This study aimed to evaluate the accuracy of intraoral scanners in full-arch scans.A representative model with 14 prepared abutments was digitized using an industrial scanner (reference scanner) as well as four intraoral scanners (iTero, CEREC AC Bluecam, Lava C.O.S., and Zfx IntraScan). Datasets obtained from different scans were loaded into 3D evaluation software, superimposed, and compared for accuracy. One-way analysis of variance (ANOVA) was implemented to compute differences within groups (precision) as well as comparisons with the reference scan (trueness). A level of statistical significance of p < 0.05 was set.Mean trueness values ranged from 38 to 332.9 μm. Data analysis yielded statistically significant differences between CEREC AC Bluecam and other scanners as well as between Zfx IntraScan and Lava C.O.S. Mean precision values ranged from 37.9 to 99.1 μm. Statistically significant differences were found between CEREC AC Bluecam and Lava C.O.S., CEREC AC Bluecam and iTero, Zfx Intra Scan and Lava C.O.S., and Zfx Intra Scan and iTero (p < 0.05).Except for one intraoral scanner system, all tested systems showed a comparable level of accuracy for full-arch scans of prepared teeth. Further studies are needed to validate the accuracy of these scanners under clinical conditions.Despite excellent accuracy in single-unit scans having been demonstrated, little is known about the accuracy of intraoral scanners in simultaneous scans of multiple abutments. Although most of the tested scanners showed comparable values, the results suggest that the inaccuracies of the obtained datasets may contribute to inaccuracies in the final restorations.
The aim of the study was to assess the thickness of softened enamel removed by toothbrushing. Human enamel specimens were indented with a Knoop diamond. Softening was performed with citric acid or orange juice. The specimens were brushed in a brushing machine with a manual soft toothbrush in toothpaste slurry or in artificial saliva. Enamel loss was calculated from the change in indentation depth of the same indent before and after abrasion. Mean surface losses (95% confidence interval) were recorded in treatment groups (in nanometers): (1) citric acid, abrasion with slurry = 339 (280–398); (2) citric acid, abrasion with artificial saliva = 16 (5–27); (3) orange juice, abrasion with slurry = 268 (233–303); (4) orange juice, abrasion with artificial saliva = 14 (5–23); (5) no softening, abrasion with slurry = 28 (10–46). The calculated thickness of the softened enamel varied between 254 and 323 nm, depending on the acid used.
Digital impression techniques are advertised as an alternative to conventional impressioning. The purpose of this in vitro study was to compare the accuracy of full ceramic crowns obtained from intraoral scans with Lava C.O.S. (3M ESPE), CEREC (Sirona), and iTero (Straumann) with conventional impression techniques.A model of a simplified molar was fabricated. Ten 2-step and 10 single-step putty-wash impressions were taken using silicone impression material and poured with type IV plaster. For both techniques 10 crowns were made of two materials (Lava zirconia, Cera E cast crowns). Then, 10 digital impressions (Lava C.O.S.) were taken and Lava zirconia crowns manufactured, 10 full ceramic crowns were fabricated with CEREC (Empress CAD) and 10 full ceramic crowns were made with iTero (Copran Zr-i). The accessible marginal inaccuracy (AMI) and the internal fit (IF) were measured.For AMI, the following results were obtained (mean ± SD): overall groups, 44 ± 26 μm; single-step putty-wash impression (Lava zirconia), 33 ± 19 μm; single-step putty-wash impression (Cera-E), 38 ± 25 μm; two-step putty-wash impression (Lava zirconia), 60 ± 30 μm; two-step putty-wash impression (Cera-E), 68 ± 29 μm; Lava C.O.S., 48 ± 25 μm; CEREC, 30 ± 17 μm; and iTero, 41 ± 16 μm. With regard to IF, errors were assessed as follows (mean ± SD): overall groups, 49 ± 25 μm; single-step putty-wash impression (Lava zirconia), 36 ± 5 μm; single-step putty-wash impression (Cera-E), 44 ± 22 μm; two-step putty-wash impression (Lava zirconia), 35 ± 7 μm; two-step putty-wash impression (Cera-E), 56 ± 36 μm; Lava C.O.S., 29 ± 7 μm; CEREC, 88 ± 20 μm; and iTero, 50 ± 2 μm.Within the limitations of this in vitro study, it can be stated that digital impression systems allow the fabrication of fixed prosthetic restorations with similar accuracy as conventional impression methods.Digital impression techniques can be regarded as a clinical alternative to conventional impressions for fixed dental restorations.
