Interleukin-2 and interleukin-6 gene promoter polymorphisms, and early failure of dental implants

Single nucleotide polymorphisms in the promoter region of the human interleukin (IL)-2 (T-330G) and IL-6 (G-174C) genes have modified the transcriptional activity of these cytokines and are associated with several diseases. The aim of this study was to investigate the possible relationship between these single nucleotide polymorphisms and early implant failure. A sample of 74 nonsmokers was divided into 2 groups: test group comprising 34 patients (mean age 49.3 years) with ĝ‰¥1 implants that failed and control group consisting of 40 patients (mean age 43.8 years) with ĝ‰¥1 healthy implants. Genomic deoxyribonucleic acid from oral mucosa was amplified by polymerase chain reaction and analyzed by restriction fragment length polymorphism. Monte Carlo simulations (P < 0.05) were used to assess differences in allele and genotypes frequencies of the single nucleotide polymorphisms between the 2 groups. No significant differences were observed in the allele and genotypes distribution of both polymorphisms when the 2 groups were compared. The results indicate that polymorphisms in the IL-2 (T-330G) and IL-6 (G-174C) genes are not associated with early implant failure, suggesting that the presence of those single nucleotide polymorphisms does not constitute a genetic risk factor for implant loss in the studied population. Copyright © 2005 by Lippincott Williams & Wilkins.

Study of the effects of exposure to ionizing irradiation on the materials used for dental restoration

A quantitative study was made about the effects caused by ionizing irradiation on materials used for dental restoration (amalgams, compound resins and compomere), aiming to alleviate in bearers of head and neck cancer, the possible harmful effects of radiotherapy perceived when the repaired teething is within the radiation field. Research also encourages further studies for new alternative materials to be used in dental repair of patients submitted to radiotherapy for head and neck cancer. Test samples were submitted to a gamma radiation beam coming from a cobalt-therapy source and analyzed according to the X-ray fluorescence technique, comparing the chemical composition of the samples before and after irradiation. Radiation detectors such as an ionization chamber and a Geiger-Muller were used to measure the rate of residual dose. Gamma spectrometry with Nal detectors was also performed on the same samples. Results showed that there was no significant change in the chemical composition and that at post-irradiation, samples did not exhibit radiation emission, that is to say they had not become radioactive.

Experimental peri-implant tissue breakdown around different dental implant surfaces: Clinical and radiographic evaluation in dogs

Purpose: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. Materials and Methods: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. Results: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r 2 = 0.81; P = .014) and between mobility and vertical bone loss (r 2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. Discussion and Conclusions: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.

Relation between bruxism and dental implants

OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review. METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medline databases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled trials, in vitro studies, literature and systematic reviews, with or without meta-analysis, of the last 20 years that addressed the theme. Articles without abstracts, animal studies, articles in languages other than English and articles from journals unrelated to the dental field were excluded. RESULTS: after analysis according to inclusion and exclusion criteria, 28 articles were selected from a total of 54. It is known from the array of scientific articles which have assessed, either through retrospective, prospective or experimental studies, that the biomechanical and biological impact of bruxism on implant-supported prostheses is small, and that the literature has contributed little to exemplify the prosthetic limits of safety for the specialist from a clinical point of view. CONCLUSION: Although there is still no general consensus on this matter, most of the literature review articles do provide clinical guidelines that contribute to implant supported prostheses longevity and stability in patients with bruxism.

The effect of CO 2 laser irradiation on failed implant surfaces

The aim of this investigation was to evaluate the cleaning effect of CO 2 on surface topography and composition of failed dental implant surfaces. Ten failed dental implants were retrieved from nine patients (mean age, 46.33 ± 5.81 years) as a result of early or late failure. The implants were divided into two parts: one side of the implant was irradiated with a CO 2 laser (test side), while the other side did not receive irradiation (control side). The CO 2 laser was operated at 1.2 W in a continuous wave for 40 seconds (40 J energy). The handpiece of the CO 2 laser was kept at a distance of 30 mm from the implant surface, resulting in a spot area of 0.031415 cm 2 (38.20 W/cm 2; 1559 J/cm 2) in scanning mode (cervical-apical). One unused dental implant was used as a negative control for both groups. All implant surfaces were examined by scanning electron mi croscopy (SEM) and energy-dispersive spectrometer x-ray (EDS) for element analysis. SEM showed that the surface of the test sides consisted of different degrees of organic residues, appearing mainly as dark stains similar to those observed on the control sides. None of the test surfaces presented alterations such as crater-like alterations, lava-like layers, or melting compared with the nonirradiated surfaces. Foreign elements such as carbon, oxygen, sodium, calcium, and aluminum were detected on both sides. These results suggest that CO 2 laser irradiation does not modify the implant surface, although the cleaning effect was not satisfactory.

