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BACKGROUND: Mechanical complications affect the stability of implant restorations and are a key concern for clinicians, especially with the frequent introduction of new implant designs featuring various structures and materials. This study evaluated the effect of different prosthetic index structure types and implant materials on the stress distribution of implant restorations using both in silico and in vitro methods. METHODS: Four finite element analysis (FEA) models of implant restorations were created, incorporating two prosthetic index structures (cross-fit (CF) and torc-fit (TF)) and two implant materials (titanium and titanium-zirconium). A static load was applied to each group. An in vitro study using digital image correlation (DIC) with a research scenario identical to that of the FEA was conducted for validation. The primary strain, sensitivity index, and equivalent von Mises stress were used to evaluate the outcomes. RESULTS: Changing the implant material from titanium to titanium-zirconium did not significantly affect the stress distribution or maximum stress value of other components, except for the implant itself. In the CF group, implants with a lower elastic modulus increased the stress on the screw. The TF group showed better stress distribution on the abutment and a lower stress value on the screw. The TF group demonstrated similar sensitivity for all components. DIC analysis revealed significant differences between TF-TiZr and CF-Ti in terms of the maximum (P < 0.001) and minimum principal strains (P < 0.05) on the implants and the minimum principal strains on the investment materials in both groups (P < 0.001). CONCLUSIONS: Changes in the implant material significantly affected the maximum stress of the implant. The TF group exhibited better structural integrity and reliability.
Subject(s)
Dental Implants , Dental Materials , Dental Stress Analysis , Finite Element Analysis , Titanium , Zirconium , Zirconium/chemistry , Humans , Dental Materials/chemistry , Dental Stress Analysis/methods , Stress, Mechanical , Dental Prosthesis Design , Elastic Modulus , Computer Simulation , Imaging, Three-DimensionalABSTRACT
OBJECTIVES: To evaluate the clinical performance of direct restorations for pit-and-fissure caries in molars using stamp combined with single-shade composite resin (S/SCR) technique, and assess the effect of the number of stamp pressing on the trueness of S/SCR technique. METHODS: Twenty molars of fifteen patients with pit-and-fissure caries but with an intact or micro-cavitated occlusal morphology were restored using S/SCR technique and were randomly divided into single pressing group (n = 10) and double pressing group (n = 10). Intraoral scans were obtained before treatment (scan 1), after filling (scan 2) and after polishing (scan 3). Deviation distribution maps of pairwise fitting were created including comparison 1 (scan1/scan 2), comparison 2 (scan1/scan 3), and comparison 3 (scan2/scan 3) using Geomagic Control X software. Root mean square (RMS) values were calculated to evaluate the trueness of restorations. Clinical performances including esthetic, functional, and biological properties of all restorations were evaluated according to FDI criteria after a 12-month follow-up. Analysis of variance, independent-samples T test and Wilcoxon rank-sum test were used for statistical analysis (α=0.05). RESULTS: RMS values for comparison 1, comparison 2, and comparison 3 were 0.1243 ± 0.0151, 0.0966 ± 0.0136, and 0.0605 ± 0.0137 mm in single pressing group, while 0.0831 ± 0.0140, 0.0741 ± 0.0107, and 0.0475 ± 0.0099 mm in double pressing group, respectively. RMS value of single pressing group was higher than that of double pressing group in the same comparison (p ≤ 0.001). No statistically significant differences were observed between the two groups regarding esthetic, functional and biological properties (p > 0.05). For all properties, all restorations scored within 3, with over 80% scoring 1. CONCLUSION: S/SCR technique presents satisfying clinical performances for pit-and-fissure caries in molars after a 12-month follow-up. Besides, double pressing can improve the trueness of restorations compared to single pressing. CLINICAL SIGNIFICANCE: S/SCR technique is efficient in direct composite resin restoration for pit-and-fissure caries, with satisfying esthetic, functional and biological properties after a 12-month follow-up. Significantly, double pressing improves the trueness of S/SCR technique, reducing the need for occlusion adjustment.
