Could Helium Plasma Treatment be a Novel Approach to Prevent the Biofilm Formation of Candida albicans?

There is no definitive method to prevent Candida albicans (C. albicans) biofilm formation on polymethyl methacrylate (PMMA) surfaces. The objective of this study was to evaluate the effect of Helium plasma treatment (before the application of removable dentures to the patient) to prevent or reduce C. albicans ATCC 10,231 the anti-adherent activity, viability, and biofilm formation on PMMA surfaces. One hundred disc-shaped PMMA samples (2 mm × 10 mm) were prepared. The samples were randomly divided into 5 surface groups and treated with different concentrations of Helium plasma: G I: Control group (untreated), G II: 80% Helium plasma-treated group, G III: 85% Helium plasma-treated group, G IV: 90% Helium plasma-treated group, G V: 100% Helium plasma-treated group. C. albicans viability and biofilm formations were evaluated using 2 methods: MTT (3-(4,5-dimethyl thiazolyl-2)-2, 5-diphenyltetrazolium bromide) assays and Crystal Violet (CV) staining. The surface morphology and C. albicans biofilm images were observed with scanning electron microscopy. The Helium plasma-treated PMMA groups (G II, G III, G IV, G V) observed a significant reduction in C. albicans cell viability and biofilm formation compared with the control group. Treating PMMA surfaces with different concentrations of Helium plasma prevents C. albicans viability and biofilm formation. This study suggests that Helium plasma treatment might be an effective strategy in modifying PMMA surfaces to prevent denture stomatitis formation.

Maintenance requirements and marginal bone loss associated with implant-retained overdentures: a retrospective cohort study.

OBJECTIVES: To evaluate the maintenance requirements and the presence of prosthetic complications associated with marginal bone loss in the implant-retained bar and locator prostheses. MATERIALS AND METHODS: The study was executed between the years 2013 and 2018 on 114 patients who had undergone 283 dental implants. Patients were examined at follow-up recall sessions at 12 and 24 months after the placement of the dentures. The clinical examination also included intraoral and extraoral examinations of the patients; compatibility of the prostheses placed to about occlusion; an adaptation of the prosthesis to the tissues, health, and continuity of the soft tissues; complaints of the patients; implant success rates; and marginal bone loss, and prosthetic complications were evaluated at follow-up sessions, and statistical analysis was performed. RESULTS: Locator attachment was placed in 94 patients with separated mandibles and maxillae, and a removable prosthesis with a bar attachment was placed in 20 patients. When evaluating the level of marginal bone loss regardless of the presence of complications, the area where the implant was set, the number of days after loading, and the type of retainer, it was found to be significant at the end of the 12th the 24th months. The results showed a significant relationship between the prosthesis type and the presence of complications at month 24 (p < 0.05). There was no significant relationship between the position of the denture and the presence of complications at month 12 (p > 0.05). There was no significant relationship between the location of the denture and the presence of complications at month 24 (p > 0.05). CONCLUSION: Complications do not affect marginal bone loss, but the resulting marginal bone loss is the result of the patient not paying enough attention to oral hygiene. Routine inspections of the prosthesis after the completion of treatment seem to be important. If the requirements resulting from these checks are met, complications that may occur in the future will be prevented. CLINICAL RELEVANCE: The maintenance requirements and the presence of prosthetic complications associated with marginal bone loss in the implant-retained bar and locator prostheses were evaluated. Complications occurred more frequently with the bar-supported removable implant prostheses.

Comparison of the Crestal Bone Loss Between Implant-Supported Prosthesis With Sinus Augmentation and Distal Cantilevered Implant-Supported Prosthesis Without Sinus Augmentation.