Histomorphometric evaluation of a threaded, sandblasted, acid-etched implant retrieved from a human lower jaw: A case report

The purpose of this study was to histomorphometrically evaluate the bone-to-implant contact and bone area around a titanium implant retrieved from a human lower jaw. A screw-shaped titanium implant (sandblasted and acid-etched surface) was removed from a 68-year-old male after having been in function for 40 months because of a fracture of the abutment screw. Following the implant removal, an undecalcified section was obtained. The histomorphometric analysis showed a rate of 75.40% of bone-to-implant contact and 89.30% of bone area filling within the limits of the implant threads. The surrounding bone healed in a well-organized pattern and could not be differentiated from the anginal alveolus. The histologic evidence showed a high degree of osseointegration in a threaded, sandblasted, and acid-etched implant retrieved from a human lower jaw after functional loading for 40 months. Copyright © 2005 by Lippincott Williams & Wilkins.

Effect of resin luting film thickness on fracture resistance of a ceramic cemented to dentin

Purpose: The aim of this study was to evaluate the fracture resistance of ceramic plates cemented to dentin as a function of the resin cement film thickness. Materials and Methods: Ceramic plates (1 and 2 mm thicknesses) were cemented to bovine dentin using resin composite cement. The film thicknesses used were approximately 100, 200, and 300 μm. Noncemented ceramic plates were used as control. Fracture loads (N) were obtained by compressing a steel indenter in the center of the ceramic plates. ANOVA and Tukey tests (α = 0.05) were used for each ceramic thickness to compare fracture loads among resin cement films used. Results: Mean fracture load (N) for 1-mm ceramic plates were: control - 26 (7); 100 μm - 743 (150); 200 μm - 865 (105); 300 μm - 982 (226). Test groups were significantly different from the control group; there was a statistical difference in fracture load between groups with 100 and 300 μm film thicknesses (p < 0.01). Mean fracture load for 2-mm ceramic plates were: control - 214 (111); 100 μm - 1096 (341); 200 μm - 1067 (226); 300 μm - 1351 (269). Tested groups were also significantly different from the control group (p < 0.01). No statistical difference was shown among different film thicknesses. Conclusions: Unluted specimens presented significantly lower fracture resistance than luted specimens. Higher cement film thickness resulted in increased fracture resistance for the 1-mm ceramic plates. Film thickness did not influence the fracture resistance of 2-mm porcelain plates. Copyright © 2007 by The American College of Prosthodontists.

Fatigue resistance of bovine teeth restored with resin-bonded fiber posts: Effect of post surface conditioning

This study evaluated the effect of post surface conditioning on the fatigue resistance of bovine teeth restored with resin-bonded fiber-reinforced composite (FRC). Root canals of 20 single-rooted bovine teeth (16 mm long) were prepared to 12 mm using a preparation drill of a double-tapered fiber post system. Using acrylic resin, each specimen was embedded (up to 3.0 mm from the cervical part of the specimen) in a PVC cylinder and allocated into one of two groups (n = 10) based on the post surface conditioning method: acid etching plus silanization or tribochemical silica coating (30 μm SiOx + silanization). The root canal dentin was etched (H2PO3 for 30 seconds), rinsed, and dried. A multi-step adhesive system was applied to the root dentin and the fiber posts were cemented with resin cement. The specimens were submitted to one million fatigue cycles. After fatigue testing, a score was given based on the number of fatigue cycles until fracture. All of the specimens were resistant to fatigue. No fracture of the root or the post and no loss of retention of the post were observed. The methodology and the results of this study indicate that tribochemical silica coating and acid etching performed equally well when dynamic mechanical loading was used.

Comparison of resin push-out strength to root dentin of bovine- and human-teeth

Aim : To compare the push-out strength of bovine- and human-root dentin and, thus, evaluate the suitability of bovine-root dentin to substitute human-root dentin for bond strength testing. Materials and Methods : Ten single-rooted human-teeth and ten bovine incisors were prepared using a #3 bur of a fiber post system (12 mm long). The posts were duplicated with resin cement (Duolink). The root canals were treated with All Bond 2 adhesive system and the resin posts were cemented using Duolink. The specimens were cut perpendicular to their long axis, yielding disc-specimens with 1.5 mm thickness, which were submitted to a push-out test (1 mm/min). Ten bond strength values per group (n = 10) were used for statistical analysis (Student t test, a =.05). Results : Statistically significant differences were found for the bond strength values between bovine- (4.1 1.3 MPa) and human-root dentin (8.6 5.7 MPa) (P =.0001). Conclusion : The push-out strengths of bovine- and human-root dentin were statistically different.

