Enhanced audiovisual associative pair learning in migraine without aura in adult patients: An unexpected finding.

BACKGROUND: Altered sensory processing in migraine has been demonstrated by several studies in unimodal, and especially visual, tasks. While there is some limited evidence hinting at potential alterations in multisensory processing among migraine sufferers, this aspect remains relatively unexplored. This study investigated the interictal cognitive performance of migraine patients without aura compared to matched controls, focusing on associative learning, recall, and transfer abilities through the Sound-Face Test, an audiovisual test based on the principles of the Rutgers Acquired Equivalence Test. MATERIALS AND METHODS: The performance of 42 volunteering migraine patients was compared to the data of 42 matched controls, selected from a database of healthy volunteers who had taken the test earlier. The study aimed to compare the groups' performance in learning, recall, and the ability to transfer learned associations. RESULTS: Migraine patients demonstrated significantly superior associative learning as compared to controls, requiring fewer trials, and making fewer errors during the acquisition phase. However, no significant differences were observed in retrieval error ratios, generalization error ratios, or reaction times between migraine patients and controls in later stages of the test. CONCLUSION: The results of our study support those of previous investigations, which concluded that multisensory processing exhibits a unique pattern in migraine. The specific finding that associative audiovisual pair learning is more effective in adult migraine patients than in matched controls is unexpected. If the phenomenon is not an artifact, it may be assumed to be a combined result of the hypersensitivity present in migraine and the sensory threshold-lowering effect of multisensory integration.

Crack propensity of different direct restorative procedures in deep MOD cavities.

OBJECTIVE: The purpose was to evaluate the crack formation associated with different direct restorative procedures of the utilized resin composites (RC) right after and 1 week later of the restoration. MATERIALS AND METHODS: Eighty intact, crack-free third molars with standard MOD cavities were included in this in vitro study and randomly divided into four groups of 20 each. After adhesive treatment, the cavities were restored either with bulk (group 1) or layered (group 2) short-fiber-reinforced resin composites (SFRC); bulk-fill RC (group 3); and layered conventional RC (control). Right after the polymerization and a week later, crack evaluation on the outer surface of the remaining cavity walls was performed with a transillumination method utilizing the D-Light Pro (GC Europe) with the "detection mode." Between- and within-groups comparisons Kruskal-Wallis and Wilcoxon tests were used, respectively. RESULTS: Post-polymerization crack evaluation showed significantly lower crack formation in SFRC groups compared to the control (p<0.001). There was no significant difference within SFRC groups and non-SFRC groups (p=1.00 and p=0.11, respectively). Within group comparison revealed significantly higher number of cracks in all groups after 1 week (p≤0.001), however, only the control group differed significantly from all the other groups (p≤0.003). CONCLUSIONS: Post-polymerization shrinkage induced further crack formation in the tooth 1 week after the restoration. SFRC was less prone to shrinkage-related crack formation during the restorative procedure; however, after 1 week, besides SFRC, bulk-fill RC also showed less prone to polymerization shrinkage-related crack formation than layered composite fillings. CLINICAL RELEVANCE: SRFC can decrease the shrinkage stress-induced crack formation in MOD cavities.

Fatigue performance of endodontically treated molars reinforced with different fiber systems.

