Bone crestal height and bone density after third-molar extraction and grafting: a long-term follow-up study

The objective of this study was to evaluate the long-term influence of xenogenic grafts on bone crestal height and radiographic density following extraction of teeth. The right and left third lower molars of 22 patients were surgically extracted, and one randomly chosen socket was filled with a xenogenic graft (Gent-Tech). The contralateral molar was left to heal naturally, serving as a paired control. Digital intraoral radiographies were taken at surgery and 2, 6, and 24 months after, to evaluate bone density (BD) and alveolar bone crest to cementoenamel junction distance. The data obtained were subjected to two-way analysis of variance and Tukey`s test (alpha = 0.05). The significant decrease in cementoenamel junction distance observed for both groups was limited to the first 6 months. BD values increased significantly in the first 6 months, with no alterations observed up to 24 months for both groups. BD was higher for the experimental group at all time points (p < 0.05). Socket grafting with the xenogenic materials tested did not changed bone crestal height and bone radiographic density in the long term.

Monostotic fibrous dysplasia: a 23-year follow-up of a patient with spontaneous bone remodeling

Fibrous dysplasia is a benign fibro-osseous disease that affects one or more bones. Although its etiology has been defined, the mechanism of spontaneous resolution is still unclear. There is strong evidence indicating the occurrence of stabilization when bone maturation is completed. Deformities that lead to esthetic and functional disorders are observed in almost all cases. Plastic surgery is often recommended when the maxilla and mandible are involved. In the case of mild deformities, careful follow-up during skeletal growth is recommended. We describe here the 23-year follow-up of a patient with monostotic fibrous dysplasia whose disease had stabilized by 13 years of follow-up. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 229-234)

Clinical evaluation of two packable posterior composites A five-year follow-up

Background. Research has suggested that packable resin-based composites inserted with a placement technique similar to amalgam condensation can reduce the sensitivity associated with posterior restorations. The authors evaluated the clinical performance, including associated sensitivity, of two packable composites in a randomized five-year clinical trial. Methods. A single operator randomly placed two restorations in each of 33 patients: one restoration consisting of Alert (Jeneric/Pentron, Wallingford, Conn.) and the other consisting of SureFil (Dentsply/Caulk, Milford, Del.). There were 30 Class I and 36 Class II restorations. Two independent evaluators evaluated the restorations by using modified U.S.; Public Health Service criteria. The authors analyzed data by means of the Fisher, chi(2) and McNemar tests at P < .05. Results. Of 60 restorations evaluated at five years, two Class II restorations (one SureFil, one Alert) failed. All other restorations received the highest score possible for sensitivity and vitality. The only difference between the composites at the five-year recall was the significantly better surface texture of SureFil. The authors observed significantly different scores between the baseline and at five years for marginal discoloration (Alert and SureFil), surface texture (Alert and SureFil) and color (SureFil). Conclusions. Both packable resin-based composites showed excellent durability during the five-year follow-up. Clinical Implications. The investigated resin-based composites are suitable for posterior restorations.

Push-out Bond Strength of Fiber Posts Luted with Unfilled Resin Cement

Purpose: The study evaluates the behavior of different adhesive systems and resin cements in fiber post placement, with the intent to clarify the possible role of unfilled resin as a luting material for fiber posts. Materials and Methods: Two luting agents (Dual-Link and Unfilled Resin) for cementing fiber posts into root canals were applied either with All-Bond 2 or One-Step Plus, or without an adhesive system, and challenged with the push-out test. Slices of roots restored with posts were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under SEM. Results: Push-out strength was significantly influenced by the luting agent (p < 0.05), but not by the bonding strategy (p > 0.05). The best results were obtained in combination with Unfilled Resin with One-Step Plus. Dual-Link groups failed mainly cohesively within the cement, while Unfilled Resin demonstrated more adhesive fracture at the post interface. Conclusion: The results of this study support the hypothesis that adhesive unfilled resin application is essential for achieving high bond strength to radicular dentin.

