Diode Laser Irradiation Effects on the Sealing Ability of Root Canal Sealers

This study aimed to test the hypothesis that dentine alterations induced by 810 nm-diode laser may affect the interaction between root canal sealers and the dentin wall. Seventy-two single root human teeth were selected and root canals were enlarged with K-files. Dentine was treated with 0.5% NaOCl and 17% EDTA-T and irradiated (laser group) by diode laser (810 nm/P = 2.5W/I = 1989 W/cm(2)) or remained non-irradiated (control group). Six samples per group were analyzed by scanning electron microscopy (SEM). The remaining samples of each group were divided into three subgroups (n = 10) and sealed with one of the tested sealers (N-Rickert/AHPlus (TM)/Apexit (R)). Apical leakage was estimated by evaluating penetration of 0.5% methylene-blue dye. SEM analysis revealed that dentine at the apical third in irradiated samples was melted and fusioned whereas non-irradiated samples exhibited opened dentinal tubules. Despite the morphological changes induced by irradiation, laser did not affect the sealing ability of N-Rickert and AHPlus (TM) sealers. However, the length of apical leakage in roots filled with Apexit (R) was lower in irradiated root canals than in non-irradiated samples (p < 0.05). Morphological changes of root canal walls promoted by diode laser irradiation may improve de sealing ability of Apexit (R), a calcium hydroxide-based sealer, suggesting that improved sealing promoted by irradiation may represent an additional factor contributing to the endodontic clinical outcome.

Performance of techniques used for re-attachment of endodontically treated crown fractured teeth

Objectives: The aim of this study was to compare the fracture strength of three techniques used to re-attach tooth fragments in sound and endodontically treated fractured teeth with or without fiber post placement. Material and methods: Ninety human lower incisors were randomly divided into three groups of 30 teeth each. In group A teeth were not subjected to endodontic treatment; while teeth from groups B and C were endodontically treated and the pulp chamber restored with a composite resin. All teeth were fractured by an axial load applied to the buccal area in order to obtain tooth fragments. Teeth from each group were then divided into three subgroups, according to the re-attachment technique: bonded-only, buccal-chamfer and circumferential chamfer. Before the re-attachment procedures, fiber posts were placed in teeth from group C using dual cure resin luting cement (Duo-Link). All teeth (groups A-C) had the fragments re-attached using a same dual cure resin luting cement. in the bonded-only group, no additional preparation was made. After re-attachment of the fragment, teeth from groups buccal and circumferential chamfer groups had a 1.0 mm depth chamfer placed in the fracture line either on buccal surfaceor along the buccal and lingual surfaces, respectively. increments of microhybid composite resin (Tetric Ceram) were used in subgroups buccal chamfer and circumferential chamfer to restore the chamfer. The specimens were loaded until fracture in the same pre-determined area. The force required to detach each fragment was recorded and the data was subjected to a three-way analysis of variance where factors Group and Re-attachment technique are independent measures and Time of fracture is a repeated measure factor (first and second) and Tukey`s test (alpha = 0.05). Results: The main factors Re-attachment technique (p = 0.04) and Time of fracture (p = 0.02) were statistically significant. The buccal and circumferential chamfer techniques were statistically similar (p > 0.05) and superior to the bonded-only group (p < 0.05). The first time of fracture was statistically superior to second time of fracture (p < 0.001). Conclusions: The use of fiber post is not necessary for the reinforcement of the tooth structure in re-attachment of endodontically treated teeth. When bonding a fractured fragment, the buccal or circumferential re-attachment techniques should be preferable in comparison with the simple re-attachment without any additional preparation. None of the techniques used for re-attachment restored the fracture strength of the intact teeth. (C) 2008 Elsevier Ltd. All rights reserved.

