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Medicina Oral, Patologia Oral Y Cirugia... Jul 2024Glass ionomers may be a good alternative to composite resin restorations in special needs patients with challenging behaviours. The present study was carried out to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Glass ionomers may be a good alternative to composite resin restorations in special needs patients with challenging behaviours. The present study was carried out to evaluate the restorative efficacy of glass ionomer in the occlusal cavities of permanent molars among patients with special needs after one year of follow-up.
MATERIAL AND METHODS
A randomized split-mouth study was made of a cohort of patients with special needs. First and second permanent molars with occlusal caries were treated with glass ionomer, silver amalgam and composite resin. Assessments were made at 3, 6 and 12 months, using a scale based on the original code of Ryge and the USPHS criteria.
RESULTS
A total of 34 patients and 102 restorations comprised the study sample. The survival rate of both the glass ionomer and silver amalgam was 100%, versus 97.1% in the case of composite resin. The glass ionomer afforded good marginal adaptation and stable color, with no fractures or secondary caries.
CONCLUSIONS
The glass ionomer remained successfully for one year in the occlusal cavities of the permanent molars, with the same survival rate as silver amalgam, and better survival than composite resin, in the patients with special needs.
Topics: Humans; Male; Female; Dental Restoration, Permanent; Adult; Glass Ionomer Cements; Young Adult; Dental Caries; Dental Care for Disabled; Middle Aged; Dental Amalgam; Adolescent; Composite Resins; Acrylic Resins; Silicon Dioxide
PubMed: 38907639
DOI: 10.4317/medoral.26537 -
Clinical Oral Investigations Jun 2024To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and...
OBJECTIVES
To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals.
MATERIALS AND METHODS
In 11 T2DM patients with a concentration of glycated hemoglobin (HbA1C) > 6.5% (test group) and 15 normoglycemic patients (HbA1C < 6.0%; control group), one narrow-diameter tissue level implant, placed in the posterior maxilla or mandible, was investigated. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession, and papilla bleeding index (PBI) were assessed manually after 24 and 48 months of function. The paired digital periapical radiographs were analyzed regarding the change in marginal bone level (MBL) from baseline to 48 months post-op. The technical complications were recorded.
RESULTS
In the T2DM group, 11 patients were available for follow-ups. The overall implant survival rate after 48 months was 100%. The differences in means for the clinical parameters and the MBL between the T2DM and normo-glycemic patients for the observation period were statistically non-significant. No technical complications were recorded.
CONCLUSIONS
The study demonstrated an encouraging clinical outcome with ND implants in patients with uncontrolled T2DM compared to non-diabetics after 48 months' post loading.
CLINICAL RELEVANCE
Patients with HbA1C > 6.5% may benefit from the treatment with narrow-diameter implants by avoiding complex surgical interventions with augmentation procedures. REGISTRATION NUMBER (CLINICALTRIALS.GOV): NCT04630691.
Topics: Humans; Male; Female; Middle Aged; Case-Control Studies; Diabetes Mellitus, Type 2; Treatment Outcome; Dental Prosthesis Design; Dental Implants; Glycated Hemoglobin; Aged; Dental Implantation, Endosseous; Alveolar Bone Loss; Periodontal Index; Adult; Hyperglycemia
PubMed: 38907052
DOI: 10.1007/s00784-024-05786-0 -
Medical Engineering & Physics Jul 2024Anchorage, evaluated by the maximum insertion torque (IT), refers to mechanical engagement between dental implant and host bone at the time of insertion without external...
Anchorage, evaluated by the maximum insertion torque (IT), refers to mechanical engagement between dental implant and host bone at the time of insertion without external loads. Sufficient anchorage has been highly recommended in the clinic. In several studies, the effects of implant diameter and taper body design under external loading have been evaluated after insertion; however, there are few studies, in which their effects on stress distribution during insertion have been investigated to understand establishment of anchorage. Therefore, the objective of this study was to investigate the effects of dental implant diameter and tapered body design on anchorage combining experiments, analytical modeling, and finite element analysis (FEA). Two implant designs (parallel-walled and tapered) with two implant diameters were inserted into rigid polyurethane (PU) foam with corresponding straight drill protocols. The IT was fit to the analytical model (R = 0.88-1.0). The insertion process was modeled using explicit FEA. For parallel-walled implants, normalized IT and final FEA contact ratio were not related to the implant diameter while the implant diameter affected normalized IT (R = 0.90, p < 0.05, β = 0.20 and β = 0.93, standardized regression coefficients for implant diameter and taper body design) and final FEA contact ratio of tapered implants. The taper design distributed the PU foam stress further away from the thread compared to parallel-walled implants, which demonstrated compression in PU foam established by the tapered body during insertion.
