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Aim: The aim of the study was to determine the plaque and gingivitis reducing effect of a dentifrice containing chlorhexidine and aluminium lactate compared with a control toothpaste during the course of 6 months. Material and Methods: This randomized, double-blind study looked prospectively at participants over a 6-month period. Plaque, gingivitis, calculus formation and tooth staining were assessed in 59 participants, who were divided into parallel groups. The participants used either a chlorhexidine and aluminium lactate-containing toothpaste (test group) or a minus active control toothpaste (control group). Parameters were assessed at baseline and again after 1, 3 and 6 months. Results: After 6 months of product use, both groups had less gingivitis compared with the baseline evaluation ( p<0.001). At this time point, the test group showed a statistically significant lower gingival index values compared with the control group ( p=0.001). No statistically significant differences between either the groups or time points were detected with regard to plaque index and the development of calculus and staining. Conclusion: Although there was a statistically significant difference at 6 months between test and control groups, this difference was too small to be considered clinically meaningful. [ABSTRACT FROM AUTHOR]

This clinical study compared the efficacy of three different bleaching techniques with respect to the bleaching times required in order to achieve six grades of whitening in human teeth. Any side effects that were noted and the patients' acceptance of the method were recorded by a visual analog scale ranging from 0 to 10. Moreover, epoxy casts from the study teeth were analyzed by scanning electron microscopy in order to detect any potential changes in the enamel surface due to treatments. Thirty-nine volunteers participated in the study and were allocated randomly to one of three different bleaching treatments: Group A (n=13) used Whitestrips (over-the-counter technique; one cycle=30 minutes), Group B (n=13) used Opalescence PF 10% (at-home bleaching technique; one cycle=8 hours) and Group C (n=13) used Opalescence Xtra Boost (in-office bleaching technique; one cycle=15 minutes) until a defined whitening of six tabs compared to the baseline were reached (assessed by the VITA shade guide). All three methods achieved six grades of whitening. The mean treatment time required to reach the defined level of whitening was 31.85 ± 6.63 cycles in Group A, 7.15 ± 1.86 cycles in Group B and 3.15 ± 0.55 cycles in Group C. All products differed significantly from each other in terms of treatment cycles and required treatment time (p<0.001 by ANOVA and Mann-Whitney-U-test). Using the VA scale, side effects noted within the three groups were minimal. Tooth hypersensitivity ranged from 2.62 (Whitestrips) to 3.38 (Opalescence PF), and gingival irritation ranged between 0.23 (Opalescence Xtra Boost) and 0.85 (Whitestrips). The most accepted method was the at-home bleaching technique. None of the teeth studied showed detectable enamel surface changes in the subsequent SEM analysis using 200x and 2000x magnification. [ABSTRACT FROM AUTHOR]

