Instrumentation of dental implants: a literature review

The aim of this study was to review the literature on the systems used to decontaminate the implant's surface. Different instruments have been proposed, but there is no agreement in the literature about which methods would be more efficient with no damage to the implant surface. It was reported the use of plastic, carbon fiber, stainless-steel and titanium curettes and also the use of other systems such as ultrasonic points with different tips, rubber cups and air abrasion. Literature review: In most of the studies, the injury caused on the titanium surface at the time of instrumentation was examined. In others, the cell adhesion on the titanium dental implants following instrumentation of the implant surface was observed. Moreover, to enhance cleaning around implants, ultrasonic systems were recently tested. Conclusion: Metal instruments can lead to major damage to implant surface, therefore, they are not indicated for decontamination of dental implants surfaces. Furthermore, non-metallic instruments, such as plastic curettes, rubber cups, air abrasion and some ultrasonic systems seem to be better choices to remove calculus and plaque of the sub- and supra-gingival peri-implant area. It is noteworthy that more studies evaluating the effects of these systems are required to establish best practices to be used in the treatment of patients with dental implants.

Effect of Different Fluoride Concentrations of Experimental Dentifrices on Enamel Erosion and Abrasion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Treatment options for the occlusal surface of first permanent molars

Restorative dentistry has been increasingly concerned with preservation of the dental structure. For that reason, ultraconservative cavity preparations have been performed with air abrasion systems. The aim of this study was to present treatment options for the occlusal surface of first permanent molars with employment of the conventional method and the air abrasion system for accomplishment of the cavity preparation and a composite occlusal matrix for an accurate reproduction of the tooth surface.

Effect of surface treatments on the resin bond to zirconium-based ceramic

Purpose: This study tested the hypothesis that the tribochemical silica coating on ceramic surfaces increases the bond strength of resin cement to a glass-infiltrated zirconium-based ceramic. Materials and Methods: Fifteen blocks of In-Ceram Zirconia from CEREC InLab (5 per group) and 15 composite blocks (Z-250) 5 mm x 5 mm x 4 mm were made. The ceramic surfaces were polished, and the blocks were divided into three groups: (1) airborne abrasion with 110-μm aluminum oxide particles; (2) Rocatec system, tribochemical silica coating; and (3) CoJet system, tribochemical silica coating. The ceramic blocks were cemented to the composite blocks using Panavia F according to the manufacturer's specifications. All samples were stored in 37°C distilled water for 7 days and later sectioned in two axes using a diamond disk under cooling to obtain specimens with a cross-sectional area of approximately 1 mm2 (n = 45). Each specimen was then attached with cyanoacrylate glue to an adapted device for the microtensile test, which was carried out on a universal testing machine. Results: The results were subjected to ANOVA and Tukey's test. Group 2 (23.0 ± 6.7 MPa) and group 3 (26.8 ± 7.4 MPa) showed greater bond strength than group 1 (15.1 ± 5.3 MPa). There was no significant difference between groups 2 and 3. All failures were in the adhesive zone. Conclusion: The hypothesis was confirmed - the tribochemical systems increased the bond strength between Panavia F and In-Ceram Zirconia.

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 silica coating on flexural strength of fiber posts

Purpose: Fiber-reinforced composite (FRC) posts can be air-abraded to obtain good attachment to the resin cement. This study tested the effect of silica coating on the flexural strength of carbon, opaque, and translucent quartz FRC posts. Materials and Methods: Six experimental groups of FRC posts (n = 10 per group) were tested, either as received from the manufacturer or after chairside silica coating (30-μm CoJet-Sand). Results: There was no significant difference in the flexural strength of nonconditioned (504 to 525 MPa) and silica-coated (514 to 565 MPa) specimens (P > .05) (analysis of variance). The type of post did have a significant effect on flexural strength (P < .05). Conclusion: Chairside silica coating did not affect the flexural strength of both carbon and quartz FRC posts.

