Effects of Hard Thin-Film Coatings on Adhesion of Early Colonizer Bacteria Over Titanium Surfaces.

PURPOSE: The purpose of this in vitro study was to evaluate the effect of diamond-like carbon (DLC) and titanium (Ti) nitride coatings over Ti surfaces on the adhesion of early colonizer bacteria. MATERIALS AND METHODS: Specimens were divided into 3 groups (n = 10) according to different surface modifications: titanium nitride (TiN)-coated Ti discs (experimental group 1), DLC-coated Ti discs (experimental group 2), and uncoated polished Ti discs (control group). Discs were incubated in bacterial cell suspension (Streptococcus mutans and Streptococcus sanguis) for 1 hour, and the single colonies formed by adhering bacteria were counted by fluorescence microscopy. Surface roughness and topography were examined by atomic force microscopy. RESULTS: The surface roughness of DLC was lower than TiN coating and the control group. Statistically significant reduction of the number of adherent bacteria was observed on DLC-coated surfaces. CONCLUSIONS: DLC coating over Ti surfaces strongly inhibits the adhesion of early colonizer oral bacteria.

Diamondlike carbon coating as a galvanic corrosion barrier between dental implant abutments and nickel-chromium superstructures.

PURPOSE: The objectives of this study were to evaluate the galvanic corrosion behavior between titanium and nickel-chromium (Ni-Cr) alloy, to investigate the effect of diamondlike carbon (DLC) coating over titanium on galvanic corrosion behavior between titanium and Ni-Cr alloy, and to evaluate the effect of DLC coating over titanium abutments on the fit and integrity of prosthetic assemblies by scanning electron microcopy (SEM). MATERIALS AND METHODS: Five Ni-Cr and 10 titanium disks with a diameter of 5 mm and thickness of 3 mm were prepared. DLC coating was applied to five titanium disks. Electrode samples were prepared, and open circuit potential measurements, galvanic current measurements over platinum electrodes, and potentiodynamic polarization tests were carried out. For the SEM evaluation, 20 Ni-Cr alloy and 10 gold alloy superstructures were cast and prepared over 30 abutments. DLC coating was applied to 10 of the abutments. Following the fixation of prosthetic assemblies, the samples were embedded in acrylic resin and cross sectioned longitudinally. Internal fit evaluations were carried out through examination of the SEM images. RESULTS: Titanium showed more noble and electrochemically stable properties than Ni-Cr alloy. DLC coating over the cathode electrode served as an insulating film layer over the surface and prevented galvanic coupling. Results of the SEM evaluations indicated that the DLC-coated and titanium abutments showed no statistically significant difference in fit. Hence, no adverse effects on the adaptation of prosthetic components were found with the application of DLC coating over abutment surfaces. CONCLUSIONS: DLC coating might serve as a galvanic corrosion barrier between titanium abutments and Ni-Cr superstructures.

Mechanical properties of polyamide versus different PMMA denture base materials.

PURPOSE: Polymethyl methacrylate (PMMA) resins are the most commonly used denture materials; however, they do not have a high flexural strength (FS). This study aimed to compare the mechanical properties of a polyamide-based, injection-molded denture material (Deflex) with another injection-molded PMMA base material (SR-Ivocap) and a conventional compression-molded PMMA (Meliodent). MATERIALS AND METHODS: Flexural properties (deflection, bending strength, and bending modulus) of denture base materials were evaluated (n = 10). Specimens meeting International Standards Organization (ISO) specification number 20795-1 requirements were prepared (65 × 10 × 3 mm(3)). A three-point bending test was carried out on an Instron testing machine at a 5 mm/min crosshead speed. The Knoop hardness test was used to compare microhardness values. Data were analyzed using ANOVA, followed by REGWQ. RESULTS: The group results, standard deviations, and statistical differences (p < 0.01) for Deflex, SR-Ivocap, and Meliodent were (A) flexural strength (MPa: 78.3 ± 1.0,(a) 69.8 ± 1.4,(b) 81.1 ± 1(a)), (B) flexural modulus (GPa: 0.70 ± 0.13,(a) 0.85 ± 0.27,(a) 1.70 ± 0.23(b)), (C) Knoop Hardness (kg/cm(2) : 7.5 ± 1.0,(a) 13.5 ± 1.4,(b) 16.9 ± 1.0(c)). Different superscript letters indicate significant difference. All Meliodent specimens fractured during flexural testing, but no Deflex specimens did. CONCLUSIONS: While polyamide denture material produced good fracture resistance, its modulus is not yet sufficiently high to be equal to standard PMMA materials. Clinical Implications. Polyamide has some attractive advantages, but will require modification to produce consistently better properties than current PMMA materials.

