Effectiveness of an intraoral thermoformed splint with magnet device in patients with xerostomia and hyposalivation: A pilot study.

AIM: The aim of the study was to examine the effectiveness of intraoral thermoformed splint with a magnet device over a period of 3 months, that is, to assess acceptability of this method of treatment using both objective and self-reported measures. MATERIALS AND METHODS: This study was designed as a prospective clinical pilot trial. 22 patients with xerostomia and hyposalivation were included. Xerostomia was assessed using a 4-question xerostomia questionnaire score and a test for unstimulated salivary flow rates. Evaluations were performed before the treatment and 3 months after the treatment using a thermoformed splint with a magnet device. RESULTS: There was a significant reduction in subjective symptoms after using a thermoformed splint with a magnet device for 3 months. For all 4 scored items, there was a statistically significant difference (P < .001) in median VAS scores before and 3 months after treatment. There was also a statistically significant difference in USFR before (0,15 ± 0,04 ml/min) and after treatment (0,24 ± 0,03 mL/min). CONCLUSION: Our findings indicate that the use of this device alleviated oral dryness and stimulated the function of the submandibular salivary gland. An intraoral thermoformed splint with a magnet device is safe, physiologically indifferent, useful, and effective in treating xerostomia and hyposalivation.

Clinical Characteristics of Abutment Teeth with Gingival Discoloration.

PURPOSE: The grey-bluish discoloration of gingiva (known as "amalgam tattoo") does not appear only in the presence of amalgam restorations. It may also be seen in cases of teeth restored with cast dowels and porcelain-fused-to-metal (PFM) restorations. The aim of this article was to determine the clinical characteristics of abutment teeth with gingival discoloration. MATERIALS AND METHODS: This research was conducted on 25 patients referred for cast dowel and PFM restorations. These restorations were manufactured from Ni-Cr alloys. Ninety days after cementing the fixed prosthodontic restorations, the abutment teeth (n = 61) were divided into a group with gingival discoloration (GD) (n = 25) and without gingival discoloration (NGD) (n = 36). The control group (CG) comprised the contralateral teeth (n = 61). Plaque index, gingival index, clinical attachment level, and probing depth were assessed before fabrication and also 90 days after cementation of the PFM restorations. RESULTS: The gingival index, clinical attachment level, and probing depths of the abutment teeth that had GD were statistically higher before restoration, in comparison with the abutment teeth in the NGD and control groups. Ninety days after cementation, the abutment teeth with GD had significantly lower gingival indexes and probing depths, compared to the abutment teeth in the NGD group. Both abutment teeth groups (GD and NGD) had significantly higher values of clinical attachment levels when compared to the control group. There were no statistically significant differences in plaque index values between the study groups. CONCLUSIONS: The results of this study indicated that impairment of periodontal status of abutment teeth seemed to be related to the presence of gingival discolorations. Therefore, fabrication of fixed prosthodontic restorations requires careful planning and abutment teeth preparation to minimize the occurrence of gingival discolorations. CLINICAL RELEVANCE: With careful preparation of abutment teeth for cast dowels and crown restorations it may be possible to decrease the frequency of gingival discolorations adjacent to abutment teeth.

Treatment of teeth in the esthetic zone in a patient with amelogenesis imperfecta using composite veneers and the clear matrix technique: A case report.

INTRODUCTION: Restorative dental treatment of patients with a generalized form of amelogenesis imperfecta (AI) remains a challenge even today. The treatment approach is multidisciplinary and includes action of several dental disciplines such as restorative, orthodontic, and prosthetic dental specialties. CASE REPORT: A 18-year-old female patent was referred to the Department of Restorative Dentistry and Periodontology at the Military Medical Academy of Belgrade, Serbia. She was diagnosed with Al and formerly had been treated for a long period of time at the Department of Pediatric Dentistry and Orthodontics. Her primary concern upon arrival was discomfort and concern for the esthetic appearance of the anterior teeth. The treatment was done with the modified clear matrix technique used in composite veneer restoration of teeth in the esthetic zone. CONCLUSION: Because fixed prosthetic restoration with crowns, is the final treatment of AI patients it involves severe tooth structure loss. The clear matrix method which was done in this case allowed for greater comfort, functionality, simplicity, speed, greater economic efficiency and tooth structure preservation.

Corrosive and cytotoxic properties of compact specimens and microparticles of Ni-Cr dental alloy.

