Effect of low level laser therapy on crestal bone levels around dental implants-A pilot study.

BACKGROUND: Implant success is affected by initial bone resorption at the implant surface. Continuous efforts have been made to reduce the peri-implant crestal bone loss. Limited information is available regarding the influence of low level laser therapy (LLLT) on interaction between the bone and implant surface. PURPOSE: The aim of this pilot study was to assess the effect of LLLT on peri-implant crestal bone levels. MATERIALS AND METHODS: Twenty implants were placed in 20 patients who were randomly assigned to two groups. Group I patients' received no adjunctive treatment and group II patients' were administered LLLT using 980 nm diode laser at 0.1 W output power following implant placement. The energy density of 4 J/cm2 was delivered at six sites for a duration of 10 seconds per site. Crestal bone levels were evaluated primarily using digital intraoral periapical (IOPA) radiograph. The measurements were made immediately (T0) and 6 weeks (T1) post implant placement; and 6 months (T2) and 1 year (T3) post prosthetic loading time intervals and compared using repeated measures ANOVA test. RESULTS: Crestal bone levels at baseline were statistically not significant between groups (P = .880). At T3 time interval, the mean change in crestal bone levels around all anatomical implant sites measured was 0.81 (SE 0.04) mm for irradiated group and 0.97 (SE 0.04) mm for nonirradiated group. Intergroup analysis revealed statistically significant (P = .020) less crestal bone loss in group that received LLLT. CONCLUSION: Under the conditions of this study, LLLT reduced the crestal bone resorption surrounding dental implants. TRIAL REGISTRATION: The present clinical trial was not registered.

[Effect of dental implants with conditioned surface based on sodium hydroxide in patients with osteoporosis]. / Otsenka éffektivnosti primeneniia dental'nykh implantatov s konditsionirovannoi poverkhnost'iu na osnove gidroksida natriia u patsientov s osteoporozom.

The problem of improving the efficiency of implantological treatment of patients with osteoporosis (OP) today remains relevant due to the high frequency of postoperative complications. Among the main factors affecting the success of dental implant treatment, the nature of the implant surface is essential. Patients with adentia and OP especially relevant in use of dental implants with optimized surface, air conditioned component influencing bone remodelling. OBJECTIVE: Evaluation of the effectiveness of dental implants with a conditioned surface based on sodium hydroxide in men with osteoporosis. MATERIAL AND METHODS: The study included 60 men 54-65 years of age in need of dental implants of which 40 were diagnosed with OP. Patients with OP were divided into groups: I - 20 men without antiresorptive therapy; II - 20 men taking ibandronate 150 mg monthly, calcium and vitamin D (1000 mg/800 IU daily). The control group consisted of 20 men 54-65 years without OP. Microarchitectonics of the mandible was studied using cone-beam computed tomography and histomorphometry. Implants with bioactive surface based on sodium hydroxide (NaOH) were used. RESULTS: The results showed that the success of osseointegration is due to the qualitative parameters of the bone tissue of the perceived bed and the initial level of remodeling processes and does not depend on the conditioning of the implant surface NaOH. Comprehensive antiosteoporotic therapy with bisphosphonates and calcium supplementation with vitamin D leads to restoration of micro-alveolar part.

A Study to Evaluate the Effect of Hyperbaric Oxygen on Osseointegration of Root-form Endosseous Titanium Dental Implants: An In Vivo Study.