Effect of supplementation of soft drinks with green tea extract on their erosive potential against dentine

Background: Matrix metalloproteinase (MMP) inhibitors reduce dentine erosion. This in vitro study evaluated the effect of the supplementation of soft drinks with green tea extract, a natural inhibitor of MMPs, on their erosive potential against dentine. Methods: For each drink tested (Coca-Cola (TM), Kuat (TM) guarana, Sprite (TM) and light Coca-Cola (TM)), 40 dentine specimens were divided into two subgroups differing with respect to supplementation with green tea extract at 1.2% (OM24 (R), 100% Camellia sinensis leaf extract, containing 30 +/- 3% of catechin; Omnimedica, Switzerland) or not (control). Specimens were subjected to four pH cycles, alternating de-and remineralization in one day. For each cycle, samples were immersed in pure or supplemented drink (10 minutes, 30 mL per block) and in artificial saliva (60 minutes, 30 mL per block) at 37 degrees C, under agitation. Dentine alterations were determined by profilometry (mu m). Data were analysed by two-way ANOVA and Bonferroni`s test (p < 0.05). Results: A significant difference was observed among the drinks tested with Sprite (TM) leading to the highest surface loss and light Coca-Cola (TM) to the lowest. Supplementation with green tea extract reduced the surface loss by 15% to 40% but the difference was significant for Coca-Cola (TM) only. Conclusions: Supplementation of soft drinks with green tea extract might be a viable alternative to reduce their erosive potential against dentine.

Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses

The extraction of teeth involves the elimination of extremely sensitive periodontal mechanoreceptors, which play an important role in oral sensory perception. Objectives: The aim of this study was to evaluate the recovery of interocclusal sensory perception for micro-thickness in individuals with different types of implant-supported prostheses. Materials and Methods: Wearers of complete dentures (CDs) comprised the negative control group (group A, n=17). The experimental group consisted of wearers of prostheses supported by osseointegrated implants (Group B, n=29), which was subsequently divided into 4 subgroups: B(1) (n=5) - implant supported overdentures (ISO) occluding with CD; B(2) (n=6) - implant-supported fixed prostheses (ISFP) occluding with CD; B3 (n=8) - wearers of maxillary and mandibular ISFP, and B(4) (n=10) - ISFP occluding with natural dentition (ND). Individuals with ND represented the positive control group (Group C, n=24). Aluminum foils measuring 10 mu m, 24 mu m, 30 mu m, 50 mu m, 80 mu m, and 104 mu m thickness were placed within the premolar area, adding up to 120 tests for each individual. Results: The mean tactile thresholds of groups A, B(1), B(2), B(3), B(4), and C were 92 mu m, 27 mu m, 27 mu m, 14 mu m, 10 mu m, and 10 mu m, respectively. [Correction added after publication online 18 April 2008: in the preceding sentence 92 mu m, 27 mu m, 14 mu m, 10 mu m and 10 mu m, was corrected to 92 mu m, 27 mu m, 27 mu m, 14 mu m, 10 mu m and 10 mu m.] The Kruskal-Wallis test revealed significant difference among groups (P < 0.05). The Dunn test revealed that group A was statistically different from groups C, B(3), and B(4), and that B(1) and B(2) were statistically different from group C. Conclusion: Progressive recovery of osseoperception as a function of the combination of implant-supported prostheses could be observed. Moreover, ISO and/or ISFP combinations may similarly maximize the recovery of osseoperception.

Association between sleep bruxism and temporomandibular disorders: A polysomnographic pilot study

The aim of this study was to verify the association between sleep bruxism (SB) and temporomandibular disorders (TMD) in a sample of 14 TMD patients and 12 healthy control subjects. All participants were evaluated using a clinical questionnaire, visual analog scale (VAS) for TMJ/muscle palpation, and by functional examination. The experimental group was divided into three TMD subgroups: joint sounds and pain, muscular tenderness, and mixed diagnosis. All participants underwent polysomnographic recording (PSG). A second clinical examination was then carried out to verify the relationship between rhythmic masticatory muscle activity and pain/tenderness on the following morning. e experimental and control groups presented VAS mean scores of 36.85 +/- 23.73 mm and 0 mm, respectively. The presence of SB was neither associated with TMD (p>0.05) nor with pain on palpation (p>0.05). Further research with a more representative sample of each TMD subgroup is necessary to elucidate its interaction with SB.