The aim of this study was to quantify the blue light that passes through different incremental thicknesses of bulk fill in comparison to conventional resin-based composites (RBCs) and to relate it to the induced mechanical properties.Seven bulk fill, five nanohybrid and two flowable RBCs were analysed. Specimens (n = 5) of three incremental thicknesses (2, 4 and 6 mm) were cured from the top for 20 s, while at the bottom, a spectrometer monitored in real time the transmitted irradiance. Micro-mechanical properties (Vickers hardness, HV, and indentation modulus, E) were measured at the top and bottom after 24 h of storage in distilled water at 37 °C. Electron microscope images were taken for assessing the filler distribution and size.Bulk fill RBCs (except SonicFill) were more translucent than conventional RBCs. Low-viscosity bulk fill materials showed the lowest mechanical properties. HV depends highly on the following parameters: material (ηp 2 = 0.952), incremental thickness (0.826), filler volume (0.747), filler weight (0.746) and transmitted irradiance (0.491). The bottom-to-top HV ratio (HVbt) was higher than 80 % in all materials in 2- and 4-mm increments (except for Premise), whereas in 6-mm increments, this is valid only in four bulk fill materials (Venus Bulk Fill, SDR, x-tra fil, Tetric EvoCeram Bulk Fill).The depth of cure is dependent on the RBC’s translucency. Low-viscosity bulk fill RBCs have lower mechanical properties than all other types of analysed materials. All bulk fill RBCs (except SonicFill) are more translucent for blue light than conventional RBCs.Although bulk fill RBCs are generally more translucent, the practitioner has to follow the manufacturer’s recommendations on curing technique and maximum incremental thickness.
The aim of this study was to evaluate the marginal adaptation of CEREC ceramic inlays, CEREC composite inlays and direct composite restorations in unbeveled proximal slot cavities under artificial aging conditions. Two groups of each restoration type were prepared (n = 6), one group with a self-etch adhesive, the other group with H3PO4 enamel etching before the self-etch adhesive application. Replicas were generated before and after long-term thermo-mechanical loading under dentinal fluid simulation and margins were evaluated at ×200 magnification in the scanning electron miscroscope (SEM). Statistically, significant differences were found before and after loading with respect to the percentages of “continuous margins”, the direct composite filling with H3PO4 enamel etching giving the lowest percentages of “continuous margins” after loading (p < 0.05). The highest percentage of “continuous margin” was attained by composite inlays without H3PO4 enamel etching. However, these results were not significantly different from ceramic inlays after stressing. Polymerization shrinkage is still one critical property of composite restorative materials. The marginal adaptation of indirect adhesive proximal slot restorations without enamel bevels both fabricated out of composite and ceramic is better than that of directly placed composite restorations.