AIM: To evaluate the effect of hyperbaric oxygen (HBO) therapy on the osseointegration of dental implants by resonance frequency analysis. MATERIALS AND METHODS: Six rabbits of age 2 to 2 and 1/2 years, weight approximately 2 kg were selected and tagged 1-6. For all the animals' right femur was selected as a control group (R) and left femur as test group (L). Initially, implants of dimensions 3.75×8mm (Adin Touareg) were placed in the right femur. Implant stability quotient (ISQ) values were recorded using OSSTELL ISQ at the time of surgery (R0), after one month (R1), and the end of the second month (R2). After two months of uneventful healing, implants were placed on the left femur of all the six rabbits and three were grouped as 2S (subjected to 2 HBO sessions at the weekly interval) and other three as 4S (subjected to 4 HBO sessions at weekly interval for a month). At the time of surgery (L0), end of one month (L1) and two months (L2), ISQ values were recorded and subjected to statistical analysis. The total duration of the study was 4 months from 3 March 2013 to 03 July 2013. RESULTS: The data were statistically analyzed using t-test and analysis of variance (ANOVA) F. On the comparison between the control group (R) and test groups (2S and 4S) ISQ values for test groups were more which was highly statistically significant (p <0.001). Among the two test groups 4S group has more ISQ values compared to 2S (p <0.001). CONCLUSION: This study indicated that HBO therapy has a promotive effect on the rate of osseointegration of dental implants. CLINICAL SIGNIFICANCE: Study opens new scope for further in vivo research in utilizing hyperbaric oxygen therapy (HBOT) in implant surgeries, maxillofacial trauma cases and irradiated patients to hasten or improve osseointegration.

Interfacial Fracture Toughness of Adhesive Resin Cement-Lithium-Disilicate/Resin-Composite Blocks.

PURPOSE: Resin composite blocks (RCB) are advocated as alternative to ceramic blocks (CB). Prior to use, adherence to these materials should characterized. This study aimed to test the null hypothesis (H0 ) that material and surface treatment combinations do not influence interfacial fracture toughness (KIC ) of a self-cured adhesive resin cement [RelyX Ultimate (RXU)] to RCB or CB, under nonaged and aged conditions. MATERIALS AND METHODS: Two RCB, Lava Ultimate (LU) and Enamic (EN), and one CB, IPS e.max Press (EMP) were used. Half-size [(6 × 6 × 6 × 6 mm)] specimens were prepared for EMP (n = 30), EN (n = 30), and LU (n = 60). RCB specimens were prepared by wet cutting/grinding, while CB specimens were pressed. Surfaces of EMP and EN were preconditioned with hydrofluoric acid (5%); surfaces of LU were sandblasted with either 27 µm alumina (LUS) or 30 µm silica-modified alumina Rocatec soft (LUR). All specimens were bonded with Scotchbond Universal adhesive and RXU. Additionally, twenty (4 × 4 × 4 × 8 mm) RXU specimens were prepared. All specimens were stored in water at 37°C and tested after 1 and 60 days. Interfacial KIC was determined with the notchless triangular prism specimen KIC test. Results were analyzed with two-way ANOVA and Scheffé multiple means comparisons (α = 0.05). Preconditioned and selected fractured surfaces were characterized with scanning electron microscopy. RESULTS: At 24 hours, LUS-RXU and LUR-RXU had significantly higher interfacial KIC than EN-RXU and EMP-RXU and were not different from KIC of RXU. Aging lead to a significant decrease in KIC of RXU and interfacial KIC of LUS-RXU, LUR-RXU, and EMP-RXU; interfacial KIC of EN-RXU was not affected. Based on the results, H0 was rejected. CONCLUSION: Under the conditions of this study, at 24 hours, interfacial KIC of LUS-RXU and LUR-RXU was superior to EMP-RXU and EN-RXU. Aging in water at 37°C did not affect interfacial KIC of EN-RXU but adversely affected KIC of RXU and the other interfacial KIC . CLINICAL IMPLICATIONS: The results suggest that RXU and its adherence to LU and EMP deteriorates upon exposure to water at 37°C. In making clinical decisions related to material selection, practitioners should consider in vitro results.

Miniaturized Electromagnetic Device Abutment Improves Stability of the Dental Implants.

