Particle generation and dispersion from high-speed dental drilling.

OBJECTIVE: To investigate the characteristics of particle generation and dispersion during dental procedure using digital inline holography (DIH) METHODS: Particles at two locations, near-field and far-field, which represent the field closer to the procedure location and within 0.5 m from the procedure location respectively, are studied using two different DIH systems. The effect of three parameters namely rotational speed, coolant flow rate, and bur angle on particle generation and dispersion are evaluated by using 10 different operating conditions. The particle characteristics at different operating conditions are estimated from the holograms using machine learning-based analysis. RESULTS: The particle concentration decreased by at least two orders of magnitude between the near-field and far-field locations across the 10 different operating conditions, indicating significant dispersion of the particles. High rotational speed is found to produce a larger number of smaller particles, while lower rotational speeds generate larger particles. Coolant flow rate is found to have a greater impact on particle transport to the far-field location. Irregular shape dental particles account for 29% of total particles at far-field location, with the majority of these irregular shape particles having diameters ranging from 12 to 18 µm. CONCLUSIONS: All three parameters have significant effects on particle generation and dispersion, with rotational speed having a more significant influence on particle generation at near-field and coolant flow rate playing a more important role on particle transport to the far-field. CLINICAL RELEVANCE: This study provides valuable insights on particle characteristics during high-speed drilling. It can help dental professionals minimize exposure risks for themselves and patients by optimizing clinical operating conditions.

Examination of multiple sources of selenium release from coal wastes and strategies for remediation.

Selenium (Se) has been mobilised by leaching from coal and associated waste rock exposed by mining activities in Western Canada, with deleterious impact on aquatic wildlife. Waste rock characterisation indicates that up to 7% of the Se, as Se(IV), may be associated with organic matter, with ≈9%, as Se(0), associated with euhedral pyrite. Small 1-2 µm mineral particles with average Se concentration of 1.0 ± 0.4 wt% account for the remaining Se with the largest components likely to be associated with Fe oxide/hydroxide/carbonate as Se(0) and framboidal pyrite as Se(IV) and Se(0). No evidence was found for the presence of Se(-I), Se(-II) or Se(VI). In the first 8 weeks of leaching Se release was not correlated to the addition of aqueous silicate, added to aid pyrite passivation, but was reduced by approximately one third when the waste was treated with manure. This suggests the primary initial source of leached Se was not pyrite. Added organic C results in increased microbial numbers, particularly aerobic microbes, and promotes the formation of extensive coating of extracellular polymeric substances resulting in depletion of O2 at particle surfaces, reducing oxidation of Se(IV) and therefore reducing the leach rate of Se. Subsequent to 8 weeks of leaching the rates of release of Se from the treated wastes were similar regardless of treatment strategy but were reduced as compared to the untreated waste rock, suggestive of partial framboidal pyrite geochemical and microbial passivation. Se leaching was not correlated to S leaching, but the source(s) of the leached S was not known as approximately half of the S within the waste rock was non-sulfidic. These results indicate that utilisation of local organic carbon-containing wastes for coverage of coal waste rock may be a cost-effective strategy to reduce Se leaching to acceptable rates of release regardless of whether the Se is associated with framboidal pyrite or organics.

Characterization and mitigation of aerosols and spatters from ultrasonic scalers.

BACKGROUND: Dental procedures often produce aerosols and spatter, which have the potential to transmit pathogens such as severe acute respiratory syndrome coronavirus 2. The existing literature is limited. METHODS: Aerosols and spatter were generated from an ultrasonic scaling procedure on a dental manikin and characterized via 2 optical imaging methods: digital inline holography and laser sheet imaging. Capture efficiencies of various aerosol mitigation devices were evaluated and compared. RESULTS: The ultrasonic scaling procedure generated a wide size range of aerosols (up to a few hundred µm) and occasional large spatter, which emit at low velocity (mostly < 3 m/s). Use of a saliva ejector and high-volume evacuator (HVE) resulted in overall reductions of 63% and 88%, respectively, whereas an extraoral local extractor (ELE) resulted in a reduction of 96% at the nominal design flow setting. CONCLUSIONS: The study results showed that the use of ELE or HVE significantly reduced aerosol and spatter emission. The use of HVE generally requires an additional person to assist a dental hygienist, whereas an ELE can be operated hands free when a dental hygienist is performing ultrasonic scaling and other operations. PRACTICAL IMPLICATIONS: An ELE aids in the reduction of aerosols and spatters during ultrasonic scaling procedures, potentially reducing transmission of oral or respiratory pathogens like severe acute respiratory syndrome coronavirus 2. Position and airflow of the device are important to effective aerosol mitigation.

Effects of salinity and transparent exopolymer particles on formation of aquatic aggregates and their association with norovirus.

