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Clinical Oral Implants Research Sep 2023In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year?
MATERIALS AND METHODS
This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487).
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material.
CONCLUSIONS
Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.
Topics: Humans; Titanium; Dental Implants; Alloys; Aluminum Oxide
PubMed: 37750527
DOI: 10.1111/clr.14159 -
American Journal of Dentistry Aug 2023To present the antibacterial effect of new generation boron-doped carbon quantum dots (B-CQD) and compare the antibacterial effect of silk sericin (SS), hydrolyzed silk...
PURPOSE
To present the antibacterial effect of new generation boron-doped carbon quantum dots (B-CQD) and compare the antibacterial effect of silk sericin (SS), hydrolyzed silk peptide (HSP) and SS/HSP coated silver nanoparticle (AgNP) and B-CQDs on titanium alloy (Ti) surfaces.
METHODS
SS and HSP were formed on the surface of the Ti alloy (Ti-SS/HSP). Different concentrations of citric acid and boric acid, B-CQDs and AgNP were attached to Ti-SS/HSP surfaces. To characterize all samples, Fourier Transform Infrared (FTIR), scanning electron microscopy (SEM) and energy dispersive X-ray (EDS) analyses were performed. Their antibacterial potential was analyzed against gram-positive Staphylococcus aureus (S. aureus) and gram-negative Pseudomonas aeruginosa (P. aeruginosa) with Mueller-Hinton Test. One-way ANOVA was used to assess any difference between groups. P< 0.05 was considered statistically significant.
RESULTS
No antibacterial activity was detected for Ti and SS/HSP. Inhibition holes ranged from 11 mm to 25.7±3.2 mm and 11 mm to 26.3±0.6 mm in the S. aureus and P. aeruginosa cultures respectively, showing that AgNP was the molecule which had the least antibacterial effect regardless of type of bound silk protein on both bacteria, and B-CQD had antibacterial superiority against S. aureus and P. aeruginosa on Ti-SS surfaces.
CLINICAL SIGNIFICANCE
The application of boron-doped carbon quantum dots to titanium alloy surfaces is a new approach for the development of a powerful bactericidal method to prevent implant failures.
Topics: Quantum Dots; Silk; Boron; Metal Nanoparticles; Staphylococcus aureus; Titanium; Silver; Alloys; Anti-Bacterial Agents; Carbon
PubMed: 37587025
DOI: No ID Found -
The Journal of Prosthetic Dentistry Oct 2023The properties of commercially pure titanium are better than those of cobalt chromium alloys in various ways. However, casting pure titanium is challenging because of...
STATEMENT OF PROBLEM
The properties of commercially pure titanium are better than those of cobalt chromium alloys in various ways. However, casting pure titanium is challenging because of its high melting point and chemical reactivity. Because of excellent mechanical strength, a titanium alloy, Ti-6Al-4V, has been commonly adopted, but the aluminum and vanadium ions released may be cytotoxic.
PURPOSE
The purpose of the present study was to evaluate a new titanium alloy, Ti-7.5Mo, developed by the National Cheng Kung University for casting removable denture frameworks. The casting success rate, porosity, and guide plane or rest fit were compared among frameworks cast with Ti-7.5Mo alloy and pure titanium for 3 types of edentulism.
MATERIAL AND METHODS
Ti-7.5Mo alloy and pure titanium were used to cast frameworks for Kennedy Class I and II and completely edentulous conditions, with 5 frameworks for each condition. Wax patterns of the frameworks were designed and fabricated by using computer-aided design and computer-aided manufacture (CAD-CAM) technology to ensure their geometrical consistency. They were then invested with aluminum oxide-based material and cast. The castings were examined with microcomputed tomography (μCT) for porosity, and fit was evaluated from the thickness of a vinyl polyether silicone material at the guide plane or the rest by using an optical microscope. The casting was determined to be successful if the frameworks were complete. The porosity and fit were statistically evaluated by using 2-way ANOVA (α=.05).
RESULTS
Using pure titanium, the casting success rate was 80%, with only 64% of the major connectors in the deficient castings being complete. The μCT images showed that the percentage of casting defects in Ti-7.5Mo castings was one-third of the pure titanium castings. Furthermore, internal voids were detected in the clasps of the pure titanium castings, while the Ti-7.5Mo castings had few defects in the minor connectors and no radiographically detectable defects in the clasps. The fit analysis demonstrated smaller gaps over both guide planes and rests in the Ti-7.5Mo castings.
CONCLUSIONS
Ti-7.5Mo alloy had better castability than pure titanium. Based on the results, Ti-7.5Mo alloy is suitable for dental casting and may provide better performance.