BACKGROUND: The overall success and predictability of dental implant treatment hinge on the primary stability, direct bone-to implant contact formation, and quantity and/or quality of residual bone. Pulsed electromagnetic field has been reported to increase bone regeneration in various clinical situations. Therefore, it was hypothesized that devices which could locally generate a Pulsed electromagnetic field would stimulate bone healing and increase bone density surrounding implants. OBJECTIVE: To retrospectively assess the effects of the miniaturized electromagnetic device (MED) on the implants stability for the first time in human subjects, in a prospective case controlled series. METHODS: Twelve consecutive patients (28 implants) were included in the study.Twelve MED healing caps and 16 regular control healing caps were inserted. Resonance frequency analysis (RFA) was performed at implant placement and abutment connection and an implant stability quotient value was given for each implant. RESULTS: Twenty-eight dental implants were included in the current study. Maxillary implants stability was significantly higher with MED healing cups compared with controls at 15 days postimplantation (66.2 vs 62.1, P = .0008). Resonance frequency analysis test performed at 30 days postimplantation demonstrated significantly increased stability in MED as compared with the control 73.5 ±â€Š3.2 vs 66.7 ±â€Š4.8 in mandibular implants and 74 ±â€Š1.7 vs 65 ±â€Š2.3 in maxillary implants. At the 50 days postimplantation, RFA tests revealed markedly higher stability of the maxillary implants with MED active healing caps compared with nonactive 75.4 ±â€Š5.1 vs 68.5 ±â€Š8.5, respectively. CONCLUSIONS: We conclude that MED-abutment implants demonstrated a superior stability during the early phase of healing as compared with standard implants.

Investigation of surface structure and biocompatibility of chitosan-coated zirconia and alumina dental abutments.

BACKGROUND: For long-term success of dental implants, it is essential to maintain the health of the surrounding soft tissue barrier, which protects the bone-implant interface from the microorganisms. Although implants based on titanium and its alloys still dominate the dental implant market, alumina (Al2 O3 ) and zirconia (ZrO2 ) implant systems are widely used in the area. However, they provide smooth and bioinert surfaces in the transmucosal region, which poorly integrate with the surrounding tissues. OBJECTIVE: The main aim of this research was to investigate the surface characteristics and biocompatibility of chitosan-coated alumina and zirconia surfaces. MATERIALS AND METHODS: The substrates were coated via solution casting technique. Additionally, an aging process with a thermocycle apparatus was applied on the coated materials to mimic the oral environment. To define the morphology and chemical composition of the surfaces of untreated, chitosan-coated, and chitosan-coated-aged samples, scanning electron microscopy and energy dispersive X-ray spectrometry were used. The phases and bonds characterized by Fourier transform infrared spectroscopy and X-ray diffraction analysis. The human gingival fibroblast cells were used to evaluate cytocompatibility by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium salt assay. RESULTS: It was observed that both substrates were successfully coated with chitosan and the aging process did not significantly affect the integrity of the coating. The attachment and proliferation of human gingival fibroblast cells were shown to be good on both kinds of chitosan-coated surfaces. CONCLUSION: Coating zirconia and alumina surfaces with chitosan is an efficient surface modification for increasing biocompatibility and bioactivity of these materials in vitro.

Hard and soft tissue responses to implant made of three different materials with microgrooved collar in a dog model.

The objective of the present study was to assess hard and soft tissue around dental implants made of three different materials with microgrooves on the collar surface. Microgrooved implants were inserted in the mandibles of five male beagles. Implants were made of three kinds of material; titanium (Ti), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) and ceria partially stabilized zirconia/alumina nanocomposite (Ce-TZP/Al2O3). The animals were euthanatized at three months after implantation, and harvested tissue was analyzed by means of histology. All kinds of implant were osseointegrated, and there were no significant differences in any histomorphometric parameters among the three groups of microgrooved implants made of different materials. Within the limitations of this study, implants with microgrooves integrated into the surrounding bone tissue, without statistically significant differences among the three tested materials, Ti, Y-TZP, and Ce-TZP/Al2O3.

Unravelling the effect of macro and microscopic design of dental implants on osseointegration: a randomised clinical study in minipigs.

