The influence of Zirconia and Fiber posts with different lengths on Fracture strength of Maxillary Central Incisors restored with zirconia crowns - An in vitro study.

PURPOSE: Endodontically treated teeth are more susceptible to fractures than vital teeth because of significant coronal and radicular dentin loss during endodontic therapeutic procedures. The objective of this study was to estimate and compare the influence of length and post type on the fracture strength of endodontically treated maxillary central incisors. MATERIAL AND METHODS: In this in vitro study, sixty extracted human maxillary central incisors were decoronated 2 mm above the cemento-enamel junction.They were selected and subjected to standard endodontic treatment ,resulting in preparation with lengths of 5 mm (group 5mm),7,5 mm (group 7,5 mm) and 10 mm (group 10mm). Each group was randomly divided into 2 subgroups according to the post type , zirconia and fiber post. After appropriate surface treatment,they were cementet with resin adhesive cement and restored with zirconia crowns. Thermocycling (5 -55°C, 60 seconds, 1500 cycles) was performed after cementing the zirconia crowns on each tooth. Prepared samples were subjected to compresive static load of 0.5mm / min, at an angle of 130° to the long axis of the roots, using Universal Testing Machine (Matest ) at an cross head speed of 0.5 mm / min, until fracture.The significance of the results was assessed using 2-way ANOVA and the Tukey-Kramer test (α=0.05) Results:The ANOVA analysis indicated significant differences (P<0.05) between the groups. Tukey test revealed no significant difference among the zirconia posts of 5-mm length (26.5 N ±13.4) 7,5-mm length (25.2 N ±13.9), and 10-mm length (17.1 N ±5.2). Also, in the fiber post group, there was no significant difference when posts of 7.5-mm length (13.4 N ±11.0) were compared with the 5-mm (6.9 N ±4.6) and 10-mm (31.7 N ±13.1) groups. The 10-mm long post displayed superior fracture strength, and the 5mm-long post showed significantly lower mean values (P<0.001). CONCLUSION: The fracture strength of zirconia posts (5-mm and 7,5- mm length)was found to be significantly higher than those of fiber posts (5-mm and 7,5- mm length). The 10-mm long fiberpost group demonstrated significantly higher values of fracture strengths and the 5-mm long fiberpost group showed the lowest values for the force resulting in root fracture; these groups were significantly different from each other (P<.001).The fracture strength analysis with Universal Testing Machine is the only method that enables us to estimate the differences between zirconia and fiber posts with different lengths on endodontically treated teeth.

Modern Applications and Innovations of 3D Dental Imaging.

Recent improvements in imaging techniques have profoundly facilitated the diagnosis of pathologies of the maxillofacial district and provided all the information necessary to plan an adequate treatment plan. Three-dimensional (3D) radiographic diagnostic exams, reworked by specific software that allow easy viewing of images and various graphic reworkings, are frequently applied to maxillofacial district for the diagnosis of various pathologies, which, until a few years ago, required several radiographic examinations.1,2.

THE IMPACT OF THE DIABETES ON ORAL HEALTH - AN OBSERVATIONAL STUDY.

OBJECTIVE: The aim: To evaluate the impact of diabetes mellitus on the oral health. PATIENTS AND METHODS: Materials and methods: This is an observational study. In the present research were taken into consideration 300 patients. The study sample consisted of 191 males, respectively (63.7%) of them and 109 females (36.3%) of the participants. RESULTS: Results: In the current study, we analyzed the oral health of diabetic patients within the age class of 11-80 years. We divided them into seven age groups: 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 years. Based on the results of the current study it was observed that 83.7% of patients were affected by gingivitis. The results of our study show that dental caries prevalence was 68.7 % and the prevalence of missing teeth among patients with diabetes mellitus was 78.7%. According to the ANOVA test, high blood sugar values had a direct impact on the manifestation of gingivitis and there it was a strong correlation between them P-value = .000. Males with diabetes mellitus were more affected by dental caries and this was indicated by the P-value= .02, in comparison to females who recorded a P-value = .03. The relation between gender males and missing teeth was highly significant P-value = .001. CONCLUSION: Conclusions: The present study proved that diabetes mellitus is risk factor for oral health. The authors studied this group of patients exposed to high blood glucose levels and found out that oral diseases were high in these patients.

Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature.

Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.

Incidence of Different Types of Intracanal Fracture of Nickel-Titanium Rotary Instruments: A Systematic Review.

AIM: The aim of this systemic review is to investigate these parameters by analyzing the characteristics of fractured instruments to determine which is the most relevant mechanical stress that induces intracanal separation in vivo. BACKGROUND: The fracture of nickel-titanium (Ni-Ti) instruments is a result of flexural fatigue and torsional fatigue. An electronic search was conducted in MEDLINE database, Web of Science, and Cochrane following preferred reporting items for systematic reviews and meta-analyses guidelines. Data were collected and the key features from the included studies were extracted. Overview quality assessment questionnaire scoring assessed the quality of the articles. A total of 12 articles were selected, where the lowest score was 13. REVIEW RESULTS: Considering Ni-Ti rotary instruments, this overall evaluation comprehends 939 broken instruments with an incidence of fracture of 5%. Out of the 12 selected articles, 10 studies revealed that flexural failure was the predominant mode (range of 62-92%). It appears that motion plays an important role when it comes to mechanisms of fracture. The majority of defects found in hand-operated instruments were in the form of torsional failure. Although the major cause of separation of rotary instruments is flexural fatigue, smaller instruments show more torsional fracture than the larger instruments. The average fragment length was found to be 2.5 mm and 3.35 mm, respectively, for torsional failure and flexural failure. The risk of bias depends on fractographic analysis. CONCLUSION: Flexural fatigue is the predominant mode of fracture in rotary Ni-Ti instruments. The type of motion and size of the instrument seem to affect the mechanism of fracture. Fragment length may show a strong association with the type of fracture mechanism. CLINICAL SIGNIFICANCE: This systemic review found that flexural fatigue is the most relevant mechanical stress that induces intracanal separation in vivo. Moreover, in clinical practice, the fragment length might be an excellent indicator of the type of fracture.

