The effect of different implant-abutment types and heights on screw loosening in cases with increased crown height space.

OBJECTIVES: The stability of the abutment screw is pivotal for successful implant-supported restorations, yet screw loosening remains a common complication, leading to compromised function and potential implant failure. This study aims to evaluate the effect of different implant-abutment types and heights on screw loosening in cases with increased crown height space (CHS). MATERIALS AND METHODS: In this in vitro study, a total of 64 abutments in eight distinct groups based on their type and height were evaluated. These groups included stock, cast, and milled abutments with heights of 4 mm (groups S4, C4, and M4), 7 mm (groups S7, C7, and M7), and 10 mm (groups C10 and M10). Removal torque loss (RTL) was assessed both before and after subjecting the abutments to dynamic cyclic loading. Additionally, the differences between initial RTL and RTL following cyclic loading were analyzed for each group (p < .05). RESULTS: The C10 group demonstrated the highest RTL, whereas the S4 group exhibited the lowest initial RTL percentage (p < .05). Furthermore, the study established significant variations in RTL percentages and the discrepancies between initial and postcyclic loading RTL across different abutment groups (p < .05). Additionally, both abutment types and heights were found to significantly influence the RTL percentage (p < .05). CONCLUSION: The type and height of the implant abutment affected screw loosening, and in an increased CHS of 12 mm, using a stock abutment with a postheight of 4 mm can be effective in minimizing screw loosening.

Introducing a new auto edge detection technique capable of revealing cervical root resorption in CBCT scans with pronounced metallic artifacts.

Cervical resorption is a serious threat to the longevity of the teeth. In this study, the Canny edge-detection algorithm was applied on CBCT images to compare the accuracy of original and Canny views for diagnosing cervical resorption in endodontically treated teeth. Intracanal metallic posts were inserted in 60 extracted teeth being randomly divided into three groups: control, 0.5 mm, and 1 mm cervical resorption. CBCT scans of the teeth were presented to three observers in both original and Canny formats with the accuracy being determined by receiver operating characteristic (ROC) analysis. The DeLong test was used for paired comparisons with the significance level set at 0.05. The highest accuracy belonged to Canny images in 1 mm resorption, followed by Canny images in 0.5 mm resorption, original images in 1 mm resorption, and original images in 0.5 mm resorption, respectively. The Canny images were significantly more accurate in the diagnosis of 0.5 mm (p < 0.001) and 1 mm (p = 0.009) resorption. Application of the Canny edge-detection algorithm could be suggested as a new technique for facilitating the diagnosis of cervical resorption in teeth that are negatively affected by metallic artifacts.

Comparison of marginal leakage and retentive strength of implant-supported milled zirconia and cobalt-chromium copings cemented with different temporary cements.

Background: Few studies assessed the effect of coping material (particularly milled metal copings) on the retentive strength of cements and reported contradictory results. Thus, this study aims to assess the marginal leakage and retentive strength of implant-supported milled zirconia and cobalt-chromium (Co-Cr) copings cemented with different temporary cements. Materials and Methods: In this in vitro study, Zirconia and Co-Cr copings were fabricated on 100 straight titanium abutments. Each group of copings was divided into five subgroups (n = 10) for the use of different cements: permanent zinc-phosphate (ZP) cement, temporary zinc oxide eugenol cement (temp bond [TB]), calcium hydroxide-based temporary cement (Dycal [DC]), polymer-based eugenol-free acrylic-urethane temporary cement (Dentotemp [DT]), and methacrylate-based temporary cement (Implantlink [IL]). The retentive strength and marginal leakage of restorations were assessed. Data were analyzed by one-way ANOVA, Tukey, and Fisher's exact tests (α = 0.05). Results: In the Co-Cr group, the retentive strength values (in Newtons) were as follows: ZP (411.40 ± 5.19) >DC (248.80 ± 5.01) >IL (200.10 ± 5.06) >DT (157.90 ± 5.19) >TB (98.50 ± 6.88). This order was as follows in the zirconia group: ZP (388.70 ± 5.35) >DC (226.60 ± 5.08) >IL (179.00 ± 3.71) >DT (136.00 ± 4.88) >TB (78.60 ± 3.50). All pairwise comparisons were statistically significant (P < 0.001). The difference in marginal leakage was not significant among the groups (P = 0.480). Conclusion: The type of coping material and cement type significantly affected retentive strength, but not marginal leakage, of implant restorations. Milled Co-Cr copings showed higher retentive strength than zirconia copings, and ZP cement followed by DC yielded the highest retention.

Evaluation of Effect of Zirconia Surface Treatment with CO2 and Nd:YAG Lasers on Shear Bond Strength between Zirconia Frameworks and Porcelain Veneers.