Several dental implants are commercially available and new prototype design are constantly being fabricated. Nevertheless, it is still unclear what parameters of the design affect most the osseointegration of dental implants. The purpose of this study is to assess the effects of the microscopic and macroscopic design of dental implants in the osseointegration by comparing three macroscopic designs (Straumann tissue level (STD), essential cone (ECD) and prototype design (PD)) and six surface treatments. A total of 96 implants were placed in 12 minipigs. The implant stability quotient (ISQ), was assessed at the time of implantation, as well as at 2, 4 and 8 weeks. Histomorphometric and statistical analyses were conducted at the different sacrifice times, being 2, 4 and 8 weeks, to analyse the bone to implant contact (BIC), the bone area density (BAT) and the density of bone outside the thread region (ROI). The macroscopic design results showed higher ISQ values for the ECD, whereas the histomorphometric analysis showed higher ossoeintegration values for the STD. Regarding the microscopic design, both Sandblasted plus acid etching (hydrochloric/sulphuric acid) in a nitrogen atmosphere (SLActive) and Shot-blasted or bombarded with alumina particles and posterior alkaline immersion and thermal treatment (ContacTi) showed superior results in terms of osseointegration and reduced the osseointegration times from 8 weeks to 4 weeks compared to the other analysed surfaces. In conclusion, each of the macroscopic and microscopic designs need to be taken into account when designing novel dental implants to enhance the osseointegration process.

Effects of fabrication and shading technique on the color and translucency of new-generation translucent zirconia after coffee thermocycling.

STATEMENT OF PROBLEM: The color stability and translucency of preshaded and externally shaded monolithic and veneered new generation translucent zirconia are not well known. PURPOSE: The purpose of this in vitro study was to investigate the effect of fabrication (veneered or monolithic) and shading (preshaded or externally shaded) techniques on the color and relative translucency of translucent zirconia after coffee thermocycling. MATERIAL AND METHODS: Specimens of different thicknesses (0.5 mm for veneered and 1.5 mm for monolithic) were sectioned from preshaded and externally shaded translucent zirconia. Externally shaded specimens were colored by using the dipping technique. Externally shaded (Ext Mono) and preshaded (Pre Mono) monolithic zirconia specimens were sintered and glazed. Externally shaded (Ext Vene) and preshaded (Pre Vene) 0.5-mm-thick specimens were sintered, veneered with feldspathic porcelain (1 mm), and glazed. The color coordinates of specimens were measured with a spectroradiometer before and after 10 000 thermocycles in coffee solution. Color differences were calculated using CIEDE2000, and relative translucency parameter (RTP) values were calculated using the RTPCIEDE2000 formula. Analysis of variance (ANOVA) was used to analyze the CIEDE2000 color differences and RTP values (α=.05). RESULTS: Shading technique had a significant effect on the color difference values (P=.018). For the translucency data, the 3-way ANOVA revealed a significant interaction between the fabrication technique and shading technique (P=.002). Each pair of material subgroups within each combination of fabrication technique and shading technique was found to have a significantly different RTP, except between Ext Vene and Pre Vene (P=.115). CONCLUSIONS: Externally shaded translucent zirconia had a greater color change in coffee than the preshaded translucent zirconia, either in monolithic or veneered form. Fabrication technique significantly affected the RTP, and the monolithic zirconia was more translucent than the veneered zirconia.

Effect of shading technique and thickness on color stability and translucency of new generation translucent zirconia.