OBJECTIVE: The aim was to investigate the fatigue performance of root canal-treated (RCT) molars restored with different direct restorations utilizing discontinuous and continuous fiber-reinforced composite (FRC) systems. The impact of direct cuspal coverage was also evaluated. MATERIALS AND METHODS: One hundred and twenty intact third molars extracted for periodontal or orthodontic reasons were randomly divided into six groups (n=20). Standardized MOD, regular cavities for direct restorations were prepared in all specimens, and subsequently, root canal treatment and root canal obturation was carried out. After the endodontic treatment, the cavities were restored with different fiber-reinforced direct restorations as follows: SFC group (control), discontinuous short fiber-reinforced composite (SFC) without cuspal coverage (CC); SFC+CC group, SFC with cuspal coverage; PFRC group, transcoronal fixation with continuous polyethylene fibers without CC; PFRC+CC group, transcoronal fixation with continuous polyethylene fibers with CC; GFRC group, continuous glass FRC post without CC; and GFRC+CC, continuous glass FRC post with CC. All specimens underwent a fatigue survival test in a cyclic loading machine until fracture occurred or 40,000 cycles were completed. The Kaplan-Meier survival analysis was conducted, followed by pairwise log-rank post hoc comparisons between the individual groups (Mantel-Cox). RESULTS: The PFRC+CC group was characterized by significantly higher survival compared to all the groups (p < 0.05), except for the control group (p = 0.317). In contrast, the GFRC group showed significantly lower survival compared to all the groups (p < 0.05), except for the SFC+CC group (p = 0.118). The control group (SFC) showed statistically higher survival than the SFRC+CC group (p < 0.05) and GFRC group (p < 0.05), but it did not differ significantly from the rest of the groups in terms of survival. CONCLUSIONS: Direct restorations utilizing continuous FRC systems (in the form of polyethylene fibers or FRC post) to restore RCT molar MOD cavities performed better in terms of fatigue resistance when CC was performed compared to the same FRC restorations without CC. On the contrary, teeth restored with SFC restorations performed better without CC compared to the ones where SFC was covered. CLINICAL RELEVANCE: In the case of fiber-reinforced direct restorations for MOD cavities in RCT molars, direct CC is recommended when utilizing long continuous fibers for reinforcement, however, should be avoided when only SFC is used for their reinforcement.

Accuracy of half-guided implant placement with machine-driven or manual insertion: a prospective, randomized clinical study.

OBJECTIVES: To compare the accuracy of implant placement performed with either a surgical motor or a torque wrench as part of a half-guided surgical protocol. MATERIALS AND METHODS: Implant insertion with half-guided surgical protocol was utilized by surgical motor (machine-driven group) or torque wrench (manual group) in the posterior maxilla. After the healing period, accuracy comparison between planned and actual implant positions was performed based on preoperative cone beam computed tomography and postoperative digital intraoral scans. Coronal, apical, and angular deviations, insertion time, and insertion torque were evaluated. RESULTS: Forty patients were treated with 1 implant each; 20 implants were inserted with a surgical motor and 20 implants with a torque wrench. Global coronal and apical deviations were 1.20 ± 0.46 mm and 1.45 ± 0.79 mm in the machine-driven group, and 1.13 ± 0.38 mm and 1.18 ± 0.28 mm in the manual group (respectively). The mean angular deviation was 4.82 ± 2.07° in the machine-driven group and 4.11 ± 1.63° in the manual group. Mean insertion torque was 21.75 ± 9.75 Ncm in the machine-driven group, compared to 18.75 ± 7.05 Ncm in the manual group. Implant placement duration was 9.25 ± 1.86 s in the machine-driven group at a speed of 50 rpm, and 36.40 ± 8.15 s in the manual group. CONCLUSION: No significant difference was found between the two groups in terms of accuracy and mean insertion torque, while machine-driven implant placement was significantly less time-consuming. CLINICAL RELEVANCE: Optimal implant placement accuracy utilized by half-guided surgical protocol can be achieved with both machine-driven and torque wrench insertion. TRIAL REGISTRATION: ID: NCT04854239.

Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores.

