Missing facial parts computed by a morphable model and transferred directly to a polyamide laser-sintered prosthesis: an innovation study

Mirroring of missing facial parts and rapid prototyping of templates have become widely used in the manufacture of prostheses. However, mirroring is not applicable for central facial defects, and the manufacture of a template still requires labour-intensive transformation into the final facial prosthesis. We have explored innovative techniques to meet these remaining challenges. We used a morphable model of a face for the reconstruction of missing facial parts that did not have mirror images, and skin-coloured polyamide laser sintering for direct manufacture of the prosthesis. From the knowledge gleaned from a data set of 200 coloured, three-dimensional scans, we generated a missing nose that was statistically compatible with the remaining parts of the patient's face. The planned prosthesis was manufactured directly from biocompatible skin-coloured polyamide powder by selective laser sintering, and the prosthesis planning system produced a normal-looking reconstruction. The polyamide will need adjustable colouring, and we must be able to combine it with a self-curing resin to fulfil the requirements of realistic permanent use.     

Is there any difference between the British and Japanese de?nitions of the mandibular cortical index (MCI) on panoramic radiographs? A pilot study

Objectives To assess the reproducibility of the mandibular cortical index (MCI) on panoramic radiographs among British and Japanese observers, and to investigate the difference between the British and Japanese observers in the definition of MCI.Methods Three observers, a Japanese oral radiologist, a British oral radiologist, and a British prosthodontist, classified the inferior cortex of the mandible on a set of 100 duplicated films of randomly selected panoramic radiographs twice, 2 weeks apart, using the MCI. The kappa index for intra- and interobserver agreement was calculated for the three observers.Results The kappa index for intraobserver agreement was moderate (0.56) to perfect (0.86) for the three observers. Interobserver agreement between the Japanese and the British oral radiologists was moderate at the first reading (kappa, 0.59) and substantial at the second (0.61). Interobserver agreement between the prosthodontist on the one hand and each of the oral radiologists on the other was fair (0.35, 0.38) at the first reading, but moderate (0.43, 0.60) at the second reading. The prosthodontist tended to overestimate the MCI compared with either of the oral radiologists.Conclusion Our results suggest that the definition of MCI used by Japanese observers is basically similar to that used by British observers, although some improvements in the definition of MCI would be necessary for clinical dental practice.     

Influence of different surface treatments on surface zirconia frameworks

Objectives

To evaluate the effect of different chemo-mechanical surface treatments of zirconia ceramic in the attempt to improve its bonding potential.

Methods

Sintered zirconium oxide ceramic discs (Lava™ Ø10 mm × 1 mm height) were treated with (n = 4): (1) airborne particle abrasion with 125 μm Al₂O₃ particles; (2) 9.5% HF acid etching; (3) selective infiltration etching (SIE); (4) experimental hot etching solution applied for 10, 30 and 60 min; (5) no treatment.Ceramic discs surfaces were analyzed by atomic force microscopy (AFM) recording average surface roughness measurements of the substrate. Data were statistically analyzed by Kruskall–Wallis analysis of variance and Mann–Whitney tests (α = 0.05). The same discs were used for bi-dimensional zirconia ceramic surface characterization with scanning electron microscope (SEM).

Results

Ceramic surface treatments significantly influenced surface topography and roughness (p < 0.001). Bi-dimensional changes in ceramic surface morphology were assessed on a nanometric scale. The experimental hot etching solution improved surface roughness, independently from the application time.

Conclusion

Zirconia conditioning with the experimental hot etching solution may enhance ceramic roughness and improve the surface area available for adhesion allowing the formation of micromechanical retention. The influence of this surface treatment with regard to bond strength of zirconia needs to be addressed.     

种植体-研磨杆-附着体在下颌骨缺损修复中的应用

目的 :利用种植体 -研磨杆 -附着体形式修复下颌骨缺损 ,探讨实现下颌骨缺损功能修复的新型有效方法。方法 :下颌骨缺损植骨修复半年后两次法植入种植体 ,在种植体上分别设置结合有杆卡式、杵臼式、磁性附着体的研磨杆 ,为患者制作种植覆盖义齿 ,随访 2 7～ 48月 ,观察修复效果。结果 :修复 3年后 8名患者的 2 8只种植体中只有 3只种植体周围骨吸收超过了 2mm ,仅 1例有中度种植体周围软组织炎症 ;患者均对修复效果表示满意 ,特别是其丧失的部分咀嚼功能得到了良好恢复。结论 :将种植体 -研磨杆与多种附着体结合这一新方法用于下颌骨缺损的义齿修复 ,可以满意地修复患者的软硬组织缺损并有效恢复患者的咀嚼功能。     

表面水分和不同种类的手套对于硅橡胶印模材聚合时间的影响

目的:本文研究了表面水分和不同种类的手套对于硅橡胶印膜材料聚合时间的影响.方法:使用3种手套:一次性聚乙烯塑料薄膜手套,灭菌橡胶医用手套(无粉),以及橡胶检查手套(预撒粉),分别在潮湿和干燥环境下手动混合DENT SILICONE-PLUS重体型硅橡咬印模材,并记录其硬化时间.结果:干燥情况下使用塑料薄膜手套时,橡胶印模材聚合时间最短,平均2分10秒;乳胶材料和表面水分均可延长聚合时间,达到3～分钟时间;而预撒粉则可显著延长聚合时间,超过1小时.结论:临床运用硅橡胶制取印模时,建议使用一次性聚乙烯塑料薄膜手套在干燥环境下进行操作,预撒粉的橡胶检查手套必须更换,以避免操作失败.     

