Histological findings following the use of a space-making device for bone reformation and implant integration in the maxillary sinus of primates

Background: Previous studies have shown that membrane elevation results in predictable bone formation in the maxillary sinus provided that implants can be placed as tent poles. In situations with an extremely thin residual crest which impairs implant placement, it is possible that a space-making device can be used under the sinus membrane to promote bone formation prior to placement of implants. Purpose: The present study was conducted to test the hypothesis that the use of a space-making device for elevation of the sinus membrane will result in predictable bone formation at the maxillary sinus floor to allow placement of dental implants. Materials and Methods: Eight tufted capuchin primates underwent bilateral sinus membrane elevation surgery, and a bioresorbable space-making device, about 6 mm wide and 6 mm in height, was placed below the elevated membrane on the sinus floor. An oxidized implant (Nobel Biocare AB, Gothenburg, Sweden) was installed in the residual bone protruding into the created space at one side while the other side was left without an implant. Four animals were sacrificed after 6 months of healing. The remaining four animals received a second implant in the side with a space-making device only and followed for another 3 months before sacrifice. Implant stability was assessed through resonance frequency analysis (RFA) using the Osstell™ (Osstell AB, Gothenburg, Sweden) at installation, 6 months and 9 months after the first surgery. The bone-implant contact (BIC) and bone area inside the threads (BA) were histometrically evaluated in ground sections. Results: Histologically there were only minor or no signs of bone formation in the sites with a space-making device only. Sites with simultaneous implant placement showed bone formation along the implant surface. Sites with delayed implant placement showed minor or no bone formation and/or formation of a dense fibrous tissue along the apical part of the implant surface. In the latter group the apical part of the implant was not covered with the membrane but protruded into the sinus cavity. Conclusions: The use of a space-making device, with the design used in the present study, does not result in bone formation at the sinus floor. However, membrane elevation and simultaneous placement of the device and an implant does result in bone formation at the implant surface while sites with implants placed 6 months after membrane elevation show only small amounts of bone formation. It is suggested that lack of stabilization of the device and/or a too extensive elevation of the membrane may explain the results. © 2009, Wiley Periodicals, Inc.

Evaluación de las metodologías de enseñanza-aprendizaje de la bioética en las facultades de odontología Brasileñas

Introduction. Bioethics is present in Dentistry and other health areas, as scientific research that results on profession progress, as in proper clinical attendance. The study consists on valuation of teaching-learning methods of Bioethical on Brazilian Dental Schools. Materials and methods. Data collect occurred by semi-structured questioners send by e-mail and correspondence. It was realized descriptive analysis of quantitative answers, and for qualitative answers, it was used content analysis, by categorical analysis technique in according to Bardin. Results. Among 182 Dental Schools actives in Brazil, only 57 (31.3%) showed bioethical discipline in its curricular grid. It was observed the discipline is teaching on theoretical form (77.8%). Principal forms of evaluation are: writing prove (100%) and seminaries (75%). Just 6.4% of professors use bibliographic references about bioethical faced to Odontology specifically. The majority of interviewed person (74.2%) considered that bioethics is related on the direct and indirect form with all others disciplines. In relation to importance of Bioethical on dental surgeon formation, 64.7% emphasized it in professional-patient relation. Conclusion. The Bioethics show teaching and practice method of conserver evaluation, and so, it's necessary others methods directed to reflection of actual problems in odontology area that contribute significantly on integral formation of dental surgeon. © Viguera Editores SL 2009.

A comparison of the film thickness of two adhesive luting agents and the effect of thermocycling on their microTBs to feldspathic ceramic.

