Immediate X delayed loading dental implants: An overview

The aim of this investigation was to accomplish an overview about the principles of the indication and of the success parameters involving immediate and delayed loading dental implants procedures. Studies about the philosophies (immediate and delayed loading dental implants) and their clinical indications will be discussed in order to overview the rules for the clinical success in both techniques. In addition, studies regarding the criteria for immediate loading implants as primary stabilization, surface treatments and bone density and amount will be also analyzed. More important than the philosophy selection, is how and when to use it according to biomechanical rules and principles. Among the vast limitations pointed by the literature regarding procedures of immediate and delayed loading are evidenced the parafunctional habits, primary stabilization, bone quality, surface treatments and the number of dental implants. The anterior region of the jaw seems to be associated with a major percentage of satisfactory results, regardless of rehabilitation procedures. Although several studies have demonstrated high success rates for the immediate loading dental implants, several aspects remain without an explicit definition and further studies are needed to elucidate some reservations.

Interaction between total-etch and self-etch adhesives and conventional and self-adhesive resin cements

The aim of this study was to compare the bond strength to enamel between resin cements combined with total-etch and self-etch adhesive systems and a self-adhesive cement. Eighty bovine incisors had their buccal surface ground flat exposing a plane area in the enamel. Eighty Artglass resin cylinders measuring 3 mm in diameter and 4 mm in height were fabricated. The teeth were divided into eight groups of 10 teeth each and the resin cylinders were cemented with different adhesive systems and resin cements; G1: RelyX Unicem (self-adhesive cement); G2: H 3PO 4 + Single Bond + RelyX ARC; G3: AdheSE + Variolink II; G4: H 3PO 4 + Excite + Variolink II; G5: Xeno III + Enforce; G6: H 3PO 4 + Prime&Bond NT + Enforce; G7: Biatite Primers 1 and 2 + Bistite II DC; G8: H 3PO 4 + Bistite Primers 1 and 2 + Bistite II DC. After application of the adhesives, the cylinders were cemented according to manufacturer instructions. The specimens were submitted to 2000 thermal cycles at a temperature ranging from 5±5°C to 55±5°C, and shear bond strength was then tested at a variety of 1 mm/min. The data were analyzed by ANOVA and the Tukey's test (á=5%), obtaining a p value of 0.00. The following mean (±standard deviation) bond strength values were observed for each group: G1: 5.14(±0.99)a; G3: 16.23(±4.69)b; G7: 17.82(±3.66)b; G5: 18.48(±2.88)bc; G8: 20.15(±4.12)bc; G4: 22.85(±3.08)cd; G2: 24.96(±2.89)d; G6: 26.07(±1.69)d. Groups followed by the same letters did not differ significantly. For most of the resin cements tested, the application of adhesive systems using acid etching resulted in a higher bond strength when compared to the self-etch adhesive systems and to the self-adhesive cement.

Effect of an alcoholic diet on dental caries and on Streptococcus of the mutans group: Study in rats

The objective of this study was to evaluate the effects of an alcohol diet on Streptococcus of the mutans group and on dental caries in the oral cavity of rats. Forty animals were divided into 3 groups according to the following liquid diets: 20% ethanol solution (Alcohol Group, AG), 27% sucrose solution (Isocaloric Group, IG), and water (Control Group, CG). After 56 days, samples were collected and plated on Mitis Salivarius Bacitracin agar to assess the number of colony forming units (CFU/mL) of Streptococcus of the mutans group. The animals were sacrificed and the jaws were removed in order to assess the occurrence of dental caries on the smooth and occlusal surfaces using stereomicroscopy. The data were submitted to ANOVA and Tukey test. The average numbers of CFU/mL (10 3) were: 8.17 (AG), 9.78 (IG), and 5.63 (CG). There was no significant difference among the groups for the occurrence of occlusal caries. Regarding smooth surface caries, in the upper jaw, the caries number in the IG (1.58) was similar to that in the AG (2.06) and in the CG (1.14), and the number of caries in the AG was higher than in the CG; in the lower jaw there was significant difference among the 3 groups: AG (1.14), IG (2.00) and CG (0.43). The diets with the alcohol and sucrose solutions presented a tendency of increasing the colonization by Streptococcus of the mutans group and of increasing the occurrence of smooth surface dental caries in rat molars when compared to the control diet.

Investigation of photo-bleaching through transmittance method in pigmented solution: Understanding possible mechanisms and advantages for photo dental whitening

The dental bleaching is known for many years. Recently a technique employing light has open up new and exciting possibilities. Besides its vast application there are still many important points to be understood about teeth photon bleaching. In this work we present an in vitro experiment to explore the main mechanisms involved during the photon action in tooth whitening. Our results indicated that light at same wavelengths are great absorbed by pigments creating a local heating which considerably increase the bleaching rate. This results in a fast reaction without heating the whole dental structure. We discuss details of our experiment. Work supported by Fapesp and CNPq.

