The Effect of Splint Material Rigidity in Implant Impression Techniques

Purpose This in vitro study compared the dimensional accuracy of two impression techniques Duralay splinted impression copings (D) and metal splinted impression copings (M) for implant supported pros theses Materials and Methods A master cast with four parallel implant abutment analogs and a passive framework were fabricated Vinyl polysiloxane impression material was used for all impressions with a metal stock tray Two groups (D and M) were tested (n = 5) The measurement method employed was just one titanium screw tightened to the framework Each group s measurements were analyzed using software that received the images of a video camera coupled to a stereomicroscope at X100 magnification The results were analyzed statistically (t test) Results The mean values of abutment/framework interface gaps were master cast = 32 mu m (SD 2), group D = 165 mu m (SD 60), and group M = 69 mu m (SD 36) There was a statistically significant difference between the D and M groups (P <= 001) Conclusion Under the limitations of this study, it could be suggested that a more accurate working cast can be fabricated using metal splinted impression copings INT J ORAL MAXILLOFAC IMPLANTS 2010 25 1153-1158

Efficacy of Air-abrasion Technique and Additional Surface Treatment at Titanium/Resin Cement Interface

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

The center of the incisive papilla for the selection of complete denture maxillary anterior teeth in 4 racial groups

Objectives: To evaluate the use of the center of the incisive papilla as a guide for the selection of the proper width of maxillary dentures in 4 racial groups. Method and Materials: One hundred sixty stone casts were obtained from impressions of the maxillary arch of white, black, mixed, and Asian subjects. The occlusal surfaces of the casts were photocopied and the images placed on a digitizer. The most anterior and posterior points of the papilla and cusp tips of the canines were digitized. Dentofacial Planner Plus software was used to calculate the distance from a line passing through the cusp tips of the canines to the center of the papilla, defined as the midpoint of the anterior and posterior points of the papilla. The selection error (in millimeters) due to the clinical application of the method of the incisive papilla was calculated and analyzed. Results: In all studied racial groups, there was no coincidence between the center of the incisive papilla and the canine line. The utilization of the center of the papilla would lead to the selection of wider artificial teeth. In 24.9% of the white, 19.3% of the mixed, 32.9% of the black, and 15.5% of the Asian populations, errors greater than 4 mm would be present with the utilization of the papilla. Conclusion: The method of the center of the incisive papilla is not accurate, but may aid in initial artificial teeth selection for the racial groups studied. (Quintessence Int 2008;39:841-845)

Accuracy of Impression Techniques for an Implant-Supported Prosthesis

Purpose: This in vitro study compared the dimensional accuracy of a stone index and of two impression techniques (squared impression copings and modified squared impression copings) for implant-supported prostheses. Materials and Methods: A master cast with four parallel implant-abutment analogs and a passive framework were fabricated. Vinyl polysiloxane impression material was used for all impressions with a metal stock tray. Three groups of impressions were tested (n = 5): index (1), squared (S), and modified squared (MS). The measurement method employed was just one titanium screw tightened to the framework. The measurements (60 gap values) were analyzed using software that received the images from a video camera coupled to a stereomicroscope at x 100 magnification. The results were evaluated statistically (analysis of variance, Holm-Sidak method, alpha = .05). Results: The mean abutment/framework interface gaps were: master cast = 31.63 mu m; group I = 45.25 mu m; group S = 96.14 mu m; group MS = 51.20 mu m. No significant difference was detected among the index and modified squared techniques (P = .05). Conclusion: Under the limitations of this study, the techniques modified squared and index generated more accurate casts than the squared technique. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:715-721

Comparison of impression techniques and materials for implant-supported prosthesis