OBJECTIVES: The aim of this in vitro study was to investigate the fatigue survival and fracture behavior of endodontically treated (ET) premolars restored with different types of post-core and cuspal coverage restorations. MATERIALS AND METHODS: MOD cavities were prepared on 108 extracted maxillary premolars. During the endodontic treatment, all teeth were instrumented with rotary files (ProTaper Universal) to the same apical enlargement (F2) and were obturated with a matched single cone obturation. After the endodontic procedure, the cavities were restored with different post-core and overlay restorations (n = 12/group). Three groups (A1-A3) were restored with either conventional composite core (PFC; control) or flowable short-fiber-reinforced composite (SFRC) core with/without custom-made fiber posts and without overlays. Six groups had similar post-core foundations as described above but with either direct PFC (B1-B3) or indirect CAD/CAM (C1-C3) overlays. Fatigue survival was tested for all restorations using a cyclic loading machine until fracture occurred or 50,000 cycles were completed. Kaplan-Meyer survival analysis was conducted, followed by pairwise post hoc comparisons. RESULTS: None of the restored teeth survived all 50,000. Application of flowable SFRC as luting-core material with fiber post and CAD/CAD overlays (Group C3) showed superior performance regarding fatigue survival (p < 0.05) to all the other groups. Flowable SFRC with fiber post and direct overlay (Group B3) showed superior survival compared to all other direct techniques (p < 0.05), except for the same post-core foundation but without cuspal coverage (Group A3). CONCLUSIONS: Custom-made fiber post and SFRC as post luting core material with or without cuspal coverage performed well in terms of fatigue resistance and survival when used for the restoration of ET premolars. CLINICAL RELEVANCE: The fatigue survival of direct and indirect cuspal coverage restorations in ET MOD premolars is highly dependent on whether the core build-up is fiber-reinforced or not. The combination of short and long fibers in the form of individualized post-cores seems to offer a favorable solution in this situation.

Visually guided associative learning in pediatric and adult migraine without aura.

INTRODUCTION: The Rutgers Acquired Equivalence Test is a visually guided equivalence learning paradigm that involves rule acquisition and generalization. Earlier we found impaired performance in this paradigm among adult migraine patients without aura. The aim of the study was to investigate if similar impairments can be found already in the pediatric form of the disease and to compare the performance of the pediatric study population with that of an adult study population. We hypothesized that the deficits observed in adults would be observable already in the pediatric population. METHODS: Twenty-seven children and adolescents newly diagnosed with migraine without aura and 27 age- and sex-matched healthy controls were tested with the Rutgers Acquired Equivalence Test. Their performance data were compared to each other and those of an earlier adult study population involving 22 patients and 22 age- and sex-matched healthy controls. Four parameters characterizing performance in the two main phases of the paradigm were calculated for each of the four groups. Performance parameters were compared with Mann-Whitney U test. RESULTS: In contrast to the decreased performance of the adult patients in the Rutgers Acquired Equivalence Test, no significant difference was found between pediatric patients and controls in any phase of the paradigm. CONCLUSION: Children living with migraine without aura do not exhibit the same cognitive deficits in the Rutgers Acquired Equivalence Test as their adult counterparts. It can be hypothesized that the deficit of equivalence learning is not an inherent feature of the migrainous cognitive profile, rather the result of the interference of the disease with normal development.

Fatigue failure load of immature anterior teeth: influence of different fiber post-core systems.

The aim was to explore the fracture-behavior, survival and marginal-microgaps within the root-canal of immature anterior teeth restored with different fiber-reinforced post-core composites (FRCs). 180 bovine-incisors were randomly divided into 6 groups (n = 30). One group served as control (group 6). The rest of the teeth were prepared to an internal diameter of 1.6 mm and the apex was sectioned. After application of an MTA-plug, teeth were restored with FRC materials: Group 1: Bioblock technique with short fiber-reinforced composite (SFRC); Group 2: Bioblock technique with flowable SFRC; Group 3: Individually-made FRC post; Group 4: Conventional FRC post; Group 5: dual-cure core build-up composite. After restorations were completed, teeth (n = 5/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root-canal was calculated. Fatigue-survival was measured using a cyclic-loading testing machine in the rest of the specimens. Flowable SFRC application in the root-canal (Group 2) did not differ from intact-teeth regarding fatigue-survival (p > 0.05). The rest of the groups produced significantly lower survival (p < 0.05) compared to intact-teeth. Post/core restorations made from conventional FRC post (Group 4) exhibited a high number of microgaps (38.3%) at the examined interphase in the root-canal. The restoration of immature incisors with the use of flowable SFRC as post-core material displayed promising performance in a matter of fatigue-resistance and survival.

Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation.