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PATIENTS: An 18-year-old woman sought treatment for caries of the anterior teeth after completing orthodontic treatment. Direct composite resin restoration was chosen because the patient preferred a minimally invasive and cost-effective treatment whenever possible. Based on diagnostic wax-up, veneer-shaped indices for composite resin injection were designed to replicate and restore tooth defects rapidly and accurately. The overall esthetic result was excellent after a 1-year of follow-up. DISCUSSION: Direct freehand composite resin restorations are clinically challenging. The recently proposed 3D printing index for the composite resin injection technique is helpful for direct restoration but is challenging to remove. The veneer-shaped indices avoid the formation of an undercut in the direction of removing the index, making them easy to remove after finishing the restorations. CONCLUSIONS: Using veneer-shaped indices for composite resin injection enables rapid esthetic rehabilitation of labial tooth defects caused by caries. This approach reduces chairside time and operational difficulty while allowing for easy index removal after completing the restorations.
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BACKGROUND: The bidirectional link of periodontitis (PD) and gastrointestinal tract (GIT) disorders has been investigated in previous epidemiological studies; however, the conclusions still remain controversial. The aim of this study was to comprehensively explore the bidirectional causal effect between PD and various GIT diseases. METHODS: Based on summary-level data of genome-wide association studies (GWASs), a two-sample bidirectional Mendelian randomization (MR) study was undertaken. Single-nucleotide polymorphisms (SNPs) associated with PD or GIT disorders (chronic gastritis [CG], gastric ulcer [GU], duodenal ulcer [DU], gastroesophageal reflux disease [GERD], irritable bowel syndrome [IBS], and diverticular disease of the intestine [DI]) in GWASs were applied as exposure. The primary method employed was the inverse-variance weighted (IVW) method, and several sensitivity analyses were performed to investigate potential pleiotropy. RESULTS: With regard to the investigation of the causality between PD and GIT disorders, the IVW method revealed that there is a causal impact of PD on GU (odds ratio [OR] 1.088; 95% confidence interval [CI], 1.036-1.141; adjusted p = 0.004) and DI (OR 0.938; 95% CI, 0.911-0.965; adjusted p = 0.000). However, no significant genetic liability was observed for the causal effect of PD on CG, DU, GERD, and IBS. Furthermore, the primary analysis did not demonstrate a causal effect of GIT disorders on PD. CONCLUSION: This MR study suggests that PD may be associated with an increased risk of GU and a reduced risk of DI, with possibly limited clinical relevance. Further studies are needed to support the conclusions of this MR study.
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OBJECTIVES: To assess the effects of aging and bleaching procedures on the color stability and surface roughness of a new single-shade composite versus multi-shade composite resins. METHODS: A single-shade composite resin (Charisma Diamond One, CDO) and 3 multi-shade composite resins (Tetric NCeram, Filtek Z350 XT, Clearfil Majesty Posterior) were tested. Thirty specimens of each material were subjected to one of the aging procedures respectively: immersion in distilled water (12 days/37 °C), immersion in coffee (12 days/37 °C), or water thermocycling (10,000 cycles/5-55 °C). All specimens underwent in-office bleaching after aging. Kruskal-Wallis tests and analysis of variance were used for statistical analysis (α=0.05). RESULTS: All materials exhibited a change of color (ΔE00), translucency (RTP), whiteness (WID) and surface roughness parameters (Sa,Sv) after aging and bleaching procedures. CDO showed the highest ΔE00 among all resins with the highest RTP value, regardless of the aging procedures. Immersion in coffee led to the significantly highest ∆E00 values and lowest RTP values for nearly all resins. Positive ΔWID1 (WID(bleaching)-WID(baseline)) values were found in distilled water immersion and thermocycling groups, while negative ΔWID1 values were found in the coffee immersion group for all materials. Besides, positive ΔWID2 (WID(bleaching)-WID(aging)) values were found in all aging groups for nearly all materials. All materials showed an increasing trend in Sa and Sv after bleaching. CONCLUSIONS: CDO showed more pronounced discoloration than multi-shade composite resins. Although the whiteness of all resins increased after bleaching, none was completely restored in the coffee immersion group. Bleaching significantly increased the surface roughness of all materials. CLINICAL SIGNIFICANCE: Charisma Diamond One is more susceptible to discoloration, which may affect its long-term success rate. Bleaching could partially reduce the color change of the composite resins but did not return them completely to their original state. The roughness of the resins increased after bleaching, prompting dentists to repolish them after bleaching.
