Effect of ultrasonic activation of the adhesive system on dentin tubule penetration and the pushout bond strength of fiber posts.

STATEMENT OF PROBLEM: Whether ultrasonic activation of the adhesive system improves dentin tubule penetration and the bond strength of fiber posts to root dentin is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of ultrasonic activation of 2 adhesive systems (etch-and-rinse and self-etch) and 1 glass ionomer cement on the dentin tubule penetration and pushout bond strength of fiber posts to root dentin. MATERIAL AND METHODS: Sixty maxillary central incisors were endodontically treated and divided into 6 groups (n=10) as per the post cementation strategy: etch-and-rinse, etch-and-rinse and ultrasonic, self-etch, self-etch and ultrasonic, glass ionomer cement, and glass ionomer cement and ultrasonic. The primers, the adhesives, and the glass ionomer cement were activated for 20 seconds each, and the fiber posts were cemented with a resin cement. Dentin tubule penetration was evaluated by confocal laser scanning microscopy and the pushout bond strength measured at 3 post locations: cervical, middle, and apical. The failure patterns were also described after pushout testing. RESULTS: Self-etch and ultrasonic showed higher dentin tubule penetration than the other cementation strategies (P<.05) and improved the bond strength values (P<.05), which were higher than etch-and-rinse and ultrasonic and glass ionomer cement and ultrasonic (P<.05). Adhesive failures at the cement and dentin interface were predominant in the etch-and-rinse, self-etch, and self-etch and ultrasonic groups. CONCLUSIONS: Ultrasonic activation improved the dentin tubule penetration of a self-etch adhesive system. The bond strength of fiber posts cemented with a self-etch adhesive system and a resin cement was improved after ultrasonic activation.

Comparison between isolated and associated with codeine acetaminophen in pain control of acute apical abscess: a randomized clinical trial.

OBJECTIVES: The study aimed to compare the acetaminophen administration efficacy or its combination with codeine for pain control in acute apical abscesses cases. MATERIALS AND METHODS: Thirty-nine patients who sought emergency treatment in the Faculty of Dentistry of the Federal University of Rio Grande do Sul were included, all of them with acute apical abscess diagnosis. These patients were divided into two groups: acetaminophen group-prescription of acetaminophen (1000 mg) and acetaminophen-codeine group-prescription of acetaminophen (1000 mg) + codeine (30 mg), both with oral intake every 6 h for 3 days. The pain scores were recorded by the patients on their own at 6, 12, 24, 48, and 72 h after finishing clinical assistance, by filling a pain evolution journal, containing a visual analogue scale (VAS). Student t test was conducted to investigate different mean ages between groups 1 and 2. A comparison of weight and means of initial pain scores between groups was carried out using the Mann-Whitney U test. Chi-square test was performed to compare gender, affected tooth, education, initial swelling, and frequency of adverse effect between test and control groups. Mann-Whitney U test was applied to compare groups in the same period. Friedman's test was used to compare results from the same group over time. RESULTS: Both groups showed score reduction over time (P < 0.05). Paracetamol-codeine group showed significant pain score reduction at 48 h registers when compared to baseline and at 6 h scores (P < 0.05). Further, pain scores at 72 h were significantly lower, when compared to the baseline, at 6 h, and at 12 h scores (P < 0.05). Acetaminophen group showed significant pain score reduction observed at 72 h, when compared to the baseline and at 6 h scores (P < 0.05). There were no significant differences in pain score reduction over time between groups (P > 0.05). There was no difference between the groups regarding the frequency of adverse reactions (P > 0.05). CONCLUSION: Both medications were effective for pain control in acute apical abscess cases. The findings might have inferred in pain control of acute apical abscess associated pain in patients who used an antibiotic drug. External validity of the findings for acute apical abscess cases with no need for an antibiotic prescription is uncertain. CLINICAL RELEVANCE: This paper suggests acetaminophen 1000 mg can be used for pain control in the treatment of acute apical abscess associated with systemic manifestation.

Effect of fiber post space irrigation with different peracetic acid formulations on the bond strength and penetration into the dentinal tubules of self-etching resin cement.

