Clinical and microbiologic investigation of an expedited peri-implantitis dog model: an animal study.

BACKGROUND: Animal studies are pivotal in allowing experimentation to identify efficacious treatment protocols for resolution of peri-implantitis. The purpose of this investigation was to characterize an expedited dog peri-implantitis model clinically, radiographically, and microbiologically. METHODS: Eight hound dogs underwent extractions (week 0) and implant (3.3 × 8.5 mm) placement with simultaneous surgical defect creation and ligature placement for induction of peri-implantitis (week 10). Ligatures were replaced at 6 weeks (week 16) and removed after 9 weeks (week 19) when supporting bone loss involved approximately 50% of the peri-implant bone. Microbial samples from the defects and healthy control implant sites collected at week 19 were analyzed utilizing a microarray. Clinical measures of inflammation were obtained and radiographic bone loss was measured from periapical radiographs. Radiographic depth and width measurements of bony defect were repeated at weeks 10 (baseline), 16, and 19. Canonical analysis of principal coordinates was used to visualize overall differences in microbial abundance between peri-implantitis and healthy implants. RESULTS: This accelerated disease protocol led to intrabony defect creation with a mean depth and width of 4.3 mm and 3.5 mm, respectively after 9 weeks of ligature placement. Microbial identification revealed 59 total bacteria in peri-implant sites, 21 of which were only present in peri-implant sites as compared to healthy controls. Overall microbial beta diversity (microbial between-sample compositional diversity) differed between peri-implantitis and healthy implants (p = 0.009). CONCLUSIONS: Within the limitations of this study, this protocol led to expedited generation of peri-implant defects with a microbial profile indicative of a shift to disease and defect patterns conducive to regenerative treatment. However, the possibility of potential spontaneous resolution of lesions due to the lack of a chronicity interval as compared to chronic disease models need to be further clarified and considered during preclinical peri-implantitis model selection.

A new method to test the fracture strength of endodontically-treated root dentin.

OBJECTIVE: To develop a new method to test the fracture strength of endodontically-treated root dentin. METHOD: Bovine tooth roots were transversely cut into 2-mm thick sections and the root canals were enlarged with a taper of 0.06. An outer layer of resin composite was bonded to each section to make the root canal-to-outer radius ratio smaller than 1/3. The resulting discs were treated with irrigants at the inner surface and then fractured by inserting through the center a steel rod of the same taper attached to a universal test system. Fracture strength was calculated by using Lame's equations for thick-walled cylinders. Micro-indentation was performed to evaluate the depth of dentin affected by irrigation. Finite element analysis (FEA) was performed to verify the reasonableness of using resin composite to surround the dentin section as well as the analytical solution. RESULTS: The fracture strength of endodontically-treated root dentin based on the analytical solution for a homogeneous section was 139.69 ± 32.59 MPa. However, FEA that took into account root canal softening caused by the irrigants showed that this was overestimated by about 33.5%. The corrected fracture strength of treated dentin was 114.58 ± 26.74 MPa. By incorporating the layer of affected dentin into the analytical solution, the difference in the fracture-causing stress between the analytical and numerical solutions dropped to around 9.5%. SIGNIFICANCE: A relatively simple but clinically relevant method has been developed for measuring the fracture strength of endodontically-treated root dentin. The method could be applied to root dentin that is treated by conventional canal opening and irrigation.

Accelerated fatigue testing of dentin-composite bond with continuously increasing load.

OBJECTIVES: The aim of this study was to evaluate an accelerated fatigue test method that used a continuously increasing load for testing the dentin-composite bond strength. METHODS: Dentin-composite disks (ϕ5mm×2mm) made from bovine incisor roots were subjected to cyclic diametral compression with a continuously increasingly load amplitude. Two different load profiles, linear and nonlinear with respect to the number of cycles, were considered. The data were then analyzed by using a probabilistic failure model based on the Weakest-Link Theory and the classical stress-life function, before being transformed to simulate clinical data of direct restorations. RESULTS: All the experimental data could be well fitted with a 2-parameter Weibull function. However, a calibration was required for the effective stress amplitude to account for the difference between static and cyclic loading. Good agreement was then obtained between theory and experiments for both load profiles. The in vitro model also successfully simulated the clinical data. SIGNIFICANCE: The method presented will allow tooth-composite interfacial fatigue parameters to be determined more efficiently. With suitable calibration, the in vitro model can also be used to assess composite systems in a more clinically relevant manner.

Determining the temporal development of dentin-composite bond strength during curing.

