Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone-beam computed tomography and 3D double-echo steady-state MRI.

PURPOSE: To evaluate image quality and diagnostic accuracy of buccal bone thickness assessment in maxillary and mandibular anterior region using cone-beam computed tomography (CBCT) and 3-dimensional double-echo steady-state (DESS) MRI for preoperative planning of immediate dental implants in healthy individuals. METHODS: One hundred and twenty teeth in 10 volunteers were retrospectively evaluated for image quality and artifacts using Likert scale (4 = excellent to 0 = decreased). Buccal bone thickness was measured at three measurement points (M1 = 2 mm from the cementoenamel junction, M2 = middle of the root, and M3 = at the root apex) for each tooth in the maxillary (13-23) and the mandibular anterior region (33-43). Descriptive statistics and two-way ANOVA with Tukey's Post-hoc test were performed to evaluate the significant differences (α = 0.05) between both imaging modalities. RESULTS: Image quality showed little to no artifacts and enabled confident diagnostic interpretation (CBCT (3.72 ± 0.46); MRI (3.65 ± 0.49)), with no significant differences between both imaging modalities (p > 0.05). Regarding the assessment of buccal bone thickness at M1-M3 for the teeth 13-23 and 33-43, no significant differences were noted (p > 0.05). MRI demonstrated slight, nonsignificant overestimation of thickness with the canines having mainly a thick buccal bone wall, where thin buccal wall was evident for the central incisors. CONCLUSION: Black bone MRI sequences, such as 3D-DESS MRI, for immediate implant planning provided confidential diagnostic accuracy in bone thickness assessment without significant disadvantages compared to CBCT. Thus, the implementation of no-dose protocols for dental rehabilitation using an immediate loading approach seems promising and could further improve the treatment strategy for dental rehabilitation.

Push-Out Bond Strength Assessment of Different Post Systems at Different Radicular Levels of Endodontically Treated Teeth.

This study assessed the bond strength of prefabricated post systems at different root levels of endodontically treated teeth. One-rooted human premolars (N = 70; n = 10) were cut to 2 mm above the cement-enamel junction. Root canals were treated and randomly assigned to one of the seven post systems: T: Titanium (Mooser), ZrO: Zirconia (Cosmopost), G: Fiber (FRC Postec Plus), E1: Fiber (Direct) (Everstick post), E2: Fiber (Indirect) (Everstick post), PP: Fiber (PinPost), and LP: Injectable Resin/Fiber composite (EverX Posterior). All posts were luted using a resin cement (Variolink II), and the roots were sectioned at the coronal, middle, and apical root levels. Push-out tests were performed in the Universal Testing Machine (0.5 mm/min). Data (MPa) were analyzed using two-way ANOVA and Tukey's tests (α = 0.05). The results showed that the bond strength (mean ± SD) of E2 posts were highest (5.3 ± 2.7) followed by PP (4.1 ± 2.0); G (4.0 ± 1.6); LP (2.6 ± 1.9): T (2.2 ± 1.5) and ZrO (1.9 ± 1.0) posts systems. No significant differences were found in bond strength of all post systems. The bond strength in the coronal root level was the highest with 3.6 ± 2.2 MPa. The bond strength of FRC post systems was significantly higher than those of rigid posts of titanium or ZrO2. Bond strength results were the highest in the coronal root level for all tested post systems but did not differ significantly from the other two root levels.

Color Change after 25% Hydrogen Peroxide Bleaching with Photoactivation: A Methodological Assessment Using Spectrophotometer versus Digital Photographs.

This study aimed to evaluate the color change of teeth bleached with light activation using two different objective color measurement approaches after two years of clinical follow-up. A cross-sectional retrospective clinical study according to STROBE was followed including 30 participants. The 25% hydrogen peroxide gel (Philips Zoom) was applied with a supplementary LED light for 15 min in four cycles. Tooth color was assessed based on CIEL*a*b* values using a spectrophotometer (Spectroshade) at different time points (baseline, post bleaching, 1 week, 1 year, and 2 years). Standardized digital photographs were taken at each time point. The L*, a*, and b* values were measured from the digital photographs using Adobe Photoshop software. The color difference (ΔE) was separately calculated using the L*, a*, and b* values obtained with spectrophotometric and photographic analyses at each evaluation time. Data were analyzed with non-parametric tests (p < 0.05). A color regression was detected by both measurement approaches after 1 and 2 years (p < 0.05). Greater ΔE values were acquired with the spectrophotometer compared to the digital photographic analysis (p < 0.05). Although a greater color change was observed with the spectrophotometer, both approaches were able to detect the color rebound using the 25% hydrogen peroxide light-activated in-office system. Digital photographic analysis might therefore be used to assess color change after bleaching.

Micro-Computed Tomographic Assessment of Microcrack Formation before and after Instrumentation of Curved Root Canals with Neoniti Rotary Files.