Human noroviruses (NoVs) are responsible for 50% of food-related disease outbreaks and are notably associated with shellfish consumption. Despite the detrimental health impacts of human NoV-contaminated seafood to public health, there is a lack of knowledge on the physicochemical conditions that govern NoV transmission in aquatic ecosystems. In the present study, we investigated the propensity for NoVs to associate with aquatic aggregates, which have been shown to efficiently deliver nano-sized particles to shellfish. Specific physicochemical conditions characteristic of shellfish cultivation waters, specifically salinity and transparent exopolymer particles (TEP), were targeted in this study for investigating aggregate formation and NoV association dynamics. Murine norovirus (MNV) was used in aggregation experiments as a model surrogate for NoVs. Results demonstrate increased aggregate formation as a function of increasing salinity and TEP concentrations, as well as greater numbers of MNV genomes incorporated into aggregates under conditions that favor aggregation. As aggregate formation was enhanced in waters representing optimal conditions for shellfish production, specifically saline and high TEP waters, the implications to virus transport and shellfish food safety are profound: more aggregates implies increased scavenging of virus particles from surrounding waters and therefor greater risk for bivalve contamination with nano-sized pathogens. These novel data provide insight into where and when NoVs are most likely to be ingested by shellfish via contaminated aggregates, thereby informing best management and water quality monitoring practices aimed at providing safe seafood to consumers.

Histomorphometric Comparison of 3 Osteotomy Techniques.

PURPOSE: This pilot study compares the histomorphometric structure of osteotomy preparation through standard extraction drilling (SD), Summers osteotomes (SO), and a new method of nonextraction drilling called osseodensification (OD). METHOD AND MATERIALS: Fresh porcine tibia plateau was used as the surgical specimen. Three preparation methods (N = 6 for each) were used to prepare 18 osteotomies according to manufacturer protocols. Eighteen tapered screw-vent (4.7 × 13 mm) implants were placed. After osteotomy preparation and implant placement, all porcine tibias were placed in 10% formalin solution in preparation for histological staining and sectioning. Histomorphometric analysis of all samples was performed to compare immediate bone-to-implant contact (BIC) and the percentage of bone volume within a 2-mm zone surrounding the implant. RESULTS: OD achieved 60.3% BIC, SO 40.7% BIC, and standard extraction drilling (SD) 16.3% BIC. The percentage of bone volume in the surrounding 2-mm width from the implant body using the same area units per sample was found to be greatest for OD. CONCLUSION: This study demonstrated that osteotomy preparation can influence both BIC and percentage of bone volume around the implant.

Comparison of Initial Implant Stability of Implants Placed Using Bicortical Fixation, Indirect Sinus Elevation, and Unicortical Fixation.

PURPOSE: The aim of this study was to determine if self-threading dental implants placed using stopper drills to bicortically engage both the alveolar crest and sinus floor (bicortical fixation) achieved primary and/or secondary stability comparable to that of short implants only engaging alveolar crest cortical bone (unicortical fixation) or implants engaging both the crest and sinus floor but via greenstick fracture and grafting (indirect sinus elevation). MATERIALS AND METHODS: Thirty-eight patients exhibiting 7 to 11 mm of bone coronal to the sinus floor as confirmed by preoperative CBCT were recruited. Forty-five implants were randomly assigned to one of the placement techniques. No patient received more than two implants, which were placed in opposite sides of the maxilla while using different surgical techniques. An Osstell ISQ was employed immediately after implant placement to measure stability six times in a buccolingual dimension. Secondary stability was measured at stage-two surgery after a 3- to 6-month healing period. RESULTS: The greatest primary implant stability was achieved via indirect sinus elevation. However, no statistically significant difference was found among the three surgical techniques (P = .13; bicortical fixation: 71.4 [standard error = 2.1]), unicortical fixation: 69.6 [2.1], indirect sinus elevation: 75.9 [2.3]). The three techniques had similar secondary stability (P > .999; 79.9 [1.2], 80.0 [1.2], and 80.0 [1.3], respectively). Baseline residual ridge height measured on CBCT was similar (P = .1; 8.8, 9.9, and 9.4 mm, respectively), but implant diameter and length placed in the maxilla differed (P = .03/P < .001; 4.7/11.4 mm, 4.3/8.1 mm, and 4.7/11.8 mm, respectively). Primary implant stability was significantly correlated to CBCT bone density (r = 0.37). CONCLUSION: Primary and secondary implant stabilities of bicortical fixation did not differ significantly from those of unicortical fixation and indirect sinus elevation. However, use of the bicortical fixation technique is warranted since it is simpler and more economical than indirect sinus elevation; plus, it allows for longer implants than the unicortical fixation while yielding similar secondary implant stability.

Prevalence of sinus augmentation associated with maxillary posterior implants.