OBJECTIVE: To evaluate the effect of shading technique and thickness on the color stability and translucency of translucent zirconia after coffee thermocycling. METHODS: Specimens in different thicknesses (1; 1.5; 2 mm) (n = 4 for each thickness) were sectioned from translucent preshaded zirconia (Pre) and externally shaded zirconia (Ext). After sintering, specimens were glazed and subjected to 10,000 thermocycling in coffee solution. The color coordinates of specimens were measured with a spectroradiometer before and after coffee thermocyling. Color differences and relative translucency parameter (RTP) values were calculated with CIEDE2000 color difference and TPCIEDE2000 formulas. ANOVA was used to analyze the CIEDE2000 color difference and RTP values (α = 0.05). RESULTS: According to 2-way ANOVA, no significant effect of shading technique and thickness on the color difference values was found (P > .05). According to 3-way ANOVA, a significant interaction between the shading technique and thickness (P < .0001) was found for RTP. The RTP parameter decreased with the increase in the thickness. Ext specimens presented significantly higher RTP than Pre specimens (P < .0001), except for between Ext 1 mm and Pre 1 mm (P = .179). CONCLUSIONS: Neither shading technique nor tested thicknesses affected the color of translucent zirconia. Shading technique and thickness affected the RTP of translucent zirconia. The RTP was inversely affected with the thickness of the material. Externally shaded zirconia presented higher RTP than preshaded zirconia for specimens thicker than 1 mm. CLINICAL SIGNIFICANCE: Discoloration with coffee was insignificant for the tested translucent zirconia in tested thicknesses (1, 1.5, 2 mm). When a translucent restoration is intended, thinner externally shaded translucent zirconia restorations should be preferred instead of preshaded translucent zirconia.

Effect of thickness on optical properties of monolithic CAD-CAM ceramics.

OBJECTIVE: To compare the effect of material and thickness on the color stability and relative translucency parameters (RTP) for monolithic ceramics subjected to coffee thermocycling. METHODS: Four specimens each at thicknesses of 0.5, 0,7 and 1 mm were sectioned from monolithic ceramics [preshaded monolithic zirconia (MonZr), lithium disilicate (LDS) and zirconia reinforced lithium silicate (ZLS)]. The specimens were glazed and subjected to 5000 coffee thermocycling. The color coordinates of specimens were determined with a spectroradiometer and color differences and RTP values were calculated with CIEDE2000 color difference and TPCIEDE2000 formulas. ANOVA was used to analyze CIEDE2000 color difference and RTP values (α = .05). RESULTS: For the color difference data, the 2-way ANOVA revealed a significant interaction between material and different thickness (P = .002). Except for 0.5 mm thick ZLS material, all materials in all thicknesses studied presented color changes within the clinically acceptable limits after coffee thermocycling. For the RTP data, the 3-way ANOVA revealed a highly significant interaction between material and different thicknesses (P < .001). CONCLUSIONS: Material type and thickness can be expected to affect color change and relative translucency of the restorations made with preshaded MonZr, LDS and ZLS materials. Except for 0.5 mm thick ZLS material, color changes of all studied materials were within the clinically acceptable limits. Except ZLS material, color changes of other materials were not significantly affected by thickness. Staining in coffee was not found to affect translucency, and the materials' translucency parameters were ranked from high to low as LDS, ZLS and MonZr at each thickness studied.

The Effect of Resin Bonding on Long-Term Success of High-Strength Ceramics.

Digital manufacturing, all-ceramics, and adhesive dentistry are currently the trendiest topics in clinical restorative dentistry. Tooth- and implant-supported fixed restorations from computer-aided design (CAD)/computer-aided manufacturing (CAM)-fabricated high-strength ceramics-namely, alumina and zirconia-are widely accepted as reliable alternatives to traditional metal-ceramic restorations. Most recent developments have focused on high-translucent monolithic full-contour zirconia restorations, which have become extremely popular in a short period of time, due to physical strength, CAD/CAM fabrication, and low cost. However, questions about proper resin bonding protocols have emerged, as they are critical for clinical success of brittle ceramics and treatment options that rely on adhesive bonds, specifically resin-bonded fixed dental prostheses or partial-coverage restorations such as inlays/onlays and veneers. Resin bonding has long been the gold standard for retention and reinforcement of low- to medium-strength silica-based ceramics but requires multiple pretreatment steps of the bonding surfaces, increasing complexity, and technique sensitivity compared to conventional cementation. Here, we critically review and discuss the evidence on resin bonding related to long-term clinical outcomes of tooth- and implant-supported high-strength ceramic restorations. Based on a targeted literature search, clinical long-term studies indicate that porcelain-veneered alumina or zirconia full-coverage crowns and fixed dental prostheses have high long-term survival rates when inserted with conventional cements. However, most of the selected studies recommend resin bonding and suggest even greater success with composite resins or self-adhesive resin cements, especially for implant-supported restorations. High-strength ceramic resin-bonded fixed dental prostheses have high long-term clinical success rates, especially when designed as a cantilever with only 1 retainer. Proper pretreatment of the bonding surfaces and application of primers or composite resins that contain special adhesive monomers are necessary. To date, there are no clinical long-term data on resin bonding of partial-coverage high-strength ceramic or monolithic zirconia restorations.