Topics: Polyurethanes; Dental Implants; Finite Element Analysis; Stress, Mechanical; Torque; Materials Testing
PubMed: 38906568
DOI: 10.1016/j.medengphy.2024.104181 -
General Dentistry 2024The purpose of this study was to determine the most effective method for bonding composite resin to artificially aged amalgam. A spherical amalgam alloy was triturated...
The purpose of this study was to determine the most effective method for bonding composite resin to artificially aged amalgam. A spherical amalgam alloy was triturated and condensed by hand into cylindrical plastic molds (6 mm in diameter and 4 mm in height) to create 90 specimens, which were then aged for 2 weeks in closed plastic containers at 23°C. The amalgam surfaces underwent 1 of 3 surface treatments (n = 30 per treatment): (1) air particle abrasion (APA) with 50-μm aluminum oxide particles applied with a force of 45 psi from a 10-mm distance, followed by rinsing with deionized water for 60 seconds; (2) APA following the same protocol with subsequent application of a metal primer (Alloy Primer); or (3) coating with 30-μm silica (CoJet) at a force of 45 psi from a 10-mm distance until the surface turned black. Specimens were then treated with 1 of 3 adhesives (n = 10 per adhesive per surface treatment): (1) 2-step total-etch adhesive (OptiBond Solo Plus), (2) 1-step self-etching adhesive (Scotchbond Universal), or (3) dual-cured resin cement (Panavia F 2.0). Each adhesive was applied to the treated amalgam surfaces following its manufacturer's instructions. The specimens were placed in a bonding clamp, and nanocomposite resin columns, 2.38 mm in diameter and 2.00 mm in height, were photocured (40 seconds, 500 mW/cm) against the treated amalgam surfaces. The specimens were stored for 24 hours in 37°C deionized water and underwent shear bond strength testing at a crosshead speed of 0.5 mm/min. Data were analyzed using 2-way analysis of variance and post hoc analysis with the Tukey test at 95% confidence. The mean (SD) shear bond strength values ranged from 12.3 (1.2) MPa for aluminum oxide-treated surfaces bonded with OptiBond Solo Plus to 25.9 (4.6) MPa for silicoated surfaces bonded with Panavia F 2.0. All bonding agents produced the highest shear bond strength when the amalgam surface was silicoated. These results indicate that composite can be effectively bonded to amalgam via silicoating.
Topics: Dental Amalgam; Composite Resins; Dental Bonding; Surface Properties; Dental Restoration Repair; Humans; Resin Cements; Materials Testing; Shear Strength; Methacrylates; Thiones
PubMed: 38905606
DOI: No ID Found -
General Dentistry 2024Patients are always looking for conservative, esthetic, and long-lasting dental restorations, and the technique used directly influences the longevity of the treatment....
Patients are always looking for conservative, esthetic, and long-lasting dental restorations, and the technique used directly influences the longevity of the treatment. The location of the restoration in the mouth and the extent of the decay influence the treatment choice. The larger the dimensions of the cavity preparation, the greater the difficulties in restoring the tooth using direct techniques. The semidirect technique, when indicated, can achieve satisfactory results. It is a relatively easy procedure, consisting of tooth preparation to receive an indirect restoration, fabrication of an alginate impression, fabrication of the composite resin restoration on a flexible cast, cementation, removal of excess cement, and occlusal adjustment. The aim of this case report is to present a viable alternative to direct and indirect restorations for posterior teeth with extensive decay. The article describes the extraoral semidirect technique for fabricating a composite resin restoration, highlighting its indications and discussing advantages and disadvantages.
Topics: Humans; Composite Resins; Dental Restoration, Permanent; Follow-Up Studies; Female; Dental Caries; Male; Dental Cavity Preparation; Cementation; Dental Materials; Molar; Dental Impression Technique
PubMed: 38905605
DOI: No ID Found -
General Dentistry 2024This study evaluated the fracture resistance of endodontically treated maxillary premolars restored with a new self-adhesive composite hybrid material (Surefil one [SO])...