This study aimed to compare the crestal bone loss between a 2-implant-supported, noncantilevered 3-unit fixed partial prosthesis (TUFPP) with sinus augmentation and a 2-implant-supported, distal cantilevered TUFPP without sinus augmentation in the posterior maxilla having insufficient crestal bone. The study subjects were enrolled in 2 groups. Group 1 included patients with 2 implants: an anterior implant placed in the native bone and a posterior implant inserted with simultaneous sinus augmentation using a xenogenic bone graft to support a TUFPP. Group 2 included patients with 2 implants inserted in the native bone to support a distal cantilevered TUFPP. The crestal bone levels at the distal and mesial aspects of each implant were measured at baseline and 6-, 12-, and 24-month follow-up controls on panoramic radiographs. Fifty-two patients and 104 implants were included. There was a significant difference in distal crestal bone loss between anterior and posterior implants in group 1 at 6 months (P < .05) but not at 12 and 24 months (P > .05). Distal crestal bone loss was significantly increased in group 1 posterior implants compared to the group 2 posterior implants at 6 months (P < .05). There was no significant difference in mesial bone loss between the anterior and posterior implants in both groups at all follow-up controls (P > .05). There was also no significant mesial crestal bone loss in relation to the anterior and posterior implants of both groups at all follow-up controls (P > .05). Noncantilevered 2-implant-supported TUFPP with sinus augmentation may have similar medium-term crestal bone loss when compared to cantilevered 2-implant-supported TUFPP without sinus augmentation. Further prospective studies should be designed to compare the performance of the 2-implant-supported cantilevered TUFPP and 2-implant-supported TUFPP with sinus augmentation.

Effect of Smoking and Locations of Dental Implants on Peri-Implant Parameters: 3-Year Follow-Up.

BACKGROUND Smoking may be a risk factor for marginal bone loss (MBL) and oral mucosal inflammation surrounding dental implants. This retrospective study evaluated the effects of smoking on dental implants in patients with fixed implant-supported prostheses over a period of 36 months following loading. MATERIAL AND METHODS We assessed 120 patients (68 women, 52 men, ages 19-74 years (mean age: 55.10 years) with 315 implants. Implants were classified according to location in the upper and lower jaws and anterior (placed between canines) or posterior (placed between pre-molars and molars) as follows: 1=maxilla anterior, 2=maxilla posterior, 3=mandible anterior, 4=mandible posterior. We also measured MBL, plaque index (PI), sulcus bleeding index (SBI), and probing depth (PD). P-values less than 0.05 were considered statistically significant. RESULTS MBL was statistically greater in smokers (P<0.001) as compared to non-smokers in both jaws. MBL did not vary significantly by location in either group (smokers: p=0.415; non-smokers: p=0.175). Mean PI and PD scores were significantly higher in smokers as compared to non-smokers (P<0.001). A positive correlation was found between PI and PD scores in both groups. No statistically significant difference in SBI was observed between the 2 groups (P>0.05). CONCLUSIONS Smoking was associated with increases in marginal bone loss around implants, independent of their location in the jaws. Also, both plaque indices and probing depths were greater in smokers than in non-smokers.

Assessment of the Effect of Clinical Independent Risk Factors on Marginal Bone Loss in 2-Implant-Supported Locator-Retained Mandibular Overdentures.

The objective of this study is to evaluate the effect of clinical parameters of gender, age, implant length, implant diameter, interimplant distance, and locator height on marginal bone loss in 2-implant-supported locator-retained mandibular overdenture prostheses in 6, 12, and 24 recall sessions after loading. Clinical and radiographic data of patients who were treated between January 1, 2014, and January 4, 2018, were retrieved from the archives. The clinical data of gender, age, implant length, implant diameter, and locator height were recorded. The mesial and distal marginal bone levels of all implants and interimplant distances were determined at baseline and at 6-, 12-, and 24-month recall sessions on panoramic radiographs in a computer program. Statistical analysis was used to evaluate the effect of implant length, implant diameter, gender, age, interimplant distance, and locator height on marginal bone loss at the 6-, 12-, and 24-month control evaluations. A total of 57 patients with a mean age of 59.2 ± 9.8 years and 114 implants were included in the study. Among the aforementioned parameters, only the locator height had a major effect on the distal and mesial marginal bone loss (P < .05). A locators with a 4-mm height showed statistically significant distal and mesial marginal bone loss compared with locators with 2- and 3-mm heights in all control periods (P < .05). The locator with a 4-mm height generated more stress compared with locators with 2- and 3-mm heights, leading to marginal bone loss. The absence of oral hygiene evaluation was identified as a limitation of the study. Clinical parameters of gender, age, implant length, implant diameter, and interimplant distance did not seem to affect marginal bone loss in the study population of the current study.

Evaluation of possible prognostic factors for the success, survival, and failure of dental implants.

