Adjusting dental ceramics: An in vitro evaluation of the ability of various ceramic polishing kits to mimic glazed dental ceramic surface.

STATEMENT OF PROBLEM: During the insertion appointment, the practitioner is often faced with the need to adjust ceramic surfaces to fit a restoration to the adjacent or opposing dentition and soft tissues. PURPOSE: The purpose of this study was to assess the ceramic surface smoothness achieved with various commercially available ceramic polishing kits on different commonly used ceramic systems. The reliability of the cost of a polishing kit as an indicator of improved surface smoothness was assessed. MATERIAL AND METHODS: A total of 350 ceramic surfaces representing 5 commonly available ceramic systems (IPS Empress Esthetic, IPS e.max Press, Cergo Kiss, Vita PM 9, Imagine PressX) were treated with 5 types of ceramic polishing systems (Cerapreshine, 94006C, Ceramiste, Optrafine, Zenostar) by following the manufacturers' guidelines. The surface roughness was measured with a profilometer (Taylor Hobson; Precision Taylor Hobson Ltd). The effects of ceramic systems and polishing kits of interest on surface roughness were analyzed by 2-way ANOVA, paired t test, and Bonferroni corrected significance level. RESULTS: The ceramic systems and polishing kits statistically affected surface roughness (P<.001).The polishing kit Zenostar on IPS e.max Press created the smoothest ceramic surface. No correlation could be established between the high cost of the polishing kit and low surface roughness. None of the commonly used ceramic polishing kits could create a surface smoother than that of glazed ceramic (P<.001). CONCLUSIONS: The inclusion of a diamond polishing paste step is recommended to improve surface smoothness (P<.001). The cost of ceramic polishing kits is not recommended as a reliable indicator of better performance of ceramic polishing kits (P>.30).

Instant dentin hypersensitivity relief of a single topical application of an in-office desensitizing paste containing 8% arginine and calcium carbonate: a split-mouth, randomized-controlled study.

OBJECTIVE: The aim of this study was to evaluate the clinical efficacy of an in-office desensitizing paste containing 8% arginine and calcium carbonate relative to calcium carbonate alone in the reduction of dentin hypersensitivity in a randomized, double-blind, split-mouth clinical trial. MATERIALS AND METHODS: Sixty teeth (30 subjects) with an air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were randomly assigned to one of two treatment groups: (1) test paste containing 8% arginine and calcium carbonate (elmex sensitive professional desensitizing paste) and (2) control paste: paris white (calcium carbonate). Tactile and air blast dentin hypersensitivity examinations were performed at baseline, immediately after paste application and 4 and 12 weeks later. RESULTS: A statistically significant difference in air blast (p = 0.001) and tactile (p = 0.047) hypersensitivity reduction over time was observed between the two therapy modes. After 12-weeks, statistically significant differences were indicated between the test and control group with respect to baseline-adjusted mean tactile (41.94%; p = 0.038) and air blast hypersensitivity scores (46.5%; p = 0.017). CONCLUSIONS: The tested in-office desensitizing paste containing 8.0% arginine and calcium carbonate provides significantly greater hypersensitivity relief compared to calcium carbonate alone.

Randomized controlled trial: lip piercing: the impact of material on microbiological findings.

PURPOSE: The purpose of this study was to investigate whether there are microbiological differences in bacterial samples collected from labial piercings made of different materials. METHODS: Sterile piercings of 4 materials were randomly allocated to 80 pierced subjects. After 2 weeks, microbiologic samples were collected and processed by checkerboard DNA-DNA hybridization methods. Wilcoxon signed ranks and Mann-Whitney tests were used for statistical analysis (adjustment for multiple comparisons). RESULTS: There were no statistically significant differences between material groups in relation to baseline data. In samples from stainless steel piercings, the total microbial load was significantly higher than the other materials (P<.05). Ten (mainly periopathogenic) species were found at significantly higher levels (P<.001) on steel than on polypropylene and/or polytetrafluoroethylene piercings. CONCLUSIONS: Labial piercings made of stainless steel could promote the development of a pathogenic biofilm.

Lateral lower lip piercing--prevalence of associated oral complications: a split-mouth cross-sectional study.

OBJECTIVE: To investigate via a split-mouth cross-sectional study the prevalence of gingival recessions associated with lateral lower lip piercing in a population obtained from a nondental setting. METHOD AND MATERIALS: A split-mouth study was performed in a sample of 47 patients with one lateral lower lip piercing. Teeth in direct contact with the intraoral closure of the stud were defined as test teeth; contralateral teeth were selected as controls. Clinical examination included full-mouth plaque and bleeding indices, probing depth, recession, clinical attachment level, periodontal biotype, evaluation of hard tissues, occlusal trauma, stud characteristics, and mucosal inspection and palpation. RESULTS: Midbuccal recession was noted in four test teeth compared with one control tooth (8.5% and 2.1%, respectively; P = .250). The canine and first premolars were the most affected. Tooth chipping occurred in one test tooth and no control teeth. Plaque levels were significantly higher in test than control teeth (P < .001). CONCLUSION: Lateral lower lip piercing is associated with significantly higher plaque accumulation on adjacent teeth. A small percentage of lateral lower lip piercings may cause tooth chipping or buccal recession in adjacent teeth.