AIM: The purpose of this study was to evaluate the effect of zirconia surface treatment with CO2 and Nd:YAG laser on shear bond strength (SBS) between the zirconia framework and porcelain veneering. MATERIALS AND METHODS: In this in vitro study, zirconia blocks were converted to 50 cubes and were divided randomly into 5 groups. After sintering (S), porcelain was applied in the control group. The surface treatment of the second to fifth groups included CO2 laser + (S), (S + CO2), Nd:YAG laser + (S), and (S + Nd), respectively. The SBS test was done, and data were analyzed by SPSS16 software. One sample was randomly chosen from each group and the type of failure was examined under scanning electron microscope (SEM). To compare the pairs of means, the least significant difference test was used and the determined significance level was 5% (p < 0.05). RESULTS: The SBS of S + Nd group was significantly higher than the other ones, except for S + CO2 group. The least amount of SBS belonged to CO2 + S and the highest to S + Nd group. There were no significant differences between the other groups. CONCLUSION: The bond strength of veneering porcelain to zirconia can be altered by surface treatments. It can also be affected by the type and sequence of laser and sintering application. The effect of Nd:YAG laser on the surface of zirconia, in order to create roughness to increase SBS, is better than that of CO2 laser. CLINICAL SIGNIFICANCE: Surface treatment of zirconia by certain types of lasers reduces the chipping of the ceramic veneer and increases the success rate of all-ceramic restorations.

Comparative Evaluation of the Effects of Antimicrobial Photodynamic Therapy With an LED and a Laser on the Proliferation of Human Gingival Fibroblasts on the Root Surface: An In Vitro Study.

Introduction: This study aimed to compare the effects of root biomodification by citric acid and antimicrobial photodynamic therapy (aPDT) with LED and laser on the proliferation of human gingival fibroblasts (HGFs). Methods: This in vitro experimental study evaluated 60 single-rooted teeth extracted due to periodontal disease. The teeth underwent scaling and root planing (SRP), and then 5 × 5 mm blocks were prepared from the cervical area of the teeth 1 mm apical to the cementoenamel junction. The blocks were divided into 4 groups (n=15 blocks): SRP alone (control), SRP + citric acid, SRP + toluidine blue (TBO) + LED light, and SRP + TBO + laser. HGFs were seeded on the surface of the samples, and the methyl thiazolyl tetrazolium (MTT) assay was performed after 24, 48 and 72 hours. Group comparisons were performed using repeated measures ANOVA, while pairwise comparisons of the time points were performed by an LSD test. Results: Cell proliferation was higher in all experimental groups at 48 and 72 hours, compared with 24 hours (P < 0.05). Cell proliferation was significantly different in the citric acid group at 24 hours (P = 0.016) and 48 hours (P = 0.015), compared with other groups. However, cell proliferation was not significantly different in the aPDT group with LED Photosan and a diode laser at 24 and 48 hours (P > 0.05). Conclusion: aPDT and citric acid can enhance the proliferation of HGFs on dentin blocks. Further studies can pave the way for their future use in the clinical setting.

Use of Digital-Conventional Method for Managing a Patient with Severely Worn Dentition: A Clinical Report.

Severe forms of attrition are frequently found in patients with no or insufficient posterior occlusal support. Management of such patients using fixed or removable prostheses is a complex procedure and is still a challenge for clinicians. The present clinical report describes step by step full mouth rehabilitation of a patient with severely worn dentition using computer-aided design/computer-aided manufacturing- (CAD/CAM-) generated wax patterns, milled zirconia frameworks, and fabrication of removable partial denture (RPD) abutments using a digital-conventional method. The results were satisfactory during 18 months of follow-up.

Management of Limited Interocclusal Distance with the Aid of a Modified Surgical Guide: A Clinical Report.

In completely edentulous patients, limited interarch distance can compromise conventional prosthetic fabrication. Bone reduction through various surgical procedures has been recommended to restore an acceptable interarch distance. In such circumstances, a surgical guide built on a mounted cast can be used to minimize and control the amount of bone reduction performed. In the present report, an innovative method of fabrication of surgical guide has been described.

Comprehensive Treatments for Congenitally Missing Teeth and Generalized Diastema.

Congenitally missing teeth and/or hypodontia is a prevalent dental anomaly. There are different treatment options available for these conditions such as space maintenance, restoring the space by resin-bonded-fixed-partial-dentures (RBFPDs), and dental implants. This study addresses the comprehensive treatments for congenitally missing tooth and diastema using interdisciplinary approaches. One patient was treated with small-diameter-implants and the other one was treated using an intraoral scanner to make digital impression and fabricating RBFPDs with CAD/CAM system. Both patients were completely satisfied.