Subject(s)
Coffee , Composite Resins , Water , Diamond , Materials Testing , Color , Surface PropertiesABSTRACT
AIM: This current Mendelian randomization (MR) study aims to comprehensively explore the potential bidirectional link between pulp and periapical disease (PAP) with type 2 diabetes mellitus (T2DM). METHODOLOGY: Summary level data of European-based population genome-wide association studies (GWASs) were employed to undertake this MR study. With the selection of single nucleotide polymorphisms (SNPs) as the instrumental variable, the radial inverse-variance weighted (radial IVW) method with modified second-order weights was applied as the primary method. Additionally, a range of sensitivity analyses were conducted to investigate pleiotropy. Results from different sources of outcome were pooled by meta-analysis with the fixed model. RESULTS: The results of this MR analysis did not suggest a significant impact of pulp and periapical disease on type 2 diabetes (combined OR = 1.04, 95% CI: 1.00-1.07, p = .033) and vice versa (OR = 1.04, 95% CI: 0.96-1.14, p = .329). No significant pleiotropy was detected in the final model after the removal of outliers, demonstrating the reliability of the results in our primary analysis. CONCLUSIONS: With the limitations inherent in the present MR study, there is no significant evidence in either direction to suggest a causal association between pulp and periapical disease and type 2 diabetes mellitus.
Subject(s)
Dental Pulp Diseases , Diabetes Mellitus, Type 2 , Periapical Diseases , Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/genetics , Genome-Wide Association Study , Mendelian Randomization Analysis , Reproducibility of Results , Periapical Diseases/complicationsABSTRACT
PURPOSE: This study aimed to assess the effect of abutment variation and creep on dental implant restorations. MATERIALS AND METHODS: Three finite element analysis (FEA) models of implant restorations were created, which were restored by conventional one-piece abutment (CA), hybrid abutment crown (HAC), and multi-unit abutment (MUA). The contacts were considered intimate (no friction), except for implant/abutment, abutment/screw, and abutment/screw/crown (HAC) attachments. The related mechanical parameters were used to improve the authenticity of the study. Instantaneous loads and constant loads (100 s) of 130 N were applied at a 30° angle to the palatal portion of the crown. Results were qualitatively and quantitatively evaluated using the equivalent von Mises stress, micro-gap distance of the implant-abutment interface (IAI), preload changes, and safety index. RESULTS: The stress state of each component differed depending on the restoration type, from CA and HAC to MUA. Implants and screws were the structures that suffered the most stress under instantaneous loads. Each metal structure exhibited a substantial decrease in stress during a constant loading period. The screws of the MUA abutment showed more preload loss (62.1 N) after constant loads for 100 s. MUA base produced less micro-gap (0.72 µm) at the IAI when it was compared with the CA group (0.93 µm) and HAC group (3.29 µm). CONCLUSIONS: The abutment type influences the mechanical properties and performance of implant restorations. The creep effect decreases the maximum stress level and increases the safety factors of each structure, indicating that stress-related mechanical complications may not occur more easily.
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The objectives of this study was to evaluate the effects of background color and restoration depth on color adjustment potential of a new single-shade resin composite versus multi-shade resin composites. Two multi-shade resin composites (Spectrum TPH3 and Clearfil AP-X) marked A2 shade and a new single-shade resin composite (Charisma Diamond One) were tested. Four base shades (A1, A2, A3, and A3.5) of the same resin composite (Filtek Z250) were selected as different background colors. Dual specimens with 1-, 2-, and 3-mm restoration depth and single specimens of all materials were fabricated. CIE color coordinates were measured using a spectrophotometer, then color differences (∆E00) and translucency parameter (TP00) were calculated using the CIEDE2000 formula. Independent observers performed visual scoring. CAP-I and CAP-V values were calculated according to ΔE00 and visual scoring. The results revealed that CAP-I and CAP-V were significantly affected by resin composite type, background color, and restoration depth. CAP-I and CAP-V decreased as restoration depth increased at the same background color for all materials. Charisma Diamond One had the highest CAP-I and CAP-V values at all background colors and restoration depths, with the highest TP00 value. These findings demonstrated that color adjustment potential was dependent on resin composite type, background color, and restoration depth, so shade selection is indispensable for multi-shade resin composites. Charisma Diamond One exhibited the highest color adjustment potential and the most pronounced color shifting, contributing to simplifying the process of shade selection and improving the efficiency of clinical work.