Effectiveness of a new dental implant bioactive surface: histological and histomorphometric comparative study in minipigs.

OBJECTIVES: The objective of this study was to assess, by histomorphometric analysis, the degree of bone apposition on two types of dental implant's surfaces: a novel implant that combines Al2O3 abrasive particle blasting with thermochemical treatment (ContacTi), compared to a standard surface treatment obtained by sandblasting and acid etching (shot blasting). MATERIALS AND METHODS: Twelve minipigs were used, placing the studied implants in the maxillae, and divided into three groups according to the time of sacrifice: 2, 4, and 8 weeks after implant placement. Histological and histomorphometric analyses were performed following standardized tissue polymerization, cutting, and staining and examined under optical and high-resolution electron microscope. RESULTS: For all measurements, the novel surface presented higher levels of osseointegration as compared to the shot blasting surface. Bone to implant contact (BIC) in the maxillae for ContacTi presented values of 49.02, 83.20, and 85.58% at 2, 4, and 8 weeks, respectively, significantly higher compared to the shot blasting surface values of 39.32, 46.53, and 46.20% for the same time points. Bone area density (BAD) presented values of 26.52, 61.21, and 59.50% for ContacTi surface implants and 22.95, 36.26, and 49.50% for the shot blasted surface implants. Signs of osteoconductivity were observed in the ContacTi surfaces at 2 weeks. CONCLUSIONS: The ContacTi surface achieved a faster growth of hard tissues around the implants, when compared to the shot blasting surface, and for all evaluated histomorphometric parameters, the values were higher at all measured time points. CLINICAL RELEVANCE: ContacTi could be a new surface improving the osseointegration in oral implantology.

Reabilitação do guia canino complementar ao tratamento harmônico e estético com prótese parcial fixa livre de metal / Rehabilitation of the canine guide complementary to the harmonic and aesthetic treatment with fixed partial denture of metal

Introdução: A reabilitação estética de dentes anteriores com próteses cerâmicas livres de metal proporciona excelência estética principalmente pela ausência da margem metálica. Pacientes que apresentam oclusão adequada e ausência de hábitos parafuncionais possuem menor chances de falhas catastróficas em movimentos excêntricos e bordejantes durante as excursões mandibulares. Objetivo: evidenciar, por meio de relato de um caso clínico, o reestabelecimento da estética e função de dentes anteriores, utilizando restaurações cerâmicas livres de metal. Conclusões: A utilização de cerâmicas livres de metal permitiu uma estética natural e funcional com ótimas propriedades ópticas, integrando as restaurações ao sorriso do paciente.(AU)

Introduction: The aesthetic rehabilitation of anterior teeth with metal-free ceramic prosthesis provides aesthetic excellence mainly due to the absence of metal margin. Patients with adequate occlusion and absence of parafunctional habits have a lower chance of catastrophic failure in eccentric movements and contours during mandibular excursions. Aim: to report, through a clinical case report, reestablishment of aesthetics and function of anterior teeth, using metal free ceramic restorations. Conclusions: The use of free metal ceramics allowed a natural and functional aesthetic with excellent optical properties, integrating the restorations to the patient's smile.(AU)

Dimensional changes from the sintering process and fit of Y-TZP copings: Micro-CT analysis.

