Evaluation of Pre- and Post-loading Peri-implant Crestal Bone Levels Using Cone-beam Computed Tomography: An In Vivo Study.

AIM: To evaluate the buccal, lingual, mesial, and distal crestal bone around implant using CBCT analysis having buccal crestal bone width of 1 mm after placement of implant and after 3 months of loading. MATERIALS AND METHODS: Twenty-five patients between 18 and 60 years of age with adequate bone width and height were selected for this in-vivo study with single or multiple missing teeth. Surgical stent was fabricated for all of them by using self-cure acrylic resin for selection of implant according to the availability of bone, and gutta-percha was used as radio-opaque marker to locate the implant site. After proper analysis, in the first stage surgery, implants were placed. After 3 months to this, the second stage surgery was performed followed by elastomeric impression for porcelain fused to metal prosthesis fabrication. The buccal, lingual, mesial, and distal bone width and height were evaluated by using cone-beam computed tomography (CBCT). CBCT was standardized in terms of FOV (field of vision), slice thickness, and interval. After 3 months of loading, CBCT was taken to evaluate the alteration in the crestal bone around implants. Pre- and post-loading, crestal bone on four locations was measured by using CBCT software. RESULTS: There is significant bone loss at all the locations, buccal, lingual, mesial, and distal, at the time of placement and after 3 months of loading of implant (p <0.05). The mean difference of 0.840, 0.933, 0.840, and 0.380 at buccal, lingual, mesial, and distal locations, respectively, shows statistically significant difference in pre- and post-values of mean bone loss at buccal, lingual, mesial, and distal positions. Pre-loading bone loss was maximum in the distal surface, while post-loading bone loss was maximum in the buccal surface. CONCLUSION: From this study, it is concluded that although crestal bone loss was higher before implant placement, there was significant alteration in crestal bone even after loading of implant. CLINICAL SIGNIFICANCE: It is widely accepted that the bone loss around the implant crest module is multidisciplinary in nature. Long-term preservation of the crestal bone is a paramount for successfully functioning of dental implants. Preserving crestal bone will help in dissipating the functional load. With proper treatment planning by the practitioner, this technical contribution to the crestal bone loss can be minimized and long-term survival of dental implants can be achieved.

Evaluation of Fracture Resistance of Reattached Fractured Tooth Fragment Stored in Different Storage Media: An In Vitro Study.

AIM: To evaluate the fracture resistance of coronal fractured tooth fragments stored in five different storage media when reattached with nanohybrid flowable composite. MATERIALS AND METHODS: The crown portion of 50 extracted human permanent maxillary central incisors were divided into three equal parts (incisal third, middle third and cervical third) and then marked incisal third were cut with the diamond disk. These were divided into five equal groups according to the type of storage media used i.e. dry storage, fresh tender coconut water, HBSS, milk, and propolis for 2 hours. Coronal fractured part with their respective apical parts were then reattached with flowable composite (G-aenial Universal Flo, GC India), then after thermocycling process samples were subjected to universal testing machine for testing fracture resistance. The collected data were subjected to statistical analysis using one way ANOVA and Post-hoc Tukey test. RESULTS: The obtained results revealed that large amount of force is required to fracture the reattached teeth which were stored in milk and fresh tender coconut water as compared to those which were stored in dry environment, HBSS and propolis. CONCLUSION: In this study, maximum fracture resistance was seen in teeth stored in milk and fresh tender coconut water. Therefore, these two were considered as better storage media. CLINICAL SIGNIFICANCE: Due to increased interest towards the use of tooth colored restoration, recently, fractured teeth reattachment treatment procedure gaining attention by preserving life like translucency of treated tooth.

Evaluation of Sealing Ability of Three Root Canal Sealers: An In Vitro Study.

AIM: To evaluate the sealing ability of three different types of sealers using confocal laser microscopy. MATERIALS AND METHODS: Sixty extracted single-root premolars were selected and divided into three groups (20 teeth in each group) according to the type of sealer used, namely, mineral trioxide aggregate (MTA) Fillapex, AH Plus, and Bio C Sealer. Root canal preparation and obturation were done in all the samples. Roots was dissected transversely in apical plane. Percentage of gap from region to canal circumference was calculated using a confocal laser microscope. Samples were subjected to statistical analysis. RESULTS: High dye penetration was seen with AH Plus compared to MTA Fillapex and least with Bio C Sealer. The AH Plus is the best sealer with respect to seal ability of all the three. CONCLUSION: This study helps to appraise the sealing ability of the different types of sealers using confocal laser microscopy which is useful for the success of root canal treatment. CLINICAL SIGNIFICANCE: As sealer has to seal voids, foramina, and canals, it should have good penetration for the success of root canal treatment.