The Effects of Laser with Different Parameters and Crosshatching on Fibroblast Adhesion and Proliferation to Implant Surfaces.

PURPOSE: To compare the adhesion and proliferation effect of HGF-1 cells on pure titanium disks when the surfaces are unprocessed (machined surfaces after slicing) or modified with a laser. MATERIALS AND METHODS: Twenty-eight titanium disks were divided into four groups. Three surface topographies were created using an erbium fiber laser: group 1 (unidirectional application [no crosshatch]), group 2 (crosshatching in two directions), and group 3 (crosshatching in three directions). The samples in group 4 were unprocessed and served as controls. The surface roughness of samples was investigated with scanning electron microscopy (SEM) and measured with a mechanical surface profilometer. HGF-1 cell line was used to analyze the adhesion of fibroblasts on the sample surfaces. The authors used SEM, XTT, and acridine orange tests to determine the adhesion of HGF-1 onto specimen surfaces and the cell morphology after incubation for 72 hours. XTT results and surface roughness values for all specimens were analyzed using the Kruskal-Wallis test. RESULTS: Ra values of group 1 to group 4 (control) were 1.13, 0.26, 0.38, and 0.19, respectively. Crosshatching decreased the surface roughness values compared with unidirectional application (P = .003). Cell morphology observed in SEM showed that the elongation direction of cells resulted in all directions related with additional filopodia extentions within the crosshatch groups. Therefore, the highest cell viability was also detected in the three-directional crosshatch group (group 3) (P = .000) in XTT assay. According to the acridine orange test, higher cell numbers were seen in group 3, similar to the XTT findings (P = .86). CONCLUSION: Crosshatching significantly increased the cell-covered implant surfaces compared with the unidirectional group. Decreasing the surface Ra values via crosshatching helped spread the fibroblast over the implants in any direction, thus increasing cell proliferation and adhesion.

A novel platelet concentrate: titanium-prepared platelet-rich fibrin.

We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

Prosthetic Rehabilitation of Partial Ear Defect: 2 Case Reports.

The loss or absence of an auricle may result from trauma, disease or congenital anomalies and causes a considerable aesthetic problem. If the deformity involves the external auditory canal, it can affect hearing. This case report describes the surgical and prosthetic treatment of two patients with partial defects of their right external ears from different causes. Implant-retained auricular prostheses fabricated from heat-temperature-vulcanised silicone were used in both the cases; they were designed to be harmonious with the remaining tissues. The patients experienced improved retention, aesthetics, hearing and quality of life with these prostheses. During the approximately 3 year follow-up, both the prostheses were re-fabricated once; however, problems related to implant stability and peri-implant tissue health were not encountered.

In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate.

We have developed a new, titanium-prepared, platelet-rich fibrin (T-PRF) together with the protocol for forming it, which is based on the hypothesis that titanium tubes may be more effective at activating platelets than the glass tubes used by Chouckroun in his platelet-rich fibrin (PRF) method. The aim of this study was to find a suitable animal model in which to evaluate the method and to investigate the efficacy of T-PRF for wound healing. Blood samples from 6 rabbits were used to confirm the protocol for formation of T-PRF. We evaluated T-PRF or T-PRF-like clots morphologically using scanning electron microscopy (EM). Blood samples from 5 rabbits were used to develop an experiment in which to evaluate the effects of T-PRF on wound healing. The mucoperiosteal flaps were filled with autologous T-PRF membranes from the vestibule in the anterior mandibular regions. Samples collected from the surgical sites were stained with haematoxylin and eosin. We found a mature fibrin network in T-PRF clots that had been centrifuged for 15 min at 3500 rpm and, 15 days after placement of the membrane, we found newly-forming connective tissue and islets of bony tissue in the T-PRF membrane. These results show that T-PRF could induce the formation of new bone with new connective tissue in a rabbit model of wound healing within 30 days of treatment.

The use of endodontically treated and/or fiber post-retained teeth as abutments for fixed partial dentures.

