Influence of air abrasion and sonic technique on microtensile bond strength of one-step self-etch adhesive on human dentin.

The purpose of this in vitro study was to evaluate the microtensile bond strength of one-step self-etch adhesive to human dentin surface modified with air abrasion and sonic technique and to assess the morphological characteristics of the pretreated dentin surface. The occlusal enamel was removed to obtain a flat dentin surface for thirty-six human molar teeth. The teeth were randomly divided into three experimental groups (n = 12 per group), according to the pretreatment of the dentin: (1) control group, (2) air abrasion group, and (3) sonic preparation group. Microtensile bond strength test was performed on a universal testing machine. Two specimens from each experimental group were subjected to SEM examination. There was no statistically significant difference in bond strength between the three experimental groups (P > 0.05). Mean microtensile bond strength (MPa) values were 35.3 ± 12.8 for control group, 35.8 ± 13.5 for air abrasion group, and 37.7 ± 12.0 for sonic preparation group. The use of air abrasion and sonic preparation with one-step self-etch adhesive does not appear to enhance or impair microtensile bond strength in dentin.

Influence of mechanical instruments on the biocompatibility of titanium dental implants surfaces: a systematic review.

OBJECTIVE: The objective of this systematic review was to evaluate the effect of mechanical instruments on the biocompatibility of titanium dental implant surfaces. MATERIALS AND METHODS: MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to December 2013, to identify controlled studies on the ability of cells to adhere and colonize non-contaminated and contaminated, smooth and rough, titanium surfaces after instrumentation with different mechanical instruments. RESULTS: A comprehensive search identified 1893 unique potential papers. Eleven studies met the inclusion criteria and were selected for this review. All studies were in vitro studies. Most studies used titanium discs, strips and cylinders. The air abrasive was the treatment mostly evaluated. The available studies had a high heterogeneity which precluded any statistical analysis of the data. Therefore, the conclusions are not based on quantitative data. Instrumentation seems to have a selective influence on the attachment of different cells. In the presence of contamination, plastic curettes, metal curettes, rotating titanium brushes and an ultrasonic scaling system with a carbon tip and polishing fluid seem to fail to restore the biocompatibility of rough titanium surfaces. The air-powder abrasive system with sodium bicarbonate powder does not seem to affect the fibroblast-titanium surface interaction after treatment of smooth or rough surfaces, even in the presence of contamination. CONCLUSION: The available data suggest that treatment with an air-powder abrasive system with sodium bicarbonate powder does not seem to adversely affect the biocompatibility of titanium dental implant surfaces. However, the clinical impact of these findings requires further clarification.

Taurolidine as an effective and biocompatible additive for plaque-removing techniques on implant surfaces.

OBJECTIVES: The aim of the present study was the evaluation of the effectiveness and efficiency of two plaque-removing techniques, plastic curettes (PC) and glycine powder airflow (GLY) in combination with taurolidine (T), chlorhexidine (CHX), or pure water (PW) as additives and compared to groups without previous treatment (NT). MATERIALS AND METHODS: Plaque was collected on titanium samples for 48 h in six subjects. Specimens were worn in a special splint in the upper jaw and randomly assigned to test and control groups. After biofilm removal procedures, clean implant surface (CIS) on the samples and treatment time were taken as parameters. RESULTS: Mean CIS was determined in the following descending order: T-GLY > CHX-GLY > NT-GLY > T-PC > PW-GLY > PW-PC > CHX-PC > NT-PC. Mean treatment time was determined in the following ascending order: T-GLY < CHX-GLY < PW-GLY < NT-GLY < T-PC < CHX-PC < PW-PC < NT-PC. CONCLUSIONS: Within the limits of this study, it can be concluded that T showed the highest CIS in the GLY and PC groups. T-GLY showed significantly more CIS than all other GLY groups. The T-PC group showed significantly more CIS than all other PC groups. The treatment times of the T groups were significantly lower than their corresponding PC or GLY groups. CLINICAL RELEVANCE: The results of the current study indicate that taurolidine seems to enhance effectiveness of plaque-removing procedures with plastic curettes and glycine powder airflow. Also, the efficiency of both treatment procedures seems to be increased.