Long-term stability of surgical-orthodontic open-bite correction

Introduction: The objective of this study was to evaluate the long-term stability of open-bite surgical-orthodontic correction. Methods: Thirty-nine patients at an initial mean age of 20.83 years were evaluated cephalometrically at pretreatment (T1), immediately after treatment (T2), and at the last recall (T3), with a mean follow-up time of 8.22 years. The surgical protocol included single-jaw or double-jaw surgery. Because the patients had different anteroposterior malocclusions, the sample was divided into a Class I and Class II (I-II) subgroup (3 Class I, 20 Class II malocclusion patients) and a Class III subgroup (16 patients). The dentoskeletal characteristics of the total sample and the subgroups were compared at T1, T2, and T3 with dependent analysis of variance (ANOVA). Results: Overbite relapse in the posttreatment period was statistically significant in the whole sample and the Class I-II subgroup. Fourteen patients of the whole sample (35.9%) had clinically significant open-bite relapse (negative overbite). Conclusions: There was a statistically significant open-bite relapse in the overall sample and in the Class I-II subgroup. The clinically significant values of long-term open-bite correction stability were 64.11%, 47.82%, and 87.50% in the overall sample, the Class I-II subgroup, and the Class III subgroup, respectively. (Am J Orthod Dentofacial Orthop 2010;138:254.e1-254.e10)

Effect of erbium:yttrium-aluminum-garnet laser energies on superficial and deep dentin microhardness

This study evaluated the microhardness of superficial and deep dentin irradiated with different erbium:yttrium-aluminum-garnet (Er:YAG) laser energies. Seventy-two molars were bisected and randomly assigned to two groups (superficial dentin or deep dentin) and into six subgroups (160 mJ, 200 mJ, 260 mJ, 300 mJ, 360 mJ, and control). After irradiation, the cavities were longitudinally bisected. Microhardness was measured at six points (20 A mu m, 40 A mu m, 60 A mu m, 80 A mu m, 100 A mu m, and 200 A mu m) under the cavity floor. Data were submitted to analysis of variance (ANOVA) and Fisher`s tests (alpha = 0.05). Superficial dentin presented higher microhardness than deep dentin; energy of 160 mJ resulted in the highest microhardness and 360 mJ the lowest one. Values at all points were different, exhibiting increasing microhardness throughout; superficial dentin microhardness was the highest at 20 A mu m with 160 mJ energy; for deep dentin, microhardness after irradiation at 160 mJ and 200 mJ was similar to that of the control. The lowest energy increased superficial dentin microhardness at the closest extent under the cavity; deep dentin microhardness was not altered by energies of 160 mJ and 200 mJ.

Ultrastructural Analysis of Radicular Dentine Surface Submitted to CO(2) Laser at Different Parameters

Background: There are no reported studies comparing different parameter settings of the CO(2) laser and irradiation direction considering their effect on the morphology of radicular dentine surface. Purpose: To evaluate the alterations of radicular dentine (cervical, middle, and apical thirds) irradiated with CO(2) laser at different potencies and irradiation directions. Study Design: Roots of 35 canines were prepared and randomly distributed according to the laser potency: GI: no laser treatment (control) (n = 5); GII, 2 W (n = 10); GIII: 4 W (n = 10); GIV: 6 W (n = 10). Each group (excepting GI) was divided in two subgroups according to the irradiation distance (n = 5): (A) parallel and (B) perpendicular to the root canal walls. The roots were splited longitudinally and analyzed by scanning electron microscopy in a qualiquatitative way. The scores were submitted to Kruskal-Wallis and Dunn`s tests. Results: No significant statistical differences were observed among root canal thirds (P > 0.05). The specimens irradiated with 2 W were statistically different (P < 0.05) from those irradiated with 4 and 6 W, which were statistically similar between themselves (P > 0.05). With 2, 4, and 6 W at in parallel irradiation and 2 W in perpendicular direction, the surface showed a fissured aspect. With 4 W in perpendicular direction and 6 W in parallel and perpendicular direction, surface was modified by laser action and exhibited fused areas. Conclusions: The intensity of the effects is dependent on the laser-irradiation dosimetries. Alterations were more intense when higher parameters were used. Microsc. Res. Tech. 72:737-743, 2009. (C) 2009 Wiley-Liss, Inc.