STATEMENT OF PROBLEM: The post space must be irrigated with solutions that do not interfere with the bond strength and enhance penetration into the dentinal tubules of self-etching resin cement. Which solution is best is unclear. Peracetic acid with different formulations appears to be a good option. PURPOSE: The purpose of this in vitro study was to evaluate the effect of irrigating the fiber post space by using 1% peracetic acid (PA) at low (LH) or high (HH) hydrogen peroxide concentration on the bond strength and penetration into the dentinal tubules of RelyX U200 self-etching resin cement. MATERIAL AND METHODS: After intraroot preparation for fiber posts in 60 endodontically treated teeth, the specimens were divided into 4 groups (n=15) according to the irrigation protocol: CG (control), distilled water; NA (NaOCl), 2.5% sodium hypochlorite; LHPA, PA with a low concentration of hydrogen peroxide; and HHPA, PA with a high concentration of hydrogen peroxide. The fiber posts were then cemented with self-etching resin cement labeled with rhodamine. Cross sections of the thirds were obtained by confocal scanning microscopy and submitted to the push-out and cement penetration tests. The data obtained in the push-out tests were evaluated by using ANOVA and the Tukey post hoc test, and those data obtained in the confocal screening were evaluated by using the Kruskal-Wallis and Dunn (Bonferroni correction) tests (α=.05). RESULTS: Bond strength values in the cervical third of the CG were higher than those in NA (P=.035) but similar to those of the other groups (P=.05). In the other thirds, CG and LHPA values were similar to one another (P=.05) but higher than those of NA and HHPA (P<.001). The penetration rate assessed by confocal scanning microscopy revealed similar results in the cervical third for all groups (P=.075), except for NA which provided the lowest penetration. In the remaining thirds, CG and LHPA provided the highest penetration rate (P=.015). CONCLUSIONS: The LHPA group had no negative effects on the bond strength and penetration into the dentinal tubules of the self-etching resin cement.

Effects of different peracetic acid formulations on post space radicular dentin.

STATEMENT OF PROBLEM: The optimal irrigating solution with antimicrobial and dentin cleansing properties for post space preparation for fiber posts is unclear. Peracetic acid is one option but is available in various chemical formulations that require evaluation. PURPOSE: The purpose of this in vitro study was to evaluate dentin surface cleanliness based on the presence of a smear layer and the number of open dentin tubules. It also investigates the chemical composition of residues after canal irrigation with a 1% peracetic acid solution (PA) at low or high concentration of hydrogen peroxide during the preparation of intracanal fiber posts. MATERIAL AND METHODS: After filling the root canals of 40 mandibular incisors, a rotary instrument was used for intracanal preparation to place fiber posts. The teeth were divided into 4 groups (n=10) according to the post space irrigation protocol as follows: CG (control): distilled water; NA (NaOCl): 2.5% sodium hypochlorite; LH: PA with low concentration of hydrogen peroxide; and HH: PA with high concentrations of hydrogen peroxide. After irrigation, the teeth were sectioned, and the intracanal dentin surface was subjected to analysis using energy dispersive spectroscopy to evaluate chemical composition and to scanning electron microscopy (×500) to evaluate the presence of the smear layer. The number of open dentin tubules was measured by scanning electron microscopy analysis (×2000) using photo-editing software. ANOVA and the Tukey test (α=.05) were used to evaluate the data, except for the presence of a smear layer, for which the Kruskal-Wallis and Dunn tests were used (α=.05). RESULTS: The highest concentrations of oxygen in the dentin residues were detected in LH and HH (P<.05); CG and NA showed similar oxygen concentrations (P>.05). NA had a higher concentration of chlorine (P<.05), whereas LH had a lower amount of smear layer and a larger number of open dentin tubules than the other groups (P<.05). These were equivalent to each other (P>.05), except for HH, which also had a larger number of open dentin tubules than CG and NA (P<.05). CONCLUSIONS: PA 1% with a low concentration of hydrogen peroxide yielded a lower amount of smear layer and a larger number of open dentin tubules in the dentin of the post space when compared with PA 1% with a high concentration of hydrogen peroxide, despite maintaining a similar oxygen concentration in these dentin residues.

Final irrigation protocols may affect intraradicular dentin ultrastructure.

