Peri-Implant Marginal Bone Changes around Dental Implants with Platform-Switched and Platform-Matched Abutments: A Retrospective 5-Year Radiographic Evaluation.

Preserving the marginal bone level (MBL) is essential for the long-term success of dental implant therapy, and bone remodeling around dental implants is considered to vary with time. Numerous studies comparing the platform-switching (PS) and platform-matching (PM) dental implants have indicated that PS dental implants showed a lesser reduction for the MBL, and the majority of them had a relatively short period. This study aimed to evaluate vertical and horizontal bone defects by using digital periapical radiographs to examine the changes in MBL around PM and PS dental implants over 5 years after functional loading. The vertical MBL (vMBL) was measured from the implant-abutment junction to the first bone-to-implant contact. The horizontal MBL (hMBL) was measured from the implant-abutment junction to the bone crest. All data were presented as means ± standard errors. Paired and independent t-tests with Welch's correction were used to analyze the data. A total of 61 dental implants in 38 patients after 5 years of functional loading were evaluated. Over time, PS dental implants were more likely to gain bone; by contrast, PM dental implants were more likely to lose bone during the observation time. Changes in vMBL for PS dental implants were significantly less than those for PM dental implants at 1-year (p = 0.045), 3-year (p = 0.021), and 5-year (p = 0.010) loading. Likewise, changes in hMBL for PS dental implants were significantly smaller than in those for PM dental implants at 3-year (p = 0.021) and 5-year (p = 0.006) loading; however, the changes were minimal in both approaches. PS dental implants had a significant increment in the percentage of bone integration, whereas that for PM dental implants dropped over time, with no significance. In PS dental implants that occlude with natural teeth, vertical and horizontal bone gain was observed, and it was significant at 3 years (p = 0.023). A significant horizontal bone gain was observed in the opposing natural teeth at 3-year (p = 0.002) and 5-year loading (p = 0.002). The PS concept appears to preserve more MBL around dental implants by stabilizing the vMBL and hMBL over a 5-year period. A minimal marginal bone change was detected in both concepts. The opposing natural teeth at PS dental implants showed a favorable effect on marginal bone tissues.

Marginal Bone Loss around Implant-Retaining Overdentures versus Implant-Supported Fixed Prostheses 12-Month Follow-Up: A Retrospective Study.

Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the mean MBL and radiographic bone-implant interface contact (r-BIIC) around IODs and implant-supported FPs. We also investigated osseointegration and MBL around non-submerged dental implants. We measured the changes between the MBL in the mesial and distal sites immediately after prosthetic delivery and after one year. The mean MBL and its changes in the IOD group were significantly higher. The mean percentage of r-BIIC was significantly higher in the FP group. MBL and its changes in males were significantly higher in the IOD group. The percentage of r-BIIC was significantly higher in the FP group. MBL in the lower site in the IOD group was significantly higher. Regarding MBL, the location of the implant was the only significant factor in the IOD group, while gender was the only significant predictor in the FP group. Regarding the r-BIIC percentage, gender was a significant factor in the FP group. We concluded that non-submerged dental implants restored with FPs and IODs maintained stable bone remodeling one year after prosthetic delivery.

Effect of Opposite Tooth Condition on Marginal Bone Loss around Submerged Dental Implants: A Retrospective Study with a 3-Year Follow-Up.

BACKGROUND: The objective of this study was to evaluate the effects of opposite tooth conditions on change in marginal bone level (MBL) around submerged dental implants. MATERIALS AND METHODS: The study included healthy patients with one or two implants. Structures opposite implants were either natural teeth (NT) or fixed restorations (FRs). MBLs were measured on digital periapical radiographs at the mesial and distal aspects of each implant. RESULTS: Sixty implants were inserted by the 3-year follow-up. Mean MBLs for NT were 0.21 ± 0.33 mm before prosthetic loading and 0.30 ± 0.41 mm 3 years later (p = 0.001). Mean MBLs with FRs were 0.36 ± 0.45 mm before loading and 0.53 ± 0.50 mm 3 years later (p < 0.001). Changes in mean MBL from the 6-month follow-up to the 1- and 3-year follow-ups were statistically significant (p < 0.01) for implants opposite NT. However, changes in mean MBL from the 6-month follow-up to the 1-year (p = 0.161) and 3-year follow-ups (p = 1.000) were not significant for implants opposite FRs. Between baseline and the 3-year follow-up, MBL change was relatively small and did not differ regarding NT and FRs. CONCLUSION: Bone loss was greater if submerged dental implants were opposed by FRs. MBLs around submerged implants continued to change after 3 years if NT opposed implants.