Evaluation of several protocols for the application of ultrasound during the removal of cast intraradicular posts cemented with zinc phosphate cement

To evaluate several protocols for the application of ultrasound during removal of cast posts with varying core configurations cemented with zinc phosphate. Sixty maxillary canines were distributed into three groups (n = 20): group 1 - core with 5 mm diameter/height and post diameter of 1.3 mm; groups 2 and 3 - core with the same diameter as the post (1.3 mm) and heights of 5 mm and 3 mm, respectively. Posts/cores were cemented using a standard technique with zinc phosphate cement. Each group was divided into two subgroups according to the ultrasonic vibration mode: point vibration - ultrasonic vibration applied to the core surface for 5 s, on each face totalling 25 s; alternate vibration - intermittent application of ultrasonic vibration for 10 s to the labial and lingual surfaces, 10 s to the mesial and distal surfaces and 5 s to the incisal surface, totalling 25 s. The specimens were submitted to the tensile test using an Instron machine (1 mm min(-1)) and results were analysed by anova and t-test. The failure type was also analysed. Statistical analysis showed significant differences between groups relating to the core preparations (P < 0.05). The lowest mean values of traction force were obtained for group 3 (46.1 +/- 7.7 N), followed by group 2 (89.0 +/- 2.7 N) and group 1 (160.4 +/- 7.5 N). Regarding ultrasonic vibration, the lowest mean was observed with alternate vibration (81.1 +/- 10.1 N), which was significantly lower than the point vibration (115.9 +/- 9.5 N) (P < 0.05). Cohesive failure occurred in all cases. A reduction in core diameter/height and intermittent ultrasonic application improved the removal of cast posts cemented with zinc phosphate.

IN VITRO FRACTURE RESISTANCE OF GLASS-FIBER AND CAST METAL POSTS WITH DIFFERENT LENGTHS

Statement of problem. Dental fractures can occur in endodontically treated teeth restored with posts. Purpose. The purpose of this study was to evaluate the in vitro fracture resistance of roots with glass-fiber and metal posts of different lengths. Material and methods. Sixty endodontically treated maxillary canines were embedded in acrylic resin, except for 4 mm of the cervical area, after removing the clinical crowns. The post spaces were opened with a cylindrical bur at low speed attached to a surveyor, resulting in preparations with lengths of 6 mm (group 6 mm), 8 mm (group 8 mm), or 10 mm (group 10 mm). Each group was divided into 2 subgroups according to the post material: cast post and core or glass-fiber post (n=30). The posts were luted with dual-polymerizing resin cement (Panavia F). Cast posts and cores of Co-Cr (Resilient Plus) crowns were made and cemented with zinc phosphate. Specimens were subjected to increasing compressive load (N) until fracture. Data were analyzed with 2-way ANOVA and the Tukey-Kramer test (alpha=.05). Results. The ANOVA analysis indicated significant differences (P<.05) among the groups, and the Tukey test revealed no significant difference among the metal posts of 6-mm length (26.5 N +/- 13.4), 8-mm length (25.2 N +/- 13.9), and 10-mm length (17.1 N +/- 5.2). Also, in the glass-fiber post group, there was no significant difference when posts of 8-mm length (13.4 N +/- 11.0) were compared with the 6-mm (6.9 N +/- 4.6) and 10-mm (31.7 N +/- 13.1) groups. The 10-mm-long post displayed superior fracture resistance, and the 6-mm-long post showed significantly lower mean values (P<.001). Conclusions. Within the limitations of this study, it was concluded that the glass-fiber post represents a viable alternative to the cast metal post, increasing the resistance to fracture of endodontically treated canines. (J Prosthet Dent 2009;101:183-188)

Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups

The research diagnostic criteria for temporomandibular disorders (RDC/TMD) are used for the classification of patients with temporomandibular disorders (TMD). Surface electromyography of the right and left masseter and temporalis muscles was performed during Maximum teeth clenching in 103 TMD patients subdivided according to the RDC/TMD into 3 non-overlapping groups: (a) 25 myogenous; (b) 61 arthrogenous; and (c) 17 psycogenous patients. Thirty-two control subjects matched for sex and age were also measured. During clenching, standardized total muscle activities (electromyographic potentials over time) significantly differed: 131.7 mu V/mu V s % in the normal subjects, 117.6 mu V/mu V s % in the myogenous patients, 105.3 mu V/mu V s % in the arthrogenous patients, 88.7 mu V/mu V s % in the psycogenous patients (p < 0.001, analysis of covariance). Symmetry in the temporalis muscles was larger in normal subjects (86.3%) and in myogenous patients (84.9%) than in arthrogenous (82.7%), and psycogenous patients (80.5%) (p=0.041). No differences were found for masseter muscle symmetry and torque coefficient (p>0.05). Surface electromyography of the masticatory muscles allowed an objective discrimination among different RDC/TMD subgroups. This evaluation could assist conventional clinical assessments. (C) 2007 Elsevier Ltd. All rights reserved.

Influence of Filling Materials on the Bonding Interface of Thin-walled Roots Reinforced with Resin and Quartz Fiber Posts

Introduction: A common complication during the restoration of severely destroyed teeth is the loss of coronal root dentine. The aim of this study was to evaluate the influence of different sealers on the bonding interface of weakened roots reinforced with resin and fiber posts. Methods: Sixty extracted maxillary canines were used. The crowns were removed, and the thickness of root dentine was reduced in the experimental (n = 40) and positive control (n = 10) groups. The specimens of experimental group were assigned to four subgroups (n = 10) according to the filling material: gutta-percha + Grossmann`s sealer, gutta-percha + AH Plus (Dentsply De Trey Gmbh, Konstanz, Germany), gutta-percha + Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon (Resilon Research LLC, Madison, CT) + Epiphany. In the negative control group (n = 10), canals were not filled. After post space preparation, the roots were restored with composite resin light-activated through a translucent fiber post. After 24 hours, specimens were transversally sectioned into 1-mm-thick slices. Push-out test and scanning electron microscopic (SEM) analyses of different regions were performed. Data from push-out test were analyzed by using Tukey post hoc multiple comparison tests. The percentage of failure type was calculated. Data from SEM analysis were compared by Friedman and Kruskal-Wallis tests (alpha = 0.05). Results: The mean bond strength was significantly higher in the negative control group as compared with the other groups (P < .05). In all groups, the most frequent type of failure was adhesive. Overall, apical and middle regions presented a lower density of resin tags than the coronal region (P < .05). Conclusions: The push-out bond strength was not affected by sealer or region. The canal region affected significantly the resin tag morphology and density at the bonding interface. (J Endod 2011;37:531-537)

Effect of repeated torque/mechanical loading cycles on two different abutment types in implants with internal tapered connections: an in vitro study