Purpose: To investigate, in vitro, the dimensional accuracy of two impression techniques (squared impression copings and squared impression copings sandblasted and coated with impression adhesive) made of vinyl polysiloxane and polyether impression materials. Materials and Methods: A master cast (control group) with four parallel implant abutment analogs, a passive framework, and a custom aluminum tray was fabricated. Four groups (n = 5 each group) were tested: squared Impregum (SI), squared Express (SE), sandblasted adhesive squared Impregum (ASI), and sandblasted adhesive squared Express (ASE). The measurement method employed was just one titanium screw tightened to the framework. A stereomicroscope was used to evaluate the fit of the framework by measuring the size of the gap between the abutment and the framework. The results were analyzed statistically. Results: The mean values for the abutment/framework interface gaps were: master cast, 31.63 mu m (SD 2.16); SI, 38.03 mu m (SD 9.29); ASI, 46.80 mu m (SD 8.47); SE, 151.21 mu m (SD 22.79); and ASE, 136.59 mu m (SD 29.80). No significant difference was detected between the SI or ASI techniques and the master cast. No significant difference was detected between the SE and ASE techniques. Conclusion: Within the limitations of this study, it can be concluded that Impregum Soft medium consistency was the best impression material and the impression technique did not influence the accuracy of the stone casts. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:771-776

Influence of Microwave Disinfection on the Linear Dimensional Stability of Complete Dentures: A Clinical Study

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

Comparison of the Accuracy of Plastic and Metal Stock Trays for Implant Impressions

Purpose: This in vitro study evaluated the dimensional accuracy of two impression techniques (tapered and splinted) with two stock trays (plastic and metal) for implant-supported prostheses. Materials and Methods: A master cast with four parallel abutment analogs and a passive framework were fabricated. Polyvinyl siloxane impression material was used for all impressions with two metal stock trays and two plastic stock trays (closed and open trays). Four groups (tapered plastic, splinted plastic, tapered metal, and splinted metal) and a control group (master cast) were tested (n = 5 for each group). After the framework was seated on each of the casts, one abutment screw was tightened, and the marginal gap between the abutment and framework on the other side was measured with a stereomicroscope. The measurements were analyzed with the Kruskal-Wallis one-way analysis of variance on ranks test followed by the Dunn method. Results: The mean values (+/- standard deviations) for the abutment/framework interface gaps were: master cast, 32 +/- 2 mu m; tapered metal, 44 +/- 10 mu m; splinted metal, 69 +/- 28 mu m; tapered plastic, 164 +/- 58 mu m; splinted plastic, 128 +/- 47 mu m. No significant difference was detected between the master cast, tapered metal, and splinted metal groups or between the tapered and splinted plastic groups. Conclusions: In this study, the rigidity of the metal stock tray ensured better results than the plastic stock tray for implant impressions with a high-viscosity impression material (putty). Statistically similar results were obtained using tapered impression copings and splinted squared impression copings. The tapered impression copings technique and splinted squared impression copings technique with a metal stock tray produced precise casts with no statistically significant difference in interface gaps compared to the master cast. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:544-550.

Accuracy of impression and pouring techniques for an implant-supported prosthesis

Purpose: The purpose of this in vitro study was to compare the dimensional accuracy of a stone index and of 3 impression techniques (tapered impression copings, squared impression copings, and squared impression copings splinted with acrylic resin) associated with 3 pouring techniques (conventional, pouring using latex tubes fitted onto analogs, and pouring after joining the analogs with acrylic resin) for implant-supported prostheses. Materials and Methods: A mandibular brass cast with 4 stainless steel implant-abutment analogs, a framework, and 2 aluminum custom trays were fabricated. Polyether impression material was used for all impressions. Ten groups were formed (a control group and 9 test groups formed by combining each pouring technique and impression technique). Five casts were made per group for a total of 50 casts and 200 gap values (1 gap value for each implant-abutment analog). Results: The mean gap value with the index technique was 27.07 mu m. With the conventional pouring technique, the mean gap values were 116.97 mu m for the tapered group, 5784 mu m for the squared group, and 73.17 mu m for the squared splinted group. With pouring using latex tubes, the mean gap values were 65.69 mu m for the tapered group, 38.03 mu m for the squared group, and 82.47 mu m for the squared splinted group. With pouring after joining the analogs with acrylic resin, the mean gap values were 141.12 jum for the tapered group, 74.19 mu m for the squared group, and 104.67 mu m for the squared splinted group. No significant difference was detected among Index, squarellatex techniques, and master cast (P > .05). Conclusions: The most accurate impression technique utilized squared copings. The most accurate pouring technique for making the impression with tapered or squared copings utilized latex tubes. The pouring did not influence the accuracy of the stone casts when using splinted squared impression copings. Either the index technique or the use of squared coping combined with the latex-tube pouring technique are preferred methods for making implant-supported fixed restorations with dimensional accuracy.