Preventing Alveolar Osteitis After Molar Extraction Using Chlorhexidine Rinse and Gel: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Alveolar osteitis (AO) may occur after molar extraction. Chlorhexidine (CHX) rinse and CHX gel are widely used to prevent AO. Although previous meta-analyses support the effectiveness of both CHX rinse and CHX gel in preventing AO, important issues regarding these two formulations have not been addressed adequately in the literature. PURPOSE: A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effectiveness of CHX rinse and CHX gel in preventing AO. METHODS: PubMed, EMBASE, SCOPUS, and Cochrane databases were searched for randomized controlled trials published before June 2018. The risk ratio (RR) was used to estimate the pooled effect of AO incidence using a random-effect model. RESULTS: The RRs of AO in patients treated with 0.12% CHX rinse (RR = 0.54, 95% CI [0.41, 0.72]) and 0.2% CHX rinse (RR = 0.84, 95% CI [0.52, 1.35]) were significantly lower than in those treated with the control. Moreover, a significantly lower RR was identified in patients treated with 0.2% CHX gel (RR = 0.47, 95% CI [0.34, 0.64]) than in those treated with the control. When CHX products of different concentrations were grouped together, patients treated with CHX rinse showed an RR of AO of 0.61 (95% CI [0.48, 0.78]) and those treated with CHX gel showed an RR of AO of 0.44 (95% CI [0.43, 0.65]). On the other hand, a meta-analysis of three trials that compared CHX rinse and CHX gel directly showed a significantly lower RR of AO in patients treated with CHX rinse than in those treated with CHX gel (RR = 0.56, 95% CI [0.34, 0.96]). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results support the effectiveness of both CHX rinse and gel in reducing the risk of AO after molar extraction. Each formulation provides unique benefits in terms of ease of application and cost. On the basis of the results of this study, the authors recommend that CHX gel be used immediately after molar extraction because of the convenience and cost-effectiveness of this treatment and that CHX rinse be used by the patient after discharge at home in combination with appropriate health education and case management.

Prevention of Bone Resorption by HA/ß-TCP + Collagen Composite after Tooth Extraction: A Case Series.

After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/ß-tricalcium plus collagen (HA/ß-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/ß-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/ß-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/ß-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.

Doping ZnO Electron Transport Layers with MoS2 Nanosheets Enhances the Efficiency of Polymer Solar Cells.

In this study, we incorporated molybdenum disulfide (MoS2) nanosheets into sol-gel processing of zinc oxide (ZnO) to form ZnO:MoS2 composites for use as electron transport layers (ETLs) in inverted polymer solar cells featuring a binary bulk heterojunction active layer. We could effectively tune the energy band of the ZnO:MoS2 composite film from 4.45 to 4.22 eV by varying the content of MoS2 up to 0.5 wt %, such that the composite was suitable for use in bulk heterojunction photovoltaic devices based on poly[bis(5-(2-ethylhexyl)thien-2-yl)benzodithiophene- alt-(4-(2-ethylhexyl)-3-fluorothienothiophene)-2-carboxylate-2,6-diyl] (PTB7-TH)/phenyl-C71-butryric acid methyl ester (PC71BM). In particular, the power conversion efficiency (PCE) of the PTB7-TH/PC71BM (1:1.5, w/w) device incorporating the ZnO:MoS2 (0.5 wt %) composite layer as the ETL was 10.1%, up from 8.8% for the corresponding device featuring ZnO alone as the ETL, a relative increase of 15%. Incorporating a small amount of MoS2 nanosheets into the ETL altered the morphology of the ETL and resulted in enhanced current densities, fill factors, and PCEs for the devices. We used ultraviolet photoelectron spectroscopy, synchrotron grazing incidence wide-/small-angle X-ray scattering, atomic force microscopy, and transmission electron microscopy to characterize the energy band structures, internal structures, surface roughness, and morphologies, respectively, of the ZnO:MoS2 composite films.