Comparison of relative efficacy of two techniques of enamel stain removal on fluorosed teeth. An in vivo study.

OBJECTIVE: The present study was conducted to compare and evaluate the relative efficacy of enamel microabrasion (using 18% HCl) and bleaching with McInnes solution in the esthetic improvement of fluorosed teeth and to check postoperative sensitivity. STUDY DESIGN: 30 children aged between 9-14yrs with a mild or moderate grade of fluorosis as classified according to Dean's fluorosis index and who complained of objectionable esthetics were selected. Split mouth study design was selected in our study. Each subject had one of their maxillary central incisor randomly selected for Enamel microabrasion and the contra lateral maxillary central incisor for McInnes bleaching. Esthetic improvement was assessed by comparing the pre and postoperative digital photographs. During the evaluation session, the pre and postoperative photographs of 30 subjects were incorporated into a power point presentation and were projected side by side in a darkened room. Four calibrated and blinded examiners, including a layman rated the photographs under standardized viewing conditions. Esthetic improvement was assessed for both short and long term improvement. The postoperative sensitivity was recorded for both the procedures immediately after treatment and at one, three and six months interval. RESULTS: The results proved that both immediate and long term (6 month) esthetic improvement achieved by McInnes bleaching were superior to enamel microabrasion. There is a reduction in aesthetics of teeth in both the procedures after six months, which was very minimal in McInnes procedure and significant in enamel micro abrasion. Postoperative sensitivity in both techniques were negligible. The sensitivity observed were transient and subsided within an one-month post operatively. None of the subjects reported sensitivity at one, three and six months intervals. CONCLUSION: McInnes bleaching is a better procedure compared to enamel microabrasion in improving the appearance of fluorosed teeth. Both techniques are conservative and safe.

[Subcutaneous emphysema following non-surgical peri-implantitis therapy using an air abrasive device: a case report]. / Subkutanes Emphysem nach nicht chirurgischer Periimplantitistherapie nach der Anwendung einer Air-Flow-Einheit.

Subcutaneous emphysema are rare complications in periodontology. In most cases, they resolve spontaneously. However, air might disperse into deeper facial spaces causing life-threatening complications such as compression of the tracheobronchial tree or the development of pneumomediastinum. Moreover, microorganisms might spread from the oral cavity into deeper spaces. Hence, rapid diagnosis of subcutaneous emphysema is important. Characteristic signs are both a shiftable swelling and a crepitation. In this case report, the case of a 69-year old man with a subcutaneous emphysema immediately after peri-implantitis therapy with the use of a glycine-based powder air-polishing device is described. Following therapy, air accumulated in the left side of the face. Seven days after non-surgical peri-implantitis therapy, the patient was asymptomatic with complete resolution of the emphysema.

Effect of different surface-cleaning techniques on the bond strength of composite resin restorations.

STATEMENT OF PROBLEM: Different techniques have been suggested for cleaning dentin surfaces after the removal of an interim prosthesis and before the application of a bonding agent. How different surface-cleaning techniques affect the bond strength of the composite resin restorations is not clear. PURPOSE: The purpose of this study was to investigate the effects of different surface-cleaning techniques on the bond strength of composite resin restorations and the surface topography of the prepared tooth surfaces. MATERIAL AND METHODS: The occlusal surfaces of 25 molars were ground until the dentin was exposed. A bonding agent and interim cement were applied on the teeth. The teeth were divided into 5 groups (n=5) according to the method used for surface-cleaning (microairborne-particle abrasion, alcohol, rubber-rotary instrument, desiccating agent, and control). Once the surfaces of the teeth had been cleaned, the same bonding material was applied to the teeth. A 5-mm-thick composite resin layer was built up. Each specimen was sectioned to microbars, and 6 centrally located beams were selected for microtensile testing (n=30) (1.10 ±0.10 mm). The data were statistically analyzed with 1-way ANOVA (1-sample Kolmogorov-Smirnov test). The Bonferroni test was used for significantly different groups (α=.05). One specimen from each group was observed under a scanning electron microscope and an atomic force microscope. Energy dispersive x-ray analysis also was performed. RESULTS: Bond strength values were in the following descending order: microairborne-particle abrasion, desiccating agent, alcohol, rubber-rotary instrument, control. Differences between the microairborne-particle abrasion group and the remainder of the groups, desiccating agent--rubber-rotary instrument, desiccating agent-control, alcohol--rubber-rotary instrument, and alcohol-control groups, were statistically significant (P<.05). The microairborne-particle abrasion group displayed the roughest surface and a different surface topography from the remainder of the groups. Increased aluminum was observed in the microairborne-particle abrasion group. CONCLUSIONS: Surface-cleaning techniques, except for the rubber-rotary instrument, increased the bond strength of composite resin. The roughest dentin surfaces and highest bond strength were achieved with the microairborne-particle abrasion technique.