OBJECTIVE: To evaluate the dimensional changes from the sintering process of Y-TZP and relate them to the fit of zirconia copings. METHODS: The sintering shrinkage rate (SSR) was obtained from the measurement of geometric specimens (4×4×2mm). Thirty-six zirconia copings made using CAD/CAM were equally divided into three groups (n=12): ZMAX - IPS e.max ZirCAD (Ivoclar Vivadent, Liechtenstein); ZYZ - InCeram YZ (Vita Zahnfabrik, Germany); and ZK - Zirklein (Zirklein, Brazil). The copings were scanned in micro-CT before and after sintering so that SSR was obtained. The SSR of geometrical specimens and copings was compared to each other and those the manufacturers reported (ANOVA-2 and Tukey, p≤.05). The copings were settled on an abutment and taken to the micro-CT to evaluate their marginal and internal fit. The data enabled the statistical comparison (ANOVA-2 and Tukey, p≤.05) between groups and measurement sites and between the fit obtained with that stipulated by the CAD/CAM software (80µm) (Dunnett test, p≤.05). RESULTS: All groups showed statistical differences between the SSR the manufacturer reported and those obtained experimentally and between the SSR of the geometric specimens and copings. In general, the SSR of the copings showed no uniformity. There was no statistical difference among the groups for marginal fit, with differences only for internal fit and between the different regions measured. The fit obtained experimentally differed from the internal space determined in the CAD/CAM software. SIGNIFICANCE: The lack of uniformity of sintering shrinkage might lead to a non-uniform internal fit of Y-TZP copings.

Functionalized pink Al2O3:Mn pigments applied in prosthetic dentistry.

STATEMENT OF PROBLEM: The color of dental poly(methyl methacrylate) (PMMA) is conventionally rendered by organic and inorganic pigments, which are usually not bonded to the polymer network. Functionalized ceramic pigments can be used to color PMMA, allowing improved chemical interaction with the resin matrix. PURPOSE: The purpose of this in vitro study was to synthesize, functionalize, and characterize pink manganese-doped alumina ceramic pigments. The hypothesis tested was that functionalized ceramic pigments would render pink coloration to a translucent PMMA without jeopardizing its mechanical properties. MATERIAL AND METHODS: Pink alumina powders doped with 1 or 2 mol% of manganese (Al2O3:Mn) were prepared by means of a polymeric precursor method. Pigment (Pig.) particles were functionalized with a silica coating method followed by silanation before preparation of PMMA-based composite resins (5 wt% pigment). The color of composite resins (Pig.1% and Pig.2%) and PMMA controls (Pink and translucent [Trans]) was evaluated (CIELab color coordinates), and their mechanical properties were tested (3-point bending). RESULTS: The microstructure of the pigment particles showed approximately 55-nm nanocrystals of manganese-doped α-alumina clustered into irregular porous particles up to 60 µm. The composite resins and pink PMMA showed similar color parameters (CIE a* pink=20.1, Pig.1%=14.6, Pig.2%=16.0, Trans=0.19, P<.001; CIE b* Pink=17.0, Pig.1%=18.6, Pig.2%=19.0, Trans=2.52, P<.001). No statistical differences were observed in mechanical properties among groups (σf pink=98.4, Pig.1%=98.1, Pig.2%=98.8, trans=89.1, P=.136). CONCLUSIONS: The addition of the functionalized pink ceramic pigments to a translucent PMMA yielded similar coloration to that of the regular pink PMMA used in dentistry and did not jeopardize its mechanical properties.

Pectin nanocoating of titanium implant surfaces - an experimental study in rabbits.