Dual nanocomposite carrier transport layers enhance the efficiency of planar perovskite photovoltaics.

In photovoltaic devices, more effective transfer of dissociated electrons and holes from the active layer to the respective electrodes will result in higher fill factors and short-circuit current densities and, thus, enhanced power conversion efficiencies (PCEs). Planar perovskite photovoltaics feature an active layer that can provide a large exciton diffusion length, reaching several micrometers, but require efficient carrier transport layers for charge extraction. In this study, we employed two nanocomposite carrier transfer layers-an electron transport layer (ETL) comprising [6,6]phenyl-C61-butyric acid methyl ester (PC61BM) doped with the small molecule 4,7-diphenyl-1,10-phenanthroline (Bphen), to enhance the electron mobility, and a hole transfer layer (HTL) comprising poly(3,4-ethylenedioxythiophene):polystyrenesulfonate (PEDOT:PSS) doped with molybdenum disulfide (MoS2) nanosheets, to enhance the hole mobility. We used ultraviolet photoelectron spectroscopy to determine the energy levels of these composite ETLs and HTLs; atomic force microscopy and scanning electron microscopy to probe their surface structures; and transmission electron microscopy and synchrotron grazing-incidence small-angle X-ray scattering to decipher the structures of the ETLs. Adding a small amount (less than 1%) of Bphen allowed us to tune the energy levels of the ETL and decrease the size of the PC61BM clusters and, therefore, generate more PC61BM aggregation domains to provide more pathways for electron transport, leading to enhanced PCEs of the resulting perovskite devices. We used quantitative pump-probe data to resolve the carrier dynamics from the perovskite to the ETL and HTL, and observed a smaller possibility of carrier recombination and a shorter injection lifetime in the perovskite solar cell doubly modified with carrier transport layers, resulting in an enhancement of the PCE. The PCE reached 16% for a planar inverted perovskite device featuring an ETL incorporating 0.5 wt% Bphen within PC61BM and 0.1 wt% MoS2 within PEDOT:PSS; this PCE is more than 50% higher than the value of 10.2% for the corresponding control device.

Block Copolymer-Tuned Fullerene Electron Transport Layer Enhances the Efficiency of Perovskite Photovoltaics.

In this study, we enhanced the power conversion efficiency (PCE) of perovskite solar cells by employing an electron transfer layer (ETL) comprising [6,6]phenyl-C61-butyric acid methyl ester (PC61BM) and, to optimize its morphology, a small amount of the block copolymer polystyrene-b-poly(ethylene oxide) (PS-b-PEO), positioned on the perovskite active layer. When incorporating 0.375 wt % PS-b-PEO into PC61BM, the PCE of the perovskite photovoltaic device increased from 9.4% to 13.4%, a relative increase of 43%, because of a large enhancement in the fill factor of the device. To decipher the intricate morphology of the ETL, we used synchrotron grazing-incidence small-angle X-ray scattering for determining the PC61BM cluster size, atomic force microscopy and scanning electron microscopy for probing the surface, and transmission electron microscopy for observing the aggregation of PC61BM in the ETL. We found that the interaction between PS-b-PEO and PC61BM resulted in smaller PC61BM clusters that further aggregated into dendritic structures in some domains, a result of the similar polarities of the PS block and PC61BM; this behavior could be used to tune the morphology of the ETL. The optimal PS-b-PEO-mediated PC61BM cluster size in the ETL was 17 nm, a large reduction from 59 nm for the pristine PC61BM layer. This approach of incorporating a small amount of nanostructured block copolymer into a fullerene allowed us to effectively tune the morphology of the ETL on the perovskite active layer and resulted in enhanced fill factors of the devices and thus their device efficiency.

