth eruption.