Search

Dental implant clinical success is dependent on effective peri‐implant tissue attachment to the trans‐mucosal portion following placement. Modification of transmucosal implant surfaces can improve cellular adhesion and function leading to formation of an effective soft‐tissue seal during healing, of which gingival fibroblasts are prominent cells to migrate to repair wounds and crucial for the development of a collagen rich connective tissue. Biocompatible loaded scaffold materials have been developed to allow local release of molecules with effective biological activity. Our previous studies indicate that strontium can promote gingival fibroblast metabolism, decrease apoptosis and support adhesion to titanium healing abutments. In this study, we developed a strontium‐loaded alginate hydrogel scaffold which can be easily personalized to fit over any size and shape of implant transmucosal collar or healing abutment. Results indicate that biologically active strontium ions are effectively released from loaded alginate hydrogel material to promote fibroblast viability and migration to repair in vitro wounds similar to that of strontium citrate solution. Overall, this novel strontium‐loaded alginate scaffold device displays good biocompatibility and functionality, demonstrating high potential as a system to provide local delivery of strontium to improve peri‐implant mucosal healing following implant placement and clinical success. [ABSTRACT FROM AUTHOR]

Abfraction may not be directly responsible for tooth damage that is not caused by dental cavities. Abfraction was the name given to the loss of tooth structure due to mechanical forces in the mouth during chewing. According to this theory, the mechanical stress of chewing causes tooth enamel to break.

Smokers may heal more slowly after periodontal therapy than non-smokers. Researchers gave detailed mouth examinations to 143 people with periodontal disease who were treated with scaling and root planing. These are mechanical techniques that remove all dental plaque below the gumline. Sixty of the patients were smokers and 55 were former smokers. Current smokers healed more slowly and had greater amounts of bacteria in the pocket between the teeth and gums. Former smokers had the same healing rates as non-smokers.

Abstract Background With the present study we introduce a novel and simple biomaterial able to induce regeneration of bone. We theorized that nourishing a bone defect with calcium and with a large amount of activated platelets may initiate a series of biological processes that culminate in bone regeneration. Thus, we engineered CS-Platelet, a biomaterial based on the combination of Calcium Sulfate and Platelet-Rich Plasma in which Calcium Sulfate also acts as an activator of the platelets, therefore avoiding the need to activate the platelets with an agonist. Methods First, we tested CS-Platelet in heterotopic (muscle) and orthotopic (bone) bone regeneration bioassays. We then utilized CS-Platelet in a variety of dental and craniofacial clinical cases, where regeneration of bone was needed. Results The heterotopic bioassay showed formation of bone within the muscular tissue at the site of the implantation of CS-Platelet. Results of a quantitative orthotopic bioassay based on the rat calvaria critical size defect showed that only CS-Platelet and recombinant human BMP2 were able to induce a significant regeneration of bone. A non-human primate orthotopic bioassay also showed that CS-Platelet is completely resorbable. In all human clinical cases where CS-Platelet was used, a complete bone repair was achieved. Conclusion This study showed that CS-Platelet is a novel biomaterial able to induce formation of bone in heterotopic and orthotopic sites, in orthotopic critical size bone defects, and in various clinical situations. The discovery of CS-Platelet may represent a cost-effective breakthrough in bone regenerative therapy and an alternative or an adjuvant to the current treatments.

Prostate cancer is the most frequently diagnosed cancer among elderly men in the United States. Skeletal architecture is affected by metastasis and androgen deprivation therapy (ADT), which is considered a gold standard treatment in prostate cancer. Osteoporosis and skeletal effects are reported among most patients on ADT. To counter these effects and to reduce bone turnover, antiresorptive drugs such as bisphosphonates and denosumab are commonly prescribed in prostate cancer. These drugs increase the prevalence of osteonecrosis of the jaw in a subset of patients. The future should hold promise for new drugs that could have a positive impact on bone metabolism without jeopardizing bone integrity. [ABSTRACT FROM AUTHOR]