五倍子对口内菌斑生物膜活性影响的体外研究

目的应用口内菌斑生物膜模型观察五倍子水提取物对菌斑生物膜活性的影响。方法将牙釉质磨片粘结于两侧下颌第一恒磨牙颊侧获得24h口内菌斑生物膜模型,实验组和对照组分别用6mg/ml五倍子水提取物和生理盐水处理3min,应用溴化乙锭/荧光素双乙酸盐(ethidium bromide/fluorescein diacetate,EB/FDA)染色技术和激光共聚焦显微镜(confocal laser scan microscope,CLSM)观察五倍子水提取物对生物膜活性的影响。结果CLSM观察可见所有样本釉质表面均有细菌的定植,有早期的生物膜形成。对照组菌斑生物膜中细菌的活性明显高于实验组,两者相比具有显著差异(P<0.05)。结论五倍子水提取物在较短的时间内就能对生物膜中的细菌产生一定的杀伤效应,使其活性下降。     

Scratch hardness and chipping of dental ceramics under different environments

OBJECTIVE: The goal of this program was to identify promising environments that could efficiently minimize machining-induced damage of dental materials. METHODS: Single point abrasion (SPA) scratch testing was used on five materials to determine the scratch hardness and amount of edge chipping as functions of chemical environment, including air, water, saline and glycerol solutions. Limited testing was also done under additional environments expected to promote chemomachining effects via crack growth promotion or debris removal. A conical diamond indenter and a conventional tungsten carbide machining tool were used in the scratch tests. One-way ANOVA analysis was used to determine statistical differences among the variables. RESULTS: There was a consistent trend across materials that the water and saline yielded the lowest values of scratch hardness, air the next lowest, and the tests performed in glycerol yielded the highest hardness values. The measured hardness values using the conical diamond tool in the glycerol environments were about twice the hardness values measured under water and saline solutions. Environmental effects on chipping were minimal, but a linear relationship between load and per cent chipping was determined for the WC tool within the 10-50 N test range. The choice of scratch tool strongly affected scratch hardness and chipping tendency. SIGNIFICANCE: The chemical environment had an effect on machining characteristics, but the effects were more dependent on tool interactions rather than material specific properties. As a result, it may not be possible to utilize a particular single environment to substantially improve the damage response of dental materials to machining operations. Improvements in damage resistance can be environmentally obtained, but only for shallow cuts (finishing operations).     

Bioreactor cultivation of osteochondral grafts

The clinical utility of tissue engineering depends upon our ability to direct cells to form tissues with characteristic structural and mechanical properties across different hierarchical scales. Ideally, an engineered graft should be tailored to (re)establish the structure and function of the native tissue being replaced. Engineered grafts of such high fidelity would also foster fundamental research by serving as physiologically relevant models for quantitative in vitro studies. The approach discussed here involves the use of human mesenchymal stem cells (hMSC) cultured on custom-designed scaffolds (providing a structural and logistic template for tissue development) in bioreactors (providing environmental control, biochemical and mechanical cues). Cartilage, bone and ligaments have been engineered by using hMSC, highly porous protein scaffolds (collagen; silk) and bioreactors (perfused cartridges with or without mechanical loading). In each case, the scaffold and bioreactor were designed to recapitulate some aspects of the environment present in native tissues. Medium flow facilitated mass transport to the cells and thereby enhanced the formation of all three tissues. In the case of cartilage, dynamic laminar flow patterns were advantageous as compared to either turbulent steady flow or static (no flow) cultures. In the case of bone, medium flow affected the geometry, distribution and orientation of the forming bone-like trabeculae. In the case of ligament, applied mechanical loading (a combination of dynamic stretch and torsion) markedly enhanced cell differentiation, alignment and functional assembly. Taken together, these studies provide a basis for the ongoing work on engineering osreochondral grafts for a variety of potential applications, including those in the craniofacial complex.     

Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study

AIM: To compare the marginal adaptation of mineral trioxide aggregate (MTA) or amalgam root-end fillings in extracted teeth under low-vacuum (LV) versus high-vacuum (HV) scanning electron microscope (SEM) viewing conditions. METHODOLOGY: Root-end fillings were placed in 20 extracted single-rooted maxillary teeth. Ten root ends were filled with MTA and the other 10 root ends were filled with amalgam. Two 1 mm thick transverse sections of each root-end filling were cut 0.50 mm (top) and 1.50 mm (bottom) from the apex. Gap size was recorded at eight fixed points along the dentine-filling material interface on each section when uncoated wet (LV wet (LVW)) and dry under LV (0.3 Torr) in a JEOL JSM-5800 SEM and backscatter emission (LV dry uncoated (LVDU)). The sections were then air-dried, gold-coated and gap size was recorded once again at the fixed points under HV (10(-6) Torr; HV dry coated (HVDC)). Specimen cracking, and the size and extent of the crack were noted. RESULTS: Gap sizes at fixed points were smallest under LVW and largest under HVDC SEM conditions. Gaps were smallest in MTA root-end fillings. A General Linear Models Analysis, with gap size as the dependent variable, showed significant effects for extent of crack in dentine, material and viewing condition (P = 0.0001). CONCLUSIONS: This study showed that MTA produced a superior marginal adaptation to amalgam, and that LVW conditions showed the lowest gap size. Gap size was influenced by the method of SEM viewing. If only HV SEM viewing conditions are used for MTA and amalgam root-end fillings, a correction factor of 3.5 and 2.2, respectively, may be used to enable relative comparisons of gap size to LVW conditions.