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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 -
The International Journal of Oral &... Jun 2024To evaluate the efficacy of combined therapy of teriparatide and raloxifene on the osseointegration of titanium dental implants in a rabbit model of osteoporotic bone.
PURPOSE
To evaluate the efficacy of combined therapy of teriparatide and raloxifene on the osseointegration of titanium dental implants in a rabbit model of osteoporotic bone.
MATERIALS AND METHODS
Sixty female rabbits were randomly divided into six groups. The sham ovariectomy group (control) consisted of animals that received no medication. Animals in the ovariectomy group (OVX) underwent ovariectomy and received no medication. The combined group consisted of ovariectomized animals that received combined teriparatide (10 mg/kg) for 12 weeks and raloxifene (10 mg/kg) for 12 weeks. The sequential group (SEQ) consisted of ovariectomized animals that received teriparatide (10 mg/kg) for the first 6 weeks and raloxifene therapy (10 mg/kg) for the following 6 weeks sequentially. The parathormone (PTH) and raloxifene (RAL) groups consisted of ovariectomized animals that received only teriparatide (10 mg/kg) for 12 weeks or raloxifene (10 mg/kg) for 12 weeks, respectively. Dental implants (Bilimplant) were placed in the proximal metaphysis of both tibias in all rabbits. Histomorphometric and microCT studies were performed on the specimens obtained from the right tibia bone. Removal torque (RTQ) and implant stability quotient (ISQ) tests were performed on the specimens obtained from the left tibia bone. The results were compared and evaluated statistically.
RESULTS
RTQ analysis revealed a statistically significant difference between the mean values of the combined group (93.01 ± 27.19 Ncm) and the OVX group (49.6 ± 12.5 Ncm) (P = .015). The highest mean T0 (implantation day) value was obtained in the control group (67.1 ± 3.4 Ncm), and the lowest mean value was obtained in the OVX group (61.4 ± 3.8 Ncm). The highest T1 mean (3 months after implantation) was obtained by the combined group (76.6 ± 3.8 Ncm), and the lowest mean was obtained by the OVX group (68.9 ± 6.2 Ncm). Histomorphometric analyses showed that the mean percentage of bone-to-implant contact (BIC%) of the combined group (51.2%) was significantly higher than that of the OVX group (28.6%) (P =.006). In the microCT examinations, it was found that the mean BIC% value of the combined group (41.1%) was significantly higher than that of the OVX group (24.1%) (P < .001).
CONCLUSIONS
According to the results of the current study, combined therapy of teriparatide and raloxifene improves the BIC and osseointegration of titanium dental implants in osteoporotic bone compared with sequential or independent therapy with these agents.
Topics: Animals; Rabbits; Teriparatide; Raloxifene Hydrochloride; Osseointegration; Female; Dental Implants; Bone Density Conservation Agents; Disease Models, Animal; Ovariectomy; Osteoporosis; Dental Implantation, Endosseous; X-Ray Microtomography; Random Allocation; Titanium; Drug Therapy, Combination
PubMed: 38905118
DOI: 10.11607/jomi.10040 -
The International Journal of Oral &... Jun 2024To answer the following focus question: In preclinical in vivo experimental models, do oral implants placed in overdimensioned (OD) sites present greater biomechanical... (Meta-Analysis)
Meta-Analysis
PURPOSE
To answer the following focus question: In preclinical in vivo experimental models, do oral implants placed in overdimensioned (OD) sites present greater biomechanical properties and histomorphometric parameters of osseointegration compared to implants placed in standard or undersized implant sockets?
MATERIALS AND METHODS
Online databases were searched for controlled animal studies reporting on OD sites up to February 2023. The relative implant- final drill discrepancy (IDD) was used to categorize the control and test groups according to surgical drilling protocol: (1) control: undersized (IDD > 0.5 mm) or standard (IDD = 0.2 to 0.5 mm); and (2) test OD: stress-free oversized (IDD = 0.0 to -0.1 mm); test GAP: friction-free oversized (IDD ≤ -0.1 mm). Random-effects meta-analyses were performed for the outcomes of insertion and removal torque values (ITV and RTV, respectively), bone-to-implant contact (%BIC), and bone density (%BD) for short- (0 to 2 weeks), intermediate- (3 to 4 weeks), and long-term (≥ 5 weeks) healing periods.