Purpose: Zirconia ceramics are a viable alternative to titanium for use as dental implants. However, the smooth surface of zirconia means that longer healing periods are needed to accomplish osseointegration compared to roughened titanium surfaces. Surface modifications can be used to increase the roughness of zirconia. The aim of this study was to assess histologically and compare the degree of early bone apposition around zirconia dental implants with sandblasted, sintered, or laser-modified surfaces to that seen around surface-modified titanium implants. Removal torque was also measured and compared. Materials and Methods: Ninety-six implants--24 each of four types (sintered zirconia, laser-modified zirconia, sandblasted zirconia, and acid-etched titanium)--were placed in 48 New Zealand White female rabbits. One implant was inserted in each distal femur. Half of the specimens were harvested at 6 or 12 weeks and processed for light microscopic analysis; the area of bone-to-implant contact was measured morphometrically. The other half were evaluated for removal torque at 6 and 12 weeks. Results: No statistically significant differences existed in bone apposition between the different surfaces at either time point. Differences in removal torque were significantly different between titanium and sandblasted zirconia and between sintered zirconia and sandblasted zirconia, with the first mentioned demonstrating a higher torque value at 6 weeks. At 12 weeks, the only significant difference in removal torque was between titanium and sandblasted zirconia, with titanium demonstrating the higher value. Conclusion: Comparable rates of bone apposition in the zirconia and titanium implant surfaces at 6 and 12 weeks of healing were observed. Removal torque values were similar for all implants with a roughened surface. [ABSTRACT FROM AUTHOR]

Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification acts through a distinct process that is associated with unique clinical characteristics. Accurate prevalence data tor each classification are not available since indices do not necessarily measure one specific ecology, or the study populations may be too diverse in age and characteristics. The treatment of teeth in each classification will depend on identifying the factors associated with each etiology. Some cases may require specific restorative procedures, while others will not require treatment. A review of the literature points to the interaction of the three entities in the initiation and progression of lesions that may act synchronously or sequentially, synergistically or additively, or in contraction with other entities to mask the true nature of tooth wear, which appears to be multifactorial (Quintessence lnt 2003;34:435-446) [ABSTRACT FROM AUTHOR]

Gingival recessions are of concern both esthetically and functionally for the dental patient. Bioabsorbable barriers were used to simultaneously treat six mucogingival recessions affecting six teeth in both maxillary quadrants of a 34-year-old woman. Root exposures ranging from 4 to 6 mm were successfully treated; complete root coverage was obtained at all treated sites. Follow-up visits up to 18 months revealed the stability of the clinical outcome, confirming the efficacy of the procedure. (Quintessence Int 2003;34: 15-18) [ABSTRACT FROM AUTHOR]

Health care providers are at risk for infection with bloodborne pathogens, including hepatitis B virus, human immunodeficiency virus, and hepatitis C virus. Recommended infection control practices are applicable to all settings in which dental treatment is provided. Dentists remain at low risk for occupationally acquired human immunodeficiency virus. Dental health care workers, through occupational exposure, may have a 10 times greater risk of becoming a chronic hepatitis B carrier than the average citizen. Tuberculosis is caused by Mycobacterium tuberculosis. In general, persons suspected of having pulmonary or laryngeal tuberculosis should be considered infectious if they are coughing, are undergoing cough-inducing or aerosol-generating procedures, or have sputum smears positive for acid-fast bacilli. Although the possibility of transmission of bloodborne infections from dental health care workers to patients is considered to be small, precise risks have not been quantified by carefully designed epidemiologic studies. Emphasis should be placed on consistent adherence to recommended infection control strategies, including the use of protective barriers and appropriate methods of sterilization or disinfection. Each dental facility should develop a written protocol for instrument reprocessing, operatory cleanup, and management of injuries. Such efforts may lead to the development of safer and more effective medical devices, work practices, and personal protective equipment. [ABSTRACT FROM AUTHOR]

The present report demonstrates a clinical approach to achieve vertical ridge augmentation around endosseous implants. Two implants were placed, leaving the threads exposed, in the atrophic mandibular right posterior quadrant of a male patient. Both implants were covered with a titanium-reinforced expanded polytetrafluoroethylene (e-PTFE) membrane. Second-stage surgery was performed 12 months after implant placement. Upon membrane removal, growth of mineralized tissue was observed around both implants, covering areas previously not covered by bone. Implants were then progressively loaded and restored. Titanium-reinforced e-PTFE membranes can be satisfactorily used for vertical augmentation of atrophic ridges. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of diode laser irradiation combined with topical fluoride application for increasing the hardness of demineralized bovine enamel and esthetically improving white-spot lesions (WSLs). In addition, the study evaluated intrapulpal temperature changes during laser irradiation. One hundred twenty bovine incisors with 4 x 4-mm artificial WSLs were randomly assigned to 8 groups (n = 15): untreated control; fluoride only; LF1, LF2, and LF3, fluoride plus 2-W laser for 15, 30, and 60 seconds, respectively; and LF4, LF5, and LF6, fluoride plus 5-W laser for 15, 30, and 60 seconds, respectively. The Vickers hardness number, CIE L*a*b* color space values, and visual analog scale ratings for color improvement were recorded at baseline, after demineralization to create the WSLs, and after treatment. The intrapulpal temperature changes were recorded at completion of irradiation for 30 bovine teeth that were assigned to 6 groups (n = 5) to receive doses of radiation equivalent to the treatment of the corresponding laser groups described previously. Statistical analysis included 1-way analysis of variance and Tukey multiple comparisons tests (α = 0.05). The mean Vickers hardness numbers were significantly greater for the laser groups, and mean visual analog scale scores were significantly greater for all the treatment groups (P < 0.05). The fluoride group had a significantly lower mean color change (ΔE*) value (P < 0.05). The mean intrapulpal temperature changes in the 5-W laser groups were significantly greater than those in the 2-W groups (P < 0.05). Diode laser irradiation combined with topical fluoride application significantly increased the hardness and improved the esthetic appearance of WSLs compared to no treatment (control) and fluoride treatment alone. Intrapulpal temperature changes indicated that diode laser irradiation is safer at a 2-W setting than a 5-W setting. [ABSTRACT FROM AUTHOR]