This in vitro study evaluated the effect of an in-office bleaching technique on the microhardness of 6 dental esthetic restorative materials. The materials used for this study included 4 resin composites (1 hybrid resin [Tetric Ceram], 1 flowable resin [Tetric Flow], 1 microhybrid resin [Enamel Plus HFO], and 1 nanohybrid [Filtek Supreme]), an ormocer (organically modified ceramics) (Definite), and a porcelain (Vitablocs Mark II for Cerec). These represent the commonly used materials for esthetic restorations. The samples were prepared using 2-mm-thick transparent thermoforming discs, into which 4.5-mm-wide holes were drilled. The discs were positioned on a transparent plastic matrix strip on a glass plate. Upon inserting the materials into the discs, another transparent plastic matrix strip was placed on top to flatten the surface. The samples were light cured for 40 seconds using halogen light. The porcelain samples were prepared using Vitablocks Mark II using the Cerec 3D system. Seventy-seven samples were prepared in total--14 samples for each type of resin composite and ormocer and 7 samples for the porcelain. The samples were divided into polished and unpolished groups. For the porcelain, only polished samples were tested. Polishing of the samples was accomplished with Sof-Lex disks on a slow-speed hand-piece. All samples were stored in distilled water at room temperature for 24 hours prior to any procedure. The bleaching procedure used 38% hydrogen peroxide that was applied to the surface of the samples at 15, 30, and 45 minutes to simulate in-office bleaching conditions. Following each bleaching procedure, the samples were washed under running distilled water and placed in fresh distilled water until the next testing procedure. Five measurements were made for each sample using a Knoop microhardness tester. For the resin composite and ormocer samples, a 50 g load was applied for 30 seconds, whereas a 300 g load was used for the porcelain samples. Measurements were made first before bleaching, then after 15, 30, and 45 minutes of bleaching, and 24 hours and 1 month after the end of the bleaching procedure. The results were analyzed at a significance level of .05 using repeated measures analysis of variance. The results indicated that the differences in the microhardness values between the bleached samples and control samples were not statistically significant for all materials (Hybrid: P = .264; flow: P = .584; microhybrid: P = .278; nanohybrid: P = .405; ceramic: P = .819). Interestingly, the bleaching procedure on the ormocer caused an increase in microhardness of the polished samples. Based on the results of this study, the authors concluded that 38% hydrogen peroxide did not cause any significant reduction in the microhardness of the 6 dental esthetic restorative materials. Polishing of the resin composites did not have any effect on the microhardness. In addition, there is no indication to replace restorations following an in-office bleaching procedure. [ABSTRACT FROM AUTHOR]

Purpose: To examine the influence of abutment emergence angle and abutment height on marginal peri-implant bone stability in patients not considered susceptible to peri-implantitis. Furthermore, it was analyzed whether titanium-base (Ti-base) abutments lead to wider abutment emergence angles compared to one-piece abutments., Materials and Methods: A total of 48 abutments (ie, 24 Ti-base and 24 one-piece abutments in 24 patients) were evaluated at abutment installation, after 1 year, and thereafter on a yearly basis for up to 5 years. Clinical and radiographic outcome variables were assessed., Results: With regard to peri-implant marginal bone stability, only moderately negative, albeit significant, correlations were found on the mesial sides of the one-piece abutments after 4 and 5 years for an abutment emergence angle > 30 degrees. No statistically significant negative correlations were found for distances of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level for either Ti-base or for one-piece abutments. Furthermore, abutments bonded to Ti-bases were not associated with larger emergence angles than one-piece abutments., Conclusions: For patients at low risk of developing peri-implantitis, it can be concluded that neither a larger abutment emergence angle (> 30 degrees) nor a distance of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level are associated with marginal peri-implant bone loss. Furthermore, abutments bonded to Ti-bases are not associated with wider emergence angles than one-piece abutments.

Purpose: Titanium bases are used frequently in daily practice for bonding to CAD/CAM abutments or crowns. Due to intimate contact between the adhesive gap of the titanium-base abutment and the peri-implant bone, the physical and chemical characteristics of the bonding material, or the gap itself, may affect peri-implant inflammatory reactions. The present study therefore aimed to examine the long-term effects of individualised abutments bonded to titanium bases on peri-implant health., Materials and Methods: A total of 24 patients, each with one test and one control abutment, participated in the present prospective, single-blind, randomised controlled clinical trial. The test abutments were CAD/CAM titanium abutments bonded to titanium bases. As the control abutments were individualised, one-piece CAD/CAM titanium abutments were used. Clinical and radiographic parameters were assessed at abutment insertion and then on a yearly basis over the following 5 years., Results: No significant differences in marginal bone level were observed between the titanium-base and one-piece abutments at any of the follow-up time points; however, when intragroup marginal bone levels were compared to the baseline values, significant differences were found at several follow-up time points. Intergroup differences were only found to be significant for pocket depth at the 4- (P = 0.006) and 5-year follow-ups (P = 0.024), favouring titanium-base abutments., Conclusions: Within the limitations of the present study, it appears that the peri-implant tissues of this specific patient cohort responded to titanium-base abutments in a rather similar manner to one-piece abutments over a 5-year period; however, no definitive conclusions can be drawn due to the low power of the present study.

Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.

Background: A common clinical observation following surgical periodontal therapy with an enamel matrix derivative (Emdogain) is the improved healing of the soft tissues and the limited inflammation of the operated areas. These clinical observations are empirical and difficult to explain. One of the factors influencing the early wound healing might be a potential antimicrobial effect of Emdogain., Aim: To investigate the effect of Emdogain on the vitality of ex vivo supragingival dental plaque and to compare this effect to that of a standard 0.2% chlorhexidine solution., Materials and Methods: 24 patients suffering from adult periodontitis were included in the study. At the beginning of the experiment, all participants were given a professional tooth cleaning. For the following 4 days, they had to refrain from any kind of oral hygiene measures. At day 5, from each of the volunteers, a voluminous plaque biofilm sample was taken with a sterile curette from the vestibular surfaces of the 1st lower molars and divided into 5 equal parts. Each part was mounted with 5 microl of the following solutions: (1) NaCl, (2) enamel matrix derivative dissolved in water (EMD), (3) enamel matrix derivative dissolved in the vehicle (Emdogain), (4) vehicle (propylene glycol alginate, PGA), (5) 0.2% chlorhexidine digluconate (CHX). After a reaction time of 2 min the test solutions were sucked off, and subsequently the biofilm was stained with a fluorescence dye. The vitality of the plaque flora after the treatments was evaluated under the fluorescence microscope (VF%)., Results: Plaque samples treated with NaCl showed a mean vitality of 76.8+/-8%. The EMD, Emdogain, PGA and CHX showed VF values of 54.4+/-9.2, 21.4+/-10.6%, 19.6+/-11.6% and 32.3+/-11.8%, respectively. Emdogain, PGA and CHX showed statistically highly significant reductions (p<0.0001) in terms of bacteria vitality when compared to water (negative control) and EMD. Both Emdogain and PGA were found to be statistically significantly different compared to CHX (p<0.001) (positive control)., Conclusion: The results of this study indicate that Emdogain might have an antibacterial effect on the vitality of the ex vivo supragingival dental plaque flora.

Purpose: The aim of this laboratory study was to evaluate the marginal sealing ability of four glass-ionomer cements in cervical restorations (Class V) using dye penetration. Two conventional (C-GIC) and two resin-modified (RM-GIC) cements were used either with or without dentin conditioning with polyacrylic acid., Materials and Methods: 96 cervical cavities of standardized size were prepared in vitro in the vestibular and lingual portions at the cementoenamel level of 48 premolars. The coronal margins were prepared in enamel, the apical margins were localized in dentin. The 96 cavities were randomly divided into 4 groups of n = 24 each. The cavities of each group were filled with one of the test materials, and only half of the cavities received a dentin conditioning for 20 s with polyacrylic acids before filling. The fillings were finished with a set of abrasive disks 24 h after setting. The restored teeth were stored in saline for 4 weeks and subjected to dye penetration. The depth of dye penetration along the coronal and apical margin was measured on 4 longitudinal sections of each tooth with a semi-automatic image analysis system at 40x magnification., Results: Mean depth of dye penetration ranged from 0 (ChemFil superior without conditioner) to 0.13 mm (ChemFil superior with conditioner) at enamel sites, and from 0.02 (Fuji II LC with conditioner) to 0.74 mm (ChemFil superior with and without conditioner) at dentin sites., Conclusion: The conditioning of the cavities before filling improved the marginal adaptation significantly only in the Ketac-Fil group. Conventional glass-ionomer cements (C-GIC) in general demonstrated a lower sealing ability than the light-activated, resin-modified cements (RM-GIC). The adaptation of Photac-Fil quick is best without pretreatment--as recommended by the manufacturer.