Bond strength of AH Plus and Epiphany sealers on root dentine irradiated with 980 nm diode laser

Aim To evaluate the bond strength of AH Plus and Epiphany sealers to human root canal dentine irradiated with a 980 nm diode laser at different power and frequency parameters, using the push-out test. Methodology Sixty canine roots were sectioned below the cementoenamel junction to provide 4-mm-thick dentine discs that had their root canals prepared with a tapered bur and irrigated with sodium hypochlorite, ethylenediaminetetraacetic acid and distilled water. The specimens were assigned to five groups (n = 12): one control (no laser) and four experimental groups that were submitted to 980 nm diode laser irradiation at different power (1.5 and 3.0 W) and frequency (continuous wave and 100 Hz) parameters. Half of specimens in each group had their canals filled with AH Plus sealer and half with Epiphany. The push-out test was performed and data (MPa) were analysed statistically by ANOVA and Tukey`s test (P < 0.05). The specimens were split longitudinally and examined under SEM to assess the failure modes after sealer displacement. Results The specimens irradiated with the diode laser and filled with AH Plus had significantly higher bond strength values (8.69 +/- 2.44) than those irradiated and filled with Epiphany (3.28 +/- 1.58) and the nonirradiated controls (3.86 +/- 0.60). The specimens filled with Epiphany did not differ significantly to each other or to the control (1.75 +/- 0.69). There was a predominance of adhesive failures at Epiphany-dentine interface (77%) and mixed failures at AH Plus-dentine interface (67%). Conclusions The 980 nm diode laser irradiation of root canal dentine increased the bond strength of AH Plus sealer, but did not affect the adhesion of Epiphany sealer.

Shear Bond Strength of A Sealant to Contaminated-Enamel Surface: Influence of Erbium : Yttrium-Aluminum-Garnet Laser Pretreatment

Salivary contamination is one of the factors that can disturb the sealing process and interfere in the longevity of pit and fissure sealants. Erbium : yttrium-aluminum-garnet (Er : YAG) laser could influence the bond strength of enamel and increase the acid resistance. To evaluate the influence of Er : YAG laser on the shear bond strength of a sealant to a salivary contaminated enamel surface. Twenty-four third molars had the roots sectioned 2 mm coronal to the cementoenamel junction. The crowns were mesiodistally sectioned providing 48 halves that were embedded in polyester resin. Enamel was flattened and a 2-mm diameter bonding area was demarcated. Specimens were randomly assigned to two groups according to the superficial pretreatment-37% phosphoric acid (A) and Er : YAG laser (80 mJ/2 Hz) + phosphoric acid (L), which were subdivided into two groups (N = 12), without salivary contamination (C) and with salivary contamination (SC). To contaminate the specimens, 0.25 mL of human fresh saliva was applied for 20 seconds and then dried. Fluroshield sealant was applied in all specimens. After storage, shear bond strength of samples were tested in a universal testing machine. Means in MPa were: AC-14.61 (+/- 2.52); ASC-6.66 (+/- 2.34); LC-11.91 (+/- 1.34); and LSC-2.22 (+/- 0.66). Statistical analysis revealed that surfaces without salivary contamination and with acid treatment had the highest mean (p < 0.05). The group with salivary contamination treated by Er : YAG laser followed by phosphoric acid application presented the lowest bond values (p < 0.05). The phosphoric acid etching under dry condition yielded better bonding performance. Er : YAG laser was not able to increase the effectiveness of conventional acid etching of enamel in the bond of sealants in both dry and wet conditions. Under the conditions of this study, the conventional etching protocol (phosphoric acid without salivary contamination) is still preferable to laser-conditioning enamel surface prior to sealant application.

Shear Bond Strength and Ultrastructural Interface Analysis of Different Adhesive Systems to Bleached Dentin

Background: It remains unclear as to whether or not dental bleaching affects the bond strength of dentin/resin restoration. Purpose: To evaluated the bond strength of adhesive systems to dentin submitted to bleaching with 38% hydrogen peroxide (HP) activated by LED-laser and to assess the adhesive/dentin interfaces by means of SEM. Study design: Sixty fragments of dentin (25 mm(2)) were included and divided into two groups: bleached and unbleached. HP was applied for 20 s and photoactivated for 45 s. Groups were subdivided according to the adhesive systems (n = 10): (1) two-steps conventional system (Adper Single Bond), (2) two-steps self-etching system (Clearfil standard error (SE) Bond), and (3) one-step self-etching system (Prompt L-Pop). The specimens received the Z250 resin and, after 24 h, were submitted to the bond strength test. Additional 30 dentin fragments (n = 5) received the same surface treatments and were prepared for SEM. Data were analyzed by ANOVA and Tukey`s test (alpha = 0.05). Results: There was significant strength reduction in bleached group when compared to unbleached group (P < 0.05). Higher bond strength was observed for Prompt. Single Bond and Clearfil presented the smallest values when used in bleached dentin. SEM analysis of the unbleached specimens revealed long tags and uniform hybrid layer for all adhesives. In bleached dentin, Single Bond provided open tubules and with few tags, Clearfil determined the absence of tags and hybrid layer, and Prompt promoted a regular hybrid layer with some tags. Conclusions: Prompt promoted higher shear bond strength, regardless of the bleaching treatment and allowed the formation of a regular and fine hybrid layer with less deep tags, when compared to Single Bond and Clearfil. Microsc. Res. Tech. 74:244-250, 2011. (C) 2010 Wiley-Liss, Inc.