Microtensile bond strength of a resin cement to glass infiltrated zirconia-reinforced ceramic: The effect of surface conditioning

This study evaluated the effect of three surface conditioning methods on the microtensile bond strength of resin cement to a glass-infiltrated zirconia-reinforced alumina-based core ceramic. Thirty blocks (5×5×4 mm) of In-Ceram Zirconia ceramics (In-Ceram Zirconia-INC-ZR, VITA) were fabricated according to the manufacturer's instructions and duplicated in resin composite. The specimens were polished and assigned to one of the following three treatment conditions (n=10): (1) Airborne particle abrasion with 110 μm Al2O3 particles + silanization, (2) Silica coating with 110 μm SiOx particles (Rocatec Pre and Plus, 3M ESPE) + silanization, (3) Silica coating with 30 μm SiOx particles (CoJet, 3M ESPE) + silanization. The ceramic-composite blocks were cemented with the resin cement (Panavia F) and stored at 37 °C in distilled water for 7 days prior to bond tests. The blocks were cut under coolant water to produce bar specimens with a bonding area of approximately 0.6 mm2. The bond strength tests were performed in a universal testing machine (cross-head speed: 1 mm/min). The mean bond strengths of the specimens of each block were statistically analyzed using ANOVA and Tukey's test (α≤0.05). Silica coating with silanization either using 110 μm SiOx or 30 μm SiOx particles increased the bond strength of the resin cement (24.6±2.7 MPa and 26.7±2.4 MPa, respectively) to the zirconia-based ceramic significantly compared to that of airborne particle abrasion with 110-μm Al2O3 (20.5±3.8 MPa) (ANOVA, P<0.05). Conditioning the INC-ZR ceramic surfaces with silica coating and silanization using either chairside or laboratory devices provided higher bond strengths of the resin cement than with airborne particle abrasion using 110 μm Al2O3. © 2005 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Bond strength of a resin cement to high-alumina and zirconia-reinforced ceramics: The effect of surface conditioning

Purpose: The aim of this study was to evaluate the effect of two surface conditioning methods on the microtensile bond strength of a resin cement to three high-strength core ceramics: high alumina-based (In-Ceram Alumina, Procera AllCeram) and zirconia-reinforced alumina-based (In-Ceram Zirconia) ceramics. Materials and Methods: Ten blocks (5 ×6 × 8 mm) of In-Ceram Alumina (AL), In-Ceram Zirconia (ZR), and Procera (PR) ceramics were fabricated according to each manufacturer's instructions and duplicated in composite. The specimens were assigned to one of the two following treatment conditions: (1) airborne particle abrasion with 110-μm Al2O3 particles + silanization, (2) silica coating with 30 μm SiOx particles (CoJet, 3M ESPE) + silanization. Each ceramic block was duplicated in composite resin (W3D-Master, Wilcos, Petrópolis, RJ, Brazil) using a mold made out of silicon impression material. Composite resin layers were incrementally condensed into the mold to fill up the mold and each layer was light polymerized for 40 s. The composite blocks were bonded to the surface-conditioned ceramic blocks using a resin cement system (Panavia F, Kuraray, Okayama, Japan). One composite resin block was fabricated for each ceramic block. The ceramic-composite was stored at 37°C in distilled water for 7 days prior to bond tests. The blocks were cut under water cooling to produce bar specimens (n = 30) with a bonding area of approximately 0.6 mm2. The bond strength tests were performed in a universal testing machine (crosshead speed: 1 mm/min). Bond strength values were statistically analyzed using two-way ANOVA and Tukey's test (≤ 0.05). Results: Silica coating with silanization increased the bond strength significantly for all three high-strength ceramics (18.5 to 31.2 MPa) compared to that of airborne particle abrasion with 110-μm Al2O3 (12.7-17.3 MPa) (ANOVA, p < 0.05). PR exhibited the lowest bond strengths after both Al2O3 and silica coating (12.7 and 18.5 MPa, respectively). Conclusion: Conditioning the high-strength ceramic surfaces with silica coating and silanization provided higher bond strengths of the resin cement than with airborne particle abrasion with 110-μm Al2O3 and silanization.