This study evaluated the fracture resistance of endodontically treated maxillary premolars restored with a new self-adhesive composite hybrid material (Surefil one [SO]) using different protocols. A total of 72 maxillary premolars were divided into 6 groups (n = 12). The control group included intact teeth, and the other 5 groups included teeth in which disto-occlusal cavities were prepared and endodontic treatment was performed. The prepared cavities were assigned to groups that were based on the restorative procedures: bulk-fill group, universal adhesive plus conventional bulk-fill composite resin plus a layer of conventional composite resin; SO-SC group, self-cured SO; SO-LC group, light-cured SO; SO-UA group, universal adhesive plus SO; or SO-core group, a 4.0-mm layer of SO covered by a layer of conventional composite resin. Specimens in each group underwent thermocycling and load cycling to test the fracture strength and fracture mode. The results were analyzed using analysis of variance and the Tukey test (α = 0.05). The SO-core group showed the highest mean (SD) fracture resistance, 959.9 (171.8) N, among the restored groups. The SO-core group did not differ significantly from the control group (P > 0.05) but did show significantly higher strength than all other test groups (P < 0.05) except SO-SC (P = 0.364). No significant differences were found between the bulk-fill, SO-SC, SO-LC, and SO-UA groups (P > 0.05). The SO-core group showed the highest number of unrestorable fractures, while the main fracture mode for the other groups was restorable fracture. Although the use of SO as a core material restored the fracture strength of endodontically treated premolars to the level of intact teeth, it also resulted in a higher incidence of unrestorable fractures. The SO-SC group demonstrated a high fracture resistance comparable to that of the SO-core group and had a greater tendency to experience restorable fractures.
Topics: Humans; Composite Resins; Bicuspid; Tooth Fractures; Tooth, Nonvital; Dental Stress Analysis; Dental Restoration, Permanent; Dental Restoration Failure; Materials Testing; Maxilla
PubMed: 38905601
DOI: No ID Found -
General Dentistry 2024Vital pulp therapy (VPT) has been increasingly advocated due to its advantages in preserving tooth vitality. While VPT is often successful, failures can occur, and...
Vital pulp therapy (VPT) has been increasingly advocated due to its advantages in preserving tooth vitality. While VPT is often successful, failures can occur, and traditional root canal therapy is often recommended following VPT failure. This case report provides an example of successful preservation of tooth vitality using coronal pulpotomy (CP), a more invasive type of VPT, after failure of partial pulpotomy (PP) that had been performed in a healthy 10-year-old boy. A mandibular right first molar with a diagnosis of reversible pulpitis was initially treated with PP, which included the use of tricalcium silicate cement as a pulp dressing and a resin-modified glass ionomer cement base, followed by placement of a composite resin restoration. The restoration dislodged after 34 months without complaints from the patient or radiographically detectable lesions. A stainless steel crown was placed on the tooth; however, 15 months after crown placement, the patient returned with symptoms in the treated tooth. The tooth was diagnosed with irreversible pulpitis and asymptomatic apical periodontitis but responded positively to cold testing, and the pulp appeared clinically vital upon direct inspection. The tooth was re-treated with CP, including the use of mineral trioxide aggregate as a dressing material, and examination 21 months posttreatment revealed successful resolution of the periapical lesion. When a tooth remains vital, a more invasive type of VPT may be an alternative to root canal therapy for treating failures in more conservatively treated teeth. Moreover, regular periodic recalls are essential for ensuring tooth survival and early detection of problems (ie, restoration failure) that may worsen treatment outcomes.
Topics: Humans; Male; Child; Pulpotomy; Retreatment; Pulpitis; Silicates; Aluminum Compounds; Calcium Compounds; Molar; Glass Ionomer Cements; Dental Restoration, Permanent; Composite Resins; Oxides; Crowns; Drug Combinations
PubMed: 38905600
DOI: No ID Found -
The International Journal of... Jun 2024To analyze the effect of disinfectants on the roughness and mechanical properties of CAD/ CAM polymethylmethacrylate (PMMA) dentures.
PURPOSE
To analyze the effect of disinfectants on the roughness and mechanical properties of CAD/ CAM polymethylmethacrylate (PMMA) dentures.
MATERIALS AND METHODS
Two groups of denture base resins were tested-heat-polymerized and milled blocks. For each resin, 120 specimens were produced for flexural strength (FS) and flexural modulus (FM) analyses (total: 240 specimens), and 40 were produced for microhardness and surface roughness evaluations (total: 80 specimens). They were categorized into the following groups based on immersion: control (deionized water); H1 (1% sodium hypochlorite); H05 (0.5% sodium hypochlorite); and C2 (2% chlorhexidine) groups. The immersion periods were 0 (T0), 130 (T1), and 260 (T2) cycles. Statistical analyses were performed for flexural properties using threeway ANOVA. Microhardness (KHN) and surface roughness (Ra) were analyzed using repeated-measures ANOVA. A significance level of 5% was set.
RESULTS
CAD/CAM PMMA showed higher FS (P = .001) and FM (P < .001) than conventional PMMA. The KHN value was superior to the conventional PMMA (P < .001). The chemical solution affected the surface roughness of both resins (P = .007). The CAD/ CAM PMMA block showed increased Ra values when H1 was used. Cycling separately increased the FS of conventional PMMA (T1 vs baseline; P < .05). However, the FM of CAD/CAM PMMA was higher (T1 and T2 vs baseline; P < .05). The time factor increased the microhardness of both resins (T2 vs baseline; P < .05).