PURPOSE: To analyze the prognostic factors that are associated with the success, survival, and failure rates of dental implants. MATERIAL AND METHODS: Data including implant sizes, insertion time, implant location, and prosthetic treatment of 1656 implants have been collected, and the association of these factors with success, survival, and failure of implants was analyzed. RESULTS: The success rate was lower for short and maxillary implants. The failure rate of maxillary implants exceeded that of mandibular implants, and the failure rate of implants that were placed in the maxillary anterior region was significantly higher than other regions. The failure rates of implants that were placed 5 years ago or more were higher than those that were placed later. CONCLUSIONS: Anterior maxilla is more critical for implant loss than other sites. Implants in the anterior mandible show better success compared with other locations, and longer implants show better success rates. The learning curve of the clinician influences survival and success rates of dental implants.

Comparison of internal fit between implant abutments and cast metal crowns vs laser-sintered crowns.

AIM: A common problem related to cemented single crowns is the internal misfit, which may cause inadequate retention, especially when seated on the implant abutment. The aim of this study was to compare the internal fit of Co-Cr crowns using a traditional lost-wax casting technique from laser-sintered Co-Cr alloy crowns. MATERIALS AND METHODS: Twelve metallic crowns per each technique were fabricated. The effect of the thickness of cement, originated internal gap was evaluated. Crowns were cemented on the implant abutments with resin cement, and the internal fit of crowns was measured at five areas with an optical microscope. The data were analyzed, and the means were compared with a t-test (p<0.05). RESULTS: The internal gap width measurements for the laser-sintered group (min. 52.19 ± 11.61 µm and max. 140.01 ± 31.84 µm) indicated the presence of a significantly closed internal gap compared to the crowns obtained through the lost wax method (min. 65.50 ± 9.54 µm and max. 313.46 ± 48.12 µm). CONCLUSION: The fit of the metal crown likely varies with the fabrication technique. The use of techniques that enable the adjustment of crown parameters, such as the laser sintering technique, maintains the desired fit between casting and implant abutments. CLINICAL SIGNIFICANCE: This study investigated which technique affects the internal fit of cemented implant-supported crowns, comparing the use of lost wax casting and laser-sintered metal dental alloys. The results of this study indicate that the use of laser-sintered crowns can improve for crown accuracy.

Expectancy from, and acceptance of augmented reality in dental education programs: A structural equation model.

OBJECTIVE: Dental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use. METHODS: A correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's ɑ, and composite reliability. Ten primary research hypotheses are tested with path analysis. RESULTS: A total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, ß = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, ß = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, ß = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, ß = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, ß = 0.046, L = 0.026, U = 0.086, p = 0.054). CONCLUSION: Infrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.

Evaluation of bite force, quality of life, and patients' satisfaction in elderly edentulous patients using implant overdentures.

Purpose: This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. Materials and methods: A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. Results: It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. Conclusion: Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

Comparison of Periodontal Health and Marginal Bone Loss in Mandibular First Molar Single-Crown Dental Implants Placed in Different Positions.

The aim of the present study is to compare the periodontal health and marginal bone loss (MBL) between single-crown dental implants placed interdentally and mesial to the edentulous space. Patients treated with single-crown dental implants between 01/04/2014 and 01/04/2021 were included in the study. The included patients were divided into 2 groups. Group 1 consisted of single implant crowns inserted interdentally with a distal neighboring mandibular second molar and Group 2 consisted of single molar implant crowns inserted distally to the second premolar tooth without a neighboring second molar. The measurements for probing pocket depth, gingival index, and plaque index were made in both groups at the 60-month control session to evaluate periodontal health of the single-crown dental implants. The marginal bone levels of distal and mesial aspects of all implants were measured at the 60-month control session on panoramic radiographs. Forty-six and sixty-one patients were included in Groups 1 and 2, respectively. There was a significantly higher distal MBL in Group 2 compared with Group 1 (P < 0.05). Mesial MBL was higher in Group 1, however, this difference was not significant. The periodontal parameters of probing pocket depth, gingival index, and PI were all significantly higher in Group 1 compared with Group 2 at the 60-month control evaluation (P < 0.05). Single-crown dental implants placed interdentally may show decreased distal MBL and periodontal health compared with single-crown dental implants placed mesial to the edentulous space.

The effects of metal nanoparticles incorporation on the mechanical properties of denture base acrylic resin.