Shear strength of the bond to primary dentin: influence of Er:YAG laser irradiation distance

The aim of this study was to assess in vitro the influence of Er:YAG laser irradiation distance on the shear strength of the bond between an adhesive restorative system and primary dentin. A total of 60 crowns of primary molars were embedded in acrylic resin and mechanically ground to expose a flat dentin surface and were randomly assigned to six groups (n = 10). The control group was etched with 37% phosphoric acid. The remaining five groups were irradiated (80 mJ, 2 Hz) at different irradiation distances (11, 12, 16, 17 and 20 mm), followed by acid etching. An adhesive agent (Single Bond) was applied to the bonding sites, and resin cylinders (Filtek Z250) were prepared. The shear bond strength tests were performed in a universal testing machine (0.5 mm/min). Data were submitted to statistical analysis using one-way ANOVA and the Kruskal-Wallis test (p < 0.05). The mean shear bond strengths were: 7.32 +/- 3.83, 5.07 +/- 2.62, 6.49 +/- 1.64, 7.71 +/- 0.66, 7.33 +/- 0.02, and 9.65 +/- 2.41 MPa in the control group and the groups irradiated at 11, 12, 16, 17, and 20 mm, respectively. The differences between the bond strengths in groups II and IV and between the bond strengths in groups II and VI were statistically significant (p < 0.05). Increasing the laser irradiation distance resulted in increasing shear strength of the bond to primary dentin.

Influence of dentin cavity surface finishing on micro-tensile bond strength of adhesives

The current trend toward minimal-invasive dentistry has introduced innovative techniques for cavity preparation. Chemical vapor deposition (CVD) and laser-irradiation technology have been employed as an alternative to the common use of regular burs in high-speed turbines. Objectives. The purpose of this study was to assess the influence of alternative techniques for cavity preparation on the bonding effectiveness of different adhesives to dentin, and to evaluate the morphological characteristics of dentin prepared with those techniques. Methods. One etch&rinse adhesive (OptiBond FL, Kerr) and three self-etch systems (Adper Prompt L-Pop, 3M ESPE; Clearfil SE Bond, Kuraray; Clearfil S3 Bond, Kuraray) were applied on dentin prepared with a regular bur in a turbine, with a CVD bur in a turbine, with a CVD tip in ultrasound and with an ErCr:YSGG laser. The micro-tensile bond strength (mu TBS) was determined after storage in water for 24 h at 37 degrees C, and morphological evaluation was performed by means of field -emission -gun scanning electron microscopy (Feg-SEM). Results. Feg-SEM evaluation revealed different morphological features on the dentin surface after the usage of both the conventional and alternative techniques for cavity preparation, more specifically regarding smear-layer thickness and surface roughness. CVD bur-cut, CVD ultra-sonoabraded and laser-irradiated dentin resulted in lower mu TBSs than conventionally bur-cut dentin, irrespective of the adhesive employed. Significance. The techniques, such as CVD diamond-bur cutting, CVD diamond ultra-sonoabrasion and laser-irradiation, used for cavity preparation may affect the bonding effectiveness of adhesives to dentin, irrespective of their acidity or approach. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Influence of Er,Cr : YSGG laser treatment on the microtensile bond strength of adhesives to dentin

