Comparative evaluation of osteogenic cell growth on titanium surface and titanium coated with boron nitride surface: An in vitro study.

Context: To promote better biological response and osseointegration continuous research is going on to modify the titanium (Ti) implant surface for successful implant treatment modality. Aims: This study aims to evaluate the osteogenic cell growth upon the uncoated Ti discs and boron nitride (BN) coated Ti to assess osseointegration and clinical success of dental implants. Settings and Design: This is an descriptive experimental study which includes coating of uncoated titanium alloy suraface with boron nitride in the form of hexagonal boron nitride sheets. Than comparative evaluation of osteogenic cell growth upon both coated and uncoated titanium surfaces was done using specific cell growth determinants. Materials and Methods: In this descriptive experimental study, both BN-coated and uncoated Ti discs were assessed for osteogenic cell growth using 3-(4, 5-dimethyl thiazolyl-2)-2, 5-diphenyltetrazolium bromide assay, 4',6-diamidino-2-phenylindole, is a fluorescent stain assay, and cell adhesion assay. Statistical Analysis Used: As this study is a descriptive experimental analysis between two variables only so there is no need of statistical analysis or p-value. Results: Overall good cell adhesion, cell differentiation, and cell proliferation occurred in the BN-coated Ti discs as compared to uncoated Ti discs. Conclusions: To promote osseointegration of dental implants, surface coating with BN proved to be an effective approach toward better osseointegration and long-duration success of dental implants as a single unit or implant-supported prosthesis BN which is a biocompatible graphene material with advantages in chemical and thermal stability. BN promoted better osteogenic cell adhesion, differentiation, and proliferation. Hence, it can be used as a new promising Ti implant surface-coating material.

Antibacterial Efficacy and Surface Characteristics of Boron Nitride Coated Dental Implant: An In-Vitro Study.

This in vitro study evaluated bacterial cell proliferation and biofilm adhesion on titanium discs with and without antibacterial surface treatment to reduce the chances of peri-implant infections. Hexagonal boron nitride with 99.5% purity was converted to hexagonal boron nitride nanosheets via the liquid phase exfoliation process. The spin coating method was used for uniform coating of h-BNNSs over titanium alloy (Ti6Al4V) discs. Two groups of titanium discs were formed: Group I (n = 10) BN-coated titanium discs and Group II (n = 10) uncoated titanium discs. Two bacterial strains, Streptococcus mutans (initial colonizers) and Fusobacterium nucleatum (secondary colonizers), were used. A zone of inhibition test, microbial colony forming units assay, and crystal violet staining assay were used to evaluate bacterial cell viability. Surface characteristics and antimicrobial efficacy were examined by scanning electron microscopy with energy dispersion X-ray spectroscopy. SPSS (Statistical Package for Social Sciences) version 21.0 was used to analyze the results. The data were analyzed for probability distribution using the Kolmogorov-Smirnov test, and a non-parametric test of significance was applied. An inter-group comparison was done using the Mann-Whitney U test. A statistically significant increase was observed in the bactericidal action of BN-coated discs compared to uncoated discs against S. mutans, but no statistically significant difference was found against F. nucleatum.

Comparison of Tensile Bond Strength of Fixed-Fixed Versus Cantilever Single- and Double-Abutted Resin-Bonded Bridges Dental Prosthesis.

Resin-bonded fixed dental prostheses (RBFDP) are minimally invasive alternatives to traditional full-coverage fixed partial dentures as they rely on resin cements for retention. This study compared and evaluated the tensile bond strength of three different resin-bonded bridge designs, namely, three-unit fixed-fixed, two-unit cantilever single abutment, and three-unit cantilever double-abutted resin-bonded bridge. Furthermore, the study attempted to compare the tensile bond strengths of the Maryland and Rochette types of resin-bonded bridges. Based on the inclusion and exclusion criteria, a total of seventy-five extracted maxillary incisors were collected and later were mounted on the acrylic blocks. Three distinct resin-bonded metal frameworks were designed: three-unit fixed-fixed (n = 30), two-unit cantilever single abutment (n = 30), and a three-unit cantilever double abutment (n = 30). The main groups were further divided into two subgroups based on the retainer design such as Rochette and Maryland. The different prosthesis designs were cemented to the prepared teeth. Later, abutment preparations were made on all specimens keeping the preparation as minimally invasive and esthetic oriented. Impression of the preparations were made using polyvinyl siloxane impression material, followed by pouring cast using die stone. A U-shaped handle of 1.5 mm diameter sprue wax with a 3 mm hole in between was attached to the occlusal surface of each pattern. The wax patterns were sprued and cast in a cobalt-chromium alloy. The castings were cleaned by sandblasting, followed by finishing and polishing. Lastly, based on the study group, specimens for Rochette bridge were perforated to provide mechanical retention between resin cement and metal, whereas the remaining 15 specimens were sandblasted on the palatal side to provide mechanical retention (Maryland bridge). In order to evaluate the tensile bond strength, the specimens were subjected to tensile forces on a universal testing machine with a uniform crosshead speed. The fixed-fixed partial prosthesis proved superior to both cantilever designs, whereas the single abutment cantilever design showed the lowest tensile bond strength. Maryland bridges uniformly showed higher bond strengths across all framework designs. Within the limitations of this study, the three-unit fixed-fixed design and Maryland bridges had greater bond strengths, implying that they may demonstrate lower clinical failure than cantilever designs and Rochette bridges.