Background interference on the color of dental composite materials with different thickness by digital contrast

In this work the color dependence of resin composites with the background color was evaluated. The objective was to measure since what thickness the color of the sample stops being influenced by the color of the background over which the resin is placed and the methodology used in experiment was based in analyzing the contrast of digital images of the sample over a black background. The results shown that since 0.8 mm the images contrast becomes almost constant; it prove that since this thickness the color of resin composite depends on the optical resin properties only. The experiment was repeated under three conditions of luminosity to evaluate the influence of it on the image contrast and the results obtained were identical.

Effects of Coffea arabica on Streptococcus mutans adherence to dental enamel and dentine

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

Effects of hemostatic agents on the histomorphologic response of human dental pulp capped with calcium hydroxide

Objective: To evaluate the response of human pulps capped with a calcium hydroxide [Ca(OH)2] cement after bleeding control with 2 hemostatic agents. Method and Materials: Pulps were exposed on the occlusal floor, and the bleeding was controlled either with saline solution (SS) or 2.5% sodium hypochlorite (NaOCI) (SH). After that, the pulp was capped with Ca(OH) 2 cement and restored with resin composite. After 30 (groups SS30 and SH30) and 60 (groups SS60 and SH60) days, the teeth were extracted and processed with hematoxylin-eosin and categorized in a histologic score system. The data were subjected to Kruskal-Wallis and Mann-Whitney tests (α = .05). Results: Regarding dentin bridge formation, an inferior response of SH60 group was observed when compared to SS60 (P < .05). The response of the SH30 group generally was similar to that of the groups treated with saline solution. However, after 60 days, 2.5% NaOCl showed a trend toward having an inferior response. Conclusion: Using saline solution as a hemostatic agent before pulp capping with Ca(OH)2 resulted in a significantly better histomorphologic response than using 2.5% NaOCl as a hemostatic agent before capping with Ca(OH)2.

A survey of radiographic measurement estimation in assessment of dental implant length.

The aim of this study is to survey radiographic measurement estimation in the assessment of dental implant length according to dentists' confidence. A 19-point questionnaire with closed-ended questions was used by two graduate students to interview 69 dentists during a dental implant meeting. Included were 12 questions related to over- and underestimation in three radiographic modalities: panoramic (P), conventional tomography (T), and computerized tomography (CT). The database was analyzed by Epi-Info 6.04 software and the values from two radiographic modalities, P and T, were compared using a chi2 test. The results showed that 38.24% of the dentists' confidence was in the overestimation of measurements in P, 30.56% in T, and 0% in CT. On the other hand, considering the underestimated measurements, the percentages were 47.06% in P, 33.33% in T, and 1.92% in CT. The frequency of under- and overestimation were statistically significant (chi2 = 6.32; P = .0425) between P and T. CT was the radiographic modality with higher measurement precision according to dentists' confidence. In conclusion, the interviewed dentists felt that CT was the best radiographic modality when considering the measurement estimation precision in preoperative dental implant assessment.

Detection of Streptococcus mutans and Streptococcus sobrinus in dental plaque samples from Brazilian preschool children by polymerase chain reaction

The purposes of this study were to detect S. mutans and S. sobrinus by polymerase chain reaction (PCR) amplification, and to relate their presence to the incidence of dental caries in 42 Brazilian preschool children. Dental plaque samples were collected from the cervical margin of all erupted teeth of 5-6 years old children with primary dentition, using a sterile explorer. Examination of the dmft (decayed, missing, filled teeth) index, performed following the World Health Organization (WHO) caries diagnostic criteria, showed a 2.71 score. Prevalence of S. mutans and S. sobrinus was respectively, of 85.7% and 14.3%; no dental plaque sample was either positive or negative for both bacterial species. Children harboring either S. mutans or S. sobrinus presented the same caries prevalence. PCR showed good discriminative ability for differentiation between these species, and suggested that it is a technique suitable for epidemiological studies on mutans streptococci.

Dental age in patients with Down syndrome

The aim of this research was to evaluate dental age in 102 patients with Down Syndrome, using panoramic radiographs. A software program developed by the Discipline of Radiology, School of Dentistry of São José dos Campos, São Paulo State University (UNESP), was used. A table of mineralization chronology of permanent teeth among Brazilians conceived by Nicodemo, Moraes and Medici Filho was used within the software. Statistical analysis of the results showed that 70.91% of the males land 61.21% of the females presented advanced dental age. Only 32.09% of the males and 39.79% of the females presented delayed dental age. Regarding the differences between the dental and chronological ages, two thirds of the males and females presented dental age with differences of up to 12 months, which means that they can be considered to be within normal standards, whereas only 18.87% of the males and 10.21% of the females presented dental age outside normal standards, with differences of over 24 months. In conclusion, the majority of the patients with Down Syndrome were considered to be within the normal standards of mineralization chronology.