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STATEMENT OF PROBLEM: Single-shade composite resins simplify the process of shade selection by providing a narrow range of color but the ability to simulate all shades. However, evidence is limited for the color shifting ability of a newly developed singleshade composite resin. PURPOSE: The purpose of this in vitro study was to evaluate the instrumental color adjustment potential (CAP-I) and visual color adjustment potential (CAP-V) of a recently introduced single-shade composite resin compared with conventional multishade composite resins against different background colors. MATERIAL AND METHODS: Four multishade composite resins (Spectrum TPH3, Beautifil II, Clearfil AP-X, and Gradia Direct) and a single-shade composite resin (Charisma Diamond One) were tested. Four base shades (A1, A2, A3, and A3.5) of the same composite resin (Filtek Z350XT) were selected as different background colors. Dual specimens (an outer base material with an inner hole filled with inner test material) and single specimens of all test and base materials were prepared (n=6 per group). Spectral reflectance values were obtained by using a spectroradiometer. The color difference (ΔE00) and relative translucency parameter (RTP) were calculated by using the CIEDE2000 and RTPCIEDE2000 formula. Visual scoring of color matching was performed by independent observers. The CAP-I and CAP-V values were calculated according to ΔE00 and visual scoring. Analysis of variance (ANOVA) was used for statistical analysis (α=.05). RESULTS: CAP-I and CAP-V were significantly affected by composite resin type, background color, and their interaction (P<.001). Positive CAP-I and CAP-V values were found for the majority of test materials. Charisma Diamond One exhibited the highest CAP-I value under all background colors, the highest CAP-V value under most background colors, and the significantly highest RTP value (P<.001). CONCLUSIONS: The color adjustment potential was dependent on the material type and background color. Charisma Diamond One exhibited the highest color adjustment potential and the most pronounced color shifting ability.
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Owing to the disparity between the computing power and hardware development in electronic neural networks, optical diffraction networks have emerged as crucial technologies for various applications, including target recognition, because of their high speed, low power consumption, and large bandwidth. However, traditional optical diffraction networks and electronic neural networks are limited by long training durations and hardware requirements for complex applications. To overcome these constraints, this paper proposes an innovative opto-electronic hybrid system that combines optical diffraction networks with electronic neural networks. Using scattering layers to replace the diffraction layers in traditional optical diffraction networks, this hybrid system circumvents the challenging training process associated with diffraction layers. Spectral outputs of the optical diffraction network were processed using a simple backpropagation neural network, forming an opto-electronic hybrid network exhibiting exceptional performance with minimal data. For three-class target recognition, this network attains a classification accuracy of 93.3% within a substantially short training time of 9.2 s using only 100 data samples (training: 70 and testing: 30). Furthermore, it demonstrates exceptional insensitivity to position errors in scattering elements, enhancing its robustness. Therefore, the proposed opto-electronic hybrid network presents substantial application prospects in the fields of machine vision, face recognition, and remote sensing.
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PURPOSE: To evaluate the effect of ultraviolet-C light (UVC) photofunctionalization treatment time on the biologic activity of airborne particle-abraded and acid-etched (SLA) titanium surfaces and to analyze its physical and chemical mechanisms. MATERIALS AND METHODS: SLA titanium was treated with UVC light for different lengths of time (10 minutes, 20 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, and 24 hours), and then changes to its surface characteristics were evaluated via electron microscope scanning, X-ray photoelectron spectroscopy (XPS), water contact angle measurement, and zeta potential measurement. The effect of UVC photofunctionalization on the biologic processes of SLA titanium surfaces was assessed by analyzing the bovine serum albumin adsorption, adhesion, proliferation, morphology, and alkaline phosphatase activity of MG-63 cells. RESULTS: UVC irradiation did not change the topography of SLA titanium surfaces. As treatment times increased, the water contact angle decreased from 120 degrees to 0 degrees, and the hydrocarbon content decreased. Zeta potential testing showed increased surface potential of photofunctionalized titanium. In vitro testing showed that cell adhesion, proliferation, morphology, and alkaline phosphate (ALP) activity on titanium surfaces were significantly improved by UVC photofunctionalization. CONCLUSIONS: UVC photofunctionalization can improve the biologic activity of SLA titanium surfaces by removing hydrocarbons and increasing the surface potential of titanium.