OBJECTIVES: The aim of this study was to evaluate the effect of different irrigation protocols on the root dentin structure using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). MATERIALS AND METHODS: Thirty-nine lower bovine incisors were hemisected longitudinally and randomly divided into 13 groups (n = 3). After the root halves were reassembled, it was applied a specific irrigation protocol for each group, as following: G1, distilled water (control); G2, 0.9% saline; G3, saline + 17% EDTA; G4, saline + PUI; G5, saline + PUI + EDTA; G6 to G9 received the same protocol as above replacing 0.9% saline by 2.5% NaOCl; and G10 to G13 by 2% CHX. One-half of each sample was prepared and evaluated using SEM and the other one by TEM observations. RESULTS: TEM descriptive analysis showed modifications in dentin organic ultrastructure, characterized by the thinning of dentin collagen fibrils, caused by NaOCl, enhanced by EDTA and/or PUI. SEM analysis showed that NaOCl with PUI caused significantly larger erosion of the peritubular dentin than in all the other groups (P < 0.05), followed by NaOCl + EDTA and NaOCl + EDTA + PUI. CONCLUSIONS: NaOCl caused ultrastructural alterations in the dentin collagen, and enhanced by EDTA and/or PUI, promoted peritubular and intertubular erosion. CLINICAL RELEVANCE: The effect of irrigating solutions on dentin ultrastructure was still unclear. The acknowledgment about the kind of solution, concentrations, application time, and sequence of use was important to achieve the right sanitization without jeopardizing the dentin ultrastructure quality.

The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study.

INTRODUCTION: The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. METHODS: Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n = 20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. RESULTS: QG and EG presented similar amounts of sealer penetration (P > .05). MG and CG presented the lowest penetrability values (P < .05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P < .05). CONCLUSIONS: Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. CLINICAL RELEVANCE: Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike gutta-percha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

Subjective qualitative assessment of the finish line of prosthetic preparations submitted to different finishing instruments.

STATEMENT OF PROBLEM: Different instruments have been developed to improve crown finish lines after conventional preparation with diamond rotary instruments. However, more evidence on the effectiveness of these instruments is required. PURPOSE OF STUDY: The purpose of this in vitro study was to assess the effectiveness of 4 different instruments used for cervical margin finishing in regard to the external line angle (ELA). MATERIAL AND METHODS: Forty-eight freshly extracted third molar teeth with similar dimensions were conventionally prepared for crowns and randomly allocated into 4 groups (n=12) according to the finishing instrument: hand trimmer (HT), tungsten carbide bur (TCB), ultrasonic instrument (UI), and diamond rotary instrument (DRI) mounted in a contra angle handpiece with reduced speed. Photomicrographs from the margin profiles of each tooth were obtained with scanning electron microscopy (×40) before and after finishing procedures. The images were qualitatively analyzed (scores 1-4) by 9 experienced dental professionals. Average results were assessed with the paired t test and repeated measures ANOVA followed by Tukey HSD test (α=.05). RESULTS: HT, TCB, and UI demonstrated no significant differences between unfinished and finished mean ELA scores. DRI was the only group to demonstrate a significantly improved ELA (P<.001). Except for HT in relation to TCB (P=.989), all the other groups demonstrated statistically significant different ELA scores. CONCLUSION: DRI mounted in a contra angle handpiece was the only finishing instrument capable of significantly improving the ELA, while TCB and UI produced nonsignificant improvement, and HT was detrimental to the ELA.

Transferring Conditioned Partially Edentulous Ridge Form to a Master Cast.

Gingival conditioning techniques in prosthodontics aim to overcome bone and soft-tissue defects that often compromise the outcome of restorations in terms of esthetics, function, and biocompatibility. Whatever the technique used, it is essential to reproduce a regular concave gingival outline in order to recreate the natural aspect of the relationship between teeth and gingiva, eliminating black triangles. Transferring the details of the conditioned soft tissue to the laboratory technician with precision may be challenging. The authors hereby propose a novel technique to transfer the clinical aspect of the conditioned soft tissue to the master cast, using a customized metal framework to help ensure accuracy.

The effect of post material on the characteristic strength of fatigued endodontically treated teeth.