OBJECTIVES: A randomized clinical trial was conducted to compare all three known static guided surgery protocols (pilot, partial, and full) with each other and with freehand surgery in terms of accuracy, under the same conditions. MATERIAL AND METHODS: A total of 207 implants of the same brand and type were placed in 101 partially edentulous volunteers in need of implantation in the mandible or maxilla or both. All cases were digitally planned, and the comparison of the planned and actual implant positions was performed using a medical image analysis software with dedicated algorithms. The primary outcome variable was angular deviation (AD, degrees). The secondary outcome variables were coronal global deviation (CGD, mm), apical global deviation (AGD, mm), and voxel overlap (VO, %). RESULTS: AD showed stepwise improvement in significant steps as the amount of guidance increased. The highest mean AD (7.03° ± 3.44) was obtained by freehand surgery and the lowest by fully guided surgery (3.04° ± 1.51). As for the secondary outcome variables, all guided protocols turned out to be significantly superior to freehand surgery, but they were not always significantly different from each other. CONCLUSIONS: As for the comparison that this study sought to perform, it can be said that the static guided approach significantly improves the accuracy of dental implant surgery as compared to freehand surgery. Furthermore, the results suggest that any degree of guidance yields better results than freehand surgery and that increasing the level of guidance increases accuracy.

Fracture resistance and marginal gap formation of post-core restorations: influence of different fiber-reinforced composites.

OBJECTIVES: The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced post-core composites (FRCs). Further aim was to evaluate the composite curing at different depths in the canal. MATERIALS AND METHODS: Eighty-seven intact upper premolars were collected and randomly divided into six groups. After endodontic procedure, standard MOD cavities were prepared and restored with their respective fiber-reinforced post-core materials: group 1: prefabricated unidirectional FRC-post + conventional composite core; group 2: prefabricated unidirectional FRC-post + short fiber composite (SFRC) core; group 3: individually formed unidirectional FRC-post + conventional composite core; group 4: randomly oriented SFRC directly layered as post and core; group 5: individually formed unidirectional FRC + randomly oriented SFRC as post and core. After restorations were completed, teeth (n = 3/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root canal was calculated. Fracture load was measured using universal testing machine. RESULTS: SFRC application in the root canal (groups 4 and 5) showed significantly higher fracture load (876.7 N) compared to the other tested groups (512-613 N) (p < 0.05). Post/core restorations made from prefabricated FRC-post (group 1) exhibited the highest number of microgaps (35.1%) at the examined interphase in the root canal. CONCLUSIONS: The restoration of ET premolars with the use of SFRC as post-core material displayed promising performance in matter of microgap and load-bearing capacity. CLINICAL SIGNIFICANCE: Fracture resistance of ET premolar restored by bilayered composite restoration that includes both SFRC as post-core material and surface conventional resin seems to be beneficial.

Fracture behavior of root-amputated teeth at different amount of periodontal support - a preliminary in vitro study.

BACKGROUND: The purpose of this study was to evaluate the effect of the amount of periodontal support on the fracture resistance of root-amputated maxillary molar teeth restored with either direct class. I. restorations or class II. mesio-occluso-distal (MOD) indirect overlay restorations with cuspal coverage. METHODS: Sixty sound maxillary first molars were collected and randomly divided into four groups. In Groups 1 and 2, MOD cavities were prepared and all cusps were reduced by 2 mm, whereas in Group 3 and 4, only a conservative Class I. cavity was prepared. Subsequently, root canal treatment was performed and the mesio-buccal roots were amputated. Groups 1 and 2 were restored with indirect composite overlay, while Groups 3 and 4 received direct composite fillings. After restoration, teeth were embedded as follows: Groups 1 and 3: normal bone level, Groups 2 and 4: furcation involvement. The specimens were submitted to static fracture resistance testing. Fracture thresholds and fracture patterns were measured and evaluated. RESULTS: Group 1 had the highest fracture resistance (2311,6 N) among the restored groups and showed statistically significant difference compared to Group 2 (p = 0.038) and Group 4 (p = 0.011). There was no statistically significant difference in terms of fracture resistance between the rest of the groups. In terms of the fracture patterns, Group 3 was characterized by the highest percentage (60%) of mostly favorable fractures, while the rest of the groups showed predominantly unfavorable ones. CONCLUSIONS: The amount of periodontal support seems to influence the fracture resistance of root-amputated and restored maxillary molars.