Between January 1992 and October 1992, 100 Minimatic screw implants made of titanium alloy with rough acid-etched surfaces were placed in 63 consecutive partially edentulous patients. At second-stage (uncovering) surgery performed after a 4- to 6-month healing period, none of the implants showed any signs of mobility, peri-implant infection, or bone loss. After an additional healing phase averaging 2 weeks, the patients were restored with fixed prostheses. Patients were reexamined every 3 months for 1 year, with all 63 patients available for evaluation during this period. Periapical radiographs were taken preoperatively, immediately after surgery, and at 6 and 12 months after implantation. There were no signs of peri-implant radiolucencies in any of the implants, and alveolar bone loss was less than 1 mm on average 1 year after implantation. Based on Plaque Index, sulcular bleeding index, pocket probing depth, attachment level, width of keratinized mucosa, and hand-tested mobility, 99 implants were considered successful and 1 (which developed peri-implant infection) was considered a failure. Study results substantiate other reports that implants with a rough surface can yield predictable good results. [ABSTRACT FROM AUTHOR]

What happens to implants after we introduce them into the oral environment? Do they keep their sterility, or are they colonized by bacteria? How fast is the surface of the implants colonized by the bacteria, and which bacteria will colonize it? Do healthy implants have the same microbial populations as diseased implants? What's the role of the remaining teeth in the contamination of the dental implants? This short review of the literature will give a general overview of critical concepts in terms of peri-implant microbiology, based on the most important evidence in the literature. [ABSTRACT FROM AUTHOR]

Peri-implantitis is a long-term complication that frequently occurs after implant surgery. Several treatment methods have been proposed that are aimed at arresting the disease and potentially regenerating bone defects related to it. The use of a combination of proposed decontaminative treatments could possibly improve outcomes. In this case report the authors describe a combined mixed protocol, in which chemical decontamination and a laser-assisted decontamination technique are used in a surgical regenerative approach to successfully manage and treat a case of peri-implantitis. The combined surgical and antimicrobial protocol described can be a suitable treatment option in cases in which implants show severe bone resorption as a result of peri-implant disease. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to report important aspects related to a sinus augmentation procedure by reviewing maxillary sinuses anatomy, indications and contra-indications and explaining proper clinical and radiographic evaluations. It also discusses different techniques of the sinus augmentation procedure. These include lateral window sinus elevation and internal sinus elevation with or without simultaneous implant placement, as well as how to prevent complications related to these procedures and how to overcome them if they occur. [ABSTRACT FROM AUTHOR]

Exposure of dental abutments to cleaning and sterilizing Radio Frequency Glow Discharge Treatment (RFGDT) triggered greater degrees of human gingival fibroblast (HGF) attachment and spreading over their surfaces. Enhanced cell growth and metabolic activity of such HGFs were found which might lead to improved cellular margins in the smile-revealing "esthetic zone". This investigation, approved by the Institutional Review Board, employed in vitro studies of HGFs to support in vivo clinical applications of differentially treated titanium healing abutments to demonstrate the possible improvements for tissue growth around dental implants. Harvested commercially pure titanium (cpTi) abutments from three clinical cases per group revealed that separation of the abutments from the human gingival tissues occurred mainly intercellularly rather than directly from the tissue, suggesting that placement of an RFGDT permanent abutment would trigger tissue-integration more completely than noted with usual alcohol-cleaned abutments. This work confirmed and extended observations of prior studies that RFGDT materials have mitogenic effects that might be captured for stimulating desired tissue growth around implanted biomaterial appliances. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 169-177, 2017. [ABSTRACT FROM AUTHOR]