Pneumatization of the maxillary sinus limits the quantity of alveolar bone available for implant placement and may result in a lack of primary stability and difficulty in achieving osseointegration. The purpose of this study was to retrospectively analyze a group of patients who had implants placed in the posterior maxilla, calculate the prevalence of sinus augmentation, and identify factors related to sinus augmentation. With institutional review board approval, dental records from a population of patients who had implants placed in the maxillary posterior region between January 2000 and December 2004 were used to create a database. Independent variables were classified as continuous (age of the patient at stage 1 implant surgery [S1], time between extraction and S1, time between extraction and sinus augmentation, and time between sinus augmentation and S1) and categorical (gender, implant failure, American Society of Anesthesiologists system classification, smoking, osteoporosis, residual crestal bone height, implant position, implant proximity, prostheses type, and implant diameter and length). The dependent variable was the incidence of a sinus augmentation procedure. Simple logistic regression was used to assess the influence of each factor on the presence of sinus augmentation (P < .05). The final database included 502 maxillary posterior implants with an overall survival rate of 93.2% over a mean follow-up period of 35.7 months. Of 502 implants, 272 (54.2%) were associated with a sinus augmentation procedure. Among variables, residual crestal bone height (P < .001), implant position (P < .001), implant proximity (P < .001), prosthesis type (P < .001), implant failure (P < .01), and implant diameter (P < .01), were statistically associated with sinus augmentation. Within the limitations of this retrospective study, the results suggest that more than half (54.2%) of the maxillary posterior implants were involved with a sinus augmentation procedure. The prevalence of sinus augmentation increased with decreased residual crestal bone height, more posterior implant locations, and complete or partial edentulism. Sinus augmentation was significantly associated with implant failure and wide implants.

Cuspal deflection and depth of cure in resin-based composite restorations filled by using bulk, incremental and transtooth-illumination techniques.

BACKGROUND: Restoration techniques affect shrinkage stress and depth of cure. The authors tested cuspal deflection and depth of cure resulting from the use of different techniques (bulk, incremental, bulk/transtooth illumination) and two resin-based composites (deep curing and conventional). METHODS: The authors restored extracted teeth with deep-curing X-tra fil (VOCO, Cuxhaven, Germany) (by using bulk and incremental techniques) and Filtek Supreme Plus (3M ESPE, St. Paul, Minn.) (by using bulk, incremental and bulk/transtooth-illumination techniques). The sample size for each technique was five. They determined cuspal deflections as changes in buccal and lingual surfaces before and after restoration. To determine the extent of cure, they measured hardness 0.5 to 3.5 millimeters deep on the sectioned restorations. RESULTS: The authors found no difference in cuspal deflection between filling techniques within the same materials (P > .05). They found no difference in hardness for X-tra fil at any depth with either the bulk or the incremental technique (P > .05). Filtek Supreme Plus had higher hardness values at depths of less than 1.5 mm with the bulk/transtooth-illumination technique, whereas the bulk technique resulted in lower hardness values at depths of 2.0 mm and below (P < .05). CONCLUSIONS: Cuspal deflection was not affected by filling techniques. X-tra fil cured up to a depth of at least 3.5 mm; Filtek Supreme Plus had lower curing values below a depth of 2 mm. The transtooth-illumination technique improved curing depth for restorations placed in bulk. CLINICAL IMPLICATIONS: When using resin-based composite restorative materials, clinicians should be more concerned about the effect of filling techniques on curing depth than about how these techniques affect shrinkage stresses.

Initial stability measurement of dental implants placed in different anatomical regions of fresh human cadaver jawbone.

STATEMENT OF PROBLEM: Initial implant stability has been used as an indicator for future osseointegration and whether an immediate/early loading protocol should be applied. However, differences in initial stability in relation to anatomical regions of jawbone have not been studied extensively because of the risks involved with stability measurements. PURPOSE: The purpose of this study was to determine whether initial implant stability varies with anatomical regions of the jawbone. MATERIAL AND METHODS: Four pairs of edentulous maxillae and mandibles were retrieved from fresh human cadavers. Six implants (Biomet 3i) per pair were placed in different anatomical regions (maxillary anterior, right and left maxillary posterior, mandibular anterior, right and left mandibular posterior). Immediately after implant placement, initial implant stability was measured with a custom-made resonance frequency analyzer, a commercial resonance frequency analysis device (Osstell), and a mechanical tapping device (Periotest). All implant surgeries and initial stability measurements were performed within 72 hours of death to simulate a clinical setting. Repeated measures ANOVA (alpha=.05) and univariate correlation analyses were used to analyze the data. RESULTS: Mandibular implants had significantly higher initial stability than maxillary implants. Posterior maxillary implants were least stable. Stability was less buccolingually than mesiodistally. The measurements from 3 stability measuring devices were strongly associated with each other. CONCLUSIONS: Initial implant stability varied among anatomical regions of jawbone. Rank of Periotest value and implant stability quotient (Osstell) had the highest correlation (r=-0.852).