Evaluation of the RB-RB/LB-LB mnemonic rule for recording optimally projected intraoral images of dental implants: an in vitro study

Objective: The aim of this study was to evaluate a simple mnemonic rule (the RB-RB/LB-LB rule) for recording intra-oral radiographs with optimal projection for the control of dental implants.Methods: 30 third-year dental students received a short lesson in the RB-RB/LB-LB mnemonic rule. The rule is as follows: if right blur then raise beam (RB-RB), i.e. if implant threads are blurred at the right side of the implant, the X-ray beam direction must be raised towards the ceiling to obtain sharp threads on both implant sides; if left blur then lower beam (LB-LB), i.e. if implant threads are blurred at the left side of the implant, the X-ray beam direction must be lowered towards the floor to obtain sharp threads on both implant sides. Intra-oral radiographs of four screw-type implants placed with different inclination in a Frasaco upper or lower jaw dental model (Frasaco GmbH, Tettnang, Germany) were recorded. The students were unaware of the inclination of the implants and were instructed to re-expose each implant, implementing the mnemonic rule, until an image of the implant with acceptable quality (subjectively judged by the instructor) was obtained. Subsequently, each radiograph was blindly assessed with respect to sharpness of the implant threads and assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable and (4) hopeless.Results: For all implants, from one non-perfect exposure to the following, a higher score was obtained in 64% of the cases, 28% received the same score and 8% obtained a lower score. Only a small variation was observed among exposures of implants with different inclination. on average, two exposures per implant (range: one to eight exposures) were needed to obtain a clinically acceptable image.Conclusion: The RB-RB/LB-LB mnemonic rule for recording intra-oral radiographs of dental implants with a correct projection was easy to implement by inexperienced examiners. Dentomaxillofacial Radiology (2012) 41, 298-304. doi: 10.1259/dmfr/20861598

Implant image quality in dental radiographs recorded using a customized imaging guide or a standard film holder

Objective: To compare a customized imaging guide and a standard film holder for obtaining optimally projected intraoral radiographs of dental implants.Material and methods: Intraoral radiographs of four screw-type implants with different inclination placed in an upper or lower dental phantom model were recorded by 32 groups of examiners after a short instruction in the use of the RB-RB/LB-LB mnemonic rule. Half of the examiners recorded the images using a standard film holder and the other half used a customized imaging guide. Each radiograph was assessed under blinded conditions with regard to rendering of the implant threads and was assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable, and (4) hopeless.Results: For the upper jaw, the same number of exposures per implant were made to achieve an acceptable image (P = 0.86) by the standard film holder method (median = 2) and the imaging guide method (median = 2). For the lower jaw, medians for the imaging guide method and the film holder method were 1 and 2, respectively (P = 0.004). For the imaging guide method, the first exposure was rated as perfect/acceptable in 62% of the cases and for the film holder method in 41% of the cases (P = 0.013). After <= 2 exposures, 78% (imaging guide method) and 69% (film holder method) of the implant images were perfect/acceptable (P=0.23). The implant inclination did not have a major influence on the outcomes.Conclusion: Perfect or acceptable images were achieved after two exposures with the same frequency either using a customized imaging guide method or a standard film holder method. However, the use of a customized imaging guide method was overall significantly superior to a standard film holder method in terms of obtaining perfect or acceptable images with only one exposure.

Comparison of Biomaterial Implants in the Dental Socket: Histological Analysis in Dogs

Background:Bone graft procedures have been used commonly in buco-maxillo-facial surgery. For this reason, many researchers have evaluated the bone substitutes.Purpose:The present study evaluated soft and hard tissue reactions to two different hydroxyapatites HAs (synthetic HA and natural HA) and bioactive glass implanted into the sockets immediately after extraction.Materials and Methods:First and third upper and lower premolars, on both sides, were extracted from six female dogs. The alveolar sockets were randomly assigned to four groups: Group 1 - control (unfilled), Group 2 - filled with synthetic hydroxyapatite, Group 3 - filled with bovine bone mineral (natural HA), and Group 4 - filled with bioactive glass. The animals were euthanized at 4 weeks (n = 2), 8 weeks (n = 2), and 28 weeks (n = 2) after extraction. The mandible and maxilla of each animal were removed for histological analysis to determine soft tissue reactions, newly formed bone, bone characteristics, and presence or absence of implanted materials.Results:Most particles of synthetic hydroxyapatite had bone formation on their surface, although some particles showed a layer of fibrous connective tissue. The bovine bone mineral group exhibited particles partially replaced with bone formation. The bioactive glass group showed particles with a thin layer of calcified tissue, but was absent in some specimens, suggesting complete resorption.Conclusion:All biomaterials had similar behavior. Bovine bone mineral, compared to synthetic hydroxyapatite and bioactive glass, showed a larger number of particles covered with osseous tissue. All biomaterials interfered with the socket repair process.