Bond strength of acrylic teeth to denture base resin after various surface conditioning methods before and after thermocycling

This study aimed to evaluate the durability of adhesion between acrylic teeth and denture base acrylic resin. The base surfaces of 24 acrylic teeth were flatted and submitted to 4 surface treatment methods: SM1 (control): No SM; SM2: application of a methyl methacrylate-based bonding agent (Vitacol); SM3: air abrasion with 30-μm silicone oxide plus silane; SM4: SM3 plus SM2. A heat-polymerized acrylic resin was applied to the teeth. Thereafter, bar specimens were produced for the microtensile test at dry and thermocyled conditions (60 days water storage followed by 12,000 cycles). The results showed that bond strength was significantly affected by the SM (P < .0001) (SM4 = SM2 > SM3 > SM1) and storage regimens (P < .0001) (dry > thermocycled). The methyl methacrylate-based adhesive showed the highest bond strength.

Microtensile bond strength of a repair composite to leucite-reinforced feldspathic ceramic

The purpose of this study was to evaluate the microtensile bond strength of a repair composite resin to a leucite-reinforced feldspathic ceramic (Omega 900, VITA) submitted to two surface conditionings methods: 1) etching with hydrofluoric acid + silane application or 2) tribochemical silica coating. The null hypothesis is that both surface treatments can generate similar bond strengths. Ten ceramic blocks (6x6x6 mm) were fabricated and randomly assigned to 2 groups (n=5), according to the conditioning method: G1- 10% hydrofluoric acid application for 2 min plus rinsing and drying, followed by silane application for 30 s; G2- airborne particle abrasion with 30 μm silica oxide particles (CoJet-Sand) for 20 s using a chairside air-abrasion device (CoJet System), followed by silane application for 5 min. Single Bond adhesive system was applied to the surfaces and light cured (40 s). Z-250 composite resin was placed incrementally on the treated ceramic surface to build a 6x6x6 mm block. Bar specimens with an adhesive area of approximately 1 ± 0.1 mm2 were obtained from the composite-ceramic blocks (6 per block and 30 per group) for microtensile testing. No statistically significant difference was observed between G1 (10.19 ± 3.1 MPa) and G2 (10.17 ± 3.1 MPa) (p=0.982) (Student's t test; á = 0.05). The null hypothesis was, therefore, accepted. In conclusion, both surface conditioning methods provided similar microtensile bond strengths between the repair composite resin and the ceramic. Further studies using long-term aging procedures should be conducted.

Surface conditioning of a composite used for inlay/onlay restorations: Effect on μTBS to resin cement

Purpose: To assess the effect of the composite surface conditioning on the microtensile bond strength of a resin cement to a composite used for inlay/onlay restorations. Materials and Methods: Forty-two blocks (6 × 6 × 4 mm) of a microfilled composite (Vita VMLC) were produced and divided into 3 groups (N = 14) by composite surface conditioning methods: Gr1 - etching with 37% phosphoric acid, washing, drying, silanization; Gr2 - air abrasion with 50-l̀m Al2O3 particles, silanization; Gr3 - chairside tribochemical silica coating (CoJet System), silanization. Single-Bond (one-step adhesive) was applied on the conditioned surfaces and the two resin blocks treated with the same method were cemented using RelyX ARC (dual-curing resin cement). The specimens were stored for 7 days in water at 37°C and then sectioned to produce nontrimmed beam samples, which were submitted to microtensile bond strength testing (μTBS). For statistical analysis (one-way ANOVA and Tukey's test, · = 0.05), the means of the beam samples from each luted specimen were calculated (n = 7). Results: μTBS values (MPa) of Gr2 (62.0 ± 3.9a) and Gr3 (60.5 ± 7.9a) were statistically similar to each other and higher than Gr1 (38.2 ± 8.9b). The analysis of the fractured surfaces revealed that all failures occurred at the adhesive zone. Conclusion: Conditioning methods with 50-l̀m Al2O3 or tribochemical silica coating allowed bonding between resin and composite that was statistically similar and stronger than conditioning with acid etching.

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.

