Can the alendronate dosage be altered when combined with high-frequency loading in osteoporosis treatment?

Alendronate therapy has been associated with serious side effects. Altering the alendronate concentration and combining with high-frequency loading as mechanical intervention was explored in this animal study as a treatment for osteoporosis. The bone anabolic potency of high-frequency loading was overruled by the different alendronate dosages applied in the present study. Further exploration of reduced hormonal therapy associated with mechanical interventions in osteoporosis treatment should be sought. INTRODUCTION: The aim of the present study was to investigate the effect of alendronate (ALN) administration at two different dosages, associated or not with high-frequency (HF) loading, on the bone microstructural response. METHODS: Sixty-four female Wistar rats were used, of which 48 were ovariectomized (OVX) and 16 were sham-operated (shOVX). The OVX animals were divided into three groups: two groups were treated with alendronate, at a dosage of 2 mg/kg (ALN(2)) or at a reduced dosage of 1 mg/kg (ALN(1)) three times per week. A third OVX group did not receive pharmaceutical treatment. All four groups were mechanically stimulated via whole body vibration (WBV) at HF (up to 150 Hz) or left untreated (shWBV). ALN and HF were administered for 6 weeks, starting at 10-week post-(sh)OVX. Tibia bone structural parameters were analyzed using ex vivo microcomputed tomography. RESULTS: Trabecular bone loss and structural deterioration resulting from ovariectomy were partially restored by ALN administration, demonstrated by the improvement of trabecular patter factor (Tb.Pf), trabecular separation (Tb.Sp), and structure model index (SMI) of the ALN groups compared to that of the OVX group, regardless of the applied dosage [ALN(2) or ALN(1)] or mechanical loading regime (shWBV or WBV). However, a significant positive effect of the ALN(1) administration on trabecular (decrease of Tb.Sp and SMI) and cortical bone (increase of cortical thickness) microarchitecture compared to that of the OVX status group was observed for both loading regimes was not seen for ALN(2). Furthermore, HF loading resulted in cortical bone changes, with an increased trabeculary area and endocortical perimeter. Finally, the benefits of a combined therapy of ALN with HF loading could not be discerned in the present experimental conditions. CONCLUSIONS: The bone anabolic potency of HF loading was overruled by the ALN dosages applied in the present study. Further altering the ALN dosage combined with robust mechanical stimuli needs to be considered in osteoporosis research and eventually therapy.

Three-dimensional finite element analysis of stress distribution in peri-implant bone with relined dentures and different heights of healing caps.

The purpose of this study was to evaluate the influence of height of healing caps and the use of soft liner materials on the stress distribution in peri-implant bone during masticatory function in conventional complete dentures during the healing period by using finite element analysis. Three-dimensional models of a severely resorbed mandible with two recently placed implants in the anterior region were created and divided into the following situations: (i) submerged implants, (ii) healing cap at gingival level and (iii) 1·5-mm supragingival. All these situations were also analysed for a conventional complete denture and a denture relined with a 3-mm-thick layer of soft liner material. The models were exported to mechanical simulation software that presented two simulations, one with load in the inferior right canine (35 N) and the other in the inferior right first molar (50 N). Data were evaluated using Maximum Principal Stress provided by the software. All models showed a stress concentration in the cortical bone corresponding to the cervical part of the implant. The simulations with non-submerged implants showed higher values of stress concentration than those that were submerged. Likewise, soft liner materials presented better results than when the denture base was not relined. The height of the healing caps seems to have a direct influence on the stress distribution in the peri-implant bone during the healing period. Considering the values obtained in this study, the use of soft liners with submerged implants seems to be the most suitable method to use during the period of osseointegration.

Effects of laser-weld joint opening size on fatigue strength of Ti-6Al-4V structures with several diameters.

This study was conducted to evaluate the fatigue strength of Ti-6Al-4V laser-welded joints with several diameters and joint openings. Sixty dumbbell rods were machined in Ti-6Al-4V alloy with central diameters of 1·5, 2·0 and 3·5 mm. The specimens were sectioned and then welded using two joint openings (0·0 and 0·6 mm). The combination of variables created six groups, which when added to the intact groups made a total of nine groups (n = 10). Laser welding was executed as follows: 360 V per 8 ms (1·5 and 2·0 mm) and 380 V per 9 ms (3·5 mm) with focus and frequency regulated to zero. The joints were finished, polished and submitted to radiographic examination to be analysed visually for the presence of porosity. The specimens were then subjected to a mechanical cyclic test, and the number of cycles until failure was recorded. The fracture surface was examined with a scanning electron microscope (SEM). The Kruskal-Wallis test and Dunn test (α = 0·05) indicated that the number of cycles required for fracture was lower for all specimens with joint openings of 0·6 mm, and for 3·5-mm-diameter specimens with joint openings of 0·0 mm. The Spearman correlation coefficient (α = 0·05) indicated that there was a negative correlation between the number of cycles and the presence of porosity. So, laser welding of Ti-6Al-4V structures with a thin diameter provides the best conditions for the juxtaposition of parts. Radiographic examination allows for the detection of internal voids in titanium joints.