Comparative Evaluation of Tensile Bond Strength of Poly Ether Ether Ketone (PEEK) and Zirconia Copings Using Resin Cement with or without Adhesive: An In Vitro Study.

This in vitro research aimed to evaluate the Tensile Bond Strength of Poly Ether Ether Ketone and Zirconia copings using resin cement with or without Visio.link adhesive. From commercially available Zirconia and PEEK, blocks were machined milled using (CAD)/(CAM) to obtain 20 Zirconia and 20 PEEK copings. These specimens were sandblasted using 110 µm of alumina. The two main groups (20 Zirconia and 20 PEEK copings) were divided further into 4 subgroups, GROUP 1 (n = 10) PEEK substructure with self-adhesive resin cement without pretreatment, and GROUP 2 (n = 10) PEEK substructure with self-adhesive resin cement pre-treated with Visio.link adhesive. GROUP 3 (n = 10) Zirconia copings with self-adhesive resin cement without pretreatment. GROUP 4 (n = 10) Zirconia copings with self-adhesive resin cement pre-treated with Visio.link adhesive. Universal testing machine was used to evaluate the tensile bond strength of these copings. The results were analyzed using SPSS software Version 25.0 (SPSS Inc., Chicago, IL, USA). One-way ANOVA and independent t-test were used to compare the mean scores. Statistically significant increase was observed in Tensile Bond Strength of samples when Visio.link adhesive was used. Tensile Bond Strength of PEEK copings and Zirconia copings with Visio.link adhesive is considerably greater than PEEK copings and Zirconia copings without adhesive. The mean Tensile Bond Strength of Zirconia (with or without adhesive) is less as compared to Tensile Bond Strength of PEEK (with or without adhesive), but the difference is not statistically significant.

Comparison of Stress Distribution in Fixed Partial Prosthesis Restored with Different Combination of Support: A Finite Element Study.

AIM: This study was conducted to evaluate the distribution of stress in the bone around the natural tooth, endodontically treated tooth having post and core, and implant as an abutment in different combinations in fixed partial prosthesis using two-dimensional finite element analysis (FEA). MATERIALS AND METHODS: Six models were simulated using ANSYS Modeller19. All six models were divided into 12 zones and 4 lines, and stress values were calculated and compared. The study combinations were - tooth supported fixed partial prosthesis, fixed partial prosthesis having the combination of tooth and post- and core-treated tooth, fixed partial prosthesis with the combination of tooth and implant, fixed partial prosthesis having the combination of implant and post- and core-treated tooth, fixed partial prosthesis with the combination of post- and core-treated tooth on both sides, and fixed partial prosthesis having the combination of implant on both sides. RESULT: On comparing the stress values, the maximum stress value was observed in fixed partial prosthesis having the combination of implant on both sides (306.2434 MPa) followed by Model 4 (223.1255 MPa), Model 3 (154.3952 MPa), Model 5 (136.9041 MPa), Model 2 (116.2034 MPa), and least stress seen in Model 1 (99.6209 MPa), and minimum in tooth supported fixed partial prosthesis (99.6209 MPa). CONCLUSION: This study concluded that stress concentration in bone was maximum when the implant was used as an abutment in fixed partial prosthesis. The least stress was seen in bone around the natural tooth due to the dampening effect of the periodontal ligament. Further, the modulus of elasticity of a post acts as a vital parameter in the distribution of stress in post- and core-treated tooth. CLINICAL SIGNIFICANCE: The stress concentration in the bone around the abutments affects the longevity of the prosthesis, hence, the clinically appropriate combination of the abutments should be considered for a fixed partial prosthesis.

Unmasking the Effect of Analgesics on Endodontic Diagnosis Using a Novel Bite Force Sensor Device: A Prospective, Randomized Clinical Trial.

INTRODUCTION: A definitive diagnosis is of primary importance before initiating any endodontic treatment; yet, there are occasions when the dental professional is unable to accurately reproduce the patient's chief complaint, as it can pose a dilemma and may require consideration of multiple variables in order to reach an accurate diagnosis. So to overcome this problem, a methodical approach in providing endodontic treatment should be implemented which includes diagnosis, definitive dental treatment and adjunctive drug therapy, known as the "3D" strategy. AIM: The purpose of this study was to evaluate the possible "masking" effect of these analgesics on endodontic diagnosis using a novel bite force sensor device. MATERIALS AND METHODS: A total of 90 patients with endodontic pain were selected and they were given either a placebo or 400 mg ibuprofen (brufen) or 50mg diclofenac sodium (voveron). Both patients and operators were completely blinded to the drugs administered. Bite force tolerance values were noted before and one hour after administration of medication using the self designed bite force sensor. RESULTS: The pre- and post-bite force tolerance values were tabulated for both contralateral and affected tooth. For the affected tooth, there was statistically significant difference between pre- and post-bite force tolerance values in Group I (i.e., ibuprofen) and Group II (i.e., diclofenac sodium) (p<0.05) with no significant difference observed in Group III (placebo). CONCLUSION: The easily available over the counter self administered analgesics in addition to providing symptomatic relief to patients suffering from symptomatic apical periodontitis may also cloud the definitive diagnosis of the clinician, thus jeopardising the treatment plan. The self designed bite force sensor was effective in arriving at a definitive diagnosis in teeth with chronic irreversible pulpitis with symptomatic apical periodontitis, where the allodynia has been camouflaged by the use of analgesics like ibuprofen and diclofenac sodium.