Effect of surface treatments on the bond strength of a resin cement to commercially pure titanium

Investigation of the effectiveness of surface treatments that promote a strong bond strength of resin cements to metals can contribute significantly to the longevity of metal-ceramic restorations. This study evaluated the effect of surface treatments on the shear bond strength (SBS) of a resin cement to commercially pure titanium (CP Ti). Ninety cast CP Ti discs were divided into 3 groups (n=30), which received one of the following airborne-particle abrasion conditions: (1) 50 μm Al2O3 particles; (2) 30 μm silica-modified Al2O3 particles (Cojet Sand); (3) 110 μm silica-modified Al2O3 particles (Rocatec). For each airborne-particle abrasion condition, the following post-airborne-particle abrasion treatments were used (n=10): (1) none; (2) adhesive Adper Single Bond 2; (3) silane RelyX Ceramic Primer. RelyX ARC resin cement was bonded to CP Ti surfaces. All specimens were thermally cycled before being tested in shear mode. Failure mode was determined. The best association was Rocatec plus silane. All groups showed 100% adhesive failure. There were combinations that promote higher SBS than the protocol recommended by the manufacturer of RelyX ARC.

Complete denture wearing and fractures among edentulous patients treated in university clinics

Objective: The prevalence of wearing and fracture of complete dentures was evaluated among edentulous patients treated in two dental schools in Brazil. Background: Acceptance and wearing of complete dentures are related to adaptive behaviour of edentulous patients. However, one reason that could interfere with the wearing dentures is their potential to fracture, which is still a common complication in denture rehabilitation practice. Material and methods: Two hundred and twenty-four edentulous patients rehabilitated with complete dentures from 2000 to 2005 in Araçatuba and Araraquara Dental School, University of State of São Paulo, were assessed in 2006 and 2007 to answer a questionnaire about wearing and fracture of their dentures. Statistical analysis were performed using Epi Info software and chi-squared test to compare maxillary and mandibular data (α = 0.05). Results: Almost 26% of the patients did not wear their dentures, and among the remainder, the majority wore the maxillary denture. About 30% of the dentures were fractured, with higher prevalence in the maxillary arch (p = 0.003). Conclusions: Discontinuation of wearing dentures was quite high, especially considering the treatment which was carried out in university clinics. Prevalence of fractures was also high, greater for the maxillary denture, and was one of the main reasons for non-wearing of complete dentures. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Effects of cement-curing mode and light-curing unit on the bond durability of ceramic cemented to dentin

The aim of this study was to evaluate the effects of different light-curing units and resin cement curing types on the bond durability of a feldspathic ceramic bonded to dentin. The crowns of 40 human molars were sectioned, exposing the dentin. Forty ceramic blocks of VITA VM7 were produced according to the manufacturer's recommendations. The ceramic surface was etched with 10% hydrofluoric acid/60s and silanized. The dentin was treated with37% phosphoric acid/15s, and the adhesive was applied. The ceramic blocks were divided and cemented to dentin according to resin cement/RC curing type(dual-and photocured), light-curing unit (halogen light/QTH and LED), and storage conditions (dry and storage/150 days + 12,000 cycles/thermocycling). All blocks were stored in distilled water (37°C/24h) and sectioned (n = 10): G1-QTH + RC Photo, G2-QTH + RC Dual, G3-LED + RC Photo, G4-LED + RC Dual. Groups G5, G6, G7, and G8 were obtained exactly as G1 through G4, respectively, and then stored and thermocycled. Microtensile bond strength tests were performed (EMIC), and data were statistically analyzed by ANOVA and Tukey's test (5%). The bond strength values (MPa) were: G1-12.95 (6.40)ab; G2-12.02 (4.59)ab; G3-13.09 (5.62)ab; G4-15.96 (6.32)a; G5-6.22 (5.90)c; G6-9.48 (5.99)bc; G7-12.78 (11.30)ab; and G8-8.34 (5.98)bc. The same superscript letters indicate no significant differences. Different light-curing units affected the bond strength betweenceramic cemented to dentin when the photocured cement was used, and only after aging (LED>QTH). There was no difference between the effects of dual-and photo-cured resin-luting agents on the microtensile bond strength of the cement used in this study.

Clinical fractures of veneered zirconia single crowns

Crowns made from an yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP) core with a porcelain veneer have shown high clinical failure rates. Manifestations of clinical failure in veneering ceramic ranges from a single chip to an extended fracture. Core failures are uncommon but usually are catastrophic. This article examines the possible causes of failure in zirconia systems and presents a case report involving the diagnosis and repair of three different types of failure in six 3Y-TZP/porcelain crowns.

Efeito da infiltração de sílica pelo método sol-gel na resistência à flexão de bicamadas de porcelana e Y-TZP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Proteins, Pathogens, and Failure at the Composite-Tooth Interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.