Passive fit of frameworks in titanium and palladium-silver alloy submitted the laser welding.

This study evaluated the precision of fit of implant frameworks cast in titanium (cp Ti) and palladium-silver alloy (Pd-Ag), made by the one-piece cast and laser welding techniques. From a metal matrix with five implants, 20 master casts were obtained, to which replicas of implants were incorporated. On these masters 10 frameworks were made for each type of material (cp Ti and Pd-Ag alloy). Half of these were made by the one-piece cast technique and the other half by the laser welding technique. The implant/prosthesis interface was analysed and measured in the vestibular and lingual regions of the central and distal implants with the help of a measuring microscope. The results indicated that in the central cylinders, the Tukey test (P<0.0005) showed a significant difference in the passive fit between the laser-welded frameworks (34.73 microm) and those one-piece cast frameworks (151.39 microm), and as regards materials, the palladium-silver alloy (66.30 microm) showed better results than the titanium (119.83 microm). In the distal cylinders there was no significant difference between the frameworks cast in titanium and palladium-silver by the one-piece technique. However, after laser welding, there was a significant difference for the frameworks cast in titanium (31.37 microm) and palladium-silver (106.59 microm).

Influence of flask closure and flask cooling methods on tooth movement in maxillary dentures.

PURPOSE: This study investigated the tooth movement of standardized simulated dentures processed by traditional closure or the new Rafael Saide (RS) tension system when cooled in the curing water itself or in curing water followed by bench storage for 3 hours. MATERIALS AND METHODS: Forty stone casts were formed from a mold of an edentulous maxillary arch. The wax denture record bases were made on the casts; the height of the wax rim occlusion was 20 mm in the labial sulcus of the cast and 10 mm in the posterior region. The upper stone cast was mounted on a Mondial 4000 semi-adjustable articulator with wax rim interocclusal references in relation to the lower stone cast teeth. Metallic pins were placed in the incisal border of the maxillary central incisors (I), labial cusp of the first premolars (PM), and mesiolabial cusp of the second molars (M). The incisor-to-incisor (I-I), premolar-to-premolar (PM-PM), and molar-to-molar (M-M) transversal distances and left incisor-to-left molar (LI-LM), and right incisor-to-right molar (RI-RM) anteroposterior distances were measured before and after denture polymerization with an optical microscope with a tolerance of 0.0005 mm. For traditional closure, the dentures were flasked conventionally in standard metallic flasks, which were afterward placed in spring clamps. For the new RS system closure, the flasks were pressed between the metallic plates of the tension system after the final closure. The Clássico heat-polymerizing acrylic resin dough was packed in the flasks under a final packing pressure of 1.250 kg f. Twelve hours after flask closure, the dentures were polymerized in a moist heat-polymerizing cycle for 9 hours at 74 degrees C. The denture was deflasked after cooling in the water of the polymerizing cycle (groups A and C) or in the water of the polymerizing cycle and then bench-stored for 3 hours (groups B and D). Collected data were analyzed with analysis of variance and Tukey's test (p< 0.05). RESULTS: There was no statistically significant difference (p> 0.05) between the conventional and new RS system closure methods for the transversal distances after polymerization in all studied groups. The anteroposterior distances did not change with deflasking after water bath cooling. There were statistically significant differences (p< 0.05) in the anteroposterior distances with deflasking after water bath cooling and then bench storage for 3 hours. CONCLUSION: Tooth movement was similar in dentures processed by traditional closure and by the new RS tension system, with the exception of the anteroposterior distances when the flasks were cooled in their own curing water and bench-stored for 3 hours.

Surface roughness of acrylic resins submitted to mechanical and chemical polishing.