Purpose: In light of the concept of minimally invasive dentistry, erbium lasers have been considered as an alternative technique to the use of diamond burs for cavity preparation. The purpose of this study was to assess the bonding effectiveness of adhesives to Er,Cr:YSGG laser-irradiated dentin using irradiation settings specific for cavity preparation. Materials and Methods: Fifty-four midcoronal dentin surfaces, obtained from sound human molars, were irradiated with an Er,Cr:YSGG laser or prepared with a diamond bur using a high-speed turbine. One etch-and-rinse (Optibond FL/Kerr) and three self-etching adhesives (Adper Prompt L-Pop/3M ESPE, Clearfil SE Bond/Kuraray, and Clearfil S-3 Bond/Kuraray) were used to bond the composite to dentin. The microtensile bond strength (mu TBS) was determined after 24 h of storage in water at 37 degrees C. The Kruskal-Wallis test was used to determine pairwise statistical differences (p < 0.05). Prepared dentin surfaces, adhesive interfaces, and failure patterns were analyzed using a stereo microscope and Field-emission gun Scanning Electron Microscopy (Feg-SEM). Results: Significantly lower mu TBS was observed to laser-irradiated than to bur-cut dentin (p < 0.05), irrespective of the adhesive employed. Feg-SEM photomicrographs of lased dentin revealed an imbricate patterned substrate and the presence of microcracks at the dentin surface. Conclusion: Morphological alterations produced by Er,Cr:YSGG laser-irradiation adversely influence the bonding effectiveness of adhesives to dentin. Keywords: dentin, adhesion, adhesives, laser, ErCr:YSGG.

A Bayesian model for estimating the malaria transition probabilities considering individuals lost to follow-up

It is known that patients may cease participating in a longitudinal study and become lost to follow-up. The objective of this article is to present a Bayesian model to estimate the malaria transition probabilities considering individuals lost to follow-up. We consider a homogeneous population, and it is assumed that the considered period of time is small enough to avoid two or more transitions from one state of health to another. The proposed model is based on a Gibbs sampling algorithm that uses information of lost to follow-up at the end of the longitudinal study. To simulate the unknown number of individuals with positive and negative states of malaria at the end of the study and lost to follow-up, two latent variables were introduced in the model. We used a real data set and a simulated data to illustrate the application of the methodology. The proposed model showed a good fit to these data sets, and the algorithm did not show problems of convergence or lack of identifiability. We conclude that the proposed model is a good alternative to estimate probabilities of transitions from one state of health to the other in studies with low adherence to follow-up.

NIR to visible up-conversion, infrared luminescence, thermoluminescence and defect centres in Y(2)O(3) : Er phosphor

Er(3+) doped Y(2)O(3) phosphor was prepared by the solution combustion method and characterized using powder x-ray diffraction and energy-dispersive analysis of x-ray mapping studies. Room temperature near infrared (NIR) to green up-conversion (UC) emissions in the region 520-580 nm {((2)H(11/2), (4)S(3/2)) -> (4)I(15/2)} and red UC emissions in the region 650-700 nm ((4)F(9/2) -> (4)I(15/2)) of Er(3+) ions have been observed upon direct excitation to the (4)I(11/2) level using similar to 972 nm laser radiation of nanosecond pulses. The possible mechanisms for the UC processes have been discussed on the basis of the energy level scheme, the pump power dependence as well as based on the temporal evolution. The excited state absorption is observed to be the dominant mechanism for the UC process. Y(2)O(3) : Er exhibits one thermally stimulated luminescence (TSL) peak around 367 degrees C. Electron spin resonance (ESR) studies were carried out to study the defect centres induced in the phosphor by gamma irradiation and also to identify the centres responsible for the TSL peak. Room temperature ESR spectrum of irradiated phosphor appears to be a superposition of at least three distinct centres. One of them (centre I) with principal g-values g(parallel to) = 2.0415 and g(perpendicular to) = 2.0056 is identified as O(2)(-) centre while centre II with an isotropic g-factor 2.0096 is assigned to an F(+)-centre (singly ionized oxygen vacancy). Centre III is also assigned to an F(+)-centre with a small g-factor anisotropy (g(parallel to) = 1.974 and g(perpendicular to) = 1.967). Additional defect centres are observed during thermal annealing experiments and one of them appearing around 330 degrees C grows with the annealing temperature. This centre (assigned to an F(+)-centre) seems to originate from an F-centre (oxygen vacancy with two electrons) and the F-centre appears to correlate with the observed TSL peak in Y2O3 : Er phosphor. The trap depth for this peak has been determined to be 0.97 eV from TSL data.