PubMed: 34920871
DOI: 10.1016/j.prosdent.2021.10.014 -
Journal of Breath Research May 2024Despite the widespread use of dental restorative materials, little information exists in the literature regarding their potential impact on bad breath. This in vitro...
Despite the widespread use of dental restorative materials, little information exists in the literature regarding their potential impact on bad breath. This in vitro study aims to fill this gap by investigating the influence of different restorative materials on the release of hydrogen sulfide (HS). Thirteen diverse dental restorative materials, including composites, flowable composites, glass ionomer restorative materials, high-copper amalgam, and CAD-CAM blocks, were examined. Cellulose Sponge models were used as negative and positive control. All samples were prepared with a diameter of 5 mm and a height of 2 mm. Except for the negative control group, all samples were embedded into Allium cepa L., and the emitted HS was measured using the Wintact W8802 hydrogen sulfide monitor. Surface roughness's effect on emission was explored by roughening the surfaces of CAD-CAM material samples, and gas emission was measured again. The data were statistically analyzed using the Kruskal-Wallis test and DSCF pairwise comparison tests. Fiber-reinforced flowable composite (EverX Flow), amalgam (Nova 70-caps), and certain composite materials (IPS Empress Direct, Tetric Evoceram, Admira Fusion X-tra) released higher HS concentrations compared to the negative control. The HS release period lasted longer in the same materials mentioned above, along with G-aenial Universal Injectable. Indirectly used materials, such as GC Cerasmart, Vita Enamic, and Vita YZ HT, demonstrated significantly lower emissions compared to other direct restoratives. Importantly, the surface roughness of indirect materials did not significantly affect peak HS concentrations or release times. The study reveals variations in HS release among restorative materials, suggesting potential advantages of indirect restorative materials in reducing HS-induced halitosis. This comprehensive understanding of the relationship between restorative materials and halitosis can empower both dental professionals and patients to make well-informed treatment choices. Notably, there is evidence supporting the enhanced performance of indirect restorative materials for individuals affected by halitosis.
Topics: Humans; Halitosis; Hydrogen Sulfide; Dental Materials; In Vitro Techniques; Dental Restoration, Permanent; Composite Resins; Materials Testing; Dental Amalgam; Surface Properties
PubMed: 38744271
DOI: 10.1088/1752-7163/ad4b57 -
Journal of Conservative Dentistry and... Feb 2024Nickel-titanium (NiTi) instruments have become the backbone of endodontics due to their exceptional properties, superelasticity, and shape memory. However, challenges... (Review)
Review
Nickel-titanium (NiTi) instruments have become the backbone of endodontics due to their exceptional properties, superelasticity, and shape memory. However, challenges such as unexpected breakage, poor cutting efficiency, and corrosion have prompted researchers to explore innovative surface modifications to enhance their performance. This comprehensive review discusses the latest advancements in NiTi metallurgy and their impact on rotary NiTi file systems. Various surface treatment techniques, including ion implantation, cryogenic treatment (CT), thermal nitridation, electropolishing, and physical or chemical vapor deposition, have been investigated to minimize defects, boost surface hardness, and improve cyclic fatigue resistance. Ion implantation has shown promise by increasing wear resistance and cutting efficiency through nitrogen ion incorporation. Thermal nitridation has successfully formed titanium nitride (TiN) coatings, resulting in improved corrosion resistance and cutting efficiency. CT has demonstrated increased cutting efficiency and overall strength by creating a martensite transformation and finer carbide particles. Electropolishing has yielded mixed results, providing smoother surfaces but varying impacts on fatigue resistance. Physical or chemical vapor deposition has proven effective in forming TiN coatings, enhancing hardness and wear resistance. Furthermore, the concept of surface functionalization with silver ions for antibacterial properties has been explored. These advancements present an exciting future for endodontic procedures, offering the potential for enhanced NiTi instruments with improved performance, durability, and patient outcomes.
PubMed: 38463467
DOI: 10.4103/JCDE.JCDE_248_23 -
Journal of Prosthodontics : Official... Jul 2023This study aimed to explore the antimicrobial properties of graphene coated Ti-6Al-4V to oral pathogens.
PURPOSE
This study aimed to explore the antimicrobial properties of graphene coated Ti-6Al-4V to oral pathogens.
MATERIALS AND METHODS
Graphene directly synthesized on Ti-6Al-4V alloy was characterized by scanning electron microscopy (SEM) and Raman spectroscopy. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, live/dead fluorescent staining and SEM were used to analyze the antimicrobial properties of graphene coated Ti-6Al-4V alloy to Porphyromonas gingivalis (P. gingivalis), Fusobacterium nucleatum (F. nucleatum), and Candida albicans (C. albicans). Reactive oxygen species (ROS) generation was monitored to reveal the antimicrobial mechanism.