The aim of the present study was to evaluate the effect of thermocycling (TC) on the microtensile bond strength (microTBS) of two luting agents to feldspathic ceramic and to measure their film thickness (FT). For the microTBS test, sixteen blocks (6.4 x 6.4 x 4.8 mm) were fabricated using a feldspathic ceramic, etched with 10% hydrofluoric acid, rinsed and treated with the silane agent. The ceramic blocks were divided into two groups (n= 8): Gr1: dual-cured resin cement and Gr2: flowable resin. The luting agents were applied on the treated surfaces. Microsticks (1 +/-0. 1mm2) were prepared and stored under two conditions: dry, specimens immediately submitted to the microTBS test, and TC (6,000 cycles; 5 degrees C-55 degrees C). The microTBS was evaluated using a universal testing machine (1 mm/min). The microTBS data (MPa) were submitted to two-way ANOVA and Tukey' test (5%). For the FT test (ISO 4049), 0.05 ml of each luting agent (n=8) was pressed between two Mylar-covered glass plates (150 N) for 180 seconds and light polymerized. FT was measured using a digital paquimeter (Model 727-2001). The data (mm) were submitted to one-way ANOVA. The luting cement did not influence the microTBS results (p= 0.4467). Higher microtensile bond values were found after TC (20.5 +/- 8.6 MPa) compared to the dry condition (13.9 +/- 4. 7MPa), for both luting agents. The luting agents presented similar film thicknesses: Gr1- 0.052 +/- 0.016 mm; Gr2-0.041 +/- 0.003 mm. The luting agents presented similar film thickness and microTBS values, in dry and TC conditions and TC increased the bond strength regardless of the luting agent.

Shear bond strength of orthodontic brackets bonded using halogen light and light-emitting diode at different debond times

The aim of this in vitro study was to compare the photoactivation effects of QTH (Quartz-Tungsten-Halogen) and LED (Light-Emitting Diode) on the SBS (Shear Bond Strength) of orthodontic brackets at different debond times. Seventy-two bovine lower incisors were randomly divided into two groups according to the photoactivation system used (QTH or LED). The enamel surfaces were conditioned with Transbond self-etching primer, and APC (Adhesive Pre-Coated) brackets were used in all specimens. Group I was cured with QTH for 20 s and Group II with LED for 10 s. Both groups were subdivided according to the different experimental times after bonding (immediately, 24 h and 7 days). The specimens were tested for SBS and the enamel surfaces were analyzed according to the Adhesive Remnant Index (ARI). The statistical analysis included the Tukey's test to evaluate the main effects of photoactivation and debond time on SBS. The Chi-square test was used to compare the ARI values found for each group, and no statistically significant difference was observed. The debond time of 7 days for QTH photoactivation showed statistically greater values of SBS when compared to the immediate and 24 h periods. There was no statistically significant difference between the QTH and LED groups immediately and after the 24 h period. In conclusion, bonding orthodontic brackets with LED photoactivation for 10 s is suggested because it requires a reduced clinical chair time.

Effect of hydrofluoric acid etching duration on the roughness and flexural strength of a lithium disilicate-based glass ceramic

The aim of this study was to examine the effect of different acid etching times on the surface roughness and flexural strength of a lithium disilicate-based glass ceramic. Ceramic bar-shaped specimens (16 mm x 2 mm x 2 mm) were produced from ceramic blocks. All specimens were polished and sonically cleaned in distilled water. Specimens were randomly divided into 5 groups (n=15). Group A (control) no treatment. Groups B-E were etched with 4.9% hydrofluoric acid (HF) for 4 different etching periods: 20 s, 60 s, 90 s and 180 s, respectively. Etched surfaces were observed under scanning electron microscopy. Surface profilometry was used to examine the roughness of the etched ceramic surfaces, and the specimens were loaded to failure using a 3-point bending test to determine the flexural strength. Data were analyzed using one-way ANOVA and Tukey's test (α=0.05). All etching periods produced significantly rougher surfaces than the control group (p<0.05). Roughness values increased with the increase of the etching time. The mean flexural strength values were (MPa): A=417 ± 55; B=367 ± 68; C=363 ± 84; D=329 ± 70; and E=314 ± 62. HF etching significantly reduced the mean flexural strength as the etching time increased (p=0.003). In conclusion, the findings of this study showed that the increase of HF etching time affected the surface roughness and the flexural strength of a lithium disilicate-based glass ceramic, confirming the study hypothesis.