The aim of our study was to measure and compare degree of conversion (DC) as well as micro- (indentation modulus, E; Vickers hardness, HV) and macromechanical properties (flexural strength, σ; flexural modulus, E flexural) of two recently launched bulk fill resin-based composites (RBCs): Surefil® SDR™ flow (SF) and Venus® bulk fill (VB).DC (n = 6) was investigated by Fourier transform infrared spectroscopy (FTIR) in clinical relevant filling depths (0.1, 2, and 4 mm; 6 mm bulk, 6 mm incremental) and irradiation times (10, 20, 40 s). Micro- (n = 6) and macromechanical (n = 20) properties were measured by an automatic microhardness indenter and a three-point bending test device after storing the specimens in distilled water for 24 h at 37°C. Furthermore, on the 6-mm bulk samples, the depth of cure was determined. A field emission scanning electron microscope was used to assess filler size. Results were evaluated using one-way analysis of variance, Tukey’s honest significance test post hoc test, a multivariate analysis (α = 0.05) and an independent t test. Weibull analysis was used to assess σ.VB showed, in all depth, significant higher DC (VB, 62.4–67.4 %; SF, 57.1–61.9 %), but significant lower macro- (VB, E flexural = 3.6 GPa; σ = 122.7 MPa; SF, E flexural = 5.0 GPa; σ = 131.8 MPa) and micromechanical properties (VB, E = 7.3–8.8 GPa, HV = 40.7–46.5 N/mm²; SF, E = 10.6–12.2 GPa, HV = 55.1–61.1 N/mm²). Both RBCs showed high reliability (VB, m = 21.6; SF, m = 26.7) and a depth of cure of at least 6 mm at all polymerization times. The factor “RBC” showed the strongest influence on the measured properties (η 2 = 0.35–0.80) followed by “measuring depth” (η 2 = 0.10–0.46) and “polymerization time” (η 2 = 0.03–0.12).Significant differences between both RBCs were found for DC, E, σ, and E flexural at all irradiation times and measuring depths.Curing the RBCs in 4-mm bulks for 20 s can be recommended.
The purpose of this prospective study was to evaluate the clinical outcome of anterior and posterior crowns made of a lithium-disilicate glass–ceramic framework material (IPS e.max Press, Ivoclar Vivadent).A total of 104 single crowns were placed in 41 patients (mean age, 34 ± 9.6 years; 15 male, 26 female). Eighty-two anterior and 22 posterior crowns were inserted. All teeth received a 1-mm-wide chamfer or rounded shoulder preparation with an occlusal/incisal reduction of 1.5–2.0 mm. The minimum framework thickness was 0.8 mm. Frameworks were laminated by a prototype of a veneering material combined with an experimental glaze. Considering the individual abutment preconditions, the examined crowns were either adhesively luted (69.2 %) or inserted with glass–ionomer cement (30.8 %). Follow-up appointments were performed 6 months after insertion, then annually. Replacement of a restoration was defined as failure.Four patients (10 crowns) were defined as dropouts. For the remaining 94 crowns, the mean observation time was 79.5 months (range, 34–109.7 months). The cumulative survival rate according to Kaplan–Meier was 97.4 % after 5 years and 94.8 % after 8 years. Applying log rank test, it was shown that the location of the crown did not significantly have an impact on the survival rate (p = 0.74) and that the cementation mode did not significantly influence the occurrence of complications (p = 0.17).The application of lithium-disilicate framework material for single crowns seems to be a reliable treatment option.Crowns made of a lithium-disilicate framework material can be used clinically in the anterior and posterior region irrespective of an adhesive or conventional cementation when considering abutment preconditions.
With direct and indirect digitalisation, two access points to CAD/CAM-generated restorations are available. The aim of this study was to compare the accuracy of the single steps of both approaches by comparing construction datasets using a new methodology.Twelve test datasets were generated in vitro (1) with the Lava Chairside Oral Scanner (COS) (2) by digitizing polyether impressions (IMP) and (3) by scanning the referring gypsum cast by the Lava Scan ST laboratory scanner (ST) at a time. Using an inspection software, these datasets were superimposed by a best fit algorithm with the reference dataset (REF), gained from industrial computed tomography, and divergences were analysed.On the basis of average positive and negative deviations between test- and REF datasets, it could be shown that direct digitalisation accomplished the most accurate results (COS, 17 μm/−13 μm; SD ± 19 μm), followed by digitized polyether impression (IMP, 23 μm/−22 μm; SD ± 31 μm) and indirect digitalisation (ST, 36 μm/−35 μm; SD ± 52 μm). The mean absolute values of Euclidean distances showed the least values for COS (15 μm; SD ± 6 μm), followed by IMP (23 μm; SD ± 9 μm) and ST (36 μm; SD ± 7 μm). The mean negative and mean absolute values of all groups were significantly different. Comparing the mean positive values of the groups, IMP and COS (p = 0.082) showed no significant difference, whereas ST and COS, and ST and IMP exhibited statistically significant differences.Within the limitations of this in vitro study, the direct digitalisation with Lava C.O.S. showed statistically significantly higher accuracy compared to the conventional procedure of impression taking and indirect digitalisation.Within the limitations of this study, the method of direct digitalisation seems to have the potential to improve the accuracy of impressions for four-unit FDPs.