RESULTS
Graphene coated Ti-6Al-4V alloy caused a significant reduction in the presence of both bacterial and fungal pathogens as compared to uncoated Ti-6Al-4V alloy. P. gingivalis, F. nucleatum, and C. albicans on graphene coated Ti-6Al-4V alloy were less active than on uncoated Ti-6Al-4V alloy, and tended to become shrunk and deformed. Meanwhile, graphene coated Ti-6Al-4V alloy induced more generation of ROS in the pathogens than uncoated Ti-6Al-4V alloy.
CONCLUSIONS
Graphene coated Ti-6Al-4V alloy exhibited antimicrobial properties against oral pathogens, the induction of oxidative stress might be involved in its antimicrobial mechanisms.
Topics: Materials Testing; Antifungal Agents; Graphite; Reactive Oxygen Species; Surface Properties; Alloys; Titanium; Anti-Bacterial Agents
PubMed: 35988055
DOI: 10.1111/jopr.13595 -
Evidence-based Dentistry Mar 2024Searches were carried out using PubMed/MEDLINE and Web of Science databases between January 2008 and January 2023. Only articles in English language were included....
DATA SOURCES
Searches were carried out using PubMed/MEDLINE and Web of Science databases between January 2008 and January 2023. Only articles in English language were included. Boolean operators were used to search: "permanent teeth" OR "permanent tooth" OR "permanent dentition" AND "deep caries" OR "stepwise" AND "partial caries removal OR "stepwise caries removal" OR "pulp vitality" OR "healing rate".
STUDY SELECTION
Inclusion criteria were randomised controlled trials, which compared the total removal of carious tissue with either a selective or stepwise removal in permanent teeth with deep carious lesions. Criteria also required a follow up of at least 6 months and publications in English. Exclusion criteria were articles in other languages, articles not comparing different types of total or selective caries removal and articles published before January 2008.
DATA EXTRACTION AND SYNTHESIS
Data extraction followed PRISMA guidelines. Two reviewers independently screened articles, analysing titles and abstracts using Rayyan's Intelligent Systematic Review Platform. They also collected data and risk of bias assessed using the Cochrane Risk of Bias Tool for Randomised Trials, dividing articles into high risk of bias, few concerns and low risk of bias. A third researcher resolved conflict or doubt in case of divided opinions.
RESULTS
In total, 105 articles were identified, and 10 duplicates removed. 95 articles were reviewed by title and abstract and 75 of these did not meet the inclusion criteria. 20 articles were then read, excluding a further 15 due to comparing only partial removal or non-selective caries removal or absence of numerical data. This left 5 articles which met eligibility criteria. These were randomised controlled trials between 2010 and 2021. Follow up ranged from 1 month to 5 years. The inclusion and exclusion criteria in all studies had similar clinical parameters. 3 studies performed management only on permanent molars, whilst the rest also included management on permanent incisors/canines/premolars and molars. Management of caries was divided into non-selective caries removal vs partial caries removal (either selective or stepwise). All but 2 studies included specific information about the materials used. Liners were calcium hydroxide or Dycal, provisional restorations were glass ionomer cements or Ketax Molar and definitive restorations were Herculite Tetric N-Ceram resin, Ivolclar Vivadent or amalgam. Clinical success or failure was measured using pulp vitality, absence of periapical lesions, radiographic analysis and lack of symptoms. Clinical follow up was evaluated by external examiners, although 2 studies did not specify this clearly. There were a variety of tools used for statistical analysis in each study.
CONCLUSIONS
When comparing non-selective caries removal with either selective or stepwise, 3 studies proposed statistically significant differences in terms of longevity, marginal integrity and success rate of restorations. 1 study stated inexistence of statistically relevant divergences between procedures. Non-selective caries removal is not highly recommended for deep carious lesions and may be considered invasive and risks pulpal exposure. Both selective and stepwise removal are considered conservative approaches. Selective removal is considered the best management option in the short term (with 1.5 years follow up), predominantly related to a lower risk of pulpal exposure. At 5 years, however, the results of selective were similar to those of non-selective, accepting the null hypothesis. There were also no differences in success rates for materials used for definitive restorations.
Topics: Humans; Dental Caries Susceptibility; Dental Caries; Dentition, Permanent; Molar; Dental Amalgam
PubMed: 38253747
DOI: 10.1038/s41432-024-00973-0 -
Maxillofacial Plastic and... Aug 2023This study aimed to analyze the clinical outcome and complications of narrow-diameter dental implants (NDIs) (diameter ≤3.5 mm).
BACKGROUND
This study aimed to analyze the clinical outcome and complications of narrow-diameter dental implants (NDIs) (diameter ≤3.5 mm).