The purpose of this in vitro study was to evaluate the effect of endodontic treatment with or without fiber-post restorations on the fracture strength of abutment teeth under fixed partial dentures (FPDs). Seventy extracted premolar and canine teeth were used. Groups of fiber-post-retained and root-filled teeth were endodontically treated. The teeth were embedded in an acrylic resin perpendicular to the horizontal plane to create fixed partial dentures. The following groups were created using different abutments: (1) sound (S) canine/S premolar, (2) S canine/endodontically treated (ET) premolar, (3) ET canine/S premolar, (4) ET canine/ET premolar, (5) S canine/fiber-post-restored (FPR) premolar, (6) FPR canine/S premolar, and (7) FPR canine/FPR premolar. Each tooth was prepared for a complete-coverage full-metal crown. Impressions were taken; metal frameworks were fabricated and cemented. The samples were exposed to 5,000 cycles of thermomechanical fatigue and loaded compressively until fracture (2 mm/min). The data were statistically analyzed using (Kruskal-Wallis test, α = 0.05). No significant difference was found among the mean fracture strengths of the groups (p = 0.696). There were distinct differences in failure patterns. All of the fracture types were horizontal, and neither vertical nor non-restorable root fractures were recorded. Premolars seemed to be a critical abutment compared to canines when they were sound under FPDs. The percentage of cervical fractures was high in endodontically treated teeth when compared to post-retained groups. In case of post-debonding, the abutment fracture did not occur. When root-filled teeth are used as abutments for FPDs, fiber-post restorations or the creation of abutments from similar structures (ET/ET or FPR/FPR) results in improved conservation of root structure under loading when compared to the abutments from different structures (S/ET, ET/S, FPR/S, S/FPR).

Complex midfacial reconstruction with an implant-supported framework.

This clinical report describes the treatment of a patient with osseointegrated extraoral implants supporting a framework retainer and acrylic resin mesostructures and a large silicone midfacial prosthesis. A metal framework was used to splint the implants together and provided satisfactory retention for the facial prosthesis. A 2-piece prosthesis that composed of an obturator and facial prosthesis was fabricated. Cosmetic improvements as well as the ability to speak, swallow, and, to a lesser degree, chew, were achieved for this patient.

Evaluation of gaps or voids occurring in roots filled with three different sealers.

OBJECTIVES: The purpose of this in vitro study was to evaluate gaps or voids occurring in roots filled with three different sealers. METHODS: Thirty extracted human single-rooted teeth were decoronated, instrumented using NiTi rotary instruments, divided into three groups (n=10 per group) and obturated with one of the following: Epiphany with Resilon, MetaSEAL with gutta-percha or AH Plus with gutta-percha using the match-taper single-cone technique. After storage for one week in 100% humidity at 37 degrees C, the teeth were horizontally sectioned (n=10). Photographs were taken from the coronal, median and apical parts of the roots using a stereomicroscope at 10X magnification, and the images were then transferred to a computer. The mathematical method known as the 'Affine Transformation' was used for the transformation of pixel coordinates to ground coordinates in the Netcad Software program. The mean areas (mum(2)) of the gaps between the sealer and root dentin or gutta percha/resilon and the gaps between the sealer and/or voids inside the sealer mass were measured, scored on a 0-3 scale and statistically analyzed with the Kruskal-Wallis test. RESULTS: The mean total area of gaps or voids for each sealer was 4631.80 mum(2) for the Epiphany-Resilon, 3826.80 mum(2) for the MetaSEAL-gutta-percha and 31334 mum(2) for the AH Plus-gutta-percha. The MetaSEAL-gutta-percha group showed more gap or void-free interfaces. No significant differences were found among the sealers in the scores for the gap areas (P<.05), and the MetaSEAL showed similar interfaces with Epiphany. CONCLUSIONS: No significant differences in the mean areas of gaps or voids were found among the tested resin-based sealers.

The finite element analysis of the effect of ferrule height on stress distribution at post-and-core-restored all-ceramic anterior crowns.

The purpose of this study was to compare the effect of ferrule with different heights on the stress distribution of dentin and the restoration-tooth complex, using the finite element stress analysis method. Three-dimensional finite element models simulating an endodontically treated maxillary central incisor restored with an all-ceramic crown were prepared. Three-dimensional models were varied in their ferrule height (NF: no ferrule, 1F: 1-mm ferrule, and 2F: 2-mm ferrule). A 300-N static occlusal load was applied to the palatal surface of the crown with a 135 degrees angle to the long axis of the tooth. In addition, two post and core materials with different elastic modulus were evaluated. The differences in stress transfer characteristics of the models were analyzed. Maximum stresses were concentrated on force application areas (32.6-32.8 MPa). The stress values observed with the use of a 2-mm ferrule (14.1/16.8 MPa) were lower than the no-ferrule design (14.9/17.1 MPa) for both the glass fiber-reinforced and zirconium oxide ceramic post systems, respectively. The stress values observed with zirconium oxide ceramic were higher than that of glass fiber-reinforced post system. The use of a ferrule in endodontically treated teeth restored with an all-ceramic post-and-core reduces the values of von Mises stresses on tooth-restoration complex. At rigid zirconium oxide ceramic post system, stress levels, both at dentin wall and within the post, were higher than that of fiber posts.