The use of platelet concentrates has gained increasing awareness in recent years for regenerative procedures in modern dentistry. The aim of the present study was to compare growth factor release over time from platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and a modernized protocol for PRF, advanced-PRF (A-PRF).Eighteen blood samples were collected from six donors (3 samples each for PRP, PRF, and A-PRF). Following preparation, samples were incubated in a plate shaker and assessed for growth factor release at 15 min, 60 min, 8 h, 1 day, 3 days, and 10 days. Thereafter, growth factor release of PDGF-AA, PDGF-AB, PDGF-BB, TGFB1, VEGF, EGF, and IGF was quantified using ELISA.The highest reported growth factor released from platelet concentrates was PDGF-AA followed by PDGF-BB, TGFB1, VEGF, and PDGF-AB. In general, following 15–60 min incubation, PRP released significantly higher growth factors when compared to PRF and A-PRF. At later time points up to 10 days, it was routinely found that A-PRF released the highest total growth factors. Furthermore, A-PRF released significantly higher total protein accumulated over a 10-day period when compared to PRP or PRF.The results from the present study indicate that the various platelet concentrates have quite different release kinetics. The advantage of PRP is the release of significantly higher proteins at earlier time points whereas PRF displayed a continual and steady release of growth factors over a 10-day period. Furthermore, in general, it was observed that the new formulation of PRF (A-PRF) released significantly higher total quantities of growth factors when compared to traditional PRF.Based on these findings, PRP can be recommended for fast delivery of growth factors whereas A-PRF is better-suited for long-term release.
The aim of the in-situ study was to determine fluoride uptake in non-fluoridated, demineralized enamel after application of fluoride varnishes on enamel samples located at various distances from the non-fluoridated samples. All enamel samples used were demineralized with acidic hydroxyethylcellulose before the experiment. Intra-oral appliances were worn by ten volunteers in three series: (1, Mirafluorid, 0.15% F; 2, Duraphat, 2.3% F and 3, unfluoridated controls) of 6 days each. Each two enamel samples were prepared from 30 bovine incisors. One sample was used for the determination of baseline fluoride content (BFC); the other was treated according to the respective series and fixed in the intra-oral appliance for 6 days. Additionally, from 120 incisors, each four enamel samples were prepared (one for BFC). Three samples (a–c) were placed into each appliance at different sites: (a) directly neighboured to the fluoridated specimen (=next), (b) at 1-cm distance (=1 cm) and (c) in the opposite buccal aspect of the appliance (=opposite). At these sites, new unfluoridated samples were placed at days 1, 3 and 5, which were left in place for 1 day. The volunteers brushed their teeth and the samples with fluoridated toothpaste twice per day. Both the KOH-soluble and structurally bound fluoride were determined in all samples to determine fluoride uptake and were statistically analyzed. One day, after fluoridation with Duraphat, KOH-soluble fluoride uptake in specimen a (=next) was significantly higher compared to the corresponding samples of both the control and Mirafluorid series, which in turn were not significantly different from each other. At all other sites and time points, fluoride uptake in the enamel samples were not different from controls for both fluoride varnishes. Within the first day after application, intra-oral-fluoride release from the tested fluoride varnish Duraphat leads to KOH-soluble fluoride uptake only in enamel samples located in close vicinity to the fluoridation site.
The purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry.A review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords “photodynamic therapy”, “dentistry”, “periodontology”, “oral surgery”, and “endodontics”. It is anticipated that this overview will create a specific picture in the practitioner’s mind regarding the current status and use of PDT.In spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry.PDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections.Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.
The purpose of the study was to compare the accuracy of crowns exclusively fabricated by the digital workflow of two systems. The null hypothesis stated was: Both systems do not differ with respect to marginal and internal accuracy.In 14 patients, 13 molars and 1 premolar were prepared. Each preparation was scanned intraorally with two different digital impression systems, Lava COS and Cerec AC. On the basis of these data, Lava DVS crowns [DVS] and Vita Rapid Layering Technique crowns [RLT] were fabricated, respectively. Both systems contained of a zirconia framework and a digitally fabricated silicate ceramic veneering. The marginal and internal fit of the crowns was documented by a replica technique. The replicas were examined under microscope with a magnification of ×200. The Wilcoxon signed rank test was applied in order to test if the values of the two systems showed significant differences at p ≤ 0.05.The results were as follows in micrometers (±standard deviation): at the marginal gap, 51 (±38) for [DVS] and 83 (±51) for [RLT]; mid-axial, 130 (±56) for [DVS] and 128 (±66) for [RLT]; axio-occlusal, 178 (±55) for [DVS] and 230 (±71) for [RLT]; and centro-occlusal, 181 (±41) for [DVS] and 297 (±76) for [RLT]. According to the Wilcoxon signed rank test, the results differed significantly at the marginal, axio-occlusal, and centro-occlusal gaps.The null hypothesis had to be rejected.The exclusively digital workflow on the basis of intraoral digital impressions delivered clinically satisfying results for single crowns with both systems.
The objective of this paper is to examine the effect of alveolar ridge preservation (ARP) compared to unassisted socket healing.Systematic review with electronic and hand search was performed. Randomised controlled trials (RCT), controlled clinical trials (CCT) and prospective cohort studies were eligible.Eight RCTs and six CCTs were identified. Clinical heterogeneity did not allow for meta-analysis. Average change in clinical alveolar ridge (AR) width varied between −1.0 and −3.5 ± 2.7 mm in ARP groups and between −2.5 and −4.6 ± 0.3 mm in the controls, resulting in statistically significantly smaller reduction in the ARP groups in five out of seven studies. Mean change in clinical AR height varied between +1.3 ± 2.0 and −0.7 ± 1.4 mm in the ARP groups and between −0.8 ± 1.6 and −3.6 ± 1.5 mm in the controls. Height reduction in the ARP groups was statistically significantly less in six out of eight studies. Histological analysis indicated various degrees of new bone formation in both groups. Some graft interfered with the healing. Two out of eight studies reported statistically significantly more trabecular bone formation in the ARP group. No superiority of one technique for ARP could be identified; however, in certain cases guided bone regeneration was most effective. Statistically, significantly less augmentation at implant placement was needed in the ARP group in three out of four studies. The strength of evidence was moderate to low.Post-extraction resorption of the AR might be limited, but cannot be eliminated by ARP, which at histological level does not always promote new bone formation. RCTs with unassisted socket healing and implant placement in the ARP studies are needed to support clinical decision making.This systematic review reports not only on the clinical and radiographic outcomes, but also evaluates the histological appearance of the socket, along with site specific factors, patient-reported outcomes, feasibility of implant placement and strength of evidence, which will facilitate the decision making process in the clinical practice.