STATEMENT OF PROBLEM: The biomechanical properties of post systems may become more important as the amount of remaining tooth structure decreases, thus different materials may influence the characteristic strength of fatigued endodontically treated teeth. PURPOSE: The purpose of this study was to assess the characteristic strength and probability of survival of endodontically treated teeth restored with different intraradicular post systems. MATERIAL AND METHODS: Forty human maxillary canines with similar root lengths were randomly divided into 4 groups (n=10): cast post and core, stainless-steel prefabricated post, carbon-fiber post, and glass-fiber post. Cores and metallic crowns were fabricated for all specimens. Restored teeth were exposed to mechanical fatigue (250,000 cycles) in a controlled chewing simulator. Each intact specimen was mounted in a special device and aligned at a 45-degree angle to the long axis of the tooth. A universal testing machine was used to apply a static load at a crosshead speed of 0.5 mm/min until specimen failure. The maximum value was recorded in newtons (N). Probability Weibull curves (2-sided 90% confidence bounds) were calculated for each group, and a probability of survival as a function of load at failure was plotted for the groups. RESULTS: A significantly higher characteristic strength was observed for groups carbon-fiber post (755.82 N) and cast post and core (750.6 N) (P<.05) compared with glass-fiber post (461.35 N) and stainless-steel prefabricated post (524.78 N) groups. All the roots in the cast post and core group demonstrated catastrophic fracture, whereas the remaining groups had no root fractures. CONCLUSIONS: Prefabricated posts made of glass fiber and stainless steel showed significantly lower characteristic strength and probability of survival than cast post and core, whereas crowns with carbon-fiber posts presented a single load similar to the fracture values of cast posts.

A method of assessing the effectiveness of the friction fit interface by measuring reverse torque.

STATEMENT OF THE PROBLEM: The connection between abutments and implants is fundamental to successful prosthetic rehabilitation, and the loosening or fracture of the parts are undesirable outcomes. PURPOSE: The purpose of this study was to measure the reverse torque values of 2 different types of Morse taper implants. MATERIAL AND METHODS: Ten Morse taper implants were used, with their respective abutments. They were divided into 2 groups (n = 5): Group DH, implant interface with a double hexagon and Group OI, octagonal implant interface. Each abutment received 2 consecutive insertion torques (32 Ncm) at a 10-minute interval and 1 reverse torque after 5 minutes. The data were analyzed with the Student t test (α= .05). RESULTS: The Student t test demonstrated no significant differences between the values of the insertion and removal torques of the 2 groups (Group DH, P= .22 and Group OI, P= .42) or the removal torque values of the groups (P= .12). CONCLUSION: The results suggest that the strength required to loosen the abutment screws as measured by reverse torque is similar for both a double hexagon interface (DH) and an octagonal interface (OI).

Influence of reverse torque values in abutments with or without internal hexagon indexes.

STATEMENT OF PROBLEM: The mechanical stability of the implant-abutment connection is of fundamental importance for successful implant-supported restorations. Therefore, understanding removal torque values is essential. PURPOSE: The purpose of this study was to evaluate the reverse torque values of indexed and nonindexed abutments of the Morse Taper system. MATERIAL AND METHODS: Twelve Morse taper implants with their respective abutments were divided into 2 groups (n=6): group NI, nonindexed abutments; and group IN, indexed abutments. Each abutment received a sequence of 2 consecutive torques for insertion (15 Ncm) at an interval of 10 minutes, and 1 reverse torque, all measured with a digital torque wrench. The Student t test with a 5% significance level was used to evaluate the data. RESULTS: Statistical analysis showed no significant difference in reverse torque values between nonindexed and indexed abutments (P=.57). When comparing insertion torque and reverse torque values between the groups, group NI presented a mean torque loosening percentage of 8% (P=.013), whereas group IN presented a loosening of 15.33% (P<.001). CONCLUSION: The use of indexed abutments for the Morse taper system presented similar biomechanical stability when compared with nonindexed abutments, both with a significant reduction in reverse torque values.

The influence of different cements on the pull-out bond strength of fiber posts.