INTRODUCTION: A major determinant of successful osseointegration of endosseous implants is the surface of the implant, which influences the cellular response of the surrounding tissues. A new strategy to improve osseointegration and bone healing is biochemical stimulation by surface nanocoatings that may increase adhesion of bone proteins, and bone cells at the implant surface. Nanocoating with pectins, plant cell wall-derived polysaccharides, is frequently done using rhamnogalacturonan-I (RG-I). AIM: The aim of the study was to evaluate the effect of nanocoating titanium implants with plant cell wall-derived rhamnogalacturonan-I, on bone healing and osseointegration. MATERIAL AND METHODS: Machined titanium implants were coated with three modifications of rhamnogalacturonan-I (RG-I). Chemical and physical surface properties were examined before insertion of nanocoated implants (n = 96) into the left and right tibia of rabbits. Machined titanium implants without RG-I nanocoating were used as controls (n = 32). Total number of 128 implants was placed in tibias of 16 rabbits. Fluorochrome bone labels, calcein green and alizarin red S were given intravenously after 9 and 12 days, respectively. The bone response to the nanocoated implants was analyzed qualitatively and quantitatively after 2, 4, 6, and 8 weeks of healing using light microscopy and histomorphometric methods. RESULTS: The RG-I coating influenced the surface chemical composition; wettability and roughness, making the surface more hydrophilic without any major effect on surface micro roughness compared to control implant surfaces. The different modifications of pectin RG-I did not significantly enhance bone healing and osseointegration analyzed after 2, 4, 6, and 8 weeks of healing compared to control implants. Although the qualitative analyses of the fluorochromes indicated a higher activity of bone formation in the mineralization front at the early stage, after 9 and 12 days at the RG-I nanocoated implants compared to the control implants although no significant quantitative difference was demonstrated. CONCLUSION: The present study showed that nanocoating of titanium implants with pectin RG-Is did not significantly enhance bone healing and osseointegration when placed in rabbit tibia bone.

Marginal Fit Metal-Ceramic and In-Ceram Single Crown Cement retained in Implant-supported Abutments.

INTRODUCTION: This study evaluated the cervical fit of cemented metal-ceramic and In-Ceram implant-supported crowns, before and after the cementing procedure. MATERIALS AND METHODS: Twenty crowns cemented on implant abutments are divided into two groups (n = 10): Group 1 -cemented metal-ceramic crowns and group 2 - cemented In-Ceram crowns. The marginal adaptations before and after cementation were evaluated in a comparison microscope with an error of 1 µm. All crowns were cemented with zinc phosphate cement. RESULTS: The cervical misalignment of cemented crowns before cementation (52.65 ± 11.83 and 85.73 ± 14.06 µm) was lower than that after cementation (66.80 ± 15.86 and 89.36 ± 22.66 µm). CONCLUSION: The cementing procedure interferes with the marginal fit of cemented crowns on implant abutments, with the prosthesis having better adaptation before cementation. Cemented metal-ceramic crowns exhibited better cervical adaptation than In-Ceram crowns cemented before and after the cementing procedure. CLINICAL SIGNIFICANCE: The maintenance of gum health and the longevity of prosthetic restorations are closely related to the restoration's marginal integrity.

A comparative study of marginal fit of copings prepared with various techniques on different implant abutments.

This study evaluated fabrication techniques of recently introduced all-ceramic copings' marginal adaptation on two different implant abutments with different finish lines. Five different copings were prepared (Casted chrome-cobalt metal coping, Zirkonzahn, Cercon, In Ceram Alumina and IPS e.max Press) on two cementable implant abutments with two marginal designs. Ten samples for each coping group were prepared (totally 100 samples). Copings were cemented to implant abutments and marginal gap measurements were done from 24 points with stereomicroscope and the datas were analyzed by the Kruskal-Wallis test before cementation. Cercon copings showed the lowest marginal fit scores and metal copings showed the highest scores. After cementation, all marginal gap values have been increased. All marginal gap values obtained from crown copings can be considered in clinically acceptable limits (<120 µm) except metal copings after cementation on abutment with 135 degrees shoulder group (123 µm).

Use of ceria-stabilized zirconia/alumina nanocomposite for fabricating the frameworks of removable dental prostheses: A clinical report.

Ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/A) exhibits an elasticity equivalent to that of cobalt-chromium alloy and a flexural property that is superior to that of yttria-tetragonal zirconia polycrystal. Therefore, the use of Ce-TZP/A for the fabrication of removable dental prosthesis frameworks is being studied. However, the current English literature does not include any clinical report on the use of Ce-TZP/A for the fabrication of the entire framework. This clinical report describes the process and outcomes of fabricating a mandibular implant-supported overdenture and a maxillary complete denture with Ce-TZP/A as the framework material.