The purpose of this clinical study was to compare the marginal fit of dental crowns based on three different intraoral digital and one conventional impression methods.Forty-nine teeth of altogether 24 patients were prepared to be treated with full-coverage restorations. Digital impressions were made using three intraoral scanners: Sirona CEREC AC Omnicam (OCam), Heraeus Cara TRIOS and 3M Lava True Definition (TDef). Furthermore, a gypsum model based on a conventional impression (EXA’lence, GC, Tokyo, Japan) was scanned with a standard laboratory scanner (3Shape D700). Based on the dataset obtained, four zirconia copings per tooth were produced. The marginal fit of the copings in the patient’s mouth was assessed employing a replica technique.Overall, seven measurement copings did not fit and, therefore, could not be assessed. The marginal gap was 88 μm (68–136 μm) [median/interquartile range] for the TDef, 112 μm (94–149 μm) for the Cara TRIOS, 113 μm (81–157 μm) for the laboratory scanner and 149 μm (114–218 μm) for the OCam. There was a statistically significant difference between the OCam and the other groups (p < 0.05).Within the limitations of this study, it can be concluded that zirconia copings based on intraoral scans and a laboratory scans of a conventional model are comparable to one another with regard to their marginal fit.Regarding the results of this study, the digital intraoral impression can be considered as an alternative to a conventional impression with a consecutive digital workflow when the finish line is clearly visible and it is possible to keep it dry.
Quadrant impressions are commonly used as alternative to full-arch impressions. Digital impression systems provide the ability to take these impressions very quickly; however, few studies have investigated the accuracy of the technique in vivo. The aim of this study is to assess the precision of digital quadrant impressions in vivo in comparison to conventional impression techniques.Impressions were obtained via two conventional (metal full-arch tray, CI, and triple tray, T-Tray) and seven digital impression systems (Lava True Definition Scanner, T-Def; Lava Chairside Oral Scanner, COS; Cadent iTero, ITE; 3Shape Trios, TRI; 3Shape Trios Color, TRC; CEREC Bluecam, Software 4.0, BC4.0; CEREC Bluecam, Software 4.2, BC4.2; and CEREC Omnicam, OC). Impressions were taken three times for each of five subjects (n = 15). The impressions were then superimposed within the test groups. Differences from model surfaces were measured using a normal surface distance method. Precision was calculated using the Perc90_10 value. The values for all test groups were statistically compared.The precision ranged from 18.8 (CI) to 58.5 μm (T-Tray), with the highest precision in the CI, T-Def, BC4.0, TRC, and TRI groups. The deviation pattern varied distinctly depending on the impression method. Impression systems with single-shot capture exhibited greater deviations at the tooth surface whereas high-frame rate impression systems differed more in gingival areas. Triple tray impressions displayed higher local deviation at the occlusal contact areas of upper and lower jaw.Digital quadrant impression methods achieve a level of precision, comparable to conventional impression techniques. However, there are significant differences in terms of absolute values and deviation pattern.With all tested digital impression systems, time efficient capturing of quadrant impressions is possible. The clinical precision of digital quadrant impression models is sufficient to cover a broad variety of restorative indications. Yet the precision differs significantly between the digital impression systems.
A multicentric randomized, 3-year prospective study was conducted to determine for how long Biodentine, a new biocompatible dentine substitute, can remain as a posterior restoration.First, Biodentine was compared to the composite Z100®, to evaluate whether and for how long it could be used as a posterior restoration according to selected United States Public Health Service (USPHS)’ criteria (mean ± SD). Second, when abrasion occurred, Biodentine was evaluated as a dentine substitute combined with Z100®.A total of 397 cases were included. This interim analysis was conducted on 212 cases that were seen for the 1-year recall. On the day of restoration placement, both materials obtained good scores for material handling, anatomic form (0.12 ± 0.33), marginal adaptation (0.01 ± 0.10) and interproximal contact (0.11 ± 0.39). During the follow-up, both materials scored well in surface roughness (≤1) without secondary decay and post-operative pain. Biodentine kept acceptable surface properties regarding anatomic form score (≤1), marginal adaptation score (≤2) and interproximal contact score (≤1) for up to 6 months after placement. Resistance to marginal discoloration was superior with Biodentine compared to Z100®. When Biodentine was retained as a dentine substitute after pulp vitality control, it was covered systematically with the composite Z100®. This procedure yielded restorations that were clinically sound and symptom free.Biodentine is able to restore posterior teeth for up to 6 months. When subsequently covered with Z100®, it is a convenient, efficient and well tolerated dentine substitute.Biodentine as a dentine substitute can be used under a composite for posterior restorations.