Purpose: The aim of this study was to examine the flexural strength of acrylic resin base material incorporated with iron, copper, and titanium nanoparticles. Materials and methods: Seventy bars of samples (65x10x2.5 mm3) were divided into seven groups. Acrylic samples were prepared according to the manufacturer's instructions. Fe2O3, CuO and TiO2 nanoparticles were manually added in a proportion of 1wt% and 3wt% to the heat-polymerized acrylic resin. The Universal Testing Machine was used for 3-point flexural test of 5 mm/min force. ANOVA and Weibull analyses were used for the statistical analyses. Results: A statistical difference was found between the nanoparticle-added group and the control group. The highest mean value was observed for the 1wt% TiO2 added group, (84.99 MPa) and the lowest value was for the 3wt% CuO added group (71.32 MPa) (p<0,001). The 3wt% Fe2O3 and CuO added groups showed lower values than the control group. Conclusion: The incorporation of TiO2 nanoparticles into acrylic resin in a proportion of 1wt% increased the flexural strength values of the resins. Within the limitations, the nanoparticle addition to acrylic resins could improve the mechanical properties; however, when the percentage of nanoparticle addition increases, the flexural strength values of the acrylic resins decrease.

The Antibacterial and Antifungal Activity of Chlorhexidine Diacetate Incorporated into Acrylic Resins Used in Provisional Restorations.

Objective: The surface of provisional restorations applied before conventional or implant- supported fixed restorations may cause bacterial or fungal biofilm formation. The aim of this study was to evaluate the antimicrobial activity of acrylic resins used in provisional restorations modified with chlorhexidine diacetate. Methods: 120 cylindrical, auto-polymerized resin samples modified with chlorhexidine diacetate were prepared at concentrations of 0 (control), 1, 3, 5 wt %. The antimicrobial activity was examined against Streptococcus mutans, Enterococcus faecalis, and Candida albicans using Crystal Violet quantification, MTT assay, and Scanning Electron Microscopy. Data were analyzed by ANOVA and paired sample t-tests (α=0.05). Results: The addition of chlorhexidine diacetate influenced the growth rate and metabolic activity of microorganisms. The antimicrobial effect against C. albicans and S. mutans statistically increased with the percentage of chlorhexidine diacetate. E. faecalis bacteria were less affected by chlorhexidine diacetate compared to other pathogens. Conclusion: It has been shown that the effectiveness of CHDA in inhibiting the proliferation of microorganisms correlated positively with increasing concentration levels. More research is needed to confirm the impact of different chlorhexidine concentrations on the mechanical properties, clinical efficacy, and antimicrobial properties of CDHA.

Anti-adherent activity of nano-coatings deposited by thermionic vacuum arc plasma on C. albicans biofilm formation.

BACKGROUND: The purpose of this study was to analyze the anti-adherent activity of nano-coatings deposited by Thermionic Vacuum Arc plasma on C. albicans ATCC 10231 biofilm. MATERIALS AND METHODS: A total of 80 disc-shaped (2 × 10 mm) polymethymethacrylate samples were prepared and divided into four groups with 10 samples in each group (Control, ZnO, SnO2, Ag) (n = 10). Using thermionic vacuum arc plasma, they were coated with ZnO, SnO2, and Ag. 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and Crystal Viole (CV) assays were conducted for biofilm quantification. Scanning electron microscopy (SEM) was used to observe biofilm images of C. albicans biofilm. RESULTS: MTT and CV mean values differ statistically significantly between all groups (p ⩽ 0.05). The SnO2 group had the lowest mean value, whereas the control group received the highest value. CONCLUSION: SnO2 coating shown greater anti-adherent activity than either metal oxides. C. albicans biofilm formation on denture base surfaces is reduced following Thermionic Vacuum Arc plasma coating with SnO2.

The effect of attachment type and implant number on satisfaction and quality of life of mandibular implant-retained overdenture wearers.