OBJECTIVES: As composite restorations cure a competition develops between bond formation and shrinkage stress at the composite-dentin interface. Thus, understanding the temporal development of tooth-composite bond strength should enable better assessment of tooth-composite debonding. METHODS: In this study, bond strengths of composite-dentin specimens obtained from tensile test at different curing times were used to determine the bond formation rate. By varying the composite thickness and output from the curing light, their effects on the rate of bond formation for two different materials (a conventional and a bulk-fill composite) were also investigated. The proportions of cohesive and adhesive failure were determined by analysis of electron micrographs of the fractured surfaces. RESULTS: The development of dentin-composite bond strength (S) with time (t) can be described by the equation: S=Smax(1-exp(-αt)), where Smax is the final bond strength (∼12MPa for both composites) and α the rate of bond formation. Using bulk-fill and thinner specimens gave faster bond formation. In fact, the higher the irradiance at the interface, the higher the rate of bond formation. However, α had a maximum value of ∼0.6s(-1) and the rule of reciprocity did not hold. A minimum dose of ∼2J/cm(2) was required to achieve adequate bond strength. The predominant failure mode changed from cohesive in the composite and adhesive to interfacial at the adhesive-dentin interface, indicating the latter to be the weakest link in the cured dentin-composite assemblies considered. SIGNIFICANCE: When combined with the temporal development of shrinkage stress, the current results will help determine the likelihood of tooth-composite debonding.

A study of polymerization shrinkage kinetics using digital image correlation.

OBJECTIVE: To investigate the polymerization shrinkage kinetics of dental resin composites by measuring in real time the full-field shrinkage strain using a novel technique based on digital image correlation (DIC). METHODS: Polymerization shrinkage in resin composite specimens (Filtek LS and Z100) was measured as a function of time and position. The main experimental setup included a CCD camera and an external shutter inversely synchronized to that of the camera. The specimens (2 mm × 4 mm × 5 mm) were irradiated for 40s at 1200 mW/cm(2), while alternating image acquisition and obstruction of the curing light occurred at 15 fps. The acquired images were processed using proprietary software to obtain the full-field strain maps as a function of time. RESULTS: Z100 showed a higher final shrinkage value and rate of development than LS. The final volumetric shrinkage for Z100 and LS were 1.99% and 1.19%, respectively. The shrinkage behavior followed an established shrinkage strain kinetics model. The corresponding characteristic time and reaction order exponent for LS and Z100 were calculated to be approximately 23s and 0.84, and 14s and 0.7, respectively, at a distance of 1.0mm from the irradiated surface, the position where maximum shrinkage strain occurred. Thermal expansion from the exothermic reaction could have affected the accuracy of these parameters. SIGNIFICANCE: The new DIC method using an inversely synchronized shutter provided realtime, full-field results that could aid in assessing the shrinkage strain kinetics of dental resin composites as a function of specimen depth. It could also help determine the optimal curing modes for dental resin composites.

Digital image correlation analysis on the influence of crown material in implant-supported prostheses on bone strain distribution.

PURPOSE: A digital image correlation (DIC) method for full-field surface strain measurement was used to analyze the effect of two veneering materials for implant supported crowns on the strain distribution within the surrounding bone. METHODS: An epoxy resin model of a bone block was made by housing acrylic resin replicas of a mandibular first premolar and second molar together with threaded implants replacing the second premolar and first molar. Porcelain-veneered (G1 and G3) and resin-veneered (G2 and G4) screw-retained splinted crowns were fabricated and loaded with (G1 and G2) and without (G3 and G4) the presence of the second molar replica. A 2-dimensional DIC measuring system was used to record surface deformation of the bone block model at a frequency of 1.0 Hz during application of a 250-N load. RESULTS: Maximum compressive strains (ɛ(XX), %) were found for the following regions: between molars, G1 (-0.21), G2 (-0.18), G3 (-0.26), and G4 (-0.25); between implants, G1 (-0.19), G2 (-0.13), G3 (-0.19), and G4 (-0.14). The magnitude of strains in the simulated bone block with the resin-veneered crowns was lower than that with porcelain-veneered crowns, irrespective of the presence or absence of the second molar. CONCLUSIONS: The softer resin veneer helped to spread the load more evenly amongst the supporting teeth and implants, thus reducing the strains in the simulant bone block. Conversely, using the harder porcelain veneer resulted in the load being concentrated within one or two teeth or implants, thus leading to higher strain values in the bone block.