Since a direct comparison of composites efficacy in clinical studies is very difficult, our study aimed to analyse in laboratory tests under standardised and simulated clinical conditions a large variety of commercial composite materials belonging to eight different materials categories. Thus, 72 hybrid, nano-hybrid, micro-filled, packable, ormocer-based and flowable composites, compomers and flowable compomers were compared in terms of their mechanical behaviour. Flexural strength (FS), flexural modulus (FM), diametric tensile (DTS) and compressive strength (CS) were measured after the samples had been stored in water for 24 h at 37A degrees C. Results were statistically analysed using one-way ANOVA with Tukey HSD post hoc test (alpha = 0.05) as well as partial eta (2) statistics. Large varieties between the tested materials within the same material category were found. The hybrid, nano-hybrid, packable and ormocer-based composites do not differ significantly among each other as a material type, reaching the highest FS values. Nano-hybrid composites are characterised by a good FS, the best DTS but a low FM. The lowest mechanical properties achieved the micro-filled hybrids. The flowable composites and compomers showed for all properties comparable result. Both flowable material categories do not differ significantly from the micro-filled composites for the most mechanical properties, showing only a higher DTS. The filler volume was shown to have the highest influence on the measured properties, inducing a maximum FS and FM at a level of 60%, whereas such dependence was not measured for DTS or CS. The influence of the type of material on the mechanical properties was significant but very low, showing the strongest influence on the CS.
Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP.Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored.Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone.SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone.Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.
The aim of the present study was to investigate different fluorescence-based, two-color viability assays for visualization and quantification of initial bacterial adherence and to establish reliable alternatives to the ethidium bromide staining procedure.Bacterial colonization was attained in situ on bovine enamel slabs (n = 6 subjects). Five different live/dead assays were investigated (fluorescein diacetate (FDA)/propidium iodide (PI), Syto 9/PI (BacLight®), FDA/Sytox red, Calcein acetoxymethyl (AM)/Sytox red, and carboxyfluorescein diacetate (CFDA)/Sytox red). After 120 min of oral exposure, analysis was performed with an epifluorescence microscope. Validation was carried out, using the colony-forming units for quantification and the transmission electron microscopy for visualization after staining.The average number of bacteria amounted to 2.9 ± 0.8 × 104 cm−2. Quantification with Syto 9/PI and Calcein AM/Sytox red yielded an almost equal distribution of cells (Syto 9/PI 45 % viable, 55 % avital; Calcein AM/Sytox red 52 % viable, 48 % avital). The live/dead ratio of CFDA/Sytox red and FDA/Sytox red was 3:2. An aberrant dispersal was recorded with FDA/PI (viable 34 %, avital 66 %). The TEM analysis indicated that all staining procedures affect the structural integrity of the bacterial cells considerably.The following live/dead assays are reliable techniques for differentiation of viable and avital adherent bacteria: BacLight, FDA/Sytox red, Calcein AM/Sytox red, and CFDA/Sytox red. These fluorescence-based techniques are applicable alternatives to toxic and instable conventional assays, such as the staining procedure based on ethidium bromide.Differentiation of viable and avital adherent bacteria offers the possibility for reliable evaluation of different mouth rinses, oral medication, and disinfections.
OBJECTIVE: Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. MATERIALS AND METHODS: This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. RESULTS: ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the pre-disposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETW aims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. CONCLUSIONS: Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. CLINICAL RELEVANCE: ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.