OBJECTIVE: The aim of this study was to compare the quality of life and patient satisfaction outcomes of two attachment systems in mandibular overdentures with different numbers of supporting implants. MATERIALS AND METHODS: Sixty-two edentulous patients with either splinted or single attachments in mandibular implant overdentures with different numbers of supporting interforaminal implants were investigated for patient satisfaction and quality of life in this retrospective study. Comparisons between groups were perceived by the Mann-Whitney U test. Relations among the parameters were investigated by Spearman's rho correlation analysis. The results were evaluated statistically at a significance level of p < 0.05. RESULTS: No statistically significant association is found between visual analogue scales scores and attachment type as well as implant number (p > 0.05), whereas Oral Health Impact Profile (OHIP)-14 total scores for patients with 4-implant-supported bars were significantly lower than all the other attachment types (p < 0.05). Additionally, a negative (rate = 32.2%), statistically significant association between period of edentulism and total OHIP-14 scores was detected (p < 0.05). CONCLUSIONS: A mandibular implant-retained overdenture supported with four implants and bar attachments shows the highest 'quality of life' score and patient satisfaction is not influenced by the number of implants or attachment type.

The influence of implant number and attachment type on maximum bite force of mandibular overdentures: a retrospective study.

AIM: Assessment of the influence of such factors as attachment type, number of implants, gender and age of patients on maximum bite force (MBF). MATERIAL AND METHODS: Sixty-two edentulous patients (32 females, 30 males; aged 64.03 ± 10.07 years, range 42-90 years) with mandibular implant overdentures with various attachment types were included in the study and their MBFs were recorded. The results were evaluated statistically at a significance level of p < 0.05. RESULTS: The MBF in male patients was found to be statistically significantly (p < 0.05) higher than in female patients. No statistically significant differences (p > 0.05) were found with respect to age groups, attachment types and number of implants supporting the mandibular overdentures. CONCLUSION: Within the limitations of this study, it is concluded that independent of the number applied, dental implants increase MBF in edentulous patients. While males show higher bite force, patient age and attachment type seem not to play an important role.

The influence of maximum bite force on patient satisfaction and quality of life of patients wearing mandibular implant overdentures.

The treatment of edentulism with traditional complete dentures can often induce impaired masticatory function due to limited retention and stability, especially in the lower jaw. Mandibular interforaminal implants have been widely used to stabilize the dentures, consequently improving masticatory performance in edentulous individuals. The aim of the present study was to document the influence of this improved masticatory function on patient satisfaction and quality of life of patients wearing mandibular implant-supported overdentures. Sixty-two patients treated with various types of implant-supported mandibular overdentures between 2004 and 2007 were included in this retrospective study. Maximum bite force (MBF) was measured bilaterally using a device with 2 strain gauges connected to a strain gauge measurement system. All the included patients were asked to fill out visual analog scale (VAS) forms based on general and chewing satisfaction and OHIP-14 forms. Results were analyzed by the Spearman rho test. No statistically significant correlation was found between MBF values and VAS general or VAS chewing satisfaction or Oral Health Impact Profile scores (P > .05). The results indicate that MBF is not associated with the satisfaction or quality of life of implant-supported mandibular overdenture wearers.

Precision of implant placement with stereolithographic templates: a pilot in vitro study.

This pilot study assesses the accuracy of 2 bone-supported stereolithographic surgical templates with respect to placement of implants in originally planned positions, and it tests the precision of dental volumetric tomography planning. Two mandibles retrieved from formalin-fixed human cadavers were scanned by dental volumetric tomography for planning of the implant positions, leading to stereolithographic models and fabrication of surgical guides. The situation immediately following drilling and implant insertion by an experienced surgeon was scanned and the outcome compared with the initial planning. The 3-dimensional discrepancies were then analyzed and determined. The results show deviations of the placed implants from the original planning, especially in the vertical direction, making the seating of a prefabricated denture impossible. At present, the flapless surgery technique based on stereolithographic surgical templates appears unsafe; further improvement is required.

Biomechanical investigation of maxillary implant-supported full-arch prostheses produced with different framework materials: a finite elements study.