STATEMENT OF PROBLEM: Glass fiber posts are commonly used to provide adequate support and retention for the restoration of endodontically treated teeth, but their resistance to dislodgement depends on their adhesion to root dentin. PURPOSE: The purpose of this study was to assess the effect of cement type on the pull-out bond strength of fiber posts. MATERIAL AND METHODS: Seventy maxillary canines were endodontically treated and then divided into 7 groups according to the cement used for fiber post cementation as follows (n = 10): RelyX Unicem, BisCem, RelyX Luting 2, RelyX ARC, Panavia F, Enforce, and Allcem. The specimens were subjected to a pull-out bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/min. The results, in newtons, were analyzed with 1-way ANOVA and the Tukey post hoc test (α = .05). RESULTS: RelyX Unicem (472.3 ± 8.9 N), BisCem (506.6 ± 9.2 N), RelyX ARC (498.0 ± 8.2 N), Panavia F (502.3 ± 7.0 N), and Allcem (470.0 ± 11.3 N) presented significantly higher bond strength than RelyX Luting 2 (241.8 ± 9.70 N) and Enforce (309.5 ± 6.3 N) cements (mean ± SD; P < .05). CONCLUSIONS: Except for Enforce, all resin cements produced pull-out bond strength values twice that of resin modified glass ionomer cement. However, all cements promoted adequate retention to fiber posts to withstand functional loads.

Fracture resistance of endodontically treated teeth restored with glass fiber posts of different lengths.

STATEMENT OF PROBLEM: Endodontically treated teeth are known to have reduced structural strength. Glass fiber posts may influence fracture resistance and should be evaluated. PURPOSE: The purpose of this study was to evaluate the influence of glass fiber post length on the fracture resistance of endodontically treated teeth. MATERIAL AND METHODS: Forty intact human maxillary canines were selected and divided into 4 groups, the control group consisting of teeth restored with a custom gold cast post and core, with a length of two-thirds of the root. Other groups received prefabricated glass fiber posts in different lengths: group 1/3, removal of one-third of the sealing material (5 mm); group 1/2, removal of one-half of the sealing material (7.5 mm); and group 2/3, removal of two-thirds of the sealing material (10 mm). All the posts were cemented with resin cement, and the specimens with glass fiber posts received a composite resin core. All the specimens were restored with a metal crown and submitted to a compressive load until failure occurred. The results were evaluated by 1-way ANOVA, and the all pairwise multiple comparison procedures (Tukey honestly significantly difference test) (α=.05). RESULTS: The ANOVA showed significant differences among the groups (P<.002). The Tukey test showed that the control group presented significantly higher resistance to static load than the other groups (control group, 634.94 N; group 1/3, 200.01 N; group 1/2, 212.17 N; and group 2/3, 236.08 N). Although teeth restored with a cast post and core supported a higher compressive load, all of them fractured in a catastrophic manner. For teeth restored with glass fiber posts, the failure occurred at the junction between the composite resin core and the root. CONCLUSION: The length of glass fiber posts did not influence fracture load, but cast post and cores that extended two-thirds of the root length had significantly greater fracture resistance than glass fiber posts.

Evaluation of mercury contamination in patients and water during amalgam removal.

AIM: The aim of this study was to evaluate mercury levels in wastewater and in patients during the removal of dental amalgam restorations. MATERIALS AND METHODS: To test for mercury levels, patients were tested before and after amalgam restoration removal. To test for mercury emissions, samples of constant volume of wastewater from high-speed drills were collected before and during amalgam restoration removal. RESULTS: Although the systemic mercury levels were lower than the limit of biological tolerance, all patients had increased levels after dental restorations. All samples of wastewater had increased mercury levels too. CONCLUSION: The urinary levels of mercury increased with dental amalgam removal using a high-speed drill. During the process of amalgam removal, water used for cooling the dental drill was contaminated with mercury. CLINICAL SIGNIFICANCE: The mercury released by the physical action of the drill, the replacement material and especially the final destination of the amalgam waste can increase contamination levels that can be a risk for human and environment health.

Effect of ultrasonic activation on setting time, pH and calcium ion release, solubility, and chemical structure of calcium silicate sealers.