PURPOSE: Nickel-chromium (Ni-Cr) dental alloys have been widely used in prosthodontic practice, but there is a permanent concern about their biocompatibility due to the release of metal ions. This is especially important when Ni-Cr metal microparticles are incorporated into gingival tissue during prosthodontic procedures. Therefore, the aim of this study was to examine and compare the corrosion and cytotoxic properties of compact specimens and microparticles of Ni-Cr dental alloy. MATERIALS AND METHODS: Ni-Cr alloy, Remanium CSe bars (4 mm diameter), were made by the standard casting method and then cut into 0.5-mm-thick disks. Metal particles were obtained by scraping the bars using a diamond instrument for crown preparation. The microstructure was observed by an optical microscope. Quantitative determination and morphological and dimensional characterization of metal particles were carried out by a scanning electron microscope and Leica Application Suite software for image analysis. Corrosion was studied by conditioning the alloy specimens in the RPMI 1640 medium, containing 10% fetal calf serum in an incubator with 5% CO2 for 72 hours at 37°C. Inductively coupled plasma-optical emission spectrometry was used to assess metal ion release. The cytotoxity of conditioning medium (CM) was investigated on L929 cells using an MTT test. One-way ANOVA was used for statistical analysis. RESULTS: After casting, the microstructure of the Remanium CSe compact specimen composed of Ni, Cr, Mo, Si, Fe, Al, and Co had a typical dendritic structure. Alloy microparticles had an irregular shape with a wide size range: from less than 1 µm to more than 100 µm. The release of metal ions, especially Ni and Mo from microparticles, was significantly higher, compared to the compact alloy specimen. The CM prepared from compact alloy was not cytotoxic at any tested dilutions, whereas CM from alloy microparticles showed dose-dependent cytotoxicity (90% CM and 45% CM versus control; p < 0.005). CONCLUSION: Ni-Cr microparticles showed less corrosion resistance and lower biocompatibility than compact alloy. This could affect health on long-term exposure, especially in sensitized individuals.

[Influence of metal-ceramic fixed dental restorations on the occurrence of discoloration of gingiva].

BACKGROUND: Adverse effects of dental cast alloys on the health of patients are the problem in clinical practice. The aim of this paper was to describe the case of a patient with discolorated gingivae in the presence of fixed dental restorations and used diagnostic and therapeutic procedures. CASE REPORT: A 30-year old pacient, presented with the complaints about unsatisfactory esthetic of his fixed dental restorations. He complained about the greyish discoloration of gingivae, inappropriate color of the crowns, and a larger space between the central incisors. Both discolorated and normal gingivae around the fixed dental restorations were taken by excision and the samples of gingivae were examined histopathologically, and by using the Atomic Absorption Spectrophotometry test (AAS). Histopathological examination of the discolorated gingivae showed the presence of non-specific inflammation with a foreign body. AAS revealed the presence of various metals in the samples and the higher metal contents in the samples of discolorated gingivae as compared with the samples of normal gingivae. New metal-ceramic crowns were made for the patient. CONCLUSION: A main cause of greyish discoloration of gingivae was presence of a metal in gingival tissue. After the excision of discolorated gingivae old metal-ceramic crowns should be replaced with new crowns.

[Discoloration of gingiva in the presence of fixed dental restorations].

AIM: To investigate the frequency of discoloration of gingiva in the presence of fixed dental restorations, regarding the type of alloy of which restorations were made, and to show histopathological changes of discolored gingiva. METHODS: One hundred and eighty four patients of both sexes were examined. The average age of the examinees was 52. They were divided into four groups according to the alloys from which their restorations were made. Standardized history questionnaires and clinical examination procedures were developed for this study. In ten examinees, whose teeth were indicated for extraction and who had a discoloration of gingiva, the samples of tissue were taken from the discolored gingiva for histopathological examination. RESULTS: Our results showed the presence of discolored gingiva in all four groups. It was most frequent in the examinees with fixed restorations made of Ni-Cr alloy (43,5%) and less frequent in those with fixed dental restorations made of gold alloy (26,5%). Histopathological examination showed the presence of tissue foreign body granulomas with giant cells in which the metal particles were found, partially as small and partially as large particles. CONCLUSION: Results suggested that grayish discoloration of gingiva was present in all four groups of examinees. The highest number of examinees with discolored gingiva was in the group with restorations made of Ni-Cr alloy. Grayish discoloration of gingiva was a consequence of incorporation of metal particles into gingival tissue.