Subject(s)
Biological Products , Surface Properties , Titanium , Ultraviolet Rays , Biological Products/pharmacology , Microscopy, Electron, Scanning , Osteoblasts , Titanium/chemistry , Water/pharmacologyABSTRACT
The performance of an active control system, crucial for the co-phase maintenance of segmented mirrors, is closely related to the spatial layout of sensors and actuators. This article compares two types of edge sensor layouts, vertical and horizontal, and proposes a novel tandem differential sensor layout that saves layout space and reduces the number of positioning references. The control performance of this scheme is analyzed in terms of error propagation, mode representation, and the scalable construction of the control matrix. Finally, we constructed a tandem differential-based sensor detection system to examine the performance of edge sensors and the effect of laboratory environmental variables on sensor measurements. Simulations and experiments demonstrate that this scheme has the same ability to fully characterize actuator modification modes as the Keck edge sensor layout. Although the total error multiplier is slightly larger than the latter, it has fewer scalable control matrix types and stronger spatial and segmental shape adaptation capabilities. Actual measurements show that the sensor's own noise in a tandem differential layout is less than 20 nm, which meets the requirements for future segmented co-phase maintenance. This layout type can potentially be applied to future small and medium-sized segmented splices.
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A digital workflow to acquire actual position of the drill and assess bony preparation accuracy intraoperatively was described. Based on the widely used intraoral scanner, this digital workflow was a relatively practical and economical option for digital intraoperative measurement. As a result, it could help the clinician in accurate verification and immediate correction of the drill position and consequently facilitating the accurate implant placement in implant surgery.
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BACKGROUND: Using a rotary instrument or ultrasonic instrument for tooth preparation is a basic operation in the dental clinic that can produce a significant number of droplets and aerosols. The dental droplet and aerosol can lead to the transfer of harmful germs. The goal of this study was to analyze the properties of microbiological aerosol created by droplets and aerosol generated by three common tooth-preparation instruments. METHODS: Streptococcus mutans UA159 was used as the biological tracer to visualize the droplets and aerosols. The passive sampling method was used to map the three-dimensional spatial distribution and the six-stage Andersen microbial sampler (AMS) was used as the active sampling method to catch aerosol particles at a specific time. RESULTS: The aerosol concentration is related to instruments, three-dimensional spatial distribution, and dissipation time. Most aerosols were generated by air turbines. More microorganisms are concentrated at the 1.5 m plane. The majority of the post dental procedure contamination was detected within the 0-10-min period and it decreased rapidly within 30 min. CONCLUSION: This study is conducive to the proposal and improvement of relevant infection control measures in dental procedures and provides a basis for the assessment of measures, reducing the risk of nosocomial infection.
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Cross Infection , Humans , Aerosols , Cross Infection/prevention & control , Infection Control , Delivery of Health CareABSTRACT
Post-and-core crown is one of the most common forms of restoration of tooth after root canal therapy (RCT). Infection control is the core objective of RCT, which is usually well realized by endodontists. However, many prosthodontists often neglect the infection control of the tooth and the maintenance of the curative effect of RCT during the process of post-and-core crown, which may lead to the failure of the final restoration. The concept of integrated crown-root treatment advocated recently requires clinicians to consider the RCT and final restoration as a whole, rather than simply divided into two parts-endodontic treatment and restorative treatment. As the core content of integrated crown-root treatment, infection control should be taken seriously by clinicians and implemented throughout the whole treatment process, especially in the restorative treatment that is easily overlooked after RCT. Therefore, this article describes the infection control of post-and-core crown restoration, classifies the tooth requiring post-and-core crown restoration, and puts forward the measures of infection control before and during post-and-core crown restoration, in order to provide reference and guidance for clinical practice.