This study evaluated the setting time, pH, calcium ion release, solubility, and chemical structure of four calcium silicate sealers after ultrasonic activation (UA). Five sealers were evaluated: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC), and BioRoot RCS (BR). Ten groups were created based on the use or not of ultrasonic activation: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; and BR/UA. Setting time was performed based on ISO 6876:2012 and ASTM C266-07 specifications. Solubility at 24hs, based on ISO 6876:2012. pH and calcium release were evaluated at 1, 24, 72, and 168hs. Raman spectroscopy was used to evaluate structural changes. Quantitative data were analyzed using One-Way ANOVA and Tukey post-hoc test (α=5%). Raman spectroscopy results were qualitatively analyzed. Setting times and solubility of all sealers were not affected by UA (p>0.05). The highest solubility was found for BCS, BCS/UA; and BR, BR/UA (p<0.05). After 24hs, calcium silicate sealers had higher pH than SP and SP/UA (p<0.05). BR and BR/UA had the highest pH at all time points. SP and SP/UA had stable pH at all time points. SP and SP/UA had the lowest calcium release values at all time points (p<0.05). EBC and EBC/UA calcium release significantly differ at 24,72 and 168hs (p<0.05). No chemical changes were observed during Raman spectroscopy. In conclusion, ultrasonic activation affected calcium ion release only for EndoSequence BC Sealer. Ultrasonic activation did not influence the initial and final setting time, solubility, pH, and chemical structure of any investigated sealers.

Effect of cavity design on tooth surface strain.

STATEMENT OF PROBLEM: The loss of tooth structure can increase cuspal flexure, thereby reducing the fracture resistance of the tooth, or open the tooth-restoration interface, leading to microleakage. PURPOSE: The purpose of this study was to evaluate tooth strain in teeth with different cavity preparations after loading and unloading. MATERIAL AND METHODS: Ten intact human maxillary premolars were selected and embedded in epoxy resin molds. Constantan strain gauges were used and tested as an intact tooth (group I), occlusal cavity (group O), mesio-occlusal cavity (group MO), and finally mesio-occluso-distal cavity (group MOD). All teeth were subjected to gradual nondestructive occlusal loading and unloading (50 N, 70 N, 90 N, 110 N, 130 N, 50 N, 0 N) in a servohydraulic testing machine. All data were analyzed statistically by performing a repeated measures ANOVA with load and cavity as factors to compare the relevant mean strains, and a Bonferroni post hoc test was performed for multiple comparisons (α=.05). RESULTS: The repeated measures ANOVA did not provide any evidence of an interaction between load and cavity but indicated a significant difference in the mean strains both between the loads (P<.001) and between the cavity groups (P<.001). CONCLUSIONS: MOD cavities presented statistically significantly higher values of strain than MO, O, or intact teeth, and a significant increase in the values of mean strain for all cavities was observed, even with intact teeth, when nondestructive occlusal loading was increased.

Effect of mechanical loading on the removal torque of different types of tapered connection abutments for dental implants.

STATEMENT OF PROBLEM: The mechanical behavior of internal taper implant abutment designs needs to be evaluated. PURPOSE: The purpose of this study was to evaluate the effect of simulated mechanical loading on the removal torque of 1-piece and 2-piece abutments connected to internal taper oral implants. MATERIAL AND METHODS: Forty-eight internally notched taper implants were divided into 2 groups of 24. Group OP received solid (1-piece) abutments; group TP received esthetic (2-piece) abutments. Each group was further subdivided into subgroups C (control) without mechanical loading and T (test) with mechanical loading. In groups OPC and TPC, the abutments were placed and removed and the removal torque values (RTVs) registered. In groups OPT and TPT, abutments were placed, mechanically loaded (500 000 cycles), removed, and the RTVs registered. Groups TPC and TPT were further tested for the traction force necessary to dislodge the abutment from the implant. For data analysis, the Student t test (for RTVs) and the Mann-Whitney U test (for TFVs) (α=.05) were performed. RESULTS: All abutments tested presented torque loss with RTVs lower than the placement torque. A statistically significant difference (P=.002) was found between groups OPC (81.6% of placement torque) and OPT mean RTVs results (85.0% of placement torque), while no statistical differences (P=.362) were found between groups TPC (63.7% of placement torque) and TPT (59.1% of placement torque). The traction force values necessary to dislodge the abutment from the implant, however, were significantly higher (P<.001) for group TPT than for group TPC. CONCLUSIONS: Cold welding did not occur in any of the abutment specimens tested. Even after the mechanical loading, esthetic abutments presented similar RTVs. The traction force necessary to remove esthetic abutments from inside the implants presented a 2-fold increase after mechanical loading.