Cyclosporine-a and bone density around titanium implants: A histometric study in rabbits

Aim: Cyclosporine A (CsA) is an immunosuppressive agent commonly used to prevent organ transplantation rejection. It has been demonstrated that CsA may negatively affect osseointegration around dental implants. Therefore, the aim of this study was to evaluate the effect of CsA administration on bone density around titanium dental implants. Materials and Methods: Fourteen New Zealand rabbits were randomly divided into 2 groups with seven animals each. The test group (CsA) received daily subcutaneous injection of CsA (10mg/kg body weight) and the control group (CTL) received saline solution by the same route of administration. Three days after the beginning of immunosuppressive therapy, one machined dental implant (7.00 mm in lenght and 3.75 mm in diameter) was inserted bilaterally at the region of the tibial methaphysis. After 4 and 8 weeks the animals were sacrificed and the histometrical procedures were performed to analyse the bone density around the first four threads of the coronal part of the implant. Results: A significant increase in the bone density was observed from the 4- to the 8 week-period in the control group (37.41% + 14.85 versus 58.23% + 16.38 - p <0.01). In contrast, bone density consistently decreased in the test group overtime (46.31% + 17.38 versus 16.28 + 5.08 - p <0.05). In the 8-week period, there was a significant difference in bone density between the control and the test groups (58.23 + 16.38 eand16.28 + 5.08 - p= 0.001). Conclusion: Within the limits of this study, long-term CsA administration may reduce bone density around titanium dental implants during the osseointegration process.

Biaxial flexural strength of CAD/CAM ceramics.

Aim of the study was to evaluate the biaxial flexural strength of ceramics processed using the Cerec inLab system. The hypothesis was that the flexural strength would be influenced by the type of ceramic. Ten samples (ISO 6872) of each ceramic (N.=50/n.=10) were made using Cerec inLab (software Cerec 3D) (Ø:15 mm, thickness: 1.2 mm). Three silica-based ceramics (Vita Mark II [VM], ProCad [PC] and e-max CAD ECAD]) and two yttria-stabilized tetragonal-zirconia-polycrystalline ceramics (Y-TZP) (e-max ZirCad [ZrCAD] and Vita In-Ceram 2000 YZ Cubes [VYZ]) were tested. The samples were finished with wet silicone carbide papers up to 1200-grit and polished in a polishing machine with diamond paste (3 μm). The samples were then submitted to biaxial flexural strength testing in a universal testing machine (EMIC), 1 mm/min. The data (MPa) were analyzed using the Kruskal-Wallis and Dunn (5%) tests. Scanning electronic microscopy (SEM) was performed on a representative sample from each group. The values (median, mean±sd) obtained for the experimental groups were: VM (101.7, 102.1±13.65 MPa), PC (165.2, 160±34.7 MPa), ECAD (437.2, 416.1±50.1 MPa), ZrCAD (804.2, 800.8±64.47 MPa) and VYZ (792.7, 807±100.7 MPa). The type of ceramic influenced the flexural strength values (P=0.0001). The ceramics ECADa, e-max ZrCADa and VYZa presented similar flexural strength values which were significantly higher than the other groups (PCb and VM IIb), which were similar statistically between them (Dunn's test). The hypothesis was accepted. The polycrystalline ceramics (Y-TZP) should be material chosen for make FPDs because of their higher flexural strength values.

Influence of the hybrid layer thickness and resin tag length on microtensile bond strength.

The purpose of this study was to evaluate the correlation between the hybrid layer thickness/resin tag length and the microtensile bond strength of conventional two-step adhesive system, when applied to healthy dentinal tissue. After performing the restorative adhesive procedures and tooth extractions, ten specimens were sectioned in the mesiodistal direction. One section was used for microscopic analysis of the resin tag lengths and the hybrid layer thickness, while the other was used for the microtensile bond strength test (0.5 mm/min). The fractured surface was classified according to the fracture pattern, under a stereoscopic microscope at 40x magnification. Data obtained were submitted to analysis using one-way ANOVA and Pearson's Correlation test (alpha=0.05). The means corresponding to the hybrid layer thickness, resin tag lengths and the microtensile test were 2.68 microm, 6.43 microm and 16.23 MPa, respectively. There was no correlation between the means of the values obtained for the microtensile test, and those presented by the hybrid layer (r2=0.40, p>0.05) and resin tags (r2=0.21, p>0.05). The microtensile bond strength of the conventional two-step adhesive system Adper Single Bond 2 did not depend on the thickness of the hybrid layer and length of resin tags.