PURPOSE: Four and six implant-supported fixed full-arch prostheses with various framework materials were assessed under different loading conditions. MATERIALS AND METHODS: In the edentulous maxilla, the implants were positioned in a configuration of four to six implant modalities. CoCr, Ti, ZrO2, and PEEK materials were used to produce the prosthetic structure. Using finite element stress analysis, the first molar was subjected to a 200 N axial and 45° oblique force. Stresses were measured on the bone, implants, abutment screw, abutment, and prosthetic screw. The Von Mises, maximum, and minimum principal stress values were calculated and compared. RESULTS: The maximum and minimum principal stresses in bone were determined as CoCr < ZrO2 < Ti < PEEK. The Von Mises stresses on the implant, implant screw, abutment, and prosthetic screws were determined as CoCr < ZrO2 < Ti < PEEK. The highest Von Mises stress was 9584.4 Mpa in PEEK material on the prosthetic screw under 4 implant-oblique loading. The highest maximum principal stress value in bone was found to be 120.89 Mpa, for PEEK in 4 implant-oblique loading. CONCLUSION: For four and six implant-supported structures, and depending on the loading condition, the system accumulated different stresses. The distribution of stress was reduced in materials with a high elastic modulus. When choosing materials for implant-supported fixed prostheses, it is essential to consider both the number of implants and the mechanical and physical attributes of the framework material.

Influence of atmospheric pressure changes on dentin bond strength of conventional, bulk-fill and single-shade resin composites.

INTRODUCTION: The purpose of this study was to investigate the dentin bond strength of composite resins in response to environmental pressure changes. METHODS: Ninety extracted human molar teeth were used. A mould (3 mm x 4 mm) was adapted on dentin, resin composites (conventional [n = 30] and single-shade composites [Ohmnicroma] [n = 30]) were filled in two increments of 2 mm. The bulk-fill composites (n = 30) were filled with one 4 mm increment. The specimens were stored for 30 days in artificial saliva. The specimens were exposed to hyperbaric pressure (283.6 kPa; 2.8 atmospheres absolute [atm abs]) or hypobaric pressure (34.4 kPa; 0.34 atm abs) once daily for 30 days and the control group was stored at atmospheric pressure for 30 days. The bond strength was tested with a universal testing machine and the failures were examined with a stereomicroscope and scanning electron microscope. Statistical analyses were performed using analysis of variance with post hoc tests, and the Weibull analysis. RESULTS: Regardless of environmental pressure changes, the bulk-fill composites showed the highest bond strength. There was no significant difference in bond strength between the hypobaric and atmospheric pressure (control) groups after 30 days in all resins. The hyperbaric group showed lower bond strength for bulk-fill composites than the control group. CONCLUSIONS: Dentists experienced in diving and aviation medicine should definitely take part in the initial and periodic medical examinations of divers and aircrew to give appropriate treatment. Bulk-fill composite resins can be preferred in divers and aircrew due to high bond strength values.

Effect of Potassium Aluminum Sulfate Application on the Viability of Fibroblasts on a CAD-CAM Feldspathic Ceramic before and after Thermocycling.

Potassium aluminum sulfate (alum) is a known adjuvant, which has been used as a mordant in textile industry for color fixation. This material has potential to be incorporated into dentistry for color stability, yet its toxicity first needs to be evaluated. The present study aimed to evaluate the cytotoxic potential of potassium aluminum sulfate (alum) on fibroblasts when applied onto feldspathic ceramic before and after thermocycling. Forty-eight feldspathic ceramic specimens were divided into four groups (FC: no alum application or thermocycling; FCT: thermocycling without alum application; FA: alum application without thermocycling; FAT: alum application and thermocycling) (n = 12). Cell viability was assessed by using a tetrazolium salt 3-[4,5-dimethylthiazol-2-yl]-2,5-diphnyltetrazolium bromide assay at 24 and 72 h, and cell cultures without any ceramic specimens served as control (C). One sample from each material group was further analyzed with energy dispersive X-ray spectroscopy (EDX). Cell viability at different time intervals within each group was analyzed with Friedman tests, while Kruskal−Wallis tests were used to compare the test groups within each time interval. Pairwise comparisons were further resolved by using Wilcoxon tests (a = 0.05). C had lower (p = 0.01) and FA had higher (p = 0.019) cell viability after 72 h. After 24 h, the highest cell viability was observed in C (p ≤ 0.036). After 72 h, the differences between C and FA, C and FAT, FC and FA, and FCT and FAT were nonsignificant (p > 0.05). Cell viability was not affected by alum application or thermocycling at any time interval (p ≥ 0.631). EDX analysis showed an increase in potassium concentration in FA and FAT when compared with FC and FCT. Regardless of the time interval, alum application onto feldspathic ceramic and thermocycling did not influence the cell viability.