Tissue response to experimental dental cements prepared from a modified power glass composition

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Antimicrobial activity of disinfectant agents incorporated into type IV dental stone

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Development and application of methods for determination of residual monomer in dental acrylic resins using high performance liquid chromatography

Two high-performance liquid chromatographic methods for determination of residual monomer in dental acrylic resins are described. Monomers were detected by their UV absorbance at 230 nm, on a Nucleosil((R)) C-18 (5 mu m particle size, 100 angstrom pore size, 15 x 0.46 cm i.d.) column. The separation was performed using acetonitrile-water (55:45 v/v) containing 0.01% triethylamine (TEA) for methyl methacrylate and butyl methacrylate, and acetonitrile-water (60:40 v/v) containing 0.01% TEA for isobutyl methacrylate and 1,6-hexanediol dimethacrylate as mobile phases, at a flow rate of 0.8 mL/min. Good linear relationships were obtained in the concentration range 5.0-80.0 mu g/mL for methyl methacrylate, 10.0-160.0 mu g/mL for butyl methacrylate, 50.0-500.0 mu g/mL for isobutyl methacrylate and 2.5-180.0 mu g/mL for 1,6-hexanediol dimethacrylate. Adequate assay for intra- and inter-day precision and accuracy was observed during the validation process. An extraction procedure to remove residual monomer from the acrylic resins was also established. Residual monomer was obtained from broken specimens of acrylic disks using methanol as extraction solvent for 2 h in an ice-bath. The developed methods and the extraction procedure were applied to dental acrylic resins, tested with or without post-polymerization treatments, and proved to be accurate and precise for the determination of residual monomer content of the materials evaluated. Copyright (c) 2005 John Wiley & Sons, Ltd.

A quantitative and qualitative evaluation of reports of clinical trials published in six Brazilian dental journals indexed in the Scientific Electronic Library Online (SciELO)

Introduction: Open access publishing is becoming increasingly popular within the biomedical sciences. SciELO, the Scientific Electronic Library Online, is a digital library covering a selected collection of Brazilian scientific journals many of which provide open access to full-text articles. This library includes a number of dental journals some of which may include reports of clinical trials in English, Portuguese and/or Spanish. Thus, SciELO could play an important role as a source of evidence for dental healthcare interventions especially if it yields a sizeable number of high quality reports. Objective: The aim of this study was to identify reports of clinical trials by handsearching of dental journals that are accessible through SciELO, and to assess the overall quality of these reports. Material and methods: Electronic versions of six Brazilian dental Journals indexed in SciELO were handsearched at www.scielo.br in September 2008. Reports of clinical trials were identified and classified as controlled clinical trials (CCTs - prospective, experimental studies comparing 2 or more healthcare interventions in human beings) or randomized controlled trials (RCTs - a random allocation method is clearly reported), according to Cochrane eligibility criteria. Criteria to assess methodological quality included: method of randomization, concealment of treatment allocation, blinded outcome assessment, handling of withdrawals and losses and whether an intention-to-treat analysis had been carried out. Results: The search retrieved 33 CCTs and 43 RCTs. A majority of the reports provided no description of either the method of randomization (75.3%) or concealment of the allocation sequence (84.2%). Participants and outcome assessors were reported as blinded in only 31.2% of the reports. Withdrawals and losses were only clearly described in 6.5% of the reports and none mentioned an intention-to-treat analysis or any similar procedure. Conclusions: The results of this study indicate that a substantial number of reports of trials and systematic reviews are available in the dental journals listed in SciELO, and that these could provide valuable evidence for clinical decision making. However, it is clear that the quality of a number of these reports is of some concern and that improvement in the conduct and reporting of these trials could be achieved if authors adhered to internationally accepted guidelines, e. g. the CONSORT statement.