The aim of this study was to assess the microcrack formation of moderately and severely curved root canals following instrumentation with Neoniti rotary files using micro-computed tomography. This in vitro study evaluated 18 extracted sound mandibular molars with two separate mesial canals and foramina in two groups (n = 9) with 5−20° (moderate) and 20−40° (severe) root canal curvature. The number of microcracks in the root canal walls was counted at baseline by micro-CT. Subsequently, the root canals were instrumented with 0.20/0.06 v Neoniti files as single files with a torque of 1.5 Ncm and a speed of 400 rpm. The number of microcracks was counted again postoperatively on micro-CT images using Amira software. Statistical analysis was performed using the Shapiro−Wilk test, Levene's test and repeated-measures ANOVA (α = 0.05). The mean number of microcracks significantly increased postoperatively in both the moderately curved (11.59 ± 9.74 vs. 8.2 ± 7.4; p = 0.001) and the severely curved (13.23 ± 5.64 vs. 7.20 ± 5.94; p < 0.001) groups. However, the differences between the two groups were not significant (p = 0.668). Based on the results obtained, it can be stated that the instrumentation of moderately and severely curved root canals with Neoniti rotary files increases the number of microcracks. However, the higher degree of curvature does not necessarily translate to a higher number of microcracks after root canal instrumentation with this specific rotary system and methodological procedures.

Clinical outcomes and costs of conventional and digital complete dentures in a university clinic: A retrospective study.

STATEMENT OF PROBLEM: Scientific data analyzing the clinical outcomes and costs of complete dentures fabricated by using conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) processes are lacking. PURPOSE: The purpose of this retrospective study was to compare the treatment duration, financial costs, and postdelivery adjustments of CAD-CAM and conventional removable complete dentures. MATERIAL AND METHODS: Thirty-two edentulous participants (16 women, 16 men; age 35-85 years) who had received either CAD-CAM (n=16) or conventional (n=16) maxillary and mandibular removable complete dentures provided by prosthodontists with a minimum of 2 years of experience were evaluated. The CAD-CAM denture systems were either DDS-AV (AvaDent Digital Dental Solutions) (n=11) or DD-IV (Wieland Digital Denture) (n=5). The total treatment period (days) was recorded at 3 different time points (T0: preliminary alginate impression; T1: denture delivery; T2: last scheduled postdelivery adjustment). Adjustments during the follow-up (after T2) were noted and included the removal of areas of excessive pressure, relining, or repairs. The costs of the dental treatment and the laboratory fees were calculated. The Wilcoxon rank sum tests were used for statistical analysis (α=.05). RESULTS: No statistically significant difference regarding the treatment duration between digitally and conventionally fabricated removable complete dentures was found: T0-T1 (P=.889); T1-T2 (P=.675); T2- T3 (P=.978). No significant difference was found in the number adjustments for areas of excessive pressure, relines, or repairs (P=.757, P=1.000, P=1.000) during the period. Laboratory costs of CAD-CAM removable complete dentures were significantly lower than those of conventional removable complete dentures (P<.001), but clinical fees were similar between groups (P=.596), resulting in a reduction in the overall total costs for the CAD-CAM removable complete dentures (P=.011). Regarding the number of clinical visits, neither the group (conventional/CAD-CAM (P=.945)/DDS-AV/DD-IV [P=.848]) nor the interaction group (conventional/CAD-CAM and DDS-AV/DD-IV)/period (P=.084/P=.171) showed any significant differences. CONCLUSIONS: CAD-CAM removable complete dentures can be considered a viable alternative to conventional removable complete dentures regarding treatment duration, clinical and follow-up visits, adjustments, and maintenance requirements.

Adhesion of Resin-Resin and Resin-Lithium Disilicate Ceramic: A Methodological Assessment.

The aim of this study was to evaluate four test methods on the adhesion of resin composite to resin composite, and resin composite to glass ceramic. Resin composite specimens (N = 180, Quadrant Universal LC) were obtained and distributed randomly to test the adhesion of resin composite material and to ceramic materials (IPS e.max CAD) using one of the four following tests: (a) Macroshear SBT: (n = 30), (b) macrotensile TBT: (n = 30), (c) microshear µSBT: (n = 30) and (d) microtensile µTBT test (n = 6, composite-composite:216 sticks, ceramic-composite:216 sticks). Bonded specimens were stored for 24 h at 23 °C. Bond strength values were measured using a universal testing machine (1 mm/min), and failure types were analysed after debonding. Data were analysed using Univariate and Tukey's, Bonneferroni post hoc test (α = 0.05). Two-parameter Weibull modulus, scale (m), and shape (0) were calculated. Test method and substrate type significantly affected the bond strength results, as well as their interaction term (p < 0.05). Resin composite to resin composite adhesion using SBT (24.4 ± 5)a, TBT (16.1 ± 4.4)b and µSBT (20.6 ± 7.4)a,b test methods presented significantly lower mean bond values (MPa), compared to µTBT (36.7 ± 8.9)b (p < 0.05). When testing adhesion of glass ceramics to resin composite, µSBT (6.6 ± 1)B showed the lowest and µTBT (24.8 ± 7)C,D the highest test values (MPa) (SBT (14.6 ± 5)A,D and TBT (19.9 ± 5)A,B) (p < 0.05). Resin composite adhesion to ceramic vs. resin composite did show significant difference for the test methods SBT and µTBT (resin composite (24.4 ± 5; 36.7 ± 9 MPa) vs. glass ceramic (14.6 ± 5; 25 ± 7 MPa)) (p > 0.05). Among substrate-test combinations, Weibull distribution presented the highest shape values for ceramic-resin in µSBT (7.6) and resin-resin in µSBT (5.7). Cohesive failures in resin-resin bond were most frequently observed in SBT (87%), followed by TBT (50%) and µSBT (50%), while mixed failures occurred mostly in ceramic-resin bonds in the SBT (100%), TBT (90%), and µSBT (90%) test types. According to Weibull modulus, failure types, and bond strength, µTBT tests might be more reliable for testing resin-based composites adhesion to resin, while µSBT might be more suitable for adhesion testing of resin-based composites to ceramic materials.