Influence of brush type as a carrier of adhesive solutions and paper points as an adhesive-excess remover on the resin bond to root dentin

Purpose: To evaluate the influence of the brush type as a earner of priming adhesive solutions and the use of paper points as a remover of the excess of these solutions on the push-out bond strength of resin cement to bovine root dentin. The null hypotheses were that brush type and the use of paper points do not affect the bond strength. Materials and Methods: The canals of 80 single-root bovine roots (16 mm in length) were prepared at 12 mm using the preparation drill (FRC Postec Plus, Ivoclar). Half of each root was embedded in acrylic resin and the specimens were divided into 8 groups, considering the factors brush type (4 levels) and paper point (2 levels) (n = 10): Gr 1: small microbrush (Cavi-Tip, SDI); Gr 2: Microbrush (Dentsply); Gr 3: Endobrush (Bisco); Gr 4: conventional brush (Bisco); Gr 5: Cavi-Tip (SDI) + paper points; Gr 6: Microbrush (Dentsply) + paper points; Gr 7: Endobrush (Bisco) + paper points; Gr 8: conventional brush (Bisco) + paper points. The root dentin was treated with a multistep total-etch adhesive system (All Bond 2). The adhesive system was applied using each microbrush, with and without using paper points. One fiber post was molded with addition silicon and 80 posts were made of resin cement (Duolink), The resin posts were luted (Duolink resin cement), and the specimens were stored for 24 h in water at 37°C. Each specimen was cut into 4 disk-shaped samples (1.8 mm in thickness), which were submitted to the push-out test. Results: The brush type (p < 0.0001) (small microbrush > microbrush = endobrush = conventional brush) and the use of paper points (p = 0.0001) (with > without) influenced the bond strength significantly (two-way ANOVA). The null hypotheses were rejected. Conclusion: The smallest brush (Cavi-Tip) and the use of paper points significantly improved the resin bond to bovine root dentin.

Influence of the power level of an ultra-sonic system on dental cavity preparation

The aim of this study was to evaluate the shape of dental cavities made with the CVDentus® system using different ultrasound power levels. One standard cavity was made on the buccal aspect of 15 bovine incisors with a CVDentus® cylindrical bur (82142). The sample was divided into three groups: G1 - ultrasound with power II; G2 - ultrasound with power III; and G3 - ultrasound with power IV. A standardizing device was used to obtain standardized preparations and ultrasound was applied during one minute in each dental preparation. The cavities were sectioned in the middle, allowing observation of the cavity's profile with a magnifying glass, and width and depth measurement using the Leica Qwin program. The Kruskal-Wallis (p < 0.05) and Dunn statistical analyses demonstrated differences between the dental cavity shapes when powers III and IV were used. However, the cavities that were made with power III presented dimensions similar to those of the bur used for preparation. We concluded that the power recommended by the manufacturer (III) is the most adequate for use with the CVDentus® system.

Effect of time in hardness test on artificially demineralized human dental enamel

A cross-sectional microhardness (CSMH) test was carried out in human dental enamel exposed to a demineralizing solution in order to evaluate two different times of indentation in sound tissue and artificially induced caries. Twenty caries-free extracted human molars had one of their smooth surfaces sectioned and the enamel surface was isolated with nail polish except for an area of 6 mm2. These specimens were submitted to artificially induced enamel caries on a lactate buffer containing 0.1 ppm fluoride (F) during 28 days. All specimens were bisected to create groups A and B in which CSMH test was performed employing a Knoop indenter with a 25g load for 5 or 10 s, respectively. Student's paired t-test (p<0.05) was used to determine statistically significant differences between group A and B in 7 depths. There were no significant differences between any of the analyzed depths. Since the present experiment showed no significant difference when comparing indentations made with a 25 g load during either 5 or 10 s in different depths, this method can be used with either one of the time intervals tested without compromising a CSMH test on artificially demineralized human enamel.

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.

Prevalence of dental trauma in patients with cerebral palsy

This study presents the findings of a record review that evaluated the prevalence of dental trauma in patients with cerebral palsy and evaluated its possible relationship with age, type of palsy, and epilepsy. The dental records of 2,200 patients with special needs admitted to the special care clinic of the School of Dentistry of Araçatuba/UNESP, Brazil, between 1998 and 2003 were reviewed. Of the records that were analyzed, 500 patients who had cerebral palsy were selected for this study. Information regarding age, gender, type of palsy and dental trauma was collected and statistically analyzed. It was observed that 10.6% of the subjects (n = 53) had sustained dental trauma. The number of traumatized teeth was 84. Enamel or enamel/dentin fractures were the most frequent types of traumatic injury (84.9%). The permanent maxillary central incisors were the most commonly affected teeth (50%). The frequency of traumatic injuries showed no significant correlation (p>.05) with the type of cerebral palsy or gender and they were more frequent in subjects between the ages of 0 and 12 years. Having epilepsy was not a statistically significant risk factor (p>.05) for dental trauma. © 2008 Special Care Dentistry.