Diametral tensile strength and film thickness of an experimental dental luting agent derived from castor oil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of Incorporation of Disinfectant Solutions on Setting Time, Linear Dimensional Stability, and Detail Reproduction in Dental Stone Casts

Purpose: The aim of this paper was to analyze the influence of incorporation of disinfectants during the cast die stone-setting time. Setting time, linear dimensional stability, and reproduction details on casts were measured.Materials and Methods: Die stone type IV specimens with disinfection solutions (sodium hypochlorite 1%, glutaraldehyde 2%, chlorhexidine 2%) were incorporated in two concentrations (50%, 100%). The detail reproduction, dimensional stability, and setting time were tested in accordance with ADA recommendations.Results: Disinfecting solutions promoted an increase in setting time compared to control; sodium hypochlorite was responsible for the highest setting time. The addition of undiluted sodium hypochlorite 1.0% led to contraction during setting, but the groups with 50% diluted sodium hypochlorite 1.0% and undiluted chlorhexidine 2.0% resulted in intermediate values compared to the other groups, thus matching the control. The others did not demonstrate any effect on expansion. For detail reproduction, it was observed that the control group presented results similar to the others, except those where sodium hypochlorite was added.Conclusions The addition of sodium hypochlorite in both dilutions significantly altered, negatively, all the evaluated properties. But the addition of glutaraldehyde and chlorhexidine did not promote any significant alterations in the evaluated properties.

Cytotoxicity of monomers, plasticizer and degradation by-products released from dental hard chairside reline resins

Objectives. The aim of this study was to evaluate the cytotoxic effect of the monomers isobutyl methacrylate (IBMA) and 1,6-hexanediol dimethacrylate (1,6-HDMA), the plasticizer di-n-butyl phthalate (DBP), and the degradation by-products methacrylic acid (MA) and benzoic acid (BA) on L929 cells. Based on previous investigations on the release of these compounds from hard chairside reline resins, a range of concentrations (mu mol/L) were selected for the cytotoxicity tests (IBMA, 5.491406.57; 1,6-HDMA, 1.2239.32; DBP, 1.12143.8; MA, 9.07581; BA, 3.19409).Methods. Cytotoxic effects were assessed using MTT and 3H-thymidine assays after the cells had been exposed to the test compounds at the given concentrations for 24h. Cytotoxicity was rated based on cell viability relative to controls (cells exposed to medium without test substances).Results. DNA synthesis activity was inhibited by all compounds. Mitochondrial dehydrogenase activity decreased in cells treated with monomers, plasticizer and MA by-product, whereas no cytotoxic effect was observed on contact with BA at the majority of concentrations tested. The ranges of suppression for 3H-thymidine assay were: IBMA, 2595%; 1,6-HDMA, 9598%; DBP, 4098%; MA, 9799%; BA, 5471%. For MTT assay, the ranges of suppression were: IBMA, 096%; 1,6-HDMA, 2689%; DBP, 1780%; MA, 5266%; BA, 027%. The 3H-thymidine assay was more sensitive than the MTT assay.Significance. This study evaluated the cytotoxicity of a wide range of concentrations of monomers (IBMA and 1,6-HDMA), plasticizer (DBP) and degradation by-products (MA and BA), including those expected to be released from hard chairside reline resins. The differences observed in the cytotoxicity of these compounds, along with other properties, may assist the dental practitioners in the selection of reline materials with improved service life performance and low risk of adverse reactions in patients who wear relined dentures.

Evaluation of mechanical properties of dental feldsphatic porcelains for metal and zirconia core

Studies has been reported a significant incidence of chipping of the feldspathic porcelain veneer in zirconia-based restorations. The purpose of this study was to compare the three-point flexural strength (MPa), Weibull parameters, Vickers hardness (VHN) and Vickers indentation fracture toughness (MPa/mm(1/2)) in feldspatic porcelains for metal and for zirconia frameworks. Bar specimens were made with the porcelains e.MaxCeram (EM) and VitaVM9 (V9) for zirconia core, and Duceragold (DG) and VitaVMK95 (VK) for metal core (n = 15). Kruskal-Wallis and Dun test were used for statistical analysis. There was no significant difference (p=0.31) among the porcelains in the flexural strength (Median = 73.2; 74.6; 74.5; 74.4). Weibull calculation presented highest reliability for VK (10.8) followed by em (7.1), V9 (5.7) and DG (5.6). Vickers hardness test showed that em (536.3), V9 (579.9) and VK (522.1) had no difference and DG (489.6) had the lowest value (p<.001). The highest fracture toughness was to VK (1.77), DG (1.58) had an intermediate value while V9 (1.33) and em (1.18) had the lowest values (p<.001). Despite of the suitable flexural strength, reliability and high hardness, the porcelains used to zirconia-based fixed dental prostheses showed lower fracture toughness values.