Evaluation of an air-abrasive device with amino acid glycine-powder during surgical treatment of peri-implantitis.

OBJECTIVE: The aim of this retrospective study was to analyze collected data concerning the effect of an air-abrasive device (Perio-Flow®) during surgical treatment of peri-implantitis without addition of any antimicrobials. METHOD AND MATERIALS: Data reports from 22 implants with peri-implantitis surgically treated using either an air-abrasive device (Perio- Flow) (test group), or plastic curettes and cotton pellets impregnated with saline (control group) were analyzed for the present study. Clinical and radiographic parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bone loss (BL) were previously assessed at baseline, 6 months, and 12 months after treatment. A repeated measures ANOVA test was used for each clinical and radiographic parameter (PI, GI, PPD, and BL). The implant and the patient were considered separately as the statistical unit. RESULTS: Regarding betweengroup comparisons, PI scores remained low during the entire study period (at implant and patient levels). At the end of the study, GI and PPD reductions were statistically higher (P < .05) in the Perio-Flow group (implant level), and no differences were observed between the two groups at patient level (P > .05) (repeated measures ANOVA test). It was also noted that BL analyses (implant and patient levels) revealed no differences between baseline and 12 months in both groups. Nevertheless, only 8% from each treatment group were considered stabilized after 12 months. CONCLUSION: Within the limitations of the present study, both groups (Perio-Flow and its control group) revealed a significant reduction of the clinical parameters. Moreover, the air-abrasive device group yielded better improvements regarding GI and PPD when the implant was considered as the statistical unit. However, if the stabilization of the disease was the final objective, these two treatments failed in resolving its activity. A longer follow-up and a larger number of patients would be needed to confirm these results and the benefit of adding this air-abrasive method of decontamination to the surgical procedure.

[Differential approach to air-abrasion powder choice in patients with periodontal disease].

Using literature review data and their own clinical experience the authors compare powders for dental air-abrasion procedures and formulate differential approach to powder choice in patients with periodontal disease.

Quantitative comparison of 3 enamel-stripping devices in vitro: how precisely can we strip teeth?

INTRODUCTION: In this in-vitro study, we aimed to investigate the predictability of the expected amount of stripping using 3 common stripping devices on premolars. METHODS: One hundred eighty extracted premolars were mounted and aligned in silicone. Tooth mobility was tested with Periotest (Medizintechnik Gulden, Modautal, Germany) (8.3 ± 2.8 units). The selected methods for interproximal enamel reduction were hand-pulled strips (Horico, Hapf Ringleb & Company, Berlin, Germany), oscillating segmental disks (O-drive-OD 30; KaVo Dental, Biberach, Germany), and motor-driven abrasive strips (Orthofile; SDC Switzerland, Lugano-Grancia, Switzerland). With each device, the operator intended to strip 0.1, 0.2, 0.3, or 0.4 mm on the mesial side of 15 teeth. The teeth were scanned before and after stripping with a 3-dimensional laser scanner. Superposition and measurement of stripped enamel on the most mesial point of the tooth were conducted with Viewbox software (dHal Software, Kifissia, Greece). The Wilcoxon signed rank test and the Kruskal-Wallis test were applied; statistical significance was set at alpha ≤ 0.05. RESULTS: Large variations between the intended and the actual amounts of stripped enamel, and between stripping procedures, were observed. Significant differences were found at 0.1 mm of intended stripping (P ≤ 0.05) for the hand-pulled method and at 0.4 mm of intended stripping (P ≤ 0.001 to P = 0.05) for all methods. For all scenarios of enamel reduction, the actual amount of stripping was less than the predetermined and expected amount of stripping. The Kruskal-Wallis analysis showed no significant differences between the 3 methods. CONCLUSIONS: There were variations in the stripped amounts of enamel, and the stripping technique did not appear to be a significant predictor of the actual amount of enamel reduction. In most cases, actual stripping was less than the intended amount of enamel reduction.