Effect of maternal use of chewing gums containing xylitol on transmission of mutans streptococci in children: a meta-analysis of randomized controlled trials.

BACKGROUND: Mutans streptococci (MS) are the major causative bacteria involved in human dental decay. Habitual consumption of xylitol has been proved to reduce MS levels in saliva and plaque. AIM: To evaluate the effect of the maternal use of xylitol gum on MS reduction in infants. DESIGN: A structured literature review and meta-analysis. A random effects model was used to assess the relative risks of the incidence of MS in the saliva or plaque of children who were 6, 9, 12, 18, and 24 months old. RESULTS: We reviewed 11 RCTs derived from 5 research teams that included 601 mothers. Our results indicated that the incidence of MS in the saliva or plaque of the infants was significantly reduced in the xylitol group (risk ratio: 0.54; 95% confidence interval: 0.39-0.73, at 12-18 months) and (risk ratio: 0.56; 95% confidence interval: 0.40-0.79, at 36 months) compared with the control groups. The long-term effect of maternal xylitol gum exposure on their children's dental caries was controversial. CONCLUSION: Habitual xylitol consumption by mothers with high MS levels was associated with a significant reduction in the mother-child transmission of salivary MS.

Surface analysis of titanium biological modification with glow discharge.

BACKGROUND: Glow discharge plasma (GDP) technology has been used to graft various proteins to the titanium surface, including albumin, type I collagen, but without fibronectin. PURPOSE: The aim of this study was to evaluate and analyze the physical properties of fibronectin-grafted titanium surfaces after GDP treatment. MATERIALS AND METHODS: Grade II titanium discs after cleaning and autoclaving were considered as original specimens, thus divided into four groups. The groups were different upon two treatments (GDP only and fibronectin grafting after GDP) and two storage temperature (4°C and 25°C). The implant surface morphology was characterized by scanning electron microscopy (SEM), roughness measurement, and wettability evaluation. The concentration relationship of fibronectin was by fluorescein isothiocyanate (FITC) labeling. RESULTS: SEM images showed that regular planar texture revealed on the surface of GDP-treated group, and irregular-folding protein was found on the fibronectin-grafted discs. Fibronectin-grafted groups had higher hydrophilicity and greater surface roughness than GDP-treated specimens. The storage temperature did not make obvious difference on the surface topography, wettability, and roughness. The number of fibronectin dots on the titanium surface labeling by FITC had positive relationship with the concentration of fibronectin solution used. CONCLUSIONS: Biologically modified titanium surface is more hydrophilic and rougher than GDP-treated ones. GDP treatment combined with fibronectin grafting increased the surface hydrophilicity and surface roughness of titanium discs, which may attribute to the affinity of cell adhesion, migration, proliferation, and differentiation.

In vivo evaluation of resorbable bone graft substitutes in beagles: histological properties.

Calcium phosphate cement (CPC) is a promising material for use in minimally invasive surgery for bone defect repairs due to its bone-like apatitic final setting product, biocompatibility, bioactivity, self-setting characteristics, low setting temperature, adequate stiffness, and easy shaping into complicated geometrics. However, even though CPC is stable in vivo, the resorption rate of this bone cement is very slow and its long setting time poses difficulties for clinical use. Calcium sulfate dehydrate (CSD) has been used as a filler material and/or as a replacement for cancellous bone grafts due to its biocompatibility. However, it is resorbed too quickly to be optimal for bone regeneration. This study examines the invivo response of a hydroxyapatite (HA), [apatitic phase (AP)]/calcium sulfate (CSD) composite using different ratios in the mandibular premolar sockets of beagles. The HA (AP)/CSD composite materials were prepared in the ratios of 30/70, 50/50, and 70/30 and then implanted into the mandibular premolar sockets for terms of 5 and 10 weeks. The control socket was left empty. The study shows better new bone morphology and more new bone area in the histological and the histomorphometric study of the HA (AP)/CSD in the 50/50 ratio.