Subject(s)
Post and Core Technique , Tooth Fractures , Humans , Crowns , Tooth Crown , Root Canal Therapy , Infection ControlABSTRACT
Using composite resin restoration of full-coverage crowns to obtain a completely symmetrical esthetic restoration of individual central incisors remains difficult. Freehand direct composite resin restoration is challenging even for highly skilled dentists. This clinical report describes a digital protocol for achieving symmetrical restoration of two central incisors using a custom-designed, two-in-one template.
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Crowns , Incisor , Humans , Esthetics, Dental , Composite Resins/therapeutic use , Dental Care , Dental Restoration, Permanent/methodsABSTRACT
BACKGROUND: The purpose of this in vitro study was to evaluate the effect of the percentages of preserved enamel on ceramic laminate veneers' (CLVs) shear bond strength (SBS). METHODS: Seventy extracted human maxillary central incisors were scanned and reconstructed into three-dimensional models. The extracted teeth were then embedded and randomly divided into seven groups (n = 10 per group). Based on digital analyses of the three-dimensional models, guided tooth preparation and bonding procedures were performed individually to form seven different percentages (100%, 80%, 60% 50%, 40%, 20% and 0%) of remaining enamel thickness on the bonding surface. Finally, the SBS test was performed, and the data were statistically analysed by one-way ANOVA with LSD post hoc test (α = 0.05). RESULTS: The complete enamel surface exhibited the highest SBS (19.93 ± 4.55 MPa), followed by 80% enamel (19.03 ± 3.66 MPa), 60% enamel (18.44 ± 3.65 MPa), 50% enamel (18.18 ± 3.41 MPa), 40% enamel (17.83 ± 3.01 MPa) and 20% enamel (11.32 ± 3.42 MPa) group. The lowest SBS (9.63 ± 3.46 MPa) was detected in 0% enamel group. No significant difference was observed among the 40-100% enamel groups, while the 20% or 0% enamel group demonstrated a significantly lower mean SBS than the 40% enamel group (p < 0.05). CONCLUSION: The SBS value of CLVs bonded to 100% enamel on the finishing surfaces (nearly 20 MPa) was twice that which bonded to 0% enamel (nearly 10 MPa). Bonding to 100% enamel is the most reliable treatment. When dentin exposure is inevitable, enamel should be preserved as much as possible to maintain good bonding. In addition, 40% of preserved enamel on the bonding surface was the minimal acceptable value to fulfil the requirements of good bonding strength.
Subject(s)
Dental Bonding , Resin Cements , Acid Etching, Dental/methods , Ceramics/chemistry , Dental Enamel , Dental Porcelain/chemistry , Dental Stress Analysis , Humans , Materials Testing , Resin Cements/chemistry , Shear Strength , Surface PropertiesABSTRACT
To describe a digital workflow for creating a provisional restoration by using an extracted tooth rapidly, finally fixing the provisional restoration in the targeted position precisely and preserving the natural emergence profile from the time of provisional restoration to final restoration. CLINICAL CONSIDERATIONS: The use of extracted tooth as an immediate provisional restoration is an effective method for preserving the shape of the emergence profile. However, the existing methods for creating a provisional restoration by using natural tooth are time-consuming and there is no reliable method to precisely attach tooth to temporary abutment. This case demonstrates a new method for using patient's natural tooth as an immediate provisional restoration under a sequence of guides, which significantly reduces the chair-side time and inconvenience for clinicians and patients. Immediate provisional restoration contributes to preserving the soft tissue architecture after post-extraction implant placement, especially when using the patient's tooth as a provisional restoration. Digital technology can help to improve the chair-side clinical efficiency of dentist. CLINICAL SIGNIFICANCE: Maintaining the natural soft tissue architecture is a huge challenge in dental implantology. Use of the extracted tooth as a provisional restoration is likely to achieve an optimal outcome. And digital technology is helpful to the efficiency and accuracy of treatment.