In Vitro Fracture Resistance of Adhesively Restored Molar Teeth with Different MOD Cavity Dimensions.

PURPOSE: Molar MOD (mesial-occlusal-distal) cavity preparation weakens relative cuspal stiffness by up to 63%, often resulting in cuspal fracture. This investigation inspects fracture resistance of MOD cavities restored using direct composite restoration. MATERIALS AND METHODS: 120 extracted, intact mandibular molars were selected. MOD cavities with different depth/wall thickness were prepared in 9 groups (n = 12): A: 3 mm/3.5 mm, B: 3 mm/2.5 mm, C: 3 mm/1.5 mm, D: 5 mm/3.5 mm, E: 5 mm/2.5 mm, F: 5 mm/1.5 mm, G: 7 mm/3.5 mm, H: 7 mm/2.5 mm, I: 7 mm/1.5 mm. Specimens with 7 mm deep cavities received root canal treatment. The teeth were restored with dental composite. Maximal fracture strength test was conducted. Intact natural teeth were used as control. For statistical analysis Kruskal-Wallis ANOVA with post-hoc pairwise comparisons was used (α = 0.05). RESULTS: Significant difference was indicated between the control and groups D, E, F, G, H, and I. No significant differences were found between the A, B, C groups and the control. Comparing the 5 and 7 mm cavity depth groups, there was no statistical difference between any of them. CONCLUSIONS: Within the limitations of this investigation, the following conclusions can be drawn regarding molar teeth with a MOD cavity: 3 mm or shallower cavities can be restored to the physiological fracture strength with direct composite restorations; 5 mm or deeper cavities cannot be restored to the physiological fracture strength with direct composite restorations. Cusp thickness does not significantly influence fracture strength in molar MOD cavities with a direct composite restoration.

TiO2/Ag-TiO2 Nanohybrid Films are Cytocompatible with Primary Epithelial Cells of Human Origin: An In Vitro Study.

Failure of dental implants is caused mainly by peri-implant infections resulting in loss of supporting bone. Since there is no ideal therapy of peri-implantitis, the focus of research has been shifted toward better prevention and the development of antibacterial surfaces. In our study we examined the attachment and proliferation of primary epithelial and MG-63 osteosarcoma cells on Ti dental implants coated with photocatalytic nanohybrid films. Two polyacrylate resin based layers were investigated on commercially pure (CP4) Ti discs: 60 wt% TiO2/40 wt% copolymer and 60 wt% Ag-TiO2/40 wt% copolymer ([Ag] = 0,001 wt%). Surface properties were examined by scanning electron microscopy (SEM) and profilometry. Cell responses were investigated via dimethylthiazol-diphenyl tetrazolium bromide (MTT) and visualized with fluorescence microscopy. Profilometry revealed significant changes in surface roughness of TiO2 (Ra = 1.79 µm) and Ag-TiO2 layers (Ra = 5.76 µm) compared to the polished (Ra(P) = 0.13 µm) and sandblasted, acid-etched control surfaces (Ra(SA) = 1.26 µm). MTT results demonstrated that the attachment (24 h) of epithelial cells was significantly higher on the Ag-TiO2 coated samples (OD540 = 0.079) than on the polished control surfaces (OD540 = 0.046), whereas MG-63 cells did not show any difference in attachment between the groups. After one week, epithelial cells showed slightly increased survival as compared to MG-63 cells. The results suggest that the tested coatings are cytocompatible with epithelial cells, which means that they are not only antibacterial, but they also appear to be promising candidates for implantological use.

Intraosseous Heat Generation During Osteotomy Performed Freehand and Through Template With an Integrated Metal Guide Sleeve: An In Vitro Study.