METHODS
The 274 NDIs that met the selection criteria from 2013 to 2018 were included in the retrospective study, and the survival rates (SVR) were compared. Mechanical complications included screw loosening and fractures of the implant components, such as the implant fixture, abutment, and prosthesis. In addition, marginal bone loss (MBL) was measured immediately after surgery and 1 year after loading.
RESULTS
The 3-year cumulative SVR was 92.4%. Nineteen fixtures failed during the follow-up. The failure rate was significantly higher (OR=4.573, p<0.05) in smokers and was significantly higher in osteoporosis patients (OR=3.420, p<0.05). The vertical and horizontal values of MBL were 0.33±0.32 mm and 0.18±0.17 mm, respectively. Mechanical complications included screw loosening (5.5%) and porcelain fracture (2.2%), but no fractures of the fixture or components were observed. The choice of titanium and zirconium (TiZr) alloy implant was significantly more frequent in the posterior region. Bone graft was significantly more frequently done in the anterior region.
CONCLUSIONS
According to the high SVR and stability of NDIs, the findings of the study suggest that NDIs may be a replacement for regular diameter dental implants (RDIs) and the use of TiZr alloy could extend the indication of NDIs. In the esthetic area, contour augmentation may be a reason for increasing the frequency of bone grafts.
PubMed: 37526800
DOI: 10.1186/s40902-023-00394-6 -
Journal of Dental Education Sep 2023To identify behavioral, preferential, and professional factors influencing the use of amalgam in private practices; and to compare the incidence of the placement of...
OBJECTIVES
To identify behavioral, preferential, and professional factors influencing the use of amalgam in private practices; and to compare the incidence of the placement of amalgam versus composite resin restorations in the province of Ontario and its pedagogical implications on dental curricula.
METHODS
Participants responded anonymously to a 23-question online survey about their current use of dental amalgam and composite resins as well as their opinions regarding both dental materials. The explanatory variables were associated bivariately with the outcome variables, and the most significant predictors were identified using the multivariate analysis.
RESULTS
Higher percentages of amalgam use were reported among clinicians who trained in Canada only (P = .009), who graduated before 1980 (p = <.001) and who work outside private practice (p = <.001). Familiarity with amalgam was higher among clinicians who are female (p = <.001), older (p = <.001), trained only in Canada (p = .017), who graduated prior to 2000 (p = <.001), and who work in locations with populations over 100,000 (p = .042). Familiarity with composite resin was higher among clinicians who graduated more recently (p = .002). A higher percentage of females (p = <.001), younger clinicians (p = <.001), recent graduates (p = <.001), and clinicians who work in private practice (p = .043) suggested that over 50% of dental student training time be allocated to amalgam.
CONCLUSIONS
Decreased amalgam use was reported by later dental graduates and private practitioners; this may be impacted by familiarity with dental amalgam. As amalgam remains a safe and effective dental material, its removal may not be prudent. Dental educators play a crucial role in the future of amalgam opinion and use.
Topics: Humans; Female; Male; Dental Restoration, Permanent; Dental Amalgam; Composite Resins; Curriculum; Education, Dental
PubMed: 37280767
DOI: 10.1002/jdd.13252 -
Journal of Functional Biomaterials Sep 2023To regulate the degradation rate and improve the surface biocompatibility of the AZ31B magnesium alloy, three different coating systems were produced via plasma...
To regulate the degradation rate and improve the surface biocompatibility of the AZ31B magnesium alloy, three different coating systems were produced via plasma electrolytic oxidation (PEO): simple PEO, PEO incorporating multi-walled carbon nanotubes (PEO + CNT), and a duplex coating that included a polycaprolactone top layer (PEO + CNT/PCL). Surfaces were characterized by chemical content, roughness, topography, and wettability. Biological properties analysis included cell metabolism and adhesion. PEO ± CNT resulted in an augmented surface roughness compared with the base material (BM), while PCL deposition produced the smoothest surface. All surfaces had a contact angle below 90°. The exposure of gFib-TERT and bmMSC to culture media collected after 3 or 24 h did not affect their metabolism. A decrease in metabolic activity of 9% and 14% for bmMSC and of 14% and 29% for gFib-TERT was observed after 3 and 7 days, respectively. All cells died after 7 days of exposure to BM and after 15 days of exposure to coated surfaces. Saos-2 and gFib-TERT adhered poorly to BM, in contrast to bmMSC. All cells on PEO anchored into the pores with filopodia, exhibited tiny adhesion protrusions on PEO + CNT, and presented a web-like spreading with lamellipodia on PEO + CNT/PCL. The smooth and homogenous surface of the duplex PEO + CNT/PCL coating decreased magnesium corrosion and led to better biological functionality.
PubMed: 37754889
DOI: 10.3390/jfb14090475