Surface roughness is extremely important as it influences micro-organism accumulation and consequently oral health. The aim of the present study was to evaluate the influence of mechanical polishing (MP) and chemical polishing (CP) on surface roughness of four heat-cured denture base acrylic resins. Twenty sample discs were prepared for each of the following acrylic resins: Classico (CL), QC 20 (QC), Acron MC (AC) and Onda Cryl (ON). The first two are boiling cured resins and the latter two are microwave cured. After curing and deflasking, samples were ground and subdivided into two groups: MP, which received pumice slurry, chalk powder, soft brush and felt cone, at a bench vice; and CP, which received fluid specifically for chemical polisher. Surface roughness was measured using a Surf Corder SE 1700 rugosimeter. Data collected were statistically analysed by analysis of variance followed by Tukey's test. Surface roughness means in mum were: CL-MP: 0.0350; CL-CP: 0.2298; QC-MP: 0.0307; QC-CP: 0.1792; AC-MP: 0.0312; AC-CP: 0.2700; ON-MP: 0.0321; ON-CP: 0.2949. It can be concluded that MP produced significantly smoother surfaces than CP and that surface roughness because of MP was not influenced by acrylic resin type, whereas this was not true of CP.

Corrosion-fatigue of laser-repaired commercially pure titanium and Ti-6Al-4V alloy under different test environments.

This study evaluated the corrosion-fatigue life of laser-repaired specimens fabricated from commercially pure titanium (CP Ti) and Ti-6Al-4V alloy, tested under different storage conditions. For each metal, 30 dumbbell rods with a central 2.3 mm diameter were prepared by lost-wax casting with the Rematitan System. Simulating the failure after service, corrosion-fatigue life in different media at room temperature (air, synthetic saliva and fluoride synthetic saliva) was determined at a testing frequency of 10 Hz for intact specimens and after laser repairing, using a square waveform with equal maximum tensile and compressive stress that was 30% lower than the 0.2% offset yield strength. For laser welding, the fractured specimens were rejoined using a jig to align the sections invested in type-IV dental stone. The adjacent areas of the gap was air-abraded with 100 microm aluminum oxide, laser welded and retested under the same conditions as the initial intact specimens. The number of cycles at failure was recorded, and the fracture surface was examined with a scanning electron microscope (SEM). The number of cycles for failure of the welded and intact specimens was compared by anova and the Tukey test at a 5% probability level. Within the limitations of this study, the number of cycles required for fracture decreased in wet environments and the laser repairing process adversely affected the life of both metals under the corrosion-fatigue conditions.

Retention force and fatigue strength of overdenture attachment systems.

This study evaluated retention force and fatigue resistance of two overdenture attachment systems. Twenty samples (O-ring and Bar-Clip) from two manufacturers (Conexão Sistemas de Prótese and Lifecore Biomedical) were prepared and divided into four groups: (i) Conexão/O-ring; (ii) Conexão/Bar-Clip; (iii) Lifecore/O-ring and (iv) Lifecore/Bar-Clip, with five samples in each group. They were submitted to mechanical fatigue test using a servohydraulic machine performing 5500 cycles of insertion and removal (f=0.8 Hz), immersed in artificial saliva. Retention force values were obtained three times (0, 3000 and after 5500 cycles) simulating the clinical service, using a tensile strength at 1 mm min(-1) and load cell of 1 kN. Data were analysed with analysis of variance and Tukey's test at 5% level. Results showed that Conexão/Bar-Clip specimens had significantly higher retention values than Lifecore/Bar-Clip (44.61 and 18.44 N, respectively), Conexão/O-ring specimens had significantly lower values than Lifecore/O-ring (13.91 and 19.75 N, respectively). Conexão/Bar-Clip values were always significantly higher than those of Conexão/O-ring group (44.61 and 13.91 N, respectively). Lifecore (O-ring and Bar-Clip) presented similar values (19.75 and 18.44 N, respectively). The systems evaluated showed satisfactory retention force values, before and after fatigue testing. Conexão/Bar-Clip specimens presented the highest values. A 5-year simulation of insertion and removal did not decrease retention values or fracture components.

Effect of storage and acid etching on the tensile bond strength of composite resins to glass ionomer cement.

This in vitro study evaluates the effect of storage time and acid etching on the tensile bond strength of glass ionomer cement to composite resins. The bonded assemblies were stored at 100% relative humidity and 37 degrees C for 1 hour, 1 day, 1 week, 1 month and 3 months. The test specimen was loaded at tension to failure on an Otto Wolpert-Werke testing instrument with a crosshead speed of 6 mm/min. The results showed a significant statistical difference for etched Vidrion F when compared to etched Ketac Bond at all storage periods. The unetched samples were statistically similar at 3 months, with the highest values for Vidrion F.