A paradigm shift in mechanical biofilm management? Subgingival air polishing: a new way to improve mechanical biofilm management in the dental practice.

In the past few years indications for the use of the air polishing technology have been expanded from supragingival use (airflow) to subgingival air polishing (perioflow) by the development of new low-abrasive glycine-based powders and devices with a subgingival nozzle. Several studies on the subgingival use of air polishing have been completed. On 7 June 2012, during the Europerio 7 Congress in Vienna, a consensus conference on mechanical biofilm management took place aiming to review the current evidence from the literature on the clinical relevance of the subgingival use of air polishing and to make practical recommendations for the clinician. Bernita Bush (Bern), Prof Johannes Einwag (Stuttgart), Prof Thomas Flemmig (Seattle), Carmen Lanoway (Munich), Prof Ursula Platzer (Hamburg), Prof Petra Schmage (Hamburg), Brigitte Schoeneich (Zurich), Prof Anton Sculean (Bern), Dr Clemens Walter (Basel), and Prof Jan Wennström (Gothenburg) discussed under the moderation of Klaus-Dieter Bastendorf and Christian Becker (both ADIC Association for Dental Infection Control) the available clinical studies to reach a consensus on available clinical evidence. This paper summarizes the main conclusions of the consensus conference and points to the clinical relevance of the findings for the dental practitioner.

Minimally invasive treatment for esthetic management of severe dental fluorosis: a case report.

Dental fluorosis is a developmental disturbance of enamel caused by excessive fluoride on ameloblasts during enamel formation. Patients often present to the dentist with a main goal of improving their esthetic appearance. This case report describes a minimally invasive technique for treating a severe case of enamel fluorosis with brown surface aspect and small defects. A selective mega-abrasion and microabrasion were used to recreate macro- and micro- surface morphology, followed by power bleaching, home bleaching, and resin infiltration to improve the esthetic appearance.

Pulp hyperthermia during tooth preparation: the effect of rotary--instruments, lasers, ultrasonic devices, and airborne particle abrasion.

The rise in pulp temperature during restorative therapy can compromise vitality of the dental pulp. Of the various reasons for the increase in intrapulpal temperature, tooth preparation is considered to be the primary cause. This article describes the reasons for the rise in pulp temperature during various modalities of tooth preparation. The article also comments on the measures that need to be taken to avoid the risk of pulp hyperthermia during tooth preparation.

Non-surgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine: a prospective, randomized, controlled clinical study.

OBJECTIVES: The aim of this prospective, parallel group designed, randomized controlled clinical study was to evaluate the effectiveness of an air-abrasive device (AAD) for non-surgical treatment of peri-implantitis. MATERIAL AND METHODS: Thirty patients, each of whom displayed at least one implant with initial to moderate peri-implantitis, were enrolled in an oral hygiene program (OHI) and randomly instrumented using either (1) AAD (amino acid glycine powder) or (2) mechanical debridement using carbon curets and antiseptic therapy with chlorhexidine digluconate (MDA). Clinical parameters were measured at baseline, 3 and 6 months after treatment [e.g. bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL)]. RESULTS: At 6 months, AAD group revealed significantly higher (p<0.05; unpaired t-test) changes in mean BOP scores when compared with MDA-treated sites (43.5 ± 27.7%versus 11.0 ± 15.7%). Both groups exhibited comparable PD reductions (AAD: 0.6 ± 0.6 mm versus MDA: 0.5 ± 0.6 mm) and CAL gains (AAD: 0.4 ± 0.7 mm versus MDA: 0.5 ± 0.8 mm) (p>0.05; unpaired t-test, respectively). CONCLUSIONS: Within its limitations, the present study has indicated that (i) both treatment procedures resulted in comparable but limited CAL gains at 6 months, and (ii) OHI+AAD was associated with significantly higher BOP reductions than OHI+MDA.