OBJECTIVE: To investigate drill wear and consequent intraosseous temperature elevation during freehand and guided bone drilling, with attention to the effect of metal-on-metal contact during guided drilling. MATERIALS AND METHODS: Osteotomies were performed on bovine ribs, with 2.0 mm diameter stainless steel drill bits of the SMART Guide System, under 3 sterilization protocols, at 800, 1200, 1500, and 2000 rpm. Sterilization was performed after every 3 drilling. Temperature was measured after every 30 drilling. RESULTS: The studied contributing factors had a cumulative effect, and each contributed significantly to temperature elevation. Whether guide use led to a near-necrotic (47°C) temperature increment depended largely on the applied sterilization protocol. CONCLUSION: The metal sleeve is a significant contributing factor to heat generation during guided osteotomy, but its effect can be offset by keeping the other studied factors under control.

An observation on the severity of periodontal disease in past cigarette smokers suffering from rheumatoid arthritis- evidence for a long-term effect of cigarette smoke exposure?

BACKGROUND: Rheumatoid arthritis (RA) and cigarette smoking are both risk factors for periodontal disease (PD). Previous research suggests that systemic inflammatory conditions and cigarette smoking may act in synergy, and their co-occurrence leads to a much higher risk of developing severe stage PD than what the combination of their individual risks would suggest. We originally sought to test this in the case of RA, but it turned out that the majority of our patients were former smokers, who smoked for prolonged periods in the past. For that reason, we decided to shift our focus toward the possible effects of past chronic cigarette smoke exposure. METHODS: The data of 73 RA patients and 77 healthy controls were analyzed. The participants received a full-mouth periodontal examination to determine their periodontal status. Rheumatological indices and data on past tobacco use were also recorded. Both the patient and the control groups were divided into former smoker and non-smoker subgroups for the analyses. Non-smoker controls were used as the reference group. RESULTS: In the control group, smoking in history increased the odds of developing both the moderate and the severe stages of PD, but the change was not statistically significant. RA significantly, increased the odds of developing both stages in itself, but the highest odds were seen in the former smoker RA group. CONCLUSION: Based on this surprising observation of ours, we hypothesize that chronic cigarette smoke might bring about permanent changes in the periodontal tissues, leading to their hypersensitivity to inflammatory challenges.

Acquired equivalence and related memory processes in migraine without aura.

Introduction Interictal deficits of elementary visuo-cognitive functions are well documented in patients with migraine and are mostly explained in terms of neocortical hyperexcitability. It has been suggested that the basal ganglia and the hippocampi might also be affected in migraine. If so, a deterioration of learning and memory processes related to these structures is expected. Methods A visual learning paradigm thought to be capable of dissociating learning/memory processes mediated by the basal ganglia from processes mediated by the hippocampus (the Rutgers Acquired Equivalence Test) was applied to a group of patients with migraine without aura and to age- and sex-matched controls. Results Patients with migraine showed a significantly poorer performance in both main phases of the test and the deficit in the phase considered to be dependent on the hippocampi was especially marked. Conclusions These results can be interpreted as behavioural support for findings that have suggested the involvement of the basal ganglia and the hippocampi in migraine, but further research is needed to clarify these findings.

Further Evidence for the Utility of Electrophysiological Methods for the Detection of Subclinical Stage Retinal and Optic Nerve Involvement in Diabetes.

OBJECTIVE: To assess the utility of visual electrophysiological methods, visual evoked potentials (VEPs) and pattern electroretinograms (PERGs) were recorded for the detection of subclinical optic nerve and retinal involvement in patients with diabetes mellitus. SUBJECTS AND METHODS: The data of 63 patients (126 eyes) with no vascular retinopathy or optic neuropathy were retrospectively analyzed. The patients were divided into polyneuropathic/nonpolyneuropathic groups to differentiate between early and late subclinical stages. The recorded parameters were compared with local reference values. RESULTS: 116 eyes (92%) had VEP and 76 (60%) had PERG abnormalities. The most frequent alteration was latency delay, but waveform and amplitude irregularities were also observed. The simultaneous use of the two methods allowed us to differentiate abnormal VEPs of purely optic nerve origin from those reflecting retinal involvement. CONCLUSIONS: We suggest that regular electrophysiological screening should receive more attention in the ophthalmological care of diabetic patients.