Effect of zoledronic acid on osseointegration of titanium implants: an experimental study in an ovariectomized rabbit model.

PURPOSE: Zoledronic acid (ZA), a new-generation intravenous bisphosphonate, exhibits the greatest affinity for bone mineral with the longest retention, thereby leading to its ability to be dosed at annual intervals in the treatment of osteoporosis. The purpose of this preliminary study was to evaluate the effects of systemic administration of a single dose of ZA on osseointegration and bone healing around titanium dental implants. MATERIALS AND METHODS: Thirty-six female New Zealand rabbits (aged 6-12 months) were used in this study. Rabbits were randomly assigned to 1 of 3 groups: sham control group (SH), ovariectomy group (OVX), and OVX and ZA group (OVX + ZA). Animals in the OVX and OVX + ZA groups were subjected to bilateral ovariectomy, whereas animals in the SH group were sham operated. Eight weeks later, 1 implant was placed in each tibia of the animals. ZA was administered in the OVX + ZA group during the implantation, whereas the OVX and SH groups received saline solution infusions. All of the subjects were sacrificed 8 weeks after the implantation, and tibial specimens were harvested. Histomorphometric bone-to-implant contact analysis, resonance frequency analysis, removal torque testing, and digital radiographic absorptiometry were administered, and the data were statistically analyzed. RESULTS: Histomorphometric, resonance frequency, and radiodensitometric analyses showed significant improvement in osseointegration of implants in the OVX + ZA group compared with the OVX group. However, the differences in removal torque results between the groups were not statistically significant. CONCLUSIONS: The results of this study suggest that systemic ZA administration may improve osseointegration of titanium implants placed in estrogen-deficient states of bone.

Internal fit evaluation of crowns prepared using a new dental crown fabrication technique: laser-sintered Co-Cr crowns.

STATEMENT OF PROBLEM: Difficulties encountered during casting of base metal dental alloys limit their use. Application of these alloys might be enhanced if new techniques are used. PURPOSE: The purpose of this study was to compare the internal fit of laser-sintered Co-Cr alloy crowns with base metal restorations prepared from another Co-Cr alloy and a Ni-Cr alloy using conventional casting techniques. MATERIAL AND METHODS: Internal fit of laser-sintered Co-Cr crowns was compared with the fit of conventionally cast Ni-Cr and Co-Cr alloy crowns. Twelve crown-shaped specimens were prepared on a stainless steel die representing a prepared maxillary right central incisor for each group. Fit of crowns was evaluated using 2 different techniques: (1) weighing the light-body addition silicone that simulated a cement material, and (2) measuring the internal gap width on a die for longitudinally sectioned specimens. One-way ANOVA followed by Tukey multiple comparison test was used for statistical analysis (alpha=.05). RESULTS: Significantly higher mean (SD) light-body silicone weights (P<.001) were observed in the laser-sintered Co-Cr alloy group (14.34 (1.67) mg) compared to the conventionally cast Ni-Cr alloy group (9.36 (1.97) mg) and Co-Cr alloy group (7.85 (1.19) mg). Mean internal gap widths (SDs) were 58.21 (19.92) microm, 50.55 (25.1) microm, and 62.57 (21.62) microm, respectively, for the cast Ni-Cr and Co-Cr alloy groups and the laser-sintered Co-Cr alloy group. No significant difference was observed between the 3 groups for internal gap widths (P=.42). CONCLUSIONS: Weighing the light-body addition silicone is a convenient method for evaluating the 3-dimensional internal fit of dental crowns. However, no significant difference was found among the 3 alloy groups evaluated for the internal gap width of sectioned crown specimens.