Dental health assessed after interproximal enamel reduction: caries risk in posterior teeth.

INTRODUCTION: We investigated whether careful interdental enamel reduction (using extrafine diamond disks with air cooling, followed by contouring with triangular diamond burs and polishing) leads to increased caries risk in premolars and first molars. METHODS: Our subjects were 43 consecutive patients from 19 to 71 years of age who had received mesiodistal enamel reduction of anterior and posterior teeth 4 to 6 years previously. Dental caries were assessed on standardized bite-wing radiographs according to a 5-grade scale and with a fine-tip explorer catch. The incidence of interproximal caries was compared between reproximated and unground contralateral surfaces in the same patient. Patients were asked about their toothbrushing habits, use of dental floss and toothpicks, and regular fluoride supplementation after the orthodontic appliances were removed. RESULTS: The overall clinical impression generally showed healthy dentitions with excellent occlusion. Only 7 (2.5%) new caries lesions (all grade 1) were found among 278 reproximated mesial or distal surfaces, in 3 patients. Among 84 contralateral unground reference tooth surfaces, 2 lesions (2.4%) were seen. On nonpaired premolars and molars that had not been ground, 23 surfaces had to be referred for caries treatment (grade 3 or occlusal caries). Eleven of these occurred in 1 patient. None of the 43 patients reported increased sensitivity to temperature variations. CONCLUSIONS: Interdental enamel reduction with this protocol did not result in increased caries risk in posterior teeth. We found no evidence that proper mesiodistal enamel reduction within recognized limits and in appropriate situations will cause harm to the teeth and supporting structures.

Silica coating on alumina ceramic: comparison of three chairside air-abrasion devices working for different times and distances.

AIM: This study evaluated, by scanning electron microscope (SEM) and EDS, the effect of different strategies for silica coating (sandblasters, time and distance) of a glass-infiltrated ceramic (In-Ceram Alumina). METHODS: Forty-one ceramic blocks were produced. For comparison of the three air-abrasion devices, 15 ceramic samples were divided in three groups (N.=5): Bioart, Microetcher and Ronvig (air-abrasion parameters: 20 s at a distance of 10 mm). For evaluation of the time and distance factors, ceramic samples (N.=5) were allocated in groups considering three applied times (5 s, 13 s and 20 s) and two distances (10 mm and 20 mm), using the Ronvig device. In a control sample, no surface treatment was performed. After that, the micro-morphologic analyzes of the ceramic surfaces were made using SEM. EDS analyzes were carried out to detect the % of silica on representative ceramic surface. ANOVA and Tukey tests were used to analyze the results. RESULTS: One-way ANOVA showed the silica deposition was different for different devices (P=0.0054). The Ronvig device promoted the highest silica coating compared to the other devices (Tukey test). Two-way ANOVA showed the distance and time factors did not affect significantly the silica deposition (application time and distance showed no statistical difference). CONCLUSION: The Ronvig device provided the most effective silica deposition on glass-infiltrated alumina ceramic surface and the studied time and distance for air-abrasion did not affect the silica coating.

An in vitro evaluation of selective demineralised enamel removal using bio-active glass air abrasion.

Unnecessary over-preparation of carious enamel often occurs clinically during operative caries management. The working hypothesis to be investigated in this study is the potential for bio-active glass air abrasion to remove selectively only demineralised enamel in artificial enamel lesions when compared to equivalent alumina air abrasion, so potentially minimising cavity over-preparation. Bisected artificial, paired smooth surface enamel lesions on ethics-approved, extracted sound human molars were created and subsequently air abraded with 27 µm alumina (n = 19) and bio-active glass (n = 19). The difference between pre-operative lesion boundary and post-operative cavity margin was calculated following optical confocal fluorescent assessment of the lesion boundary. Data indicated mean% over-preparation (sound enamel removal) of 176% with alumina and 15.2% for bio-active glass (p = 0.005). Bio-active glass abrasion removed completely the demineralised enamel from artificial lesions with clinically insignificant over-preparation of sound tissue, indicating technique selectivity towards grossly demineralised enamel. Alumina air abrasion resulted in substantial enamel removal in both sound and demineralised tissues indicating the operator selectivity required to use the techniques effectively in clinical practice.