Prasugrel Versus Clopidogrel: A Comparative Examination of Local Bleeding After Dental Extraction in Patients Receiving Dual Antiplatelet Therapy.

PURPOSE: To study the effects of various parameters on local hemostasis after dental extraction in patients receiving different combinations of medications who had previously confirmed effective dual inhibition of platelet aggregation. MATERIALS AND METHODS: A total of 129 patients were enrolled. They underwent acute or planned percutaneous coronary intervention and their stomatological examination disclosed teeth that could have acted as foci and thus had to be removed. All patients took acetylsalicylic acid 100 mg and clopidogrel or prasugrel. Lidocaine with or without epinephrine was used for local anesthesia, and a gauze swab or suture was applied to help hemostasis. RESULTS: Bleeding time was significantly longer by an average of 10 minutes (+21%) in patients taking prasugrel (P < .05) compared with those taking clopidogrel. Use of a suture resulted in a significantly shorter bleeding time after anesthesia with or without epinephrine (P < .05). A considerably longer bleeding time was observed when anesthesia with no epinephrine was combined with gauze. In smokers, the bleeding time was shorter by 15% on average. CONCLUSION: This study is the first to analyze differences in bleeding times between clopidogrel and prasugrel treatments during dental extraction. In general, prasugrel is associated with a considerably longer bleeding time; nevertheless, dental extraction can be performed safely with either combination.

Short- and Long-Term Influence of Fluoride-Containing Prophylactics on the Growth of Streptococcus mutans on Titanium Surface.

OBJECTIVES: Acidic pH and high fluoride (F(-)) concentration impair the corrosion resistance of titanium (Ti). Caries-preventive products contain high amounts of F(-) and are applied at low pH. The purpose of this study was to evaluate whether fluoride applied in different forms has different short-, mid-, and long-term effects on the growth of the bacteria Streptococcus mutans. MATERIALS AND METHODS: Ti discs with polished surface were treated with a rinse containing 0.025% olaflur, a gel containing 1.25% olaflur, or a 1% aqueous solution of NaF (pH 4.5), and they were incubated with S mutans for 21 days. Control discs did not get prophylactic treatment. Protein assay analysis was performed at regular intervals to estimate the amount of S mutans. Scanning electron microscopic (SEM) images were also taken. RESULTS: Bacterial protein quantity became significantly different only by the 21st day. Fluoride in rinse and gel proved to be superior to NaF in aqueous solution or no treatment (P < 0.01 and P < 0.05, respectively). However, the discs treated with fluoride in gel showed signs of corrosion in SEM images. CONCLUSION: The results suggest that the use of fluoride-containing mouthwashes might be the best and safest oral hygienic choice for patients with oral implants. Furthermore, olaflur seems to be superior to NaF for long-term use at low pH.

Dimensional Accuracy of Two-Step Impressions Measured on Scanned Casts in CAD.

PURPOSE: The purpose of the study was to find out how light-body impression material thickness influences the horizontal dimensional accuracy of casts examined on a scanned model. MATERIALS AND METHODS: Customized manikin mandibles were used for impression taking with a dual-phase impression method. These mandibles were prepared in a way that allowed the control of light-bodied impression material thickness. First premolars were prepared for a full crown by supragingival chamfer on both sides in all mandibles. For the measurements, buccal and lingual reference points were made at the preparation margin. Impressions were taken at nine thickness levels and a control level (TTotal = 10; 0-1.2 mm), and the reference points' average distance was compared across thickness levels on both the left and right side. We carried out three measures for each specimen and used three specimens per thickness level. Total sample size was N = 180, creating a sizable database to understand the influence. RESULTS: The results indicated that light-body impression material thickness had no influence on the horizontal dimension of a die measured on scanned dies in these specific circumstances. CONCLUSIONS: The thickness of light-body impression material in the dual-phase impression taking technique did not have a significant influence on the horizontal accuracy of scanned dies, which makes the technique safe and reliable for single crown restorations without having to take extra precautions for the thickness of light-body impression material.