RESULTS
Of the 527 records identified, 13 studies met the eligibility criteria. Histologically, the OD and GAP groups prevented ischemic necrosis and extensive bone resorption at the bone-implant interface in both the marginal cortical layer and the trabeculae. Faster and increased rates of bone formation, characterized by primary osteons and highly vascularized tissue, took place in OD sites between 1 and 5 weeks of healing. Meta-analyses indicated statistically significant benefits in favor of (1) control vs OD for short-term healing in extraoral sites, with pooled estimates (weighted mean difference) of ITV = 25.35 Ncm, %BIC = 2.10%, and %BD = 26.19%; (2) control vs OD for long-term healing in intraoral sites, with %BD = 11.69%; (3) control vs GAP for intermediate-term healing in extraoral sites, with %BD = 3.03%; and (4) control vs GAP for long-term healing in extraoral sites, with RTV = 5.57 Ncm.
CONCLUSIONS
Oversized surgical preparation of the implant site does not seem to provide any additional benefit compared to standard or undersized sites regarding quantitative parameters of osseointegration. However, it does minimize marginal bone resorption and yields better-quality bone healing, despite the comparable results among different experimental animal models in the late postoperative period.
Topics: Dental Implantation, Endosseous; Osseointegration; Animals; Dental Implants; Biomechanical Phenomena; Torque
PubMed: 38905117
DOI: 10.11607/jomi.10059 -
The International Journal of Oral &... Jun 2024
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Time Factors; Dental Restoration Failure; Treatment Outcome
PubMed: 38905114
DOI: No ID Found -
The International Journal of Oral &... Jun 2024To determine the vertical space required for implant osteotomy preparation when utilizing a CAD/CAM fully guided surgical template.
PURPOSE
To determine the vertical space required for implant osteotomy preparation when utilizing a CAD/CAM fully guided surgical template.
MATERIALS AND METHODS
A total of 14 surgical osteotomy drills (individual and sequential drills) were collected and measured individually using a digital caliper, as well as the total length when the drills were positioned in a surgical handpiece. The height of the surgical guide sleeves and the offset of 14 implant systems in the market were also collected.
RESULTS
The vertical dimension of the drills included in this study ranged from 28.2 to 46.3 mm. When these drills were inserted into the handpiece, the total length ranged from 30.0 to 49.5 mm. The height of the surgical guide sleeve and the offset required for the guide had a range of 3.2 to 7.0 mm and 5.0 to 13.5 mm, respectively. This dimension resulted in the total vertical space required for CAD/CAM fully guided surgical templates for each implant system, which ranged from 30.0 to 58.5 mm.
CONCLUSIONS
Limited mouth opening can pose challenges and limitations in both guided and nonguided dental implant surgery. It can affect the accessibility of surgical implant placement and may result in increased patient discomfort, surgical implant positioning errors, and postoperative complications. Clinicians should determine the patient's mouth opening capabilities during the treatment planning phase prior to deciding on the appropriate implant system to be used and the implant placement technique.
Topics: Computer-Aided Design; Humans; Surgery, Computer-Assisted; Dental Implantation, Endosseous; Osteotomy; Dental Implants; Vertical Dimension
PubMed: 38905112
DOI: 10.11607/jomi.8440 -
Noise & HealthThe prevalence of hearing loss is increasing annually and has a strong relationship with oral health. However, existing research on hearing loss is limited to children,...
BACKGROUND
The prevalence of hearing loss is increasing annually and has a strong relationship with oral health. However, existing research on hearing loss is limited to children, making it necessary to expand the analysis to adults. Therefore, this study aims to identify differences in oral health-related factors according to hearing loss in adults over 40 years of age using the Korea National Health and Nutrition Examination Survey.
METHODS
This study analyzed survey data from 2021. The study participants were divided into 1738 individuals in the nonhearing loss group and 1384 in the hearing loss group. Complex sample chi-square and complex sample independent t-tests were performed to determine differences in the sociodemographic characteristics, systemic diseases, hearing loss-related factors, and oral health status between the two groups.
RESULTS
Compared to the nonhearing loss group, the hearing loss group was older and had lower income and education levels. In terms of oral health, the hearing loss group had fewer existing natural teeth, poorer prosthesis conditions, and a higher number of implants than the nonhearing loss group. The hearing loss group also experienced comparatively more problems with chewing and speaking (P < 0.05).
CONCLUSIONS
Individuals with hearing loss exhibited poorer oral health status than those without hearing loss. Therefore, dental professionals in clinical practice should develop their communication skills to interact effectively with patients with hearing loss and strive to improve their oral health.
Topics: Humans; Republic of Korea; Oral Health; Male; Female; Middle Aged; Nutrition Surveys; Hearing Loss; Adult; Aged
PubMed: 38904806
DOI: 10.4103/nah.nah_114_23