Clinical long-term evaluation and failure characteristics of 1,335 all-ceramic restorations.

PURPOSE: The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years. MATERIALS AND METHODS: Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis. RESULTS: The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth. CONCLUSION: All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.

Tongue piercing: the effect of material on microbiological findings.

PURPOSE: Biofilms on oral piercings may serve as a bacterial reservoir and lead to systemic bacteremia or local transmission of pathogenic microbiota. The use of piercing materials which are less susceptible to biofilm accumulation could contribute to prevention of problems. The present study investigated whether there are microbiological differences in bacterial samples collected from tongue piercings made of different materials. METHODS: A total of 85 subjects with tongue piercings participated in this study. After a baseline dental examination, sterile piercings of four different materials were randomly allocated to the study subjects. After 2 weeks, microbiologic samples were collected and processed by checkerboard deoxyribonucleic acid- deoxyribonucleic acid hybridization methods. RESULTS: About 28.8% of subjects reported 61 lingual recessions (1.91 ± .96 mm), whereas 5% reported tooth chipping on one tooth each. With the exception of Aggregatibacter actinomycetemcomitans (Y4), Fusobacterium nucleatum species, and Parvimonas micra, bacteria associated with periodontitis were not commonly found in the samples from studs or piercing channels. Of the 80 bacterial species, 67 were found at significantly higher levels (p < .001) in samples from stainless steel than from polytetrafluoroethylene or polypropylene piercings. CONCLUSION: The low bacterial counts from piercing channels suggest that having a tongue pierced would not contribute to an increased risk for oral infection. The present study demonstrated that studs made of steel might promote the development of a biofilm, whereas those made of polytetrafluoroethylene or polypropylene may be rather inert to bacterial colonization. The finding of Staphylococci on steel and titanium studs may suggest an elevated risk for complication if the piercing channel is infected.

Self-reported complications with lip and tongue piercing.

OBJECTIVES: Owing to the overwhelming popularity of oral piercing, general practitioners should be prepared to address complications arising as a result of oral piercing and to provide patients with accurate information. The purpose of this cross-sectional study was to assess the prevalence of early and late complications associated with lip and tongue piercing in a population obtained from a nondental setting. Possible cofactors were evaluated. METHOD AND MATERIALS: The study cohort included 130 lip and 80 tongue piercings. Participants were asked to complete a questionnaire to determine demographic data, smoking habits, characteristics of the piercing worn (time since piercing, material-plastic or metal), postpiercing complications, and possible cofactors. RESULTS: Prevalence of early piercing complications was 87.83%. Although there was no statistically significant difference in the overall prevalence of early postpiercing complications after lip or tongue piercing, the type of complication differed significantly according to the piercing location. Significant cofactors for early complications were oral hygiene behavior, gender, and the person who performed the piercing. The highest prevalence of late complications was found to be recurrent infections and gingival recessions. As cofactors, time since piercing and oral hygiene behavior had a significant impact on late complications. CONCLUSION: Early complications after oral piercing are frequent. Oral health care might be an important tool to minimize early and late postpiercing complications. Owing to the high prevalence of late complications-especially after median lip piercing-persons with oral piercing should attend regular dental checks and receive professional advice on tooth cleaning and oral hygiene.

Quality of impressions after use of the Magic FoamCord gingival retraction system--a clinical study of 269 abutment teeth.

PURPOSE: The aim of this study was to evaluate a new gingival retraction system relative to clinical success for fixed dental restorations under various clinical conditions. MATERIALS AND METHODS: Two hundred sixty-nine abutment teeth were evaluated. The ability to displace gingiva was indirectly measured by the quality of the final impression. Preparation finish line with respect to the crest of the marginal gingiva (Level I through III) and type of preparation finish line (ie, shoulder or beveled) were recorded. The reproduction of the preparation finish line and an absence of bubbles or voids (Criteria I through III) were assesed. The results were compared with an established retraction system using one retraction cord. RESULTS: Of the 269 impressions evaluated, 93.7% were clinically acceptable and showed complete reproduction of the preparation finish line; 17.5% showed small defects but the impressions were still rated clinically acceptable and categorized as Criteria II. Only 6.3% of the impressions were unacceptable and categorized as Criteria III. A significant influence on the quality of the impressions was found when the preparation finish line was more than 2 mm subgingivally for shoulder (P < .004) as well as beveled preparations (P < .004). Nearly twice as many impressions were rated Criteria III when using the Magic FoamCord (MFC) system compared to impressions done with the single cord retraction technique. CONCLUSIONS: In cases of epigingival and subgingival (< 2 mm) preparation margins, MFC was a less traumatic alternative method of gingival retraction. However, when there were deep subgingival margins and a beveled preparation, the material was less effective than the single cord retraction technique.