Use of bovine bone graft and bone membrane in defects surgically created in the cranial vault of rabbits. Histologic comparative analysis

Purpose: This study was proposed to analyze histologically the process of repairing bone defects created surgically in the cranial vaults of rabbits. Materials and Methods: Thirty adult male rabbits (Oryctolagus cunilicus) received, under general anesthesia, bilateral parietal osteotomies by means of a 6mm-diameter trephine. The bony defects were divided into 4 groups. In group 1 the defect did not receive any treatment; in group 2 the defect was filled with lyophilized bovine bone (Biograft); in group 3 it was filled with bovine bone and covered with a bone matrix membrane (Bioplate); in group 4 it was covered with a bone matrix membrane. Animals were sacrificed in 3 equal groups at 15, 30, and 60 days. The specimens were subjected to routine laboratory procedures to evaluate the degree of bone repair. Results: After 60 days, new bone formation in group 2 was not satisfactory when compared to that of group 3. Large amounts of new bone formation in maturation were seen in group 3. In the defects covered with a membrane the results were similar to those of group 1 (ie, the cavity was filled with fibrous connective tissue). The implanted bone and membranes were totally resorbed. Discussion and Conclusions: the use of a membrane served as a barrier against the migration of cells from the adjacent tissue and the bone graft/membrane preserved the cavity space, resulting in an enhanced osteogenic effect.

Accuracy of Digital Images in the Detection of Marginal Micro leakage: An In Vitro Study

Purpose: To evaluate the accuracy of Image Tool Software 3.0 (ITS 3.0) to detect marginal microleakage using the stereomicroscope as the validation criterion and ITS 3.0 as the tool under study.Materials and Methods: Class V cavities were prepared at the cementoenamel junction of 61 bovine incisors, and 53 halves of them were used. Using the stereomicroscope, microleakage was classified dichotomously: presence or absence. Next, ITS 3.0 was used to obtain measurements of the microleakage, so that 0.75 was taken as the cut-off point, and values equal to or greater than 0.75 indicated its presence, while values between 0.00 and 0.75 indicated its absence. Sensitivity and specificity were calculated by point and given as 95% confidence interval (95% CI).Results: The accuracy of the ITS 3.0 was verified with a sensitivity of 0.95 (95% CI: 0.89 to 1.00) and a specificity of 0.92 (95% CI: 0.84 to 0.99).Conclusion: Digital diagnosis of marginal microleakage using ITS 3.0 was sensitive and specific.

Marginal adaptation of Class 2 adhesive restorations

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups ( n = 20): ( 1) oblique incremental insertion technique ( control), ( 2) centripetal incremental insertion technique, and ( 3) bulk insertion. The teeth were restored with a total-etch adhesive and micro-hybrid composite resin. The specimens were isolated with nail varnish except for a 2-mm-wide area around the restoration and then thermocycled ( 1,000 thermal cycles, 5 degrees C/ 55 degrees C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores ( 0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests ( P <.05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores ( P =.15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins ( P =.04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques.

Nd:YAG Laser Irradiation of Etched/Unetched Dentin Through an Uncured Two-step Etch-and-Rinse Adhesive and its Effect on Microtensile Bond Strength

Purpose: To evaluate whether Nd:YAG laser irradiation of etched and unetched dentin through an uncured adhesive affected the microtensile bond strength (pTBS).Materials and Methods: Flat dentin surfaces were created in 19 extracted human third molars. Adper Single Bond (SB) adhesive was applied over etched (groups 1 to 3) or unetched dentin (groups 4 to 6). The dentin was then irradiated with a Nd:YAG laser through the uncured adhesive, using 0.75 or 1 W power settings, except for the control groups (groups 1 and 4). The adhesive was light cured and composite crowns were built up. After 24 h, the teeth were sectioned into beams, with cross-sectional areas of 0.49 mm(2), and were stressed under tension. Data were statistically analyzed using two-way ANOVA and Tukey's test (alpha = 5%). Dentin surfaces of fractured specimens and the interfaces of untested beams were observed under scanning electron microscopy (SEM).Results: Acid etching, laser irradiation, and their interaction significantly affected bonding (p < 0.05). Laser irradiation did not improve bonding of etched dentin to resin (p > 0.05). However, higher pTBS means were found on unetched lased dentin (groups 5 and 6), but only in comparison to group 4, where neither lasing nor etching was performed. Groups 4 to 6 showed the lowest pTBS means among all groups tested (p < 0.05). Laser irradiation did not change the characteristics of the hybrid layers created, while solidification globules were observed on lased dentin surfaces under SEM.Conclusion: Laser irradiation of dentin through the uncured adhesive did not significantly improve the pTBS in comparison to the suggested manufacturer's technique.