Influence of technique and manipulation on self-adhesive resin cements used to cement intraradicular posts.

STATEMENT OF PROBLEM: Resin cements are widely used to cement intraradicular posts, but bond strength is significantly influenced by the technique and material used for cementation. PURPOSE: The purpose of this study was to evaluate the bond strength of 3 self-adhesive cements used to cement intraradicular glass fiber posts. The cements all required different application and handling techniques. MATERIAL AND METHODS: Forty-five human maxillary canines were selected and randomly divided into 3 groups n= 15 by drawing lots: Group BIS - Biscem, Group BRE - Breeze, and Group MAX - Maxcem. Each group was divided into 3 subgroups according to application and handling techniques: Sub-group A - Automix/Point tip applicator, Sub-group L - Handmix/Lentulo, and Sub-group C - Handmix/Centrix. Cementation of the posts was performed according to the manufacturers' instructions. The push-out test was performed with a crosshead speed of 0.5 mm/min, and bond strength was expressed in megapascals. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05). RESULTS: Breeze cement showed the highest average for the subgroups A, L, and C when compared to the Biscem cement and Maxcem Elite (P<.05). Statistically significant differences among the subgroups were only observed for Biscem. CONCLUSIONS: This study shows that application and handling techniques may influence the bond strength of different self-adhesive cements when used for intraradicular post cementation.

Push-out bond strengths of different dental cements used to cement glass fiber posts.

STATEMENT OF PROBLEM: Since the introduction of glass fiber posts, irreversible vertical root fractures have become a rare occurrence; however, adhesive failure has become the primary failure mode. PURPOSE: The purpose of this study was to evaluate the push-out bond strength of glass fiber posts cemented with different luting agents on 3 segments of the root. MATERIAL AND METHODS: Eighty human maxillary canines with similar root lengths were randomly divided into 8 groups (n=10) according to the cement assessed (Rely X luting, Luting and Lining, Ketac Cem, Rely X ARC, Biscem, Duo-link, Rely X U100, and Variolink II). After standardized post space preparation, the root dentin was pretreated for dual-polymerizing resin cements and untreated for the other cements. The mixed luting cement paste was inserted into post spaces with a spiral file and applied to the post surface that was seated into the canal. After 7 days, the teeth were sectioned perpendicular to their long axis into 1-mm-thick sections. The push-out test was performed at a speed of 0.5 mm/min until extrusion of the post occurred. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05). RESULTS: ANOVA showed that the type of interaction between cement and root location significantly influenced the push-out strength (P<.05). The highest push-out strength results with root location were obtained with Luting and Lining (S3) (19.5 ±4.9 MPa), Ketac Cem (S2) (18.6 ±5.5 MPa), and Luting and Lining (S1) (18.0 ±7.6 MPa). The lowest mean values were recorded with Variolink II (S1) (4.6 ±4.0 MPa), Variolink II (S2) (1.6 ±1.5 MPa), and Rely X ARC (S3) (0.9 ±1.1 MPa). CONCLUSIONS: Self-adhesive cements and glass ionomer cements showed significantly higher values compared to dual-polymerizing resin cements. In all root segments, dual-polymerizing resin cements provided significantly lower bond strength. Significant differences among root segments were found only for Duo-link cement.

Tensile resistance of mineralized and demineralized rat bones in different regions (calvarial and femur).

The aim of this study was to evaluate the tensile resistance of mineralized and demineralized bones. Twelve mice were used. Specimens were collected and divided into groups 1 and 2, mineralized and demineralized calvarial bone, and groups 3 and 4, mineralized and demineralized femoral bone. There was not a statistically significant difference (analysis of variance) between the regions; however, when comparing the demineralized and mineralized groups, a statistically significant difference (Student test) for the mineralized group was noticed.