Internal tapered connections were developed to improve biomechanical properties and to reduce mechanical problems found in other implant connection systems. The purpose of this study was to evaluate the effects of mechanical loading and repeated insertion/removal cycles on the torque loss of abutments with internal tapered connections. Sixty-eight conical implants and 68 abutments of two types were used. They were divided into four groups: groups 1 and 3 received solid abutments, and groups 2 and 4 received two-piece abutments. In groups 1 and 2, abutments were simply installed and uninstalled; torque-in and torque-out values were measured. In groups 3 and 4, abutments were installed, mechanically loaded and uninstalled; torque-in and torque-out values were measured. Under mechanical loading, two-piece abutments were frictionally locked into the implant; thus, data of group 4 were catalogued under two subgroups (4a: torque-out value necessary to loosen the fixation screw; 4b: torque-out value necessary to remove the abutment from the implant). Ten insertion/removal cycles were performed for every implant/abutment assembly. Data were analyzed with a mixed linear model (P <= 0.05). Torque loss was higher in groups 4a and 2 (over 30% loss), followed by group 1 (10.5% loss), group 3 (5.4% loss) and group 4b (39% torque gain). All the results were significantly different. As the number of insertion/removal cycles increased, removal torques tended to be lower. It was concluded that mechanical loading increased removal torque of loaded abutments in comparison with unloaded abutments, and removal torque values tended to decrease as the number of insertion/removal cycles increased. To cite this article:Ricciardi Coppede A, de Mattos MdaGC, Rodrigues RCS, Ribeiro RF. Effect of repeated torque/mechanical loading cycles on two different abutment types in implants with internal tapered connections: an in vitro study.Clin. Oral Impl. Res. 20, 2009; 624-632.doi: 10.1111/j.1600-0501.2008.01690.x.

Influence of NaHCO(3) Powder on Translucency of Microfilled Composite Resin Immersed in Different Mouthrinses

The regular use of mouthrinses, particularly when combined with the use of air-powder polishing, could affect the appearance of tooth-colored restorations. The current study sought to evaluate the effect of NaHCO(3) powder on translucency of a microfilled composite resin immersed in different mouthrinses, at distinct evaluation periods. Eighty disk-shaped specimens of composite resin (Durafill VS, Heraeus Kulzer GmbH & Co. KG, Hanau, Germany) were prepared. The composite specimens were then randomly allocated into two groups according to the surface treatment: exposure to NaHCO(3) powder (10 seconds) or nonexposure, and they were randomly assigned into four subgroups, according to the mouthrinses employed (N = 10): Periogard (Colgate/Palmolive, Sao Bernardo do Campo, SP, Brazil), Cepacol (Aventis Pharma, Sao Paulo, SP, Brazil), Plax (Colgate/Palmolive), and distilled water (control group). The samples were immersed for 2 minutes daily, 5 days per week, over a 4-month test period. Translucency was measured with a transmission densitometer at seven evaluation periods. Statistical analyses (analysis of variance and Tukey`s test) revealed that: distilled water presented higher translucency values (86.72%); Periogard demonstrated the lowest translucency values (72.70%); and Plax (74.05%) and Cepacol (73.32%) showed intermediate translucency values, which were statistically similar between them (p > 0.01). NaHCO(3) air-powder polishing increased the changes in translucency associated with the mouthrinses. Air-powder polishing alone had no effect on material translucency. Translucency percent was gradually decreased from 1 week of immersion up to 4 months. It may be concluded that the NaHCO(3) powder and the tested mouthrinses have affected the translucency of microfilled composite resin, according to the tested time. CLINICAL SIGNIFICANCE During the last decade, the demand for composite resin restorations has grown considerably, however, controversy persists regarding the effect of surface roughness on color stability.

Procalcitonin is useful in identifying bacteraemia among children with pneumonia

Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-alpha) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-alpha were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-alpha (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56-7.56), non-bacteraemic typical bacterial (1.47; 0.24-4.07), atypical bacterial (0.18; 0.06-1.03) and only viral (0.65; 0.11-2.22) subgroups was significant (p = 0.02). PCT was >= 2 ng/ml in 52 (33%) cases. The presence of IFN-alpha was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT >= 2 ng/ml was 95% (89-100%), 89% (78-100%), 93% (85-100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49-68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-alpha was uncommonly detected.