Comparison of the bond strength of laser-sintered and cast base metal dental alloys to porcelain.

OBJECTIVE: The purpose of this study was to compare shear bond strengths of cast Ni-Cr and Co-Cr alloys and the laser-sintered Co-Cr alloy to dental porcelain. METHODS: Dental porcelain was applied on two cast and one laser-sintered base metal alloy. Ten specimens were prepared for each group for bond strength comparison. ANOVA followed by Tukey HSD multiple comparison test (alpha=0.05) was used for statistical analysis. Fractured specimens were observed with a stereomicroscope to classify the type of failure after shear bond testing. RESULTS: While the mean shear bond strength was highest for the cast Ni-Cr metal-ceramic specimens (81.6+/-14.6 MPa), the bond strength was not significantly different (P>0.05) from that for the cast Co-Cr metal-ceramic specimens (72.9+/-14.3 MPa) and the laser-sintered Co-Cr metal-ceramic specimens (67.0+/-14.9 MPa). All metal-ceramic specimens prepared from cast Ni-Cr and Co-Cr alloys exhibit a mixed mode of cohesive and adhesive failure, whereas five of the metal-ceramic specimens prepared from the laser-sintered Co-Cr alloy exhibited the mixed failure mode and five specimens exhibited adhesive failure in the porcelain. CONCLUSIONS: The new laser-sintering technique for Co-Cr alloy appears promising for dental applications, but additional studies of properties of the laser-sintered alloy and fit of castings prepared by this new technique are needed before its acceptance into dental laboratory practice. SIGNIFICANCE: Laser sintering of Co-Cr alloy seems to be an alternative technique to conventional casting of dental alloys for porcelain fused to metal restorations.

Intrapulpal heat generation during provisionalization: effect of desensitizer and matrix type.

PURPOSE: This study investigated the effect of different matrices and application of a desensitizer on pulpal temperature rise during direct provisionalization. MATERIALS AND METHODS: The apical third of a second premolar was resected and pulpal tissue was removed. Silicone heat-conducting medium was injected, and a J-type thermocouple was inserted into the pulp chamber and sealed. The tooth was embedded in acrylic resin with its cervical line 1 mm higher than the base. Addition and condensation silicone impression materials were mixed and placed inside plastic molds. Impressions were taken before tooth preparation. The tooth was then prepared with a 1.5-mm shoulder finish line. The experimental model was kept in a 36 degrees C water bath. Four provisional materials were applied in sequence onto the prepared tooth using matrices. Each provisional resin was used in combination with each matrix (n = 12). Then a dentin desensitizer was coated on the prepared tooth and provisionalizations were made in the same manner. The thermocouple was connected to the data-logger. During setting of the resins, pulp temperatures were recorded and transferred to the computer. Measurements were conducted for each test group by calculating the temperature rise as the difference between the start and highest temperature reading. RESULTS: The type of the silicone matrix used and the use of desensitizer did not affect the intrapulpal heat generation during direct provisionalization. CONCLUSION: Application of a desensitizer and different type of matrix seems to be noneffective on intrapulpal heat rise, although the type of provisional material used may be effective.

Effects of low-intensity pulsed ultrasound on dental implant osseointegration: a preliminary report.

OBJECTIVES: The aim of this pilot study was to evaluate the effects of low intensity pulsed ultrasound (LIPU) on dental implant osseointegration in a rabbit model using mechanical-histomorphometric methods and resonance-frequency analysis (RFA). METHODS: Twelve skeletally mature, male New Zealand rabbits (3.4 kg+/-0.5) were included in the study. A total number of 24 implants were placed bilaterally into the tibiae of the subjects. The right tibia of each rabbit received LIPU application (20 min/day) while the left side received sham treatment. The study was carried on for six weeks and the rabbits were sacrificed in 7 days intervals (two rabbits for each week). The rabbits were categorized in the early or late osseointegration period according to their sacrification date. Comparisons between the groups were made using statistical analysis of histomorphometric analysis, resonance frequency analysis and mechanical tests. RESULTS: The histomorphometry parameters showed that the bone area and the bone volume values have significantly increased in the early osseointegration period and the bone-implant contact values have significantly increased in the late osseointegration period in the LIPU treated subjects when compared to the control group. RFA scores had mild increase in the LIPU group. However the difference was not statistically significant. Mechanical test results suggest an increased mechanical stability in the LIPU group as well. CONCLUSIONS: Results of this pilot study indicate that low intensity pulsed ultrasound may have positive effects on osseointegration and stability of dental implants.

