Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects.

Background and Objectives: To compare the clinical, radiographic, and inflammatory peri-implant parameters around narrow diameter implants (NDI) supported single and splinted crowns in non-diabetics and prediabetes. Materials and Methods: The clinical and radiographic parameters and the levels of IL-6 and TNF-α in the peri-implant crevicular fluid (PICF) of narrow diameter single (NDISCs) and splinted (NDISPs) crown implants were assessed both in non-diabetics and participants with prediabetes. The glycemic state of the patient was assessed using glycated hemoglobin (HbA1c) levels. The peri-implant soft tissue indices (Plaque index (PI), bleeding on probing (BoP), probing depth (PD)) and marginal bone loss were recorded and compared between the groups. Success of the prosthesis was assessed by the frequency of technical complications and patient satisfaction. Inter-group comparison was performed using ANOVA (one-way analysis of variance) while the normal distribution of dependent variables was calculated using Shapiro-Wilk. A p-value of less than 0.05 was considered to be statistically significant. Results: Sixty participants (30 non-diabetics and 30 with prediabetes) with a total of 178 (118 NDISCs and 60 NDISPs) platform-switched NDIs were a part of the study. Of the 118 NDISCs, 56 were placed in the non-diabetic individuals and 62 were placed in the prediabetes group whereas 30 NDISPs each were placed in both the study groups. The clinical parameters of PI, BoP and PD in the single crown and splinted crown groups showed comparable results. However, a statistically significant difference (p-value of less than 0.05) in PI, BoP and PD and in the values of IL-6 and TNF-α was found when a comparison was made between the non-diabetes and prediabetes group. A total of 91% of the patients were satisfied with the esthetics of the implants while 79% of the patients showed satisfaction with function. Conclusions: All the clinical and radiographic parameters were statistically similar in both single and splinted types of narrow diameter implants. However, the bone loss, probing depth, plaque index, and levels of inflammatory markers were statistically higher in prediabetes as compared to non-diabetes implying that a slight hyperglycemic state impacts peri-implant health.

Bond integrity and microleakage of dentin-bonded crowns cemented with bioactive cement in comparison to resin cements: in vitro study.

OBJECTIVE: The aim was to compare restorative marginal integrity of ceramic crowns luted with bioactive and resin cements using micro-computed tomography (micro-CT) microleakage evaluations and bond strength assessment. METHODS: Thirty molar teeth were prepared by sectioning and polishing for dentin exposure for resin cement build-ups. Teeth were randomly divided among three groups of cements: (1) bioactive (ACTIVA); (2) glass ionomer cement (GIC; Ketac Cem); and (3) resin luting agent (Nexus 3). Bonding regime and build-ups (4 mm × 2 mm) were performed using the recommended protocol. For microleakage assessment, 30 premolar teeth were prepared for dentin-bonded crowns using lithium disilicate ceramic and the computer-aided design and computer-aided manufacturing technique. Crowns were cemented with standard load, cement amount, and duration using three cements (Group A: bioactive; Group B: GIC; Group C: resin) and photopolymerized. Cemented crowns were evaluated for volumetric infiltration using micro-CT (Skyscan, Bruker 1173- at 86 kV, 93 µA, 620 ms) after immersion in 50% solution of silver nitrate (AgNO3) (24 hours). Shear bond strength (SBS) was assessed by fracture of cement build-ups at a cross-head speed of 0.5 mm/min in a universal testing machine. RESULTS: Mean SBS among bioactive (21.54 ± 3.834 MPa) specimens was significantly higher than that for GIC (14.08 ± 3.25 MPa) specimens (p < 0.01), but they were comparable to resin samples (p > 0.05) (24.73 ± 4.32 MPa). Microleakage was significantly lower in crowns luted with bioactive (0.381 ± 0.134) cement compared to GIC (1.057 ± 0.399 mm3) (p < 0.01) and resin (0.734 ± 0.166 mm3) (p = 0.014) cemented crowns. The type of luting agent had a significant influence on the microleakage of crowns and bond strength to dentin (p < 0.05). CONCLUSION: Bioactive cement exhibited less microleakage and comparable SBS to resin luting agents in in vitro conditions.