Shear bond strength of resin cement bonded to alumina ceramic after treatment by aluminum oxide sandblasting or silica coating

Purpose: To evaluate the shear bond strength and bond durability between a dual-cured resin cement (RC) and a high alumina ceramic (In-Ceram Alumina), subjected to two surface treatments. Materials and Methods: Forty disc-shaped specimens (sp) (4-mm diameter, 5-mm thick) were fabricated from In-Ceram Alumina and divided into two groups (n = 20) in accordance with surface treatment: (1) sandblasting by aluminum oxide particles (50 μm Al 2O 3) (SB) and (2) silica coating (30 μm SiO x) using the CoJet system (SC). After the 40 sp were bonded to the dual-cured RC, they were stored in distilled water at 37°C for 24 hours. After this period, the sp from each group were divided into two conditions of storage (n = 10): (a) 24 h-shear bond test 24 hours after cementation; (b) Aging-thermocycling (TC) (12,000 times, 5 to 55°C) and water storage (150 days). The shear test was performed in a universal test machine (1 mm/min). Results: ANOVA and Tukey (5%) tests noted no statistically significant difference in the bond strength values between the two surface treatments (p= 0.7897). The bond strengths (MPa) for both surface treatments reduced significantly after aging (SB-24: 8.2 ± 4.6; SB-Aging: 3.7 ± 2.5; SC-24: 8.6 ± 2.2; SC-Aging: 3.5 ± 3.1). Conclusion: Surface conditioning using airborne particle abrasion with either 50 μm alumina or 30 μm silica particles exhibited similar bond strength values and decreased after long-term TC and water storage for both methods. © 2011 by The American College of Prosthodontists.

Influência de protocolos de jateamento na rugosidade da superfície de uma cerâmica de zircônia tetragonal parcialmente estabilizada por ítria

Objective: To evaluate the influence of different air abrasion protocols on the surface roughness of an yttria-stabilized polycrystalline tetragonal zirconia) (Y-TZP) ceramic, as well as the surface topography of the ceramic after the treatment. Method: Fifty-four specimens (7.5×4×7.5mm) obtained from two ceramic blocks (LAVA, 3M ESPE) were flattened with fine-grit sandpaper and subjected to sintering in the ceramic system's specific firing oven. Next, the specimens were embedded in acrylic resin and the surfaces to be treated were polished in a polishing machine using sandpapers of decreasing abrasion (600- to 1,200-grit) followed by felt discs with 10μm and 3μm polishing pastes and colloidal silica. The specimens were then randomly assigned to 9 groups, according to factors particle and pressure(n=6): Gr1- control; Gr2- Al 2O 3(50μm)/2.5 bar; Gr3- Al 2O 3(110μm)/2.5 bar; Gr4- SiO 2(30μm)/2.5 bar; Gr5- SiO 2(30μm)/2.5 bar; Gr6- Al 2O 3(50μm)/3.5 bar; Gr7- Al2O3(110μm)/3.5 bar; Gr8- SiO 2(30μm)/3.5 bar; Gr9- SiO 2(30μm)/3.5 bar. After treatments, surface roughness was analyzed by a digital optical profilometer and the morphology was examined by scanning electron microscopy (SEM). Data (μm) were subjected to statistical analysis by Dunnett's test (5%), two-way ANOVA and Tukey's test (5%). Results: The type of particle (p=0.0001) and the pressure (p=0.0001) used in the air abrasion protocols influenced the surface roughness values among the experimental groups (ANOVA). The mean surface roughness values (μm) obtained for the experimental groups (Gr2 to Gr9) were, respectively: 0.37 D; 0.56 BC; 0.46 BC; 0.48 CD; 0.59 BC; 0.82 A; 0.53B CD; 0.67 AB. The SEM analysis revealed that Al 2O 3, regardless of the particle size and pressure used, caused damage to the surface of the specimens, as it produced superficial damages on the ceramic, in the form of grooves and cracks. Conclusion: Al2O3 (110 μm/3.5 bar) air abrasion promoted the highest surface roughness on the ceramics, but it does not mean that this protocol promotes better ceramic-cement union compared to the other air abrasion protocols.

Análise quantitativa das partículas de óxido de alumínio geradas na abrasão a ar em consultório odontológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)