Minimal invasive prosthetic rehabilitation of a patient with Down syndrome: A case report.

INTRODUCTION: Down syndrome (DS), an easily recognized congenital disease, is associated with a high prevalence of dental anomalies. Therefore, special dental care is required. CASE PRESENTATION: This case report described the minimally invasive prosthetic rehabilitation of a 31-year-old female patient with DS. Prompt diagnosis, consultation with physicians and family, and accurate medical history were needed, and relevant dental, medical, mental, and behavioral factors were considered. A minimally invasive treatment plan was decided after clinical examination, orthopantomography (OPG), and study model analysis. For the upper jaw, an over denture was constructed. For the lower jaw, a simple metal-frame partial denture was made. This treatment plan was decided after considering the difficulty in dentist-patient collaboration and a small maxilla with poor positioning of teeth and negative overbite and over jet. CONCLUSION: Considering different patient factors including patient cooperation, as well as the medical and dental conditions associated with DS, a minimally invasive prosthodontic treatment option was recommended.

Antibiotic prescribing patterns among dentists in Italy and Albania: A comparative questionnaire analysis.

Objective: To investigate the therapeutic and prophylactic use of antibiotics in dentistry in two countries. Methods: This study used questionnaires to examine the prescribing habits of dentists in Italy (9th country in Europe for systemic antibiotic administration) and Albania an Extra European Union Country. A total of 1300 questionnaires were sent to Italian and Albanian dentists. Results: In total, 180 Italian and 180 Albanian dentists completed the questionnaire. Penicillin use was higher in Italy (96.6 %) than Albania (82.8 %). Only 26.1 % of Italian dentists and 32 % of Albanian dentists followed the national guidelines for antibiotic administration. Conclusions: Dentists tend to overprescribe antibiotics for treating existing conditions or as prophylaxis. They also highlighted a lack of adherence to established guidelines for antibiotic use. In addition, factors such as age, nationality, and sex appeared to influence the choice of antibiotics. Clinical significance: Recently, the growth of antibiotic-resistant bacteria has become a global concern. The authors of this article highlight how dentists often prescribe antibiotics without a real need. Limiting the use of antibiotics in this category may help mitigate antibiotic resistance.

Minimally invasive gingival phenotype modification in gingival recession associated with a non-carious cervical lesion using the root plastique technique: A quasi-experimental one-group pretest-posttest study.

BACKGROUND: This study introduces the root plastique technique (RPT), the aim of which is to modify the gingival phenotype of sites with gingival recessions (GRs) associated with non-carious cervical lesions (NCCLs) prior to surgical treatment. METHODS: RPT was performed in 22 subjects with 53 RT1 A/B + GRs. Changes in keratinized tissue thickness (KTT), keratinized tissue width (KTW), relative gingival recession (RGR), relative clinical attachment level (RCAL), and probing pocket depth (PPD) were measured at baseline (T0) and 2 months (T1) after the procedure was performed. All analyses were performed by means of hierarchical models. RESULTS: The study revealed statistically significant changes (P < 0.01) in KTT (0.45 ± 0.04 mm), RGR (0.80 ± 0.13 mm), KTW (0.67 ± 0.07 mm), and RCAL (-0.72 ± 0.16 mm). No changes in PPD (P > 0.05) were observed. Regression analyses of KTT increase and RGR reduction at T0 showed statistically significant correlation between the two variables (P < 0.05). All the teeth with a KTT of <0.8 mm at T0 (N = 14) reached or surpassed this threshold at T1. CONCLUSION: RPT increases KTT and KTW. In most of the sites, a reduction in GR was also achieved.

An Update on Advanced Diagnostic Imaging in Dentistry.

In recent years, CBCT has proved to be extremely widely used and widespread in dentistry [...].

Accuracy of DICOM-DICOM vs. DICOM-STL Protocols in Computer-Guided Surgery: A Human Clinical Study.

Guided implant surgery can enhance implant placement positioning, increasing predictability and decreasing postoperative complications., To date, the best protocol to be used for template realization is still unknown. Thus, the aim herein was to clinically compare the accuracy of two different protocols. A total of 48 implants were divided into Group A (24 implants), in which a stereolithographic template was realized using the digital imaging and communications in medicine (DICOM) data arrived from cone beam computer tomographies (CBCTs) (patients and prothesis alone), and Group B (24 implant), in which a standard intraoral stent with a standardized extraoral support was used for patients' intraoral impressions and CBCT. The preimplant virtual planning and postsurgery CBCT images of both groups were superimposed, and differences were registered in terms of average deviations at the platform (a) and implant apex (b), mean depth change (c), and angular deviation (d). The results demonstrated that there were no statistically significant differences between groups (p = 0.76) for the parameters measured. However, statistically significant differences (p < 0.05) were found between maxillary and mandible implant surgery, as the latter showed greater accuracy. Additional studies are necessary to further reduce discrepancies between planning and surgical procedures.