Oral Piercing Complications Among Teenage Students

Purpose: The aim of this study was to assess the use of oral piercings and their possible associated complications among students aged 14 to 18 years.Materials and Methods: A total of 927 students from private and state schools were invited to participate in this study. The participants were subjected to clinical examination, and a questionnaire was provided for collecting the following data: gender, piercing location, oral complications or alterations, and cleaning frequency.Results: Among the students who were analysed, 33 had oral piercings (3.6%); 69.70% were from state schools and 30.30% were from private schools. There was a slight predominance of males (54.55%) compared with females (45.45%). The tongue was the most common location for piercing (66.6%). The complications and alterations associated with the use of piercing were observed in 74.3% of the cases.Conclusions: In the population that was studied, oral piercing was observed in a small percentage of teenage students (3.6%) and there were local complications associated with its use.

Surface Roughness and Bacterial Adherence to Resin Composites and Ceramics

Purpose: The aim of this study was to evaluate the surface roughness and the in vitro adherence of Streptococcus mutans to indirect aesthetic restorative materials that are uncoated with saliva.Materials and Methods: Four groups of restorative materials were evaluated according to material type: (1) microparticulate feldspathic ceramic; (2) leucite-reinforced feldspathic ceramic; (3) microhybrid resin composite and (4) microfilled resin composite. Twenty standardised samples of each material were produced. Roughness analysis (Ra, n = 10) was performed using a roughness analyser. Adhesion tests (n = 10) were carried out in 24-well plates; colony-forming units (CFU/mL) were evaluated. The mean values of roughness (mu m) and adherence (CFU/mL) for each group were subjected to an analysis of variance and a Tukey test.Results: The leucite-reinforced feldspathic ceramic was rougher and presented higher bacterial adherence than the microparticulate feldspathic ceramic. The resin composites were similar with regard to surface roughness and bacterial adherence.Conclusions: The microhybrid and microfilled resin composites were similar and the leucite-reinforced feldspathic ceramic was rougher and presented higher bacterial adherence than the microparticulate feldspathic ceramic.

Influence of Osteopenia in Autogenous Bone Graft Healing With or Without Expanded Polytetrafluoroethylene Membranes: Histologic and Histomorphometric Study in Rats

Purpose: The aim of this study was to quantitatively evaluate and qualitatively describe autogenous bone graft healing with or without an expanded polytetrafluoroethylene (e-PTFE) membrane in ovariectornized rats. Materials and Methods: Eighty Wistar rats, weighing approximately 300 g each, were used. A graft was obtained from the parietal bone and fixed to the sidewall of each animal's left mandibular ramus. The animals were randomly divided into four experimental groups (n = 20 in each group): group 1, sham operated and autogenous bone graft only- group 2, sham operated and autogenous bone graft covered by e-PTFE membrane; group 3, ovariectornized (OVX) and autogenous bone graft only- group 4, OVX and autogenous bone graft covered by e-PTFE membrane. The animals were sacrificed at five different time points: immediately after grafting or at 7, 21, 45, or 60 days after grafting. Histologic examination and morphometric measurement of the sections were performed, and values were submitted to statistical analyses. Results: Both groups (sham and OVX) experienced loss of the original graft volume when it was not covered by the membrane, whereas use of the membrane resulted in additional bone formation beyond the edges of the graft and under the membrane. Histologic analysis showed integration of the grafts in all animals, although a larger number of marrow spaces was found in OVX groups. Conclusions: Association of bone graft with an e-PTFE membrane resulted in maintenance of its original volume as well as formation of new bone that filled the space under the membrane. Osteopenia did not influence bone graft repair, regardless of whether or not it was associated with e-PTFE membrane, but descriptive histologic analysis showed larger numbers of marrow spaces in the bone graft and receptor bed and formation of new bone in the OVX animals. INT J ORAL MAXILLOFAC IMPLANTS 2009;24:1074-1082