Bond Strength of Dental Adhesive Systems Irradiated with Ionizing Radiation

Purpose: The aim of the present paper was to determine the effect of different types of ionizing radiation on the bond strength of three different dentin adhesive systems. Materials and Methods: One hundred twenty specimens of 60 human teeth (protocol number: 032/2007) sectioned mesiodistally were divided into 3 groups according to the adhesives systems used: SB (Adper Single Bond Plus), CB (Clearfil SE Bond) and AP (Adper Prompt Self-Etch). The adhesives were applied on dentin and photo-activated using LED (Lec 1000, MMoptics, 1000 mW/cm(2)). Customized elastomer molds (0.5 mm thickness) with three orifices of 1.2 mm diameter were placed onto the bonding areas and filled with composite resin (Filtek Z-250), which was photo-activated for 20 s. Each group was subdivided into 4 Subgroups for application of the different types of ionizing radiation: ultraviolet radiation (UV), diagnostic x-ray radiation (DX), therapeutic x-ray radiation (TX) and without irradiation (control group, CG). Microshear tests were carried out (Instron, model 4411), and afterwards the modes of failure were evaluated by optical and scanning electron microscope and classified using 5 scores: adhesive failure, mixed failures with 3 significance levels, and cohesive failure. The results of the shear bond strength test were submitted to ANOVA with Tukey`s test and Dunnett`s test, and the data from the failure pattern evaluation were analyzed with the Mann Whitney test (p = 0.05). Results: No change in bond strength of CB and AP was observed after application of the different radiation types, only SB showed increase in bond strength after UV (p = 0.0267) irradiation. The UV also changed the failure patterns of SB (p = 0.0001). Conclusion: The radio-induced changes did not cause degradation of the restorations, which means that they can be exposed to these types of ionizing radiation without weakening the bond strength.

Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancer

Photodynamic therapy (PDT) is based on the association of a light source and tight sensitive agents in order to cause the selective death of tumor cells. To evaluate topical 5-aminolaevulinic acid (5-ALA) and diode laser photodynamic single session therapy single session for non-melanoma skin cancer (NMSC), a long-term follow-up was performed. Nineteen Bowen`s disease (BD) and 15 basal cell. carcinoma (BCC) lesions were submitted to 6-h topical and occlusive 20% 5-ALA plus DMSO and EDTA, and later were exposed to 630 nm diode laser, 100 or 300 J cm(-2) dose. At 3 months tumor-free rate was 91.2% (31/34) whereas at 60 months, 57.7% (15/26), slightly higher in BCC (63.6%; 7/11). The relation between the reduction of the clinical response and the increase of tumor dimension observed at 18 months was lost at 60 months. The sBCC recurrence was earlier compared to the nBCC one. ALA-PDT offered important advantages: it is minimally invasive, an option for patients under risk of surgical complications; clinical feasibility; treatment of multiple lesions in only one session or lesions in poor heating sites and superior esthetical results. However, the recurrence rate increase after ALA-PDT diode laser single session can be observed at tong-term follow-up, and the repetitive sessions, an additional. advantage of the method, is strongly recommended. The clinical response and recurrence time seem to be related to the laser light dose and NMSC types/sub-types, thickness and dimension, which must be considered for the choice of the ALA-PDT. (C) 2009 Elsevier B.V. All rights reserved.

Orthodontic brackets removal under shear and tensile bond strength resistance tests - a comparative test between light sources

We have investigated if a new LEDs system has enough efficient energy to promote efficient shear and tensile bonding strength resistance under standardized tests. LEDs 470 +/- 10 nm can be used to photocure composite during bracket fixation. Advantages considering resistance to tensile and shear bonding strength when these systems were used are necessary to justify their clinical use. Forty eight human extracted premolars teeth and two light sources were selected, one halogen lamp and a LEDs system. Brackets for premolar were bonded through composite resin. Samples were submitted to standardized tests. A comparison between used sources under shear bonding strength test, obtained similar results; however, tensile bonding test showed distinct results: a statistical difference at a level of 1% between exposure times (40 and 60 seconds) and even to an interaction between light source and exposure time. The best result was obtained with halogen lamp use by 60 seconds, even during re-bonding; however LEDs system can be used for bonding and re-bonding brackets if power density could be increased.