CONCLUSIONS
The CAD/CAM resin showed higher values compared to conventional PMMA in all tests, regardless of the chemical solution used; however, the values obtained for both resins were clinically acceptable.
Topics: Polymethyl Methacrylate; Surface Properties; Computer-Aided Design; Materials Testing; Flexural Strength; Hardness; Denture Bases; Disinfection; Chlorhexidine; Sodium Hypochlorite
PubMed: 38905586
DOI: 10.11607/ijp.8301 -
The International Journal of... Jun 2024To compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prostheses (FPSs) supported by three and four implants and to correlate with... (Comparative Study)
Comparative Study
PURPOSE
To compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prostheses (FPSs) supported by three and four implants and to correlate with the size of the horizontal and vertical distal cantilever at prosthesis placement (T1) and after 1 year (T2).
MATERIALS AND METHODS
A total of 72 external hexagon (EH) type implants were placed in 20 participants. Of these, 24 supported an FPS with three implants (G3I) and 48 with four implants (G4I). The mandibular implants were named 1, 2, 3, and 4 according to their location in the arch, in a clockwise direction. Digital periapical radiographs were taken at times T1 and T2 for analysis and measurement of peri-implant bone loss. The horizontal and vertical distal cantilevers were measured with a digital caliper and correlated with peri-implant bone loss.
RESULTS
The survival rate of implants in G3I was 91.66%, and in G4I it was 97.91%. The mean bone loss in G3I was 0.88 ± 0.89 mm, and in G4I it was 0.58 ± 0.78 mm (P = .225). There was no correlation between distal horizontal cantilevers and bone loss in the studied groups, with G3I being -0.25 (P = .197) and G4I -0.22 (P = .129). Larger vertical cantilevers of implants 1 (P = .018), 3 (P =.015), and 4 (P = .045) correlated with greater bone loss in G4I.
CONCLUSIONS
The number of implants in an FPS did not influence peri-implant bone loss after 1 year of follow-up. Larger vertical cantilevers influenced greater bone loss in complete-arch implant-supported fixed prostheses supported by four implants.
Topics: Humans; Dental Prosthesis, Implant-Supported; Alveolar Bone Loss; Mandible; Middle Aged; Male; Female; Aged; Dental Implants; Adult
PubMed: 38905585
DOI: 10.11607/ijp.8347 -
The International Journal of Oral &... Jun 2024To evaluate the effect of interleukin-6 (IL-6) inhibitor (tocilizumab) on bacterial infection-associated bone resorption around implants during osseointegration in...
PURPOSE
To evaluate the effect of interleukin-6 (IL-6) inhibitor (tocilizumab) on bacterial infection-associated bone resorption around implants during osseointegration in rabbits.
MATERIALS AND METHODS
At total of 24 male, 9-monthold New Zealand white rabbits were included, and their two mandibular anterior teeth were extracted. Three months after extraction, 24 one-piece Dentium implants (Ø 2.5 mm, intraosseous length of 12 mm) were inserted in the anterior mandible, and the rabbits were divided into four groups (n = 6 per group). Different treatment methods were used in each group: blank control group (BC); only silk ligation (negative control [NC]); silk ligation and injection with minocycline hydrochloride ointment (positive control [PC]); and silk ligation and injection with tocilizumab at 8 mg/kg via the auricle vein (experimental [EP]). Eight weeks later, the animals were sacrificed, and samples were collected and then analyzed using microcomputed tomography (microCT) scanning, immunohistochemical analysis, and histologic analysis.
RESULTS
From the microCT measurement, the ratio of the bone volume to the total volume (BV/TV) in the EP group was 67.00% ± 2.72%, which was higher than that in the other three groups (58.85% ± 2.43% in the BC group, 55.72% ± 2.48% in the PC group, and 36.52% ± 3.02% in the NC group). From immunohistochemical analysis, the expression of IL-6 was found to be higher in the NC group than in the BC, PC, and EP groups, but there was no statistical difference between these three groups. Furthermore, the RANKL (receptor activator of nuclear factor-κB ligand) expression was the lowest in the EP group, followed by the BC group, the PC group, and the NC group, which had the highest expression; there was no difference between the NC and PC groups. Upon histologic analysis, significant new bone was found on the implant surfaces in the EP group, sparse and less new bone could be seen in the BC and PC groups, and the most serious bone resorption occurred in the NC group.
CONCLUSIONS
Tocilizumab, an inhibitor of IL-6, has a certain effect in preventing bone loss around implants caused by bacterial infection during the osseointegration period.
Topics: Animals; Rabbits; Male; Pilot Projects; Interleukin-6; Antibodies, Monoclonal, Humanized; Osseointegration; X-Ray Microtomography; Dental Implants; Bone Resorption; Dental Implantation, Endosseous
PubMed: 38905119
DOI: 10.11607/jomi.10360