The effect of food simulants on porcelain-composite bonding.

PURPOSE: The purpose of this study was to evaluate the in vitro effects of food simulants on the bond strength of brackets to porcelain surfaces. MATERIALS AND METHODS: One hundred and eighty porcelain-fused to metal specimens were fabricated. Samples were divided into 3 groups including 60 specimens each. Different surface treatment methods were applied to each group and these were: sandblasting (SB), etching with orthophosphoric acid (OPA) and etching with hydrofluoric acid (HFA). After the surface treatments, the brackets were bonded to the center of each sample with a light-curing orthodontic composite adhesive. Then each group was divided into five test subgroups and one control subgroup each consisting of 10 specimens. The test groups were conditioned for 90 days at 37 degrees C as follows: water, 0.02N citric acid, heptane, 8% ethanol aqueous solution and 50% ethanol aqueous solution. The control specimens were stored at room temperature in air. Shear force was applied to the porcelain-bracket interface by using a universal testing machine with a crosshead speed of 1 mm/min until debonding occurred. The shear bond strength was calculated by dividing the maximum load by the cross-sectional area of the bracket to give the results in megapascals (MPa). The statistical evaluations were made by using analysis of variance. Whenever a significance was detected, Bonferroni tests were performed for post hoc analyses. RESULTS: Fifty percent ethanol conditioned specimens for all surface treatment groups showed lower shear bond strength values. HFA group showed significantly higher shear bond strength values when compared with other groups (P < 0.05). For all porcelain surface treatment groups, control groups showed statistically significant higher shear bond strength values (P < 0.05). CONCLUSION: The results of this in vitro study show that food simulants significantly decrease the bond strength between bracket and porcelain surface.

Effects of low-intensity pulsed ultrasound on healing of mandibular fractures: an experimental study in rabbits.

PURPOSE: Pulsed ultrasonic waves have been shown to accelerate fracture healing of the long bones. The aim of this study was to evaluate the effects of low-intensity pulsed ultrasound (LIPU) on healing of mandibular fractures. MATERIALS AND METHODS: Thirty skeletally mature male New Zealand rabbits were used. Animals underwent unilateral mandibular osteotomy. The bone segments were repositioned and fixed with miniplates and miniscrews. Half of the animals received daily ultrasound treatment, 20 min/day, for 20 days. Ultrasound signals consisted of a 1.5-MHz pressure wave administered in pulses of 200 microsec with an average temporal and spatial intensity of 30 mW/cm2. Animals in the control group received sham application. All of the animals were killed on postoperative day 22. Three-point bending test, digital radiodensitometric analysis, and histologic and histomorphometric examinations were performed on the harvested hemimandibles. The data were statistically analyzed. RESULTS: Biomechanical tests revealed significant improvement in the mechanical properties of the healing bone in the LIPU-treated group. This was supported by histologic and radiologic findings. CONCLUSIONS: Results of this study suggest that LIPU improves the bone healing of mandibular fractures in rabbits.

Effect of food-simulating liquids on the mechanical properties of provisional restorative materials.

