Saving teeth: Revisited. Esthetic improvement and long-term periodontal stability of a pathologic tooth migration case: An 84-month follow-up.

INTRODUCTION: Advances in implant dentistry, often influence our clinical treatment planning and steer us as periodontists from our fundamental values of preserving teeth. Pathologic tooth migration (PTM) of maxillary anterior teeth is a common sequela of periodontitis in patients and results in significant esthetic and functional problems. Patients' growing concern about the esthetics of their teeth and their fears of losing teeth are often reasons for them to seek treatment. We commonly assign a hopeless prognosis to these pathologically migrated teeth because of the significant loss of periodontal support and go with the "safer" choice of replacing them with implants. The purpose of this case report is to present the long-term (7-year) periodontal stability of compromised teeth and to emphasize the successful outcomes achieved when orthodontics, non-surgical periodontal, and restorative treatments are combined. METHODS AND RESULTS: A 38-year-old, otherwise healthy male with compromised function and esthetics, PTM, periodontal disease, and missing teeth presented to our clinic. Primary treatment objectives were to 1) eliminate the periodontal inflammation and 2) restore and stabilize the occlusion by employing non-surgical periodontal treatment, adult orthodontics, and prosthodontics. Following interdisciplinary treatment, clinical and radiographic re-evaluation revealed significant clinical attachment gain, reduction in tooth mobility, favorable esthetics, and better overall prognosis. At an 84-month follow-up, the patient was periodontally healthy and retained his natural dentition. CONCLUSIONS: Interdisciplinary collaboration along with patient compliance may increase the longevity of periodontally compromised teeth and improve esthetics for periodontitis patients who suffer from PTM. Such long-term favorable outcomes reaffirm the value of classic periodontal treatment and the success of multidisciplinary treatment to save teeth as a viable alternative to the extraction of teeth and the placement of implant retained restorations.

Bacterial adhesion on conventional and self-ligating metallic brackets after surface treatment with plasma-polymerized hexamethyldisiloxane.

INTRODUCTION:: Plasma-polymerized film deposition was created to modify metallic orthodontic brackets surface properties in order to inhibit bacterial adhesion. METHODS:: Hexamethyldisiloxane (HMDSO) polymer films were deposited on conventional (n = 10) and self-ligating (n = 10) stainless steel orthodontic brackets using the Plasma-Enhanced Chemical Vapor Deposition (PECVD) radio frequency technique. The samples were divided into two groups according to the kind of bracket and two subgroups after surface treatment. Scanning Electron Microscopy (SEM) analysis was performed to assess the presence of bacterial adhesion over samples surfaces (slot and wings region) and film layer integrity. Surface roughness was assessed by Confocal Interferometry (CI) and surface wettability, by goniometry. For bacterial adhesion analysis, samples were exposed for 72 hours to a Streptococcus mutans solution for biofilm formation. The values obtained for surface roughness were analyzed using the Mann-Whitney test while biofilm adhesion were assessed by Kruskal-Wallis and SNK test. RESULTS:: Significant statistical differences (p< 0.05) for surface roughness and bacterial adhesion reduction were observed on conventional brackets after surface treatment and between conventional and self-ligating brackets; no significant statistical differences were observed between self-ligating groups (p> 0.05). CONCLUSION:: Plasma-polymerized film deposition was only effective on reducing surface roughness and bacterial adhesion in conventional brackets. It was also noted that conventional brackets showed lower biofilm adhesion than self-ligating brackets despite the absence of film.

Bacterial adhesion on conventional and self-ligating metallic brackets after surface treatment with plasma-polymerized hexamethyldisiloxane

ABSTRACT Introduction: Plasma-polymerized film deposition was created to modify metallic orthodontic brackets surface properties in order to inhibit bacterial adhesion. Methods: Hexamethyldisiloxane (HMDSO) polymer films were deposited on conventional (n = 10) and self-ligating (n = 10) stainless steel orthodontic brackets using the Plasma-Enhanced Chemical Vapor Deposition (PECVD) radio frequency technique. The samples were divided into two groups according to the kind of bracket and two subgroups after surface treatment. Scanning Electron Microscopy (SEM) analysis was performed to assess the presence of bacterial adhesion over samples surfaces (slot and wings region) and film layer integrity. Surface roughness was assessed by Confocal Interferometry (CI) and surface wettability, by goniometry. For bacterial adhesion analysis, samples were exposed for 72 hours to a Streptococcus mutans solution for biofilm formation. The values obtained for surface roughness were analyzed using the Mann-Whitney test while biofilm adhesion were assessed by Kruskal-Wallis and SNK test. Results: Significant statistical differences (p< 0.05) for surface roughness and bacterial adhesion reduction were observed on conventional brackets after surface treatment and between conventional and self-ligating brackets; no significant statistical differences were observed between self-ligating groups (p> 0.05). Conclusion: Plasma-polymerized film deposition was only effective on reducing surface roughness and bacterial adhesion in conventional brackets. It was also noted that conventional brackets showed lower biofilm adhesion than self-ligating brackets despite the absence of film.

RESUMO Introdução: a deposição de filme de polímero a plasma foi criada para modificar as propriedades de superfície dos braquetes ortodônticos metálicos, com o intuito de inibir a adesão bacteriana. Métodos: filmes finos de polímero de hexametildisiloxano (HMDSO) foram depositados em braquetes ortodônticos de aço inoxidável convencionais (n = 10) e autoligáveis (n = 10), utilizando a técnica de radiofrequência PECVD (Plasma-Enhanced Chemical Vapor Deposition). As amostras foram divididas em dois grupos, de acordo com o tipo de braquete, e dois subgrupos após o tratamento de superfície. A microscopia eletrônica de varredura (MEV) foi realizada para avaliar a presença de adesão bacteriana sobre as superfícies das amostras (região de ranhura horizontal e aletas) e a integridade da camada de filme. A Interferometria Confocal (CI) avaliou a rugosidade, e a molhabilidade superficial foi avaliada por goniometria. Para análise de adesão bacteriana, as amostras foram expostas durante 72 horas a uma solução de Streptococcus mutans, para formação de biofilme. Os valores obtidos para a rugosidade da superfície foram analisados pelo teste de Mann-Whitney, enquanto a adesão do biofilme foi avaliada pelos testes de Kruskal-Wallis e SNK. Resultados: observaram-se diferenças estatisticamente significativas (p <0,05) para a rugosidade superficial e redução da adesão bacteriana em braquetes convencionais após o tratamento da superfície, e entre braquetes convencionais e autoligáveis. Não foram observadas diferenças estatísticas significativas entre os grupos autoligáveis (p> 0,05). Conclusão: a deposição de polímero a plasma só foi efetiva na redução da rugosidade superficial e adesão bacteriana em braquetes convencionais. Observou-se, também, que os braquetes convencionais apresentaram menor adesão ao biofilme do que os braquetes autoligáveis, apesar da ausência de filme.