Implant osseointegration in circumferential bone defects treated with latex-derived proteins or autogenous bone in dog's mandible

Background: In sites with diminished bone volume, the osseointegration of dental implants can be compromised. Innovative biomaterials have been developed to aid successful osseointegration outcomes. Purpose: The aim of this study was to evaluate the osteogenic potential of angiogenic latex proteins for improved bone formation and osseointegration of dental implants. Materials and Methods: Ten dogs were submitted to bilateral circumferential defects (5.0×6.3mm) in the mandible. Dental implant (3.3×10.0mm, TiUnite MK3™, Nobel Biocare AB, Göteborg, Sweden) was installed in the center of the defects. The gap was filled either with coagulum (Cg), autogenous bone graft (BG), or latex angiogenic proteins pool (LPP). Five animals were sacrificed after 4 weeks and 12 weeks, respectively. Implant stability was evaluated using resonance frequency analysis (Osstell Mentor™, Osstell AB, Göteborg, Sweden), and bone formation was analyzed by histological and histometric analysis. Results: LPP showed bone regeneration similar to BG and Cg at 4 weeks and 12 weeks, respectively (p≥.05). Bone formation, osseointegration, and implant stability improved significantly from 4 to 12 weeks (p≤.05). Conclusion: Based on methodological limitations of this study, Cg alone delivers higher bone formation in the defect as compared with BG at 12 weeks; compared with Cg and BG, the treatment with LPP exhibits no advantage in terms of osteogenic potential in this experimental model, although overall osseointegration was not affected by the treatments employed in this study. © 2009 Wiley Periodicals, Inc.

Degree of conversion of polymer-matrix composite assessed by FTIR analysis

Aims and objectives: The behavior of polymer-matrix composite is dependent on the degree of conversion. The aim of this study was to evaluate the degree of conversion of two resin cements following storage at 37°C immediately, 24 and 48 hours, and 7 days after light-curing by FTIR analysis. Materials and methods: The specimens were made in a metallic mold and cured with blue LED with power density of 500 mW/cm2 for 30 seconds. The specimens were pulverized, pressed with KBr and analyzed with FTIR following storage times. Statistical analysis used: ANOVA (two-way) and Tukey's post hoc. Results: To the polymer-matrix composites between 24 and 48 hours does not show a significant increase (p > 0.05), however, the highest values were found after 7 days. Conclusion: The polymer-matrix composites used in this study showed similarity on the degree of conversion and increased of according to the time of storage.

Precisão das técnicas de moldagem e vazamento para próteses implantossuportadas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise rugosimétrica de duas cerâmicas odontológicas submetidas a diferentes tratamentos de superfície

Pós-graduação em Reabilitação Oral - FOAR

Avaliação tridensional da precisão das técnicas de moldagem para próteses implantossuportadas sobre pilares alinhados e não-alinhados

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Streptococcus Mutans Photoinactivation by Combination of Short Exposure of a Broad-Spectrum Visible Light and Low Concentrations of Photosensitizers

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

In vitro reduction of Streptococcus mutans biofilm on silver nanoparticle-modified resin composite

Introduction: Currently, new methods to reduce biofilm formation on biomaterials are very studied, for example the use of silver nanoparticles, which were bactericidal. However, there are few studies investigating the benefits of these particles in dental restorative materials. Objective: This study aimed to compare in vitro the Streptococcus mutans biofilm formation on conventional light-cured composite resin with that on experimental light-cured composite resin, modified with silver nanoparticles. Material and methods: Discs were produced with either conventional resin (control group) and resin modified with different concentrations of silver nanoparticles, 0.1%, 0.3% and 0.6 % wt. (groups 1, 2 and 3, respectively). The samples were incubated in bacterial suspension (S. mutans) enriched with 20% sucrose to promote biofilm growth on the surfaces. Incubation times were 1, 4 and 7 days. After each period, adherent biofilms were disaggregated by ultrasound. Then, the numbers of viable cells recovered from the biofilms were counted through the serial dilution method. A morphological analysis of biofilm was also performed by Scanning Electron Microscopy. The data were subjected to Anova and Tukey’s test (α = 0.05). Results: The number of viable cells was statistically lower in groups 2 and 3 than in group 1 and control group, after the three incubation periods, without statistical difference between groups 2 and 3. The number of viable cells was statistically lower in group 1 than in control group, after 4 and 7 days of incubation. Conclusion: Resins modified with silver presented reduction of S. mutans biofilm on their surfaces, according to the conditions of this study.