OBJECTIVES: The purpose of this study was to investigate the effects of food-simulating liquids (FSL) on the mechanical properties of provisional restorative materials. METHODS: Four provisional restorative materials were selected: (1) Dentalon Plus (DP), (2) Protemp II (PII), (3) Systemp C&B (SCB) and (4) Integrity (INTG). The specimens were fabricated in customized molds and each type was randomly divided into five groups (n = 10). The test groups were conditioned for 7 days at 37 degrees C as follows: water, 0.02 N citric acid, heptane and 75% ethanol in aqueous solution. Specimens in the control group were stored at room temperature in air. After conditioning, the flexural strength (FS) values were assessed using a universal testing machine (5 mm/min crosshead speed) and the fractured specimens were used for the determination of the Knoop hardness number (KHN) using a digital micro-hardness tester (100 gf/15 s). Kruskal-Wallis and Mann-Whitney U-tests were used for statistical analysis. RESULTS: In ethanol and heptane solutions, DP specimens were totally degraded, thus, FS/KHN for DP could not be measured. For all materials, the FS/KHN values were significantly lower than their control groups after conditioning in ethanol. After heptane conditioning, the decrease in FS for SCB and KHN for PII were statistically significant. After citric acid conditioning, KHN for PII and INTG were significantly higher than the controls and the decrease in FS for SCB and INTG were statistically significant. SIGNIFICANCE: The mechanical properties of provisional restorative materials are strongly influenced by food-simulating liquids.

Porcelain surface treatment by laser for bracket-porcelain bonding.

INTRODUCTION: The purposes of this study were to investigate the effect of laser irradiation on the adhesion of brackets bonded to feldspathic porcelain and to compare it with brackets bonded with conventional techniques. METHODS: One hundred porcelain-fused-to-metal specimens were divided into 10 groups of 10. The treatment groups were sandblasted (SB), sandblasted with silane (SB+S), orthophosphoric acid (OFA), orthophosphoric acid with silane (OFA+S), hydrofluoric acid (HFA), hydrofluoric acid with silane (HFA+S), laser etched (L), laser etched with silane (L+S), glazed (Control 1/C1), and deglazed (Control 2/C2). Five other specimens were irradiated by 2-, 3-, 5-, 10-, and 15-watt superpulse carbon dioxide (CO2) laser for 20 seconds and examined by scanning electron microscopy. Metal brackets were bonded with a self-cure composite material and the specimens were stored in water at 37 degrees C for 24 hours and then thermocycled in water baths between 5 degrees C and 55 degrees C 500 times. Bond strength was determined in megapascals (MPa) by shear test at 1 mm/minute crosshead speed. Bond failure modes were observed under stereomicroscope. For the statistical analysis, 1-way ANOVA and Tamhane post hoc test were used. RESULTS: Statistical analysis showed significant differences between the groups at the .05 level. The HFA+S group yielded the highest mean strength (15.07 +/- 1.44). This was followed by SB+S (13.81 +/- 2.00), HFA (10.78 +/- 0.62), OFA+S (10.73 +/- 1.12), L+S (8.25 +/- 0.90), L (6.26 +/- 0.58), C2 (2.45 +/- 0.54), OFA (2.36 +/- 0.41), SB (2.04 +/- 0.41), and C1 (1.64 +/- 0.33). The bond failure modes of HFA and silane groups, except L+S, were cohesive in porcelain. Control groups and other test groups showed adhesive failure. Only irradiation by 2 watts for 20 seconds provided a porous surface texture without cracks. CONCLUSIONS: Two-watt/20 second superpulse CO2 laser irradiation might be an alternative conditioning method for pretreating ceramic surfaces. Increased bond strength can be achieved by silanation after CO2 laser irradiation.

Multidisciplinary approach for the rehabilitation of dentoalveolar trauma.

Satisfactory dental rehabilitation of dentoalveolar trauma requires intense effort and time. Usually multidisciplinary treatment planning and teamwork are necessary to deal with multitask problems associated with these cases. Dental implants have been successfully used for replacement of missing teeth, but in trauma cases insufficient alveolar bone hinders implantation. In this report we present the multidisciplinary approach for the treatment of a trauma case. Maxillary segmental alveolar osteotomy in conjunction with interpositional and onlay bone grafting was performed to prepare the site for placement of osseointegrated implants. Titanium microplate and screws were used to provide orthodontic anchorage for intrusion of the extruded mandibular incisors. The patient was rehabilitated by implant supported fixed partial denture 6 months after implant placement.