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Narrow-diameter implants (NDIs) can be inserted instead of standard dental implants (SDIs) in sites with limited space and bone availability. The aim of this study was to evaluate the effect of implant diameter on peri-implant bone, attached mucosa, and on the associated probability of implant success and survival. The implants with progressive thread design and platform switching (Ankylos®, Dentsply Sirona; Mannheim, Germany) investigated were identified retrospectively and assigned to two groups based on their diameter: 3.5 mm (NDIs) and 4.5 mm (SDIs). Peri-implant bone loss was analyzed based on available radiographs. Descriptive and implant-associated factors were gathered from patient files. Data were statistically analyzed using the Kolmogorov–Smirnov–Lilliefors test and regression analyses. The level of significance was p ≤ 0.05. Results: In total, data for 415 implants in 194 patients were included in the study. Ten-year survival was 95.8% (NDIs) and 91.1% (SDIs). Implant diameter had no significant effect on peri-implant crestal bone loss (p = 0.098) or on the width of the attached gingiva (p = 0.052). Survival and success rates of NDIs were like or slightly better than those of SDIs. Because implant diameter had no effect on peri-implant tissue, NDIs can be recommended in selected cases.

Wettability is recognized as an important property of implant surfaces for ensuring improved biological responses. However, limited information exists on how bone grafting procedures including materials influence the hydrophilic behavior of implant surfaces. This in vitro study aimed to investigate the influence of two bovine grafting materials after hydration on the wettability of four different disk surfaces: commercially pure titanium (CP-Ti), titanium–zirconium dioxide (TiZrO2-Cerid®), zirconia (SDS®), and niobium. Wettability tests were performed on each of the four implant surfaces with a solution of 0.9% sodium chloride after mixture with W-boneTM (Group A) or Bio-Oss® (Group B) or 0.9% sodium chloride alone (Group C). In total, 360 contact angle measurements were completed with n = 30 per group. Statistical analysis was performed using a one-way analysis with variance (ANOVA) test with a significant mean difference at the 0.05 level. For pure titanium, Group A demonstrated increased hydrophilicity compared to Group B. Both TiZrO2 and zirconia showed significant differences for Groups A, B and C, exhibiting a decrease in hydrophilicity after the use of bovine grafting materials compared to titanium surfaces. Niobium remained consistently hydrophobic. In summary, this study revealed that bovine grafting materials may diminish the hydrophilicity of zirconia surfaces and exert varied effects on titanium and niobium. These findings contribute to the understanding of implant surface interactions with grafting materials, offering insights for optimizing biological responses in implantology.

Proper surgical technique is crucial for optimizing wound healing and reducing scar tissue formation. There are numerous measures a surgeon can take to improve wound healing; however, the angle of the incision made at the surgical site has been suggested to potentially play a role in wound healing, particularly between beveled and perpendicular incisions. Objectives: The goal of this study was to analyze the literature and observe whether a discrepancy exists between using beveled vs perpendicular incisions in surgical procedures, as well as to understand the relationship between incision angles and physiologic wound healing. Methods: Google Scholar, Pubmed, and MEDLINE searches regarding incision techniques were made to find relevant articles in the fields of plastic surgery, dermatologic surgery, periodontal surgery, and ophthalmic surgery which included studies from 2004 to 2023. The exclusion criteria consisted of studies that did not have a comparative design and/or were not revolved around incision angle. Results: After filtering out irrelevant studies, we selected six studies that addressed the dichotomy between beveled and perpendicular incisions. Out of the six studies, four were in favor of beveled incisions, and the remaining studies either found no significant difference or reported benefits to some degree of using perpendicular cuts. Discussion: The literature seems to suggest that beveled incisions have an advantage over perpendicular incisions in wound healing, particularly in the aspects of esthetic and accelerated wound healing. This is potentially due to the increased surface area of the dermis, preservation of hair follicles, and decreased incidence of infection. Conclusion: Although the literature seems to favor beveled incisions, a definitive conclusion cannot be made as there is not sufficient evidence to support the superiority of one incision type over the other.

Background: Nonsurgical periodontal therapy is the first step of periodontal diseases treatment. It could be performed with various instruments and in recent years lasers have been tested too. The aim of the present study is to evaluate the long-term clinical effectiveness of Er:YAG laser monotherapy in the treatment of moderate chronic periodontitis. Methods: 451 teeth (1099 periodontal pockets) from 30 patients with moderate chronic periodontitis are allocated for subgingival scaling and root planing into two groups—hand instrumentation (control) and Er:YAG laser instrumentation with 100 mJ/15 Hz (test). Patients are examined for probing pocket depth, gingival recession, clinical attachment level, bleeding on probing, plaque presence at baseline, 1, 3, 6 and 12 months after instrumentation. Results: One year after therapy significant reduction of all clinical parameters examined is observed. The pocket depth decreases with 1.55 mm for the control group and 1.70 mm in the test group. The attachment level gain reveals 1.09 mm for hand instrumentation and 0.59 for laser instrumentation. The bleeding on probing reduces more significantly in the test group, where one year after treatment the index is 19.1%, whereas in the control group, it is 33.8%. Conclusions: The Er:YAG laser demonstrates similar clinical effectiveness to hand instrumentation in the non-surgical periodontal treatment. Better long-term stability is observed in the test group.

Abstract The use of immediate implants in the aesthetic area is a technique widely used in modern implantology. The characteristics of the patient, the implant, and the surgical procedure used may influence the final results. The aim was to assess whether the implant design affects primary (P.S.) and secondary stability (S.S.), bone level (B.L.), and PES/WES evaluation. Twenty implants with two different designs (n = 10) were immediately placed and randomly located in the upper anterior maxilla with no grafting material. Implant-Stability-Quotient (ISQ), B.L., and Pink-Esthetic-Score/White-Esthetic-Score (PES/WES) were evaluated. Shapiro–Wilk normality test was performed to determine the sample normality, as the data did not follow a normal distribution, the Wilcoxon-Mann–Whitney test was applied (p

The purpose of this observational follow-up clinical study was to observe the quality of posterior composite restorations more than 23 years after application. A total of 22 patients, 13 male and 9 female (mean age 66.1 years, range 50–84), with a total of 42 restorations attended the first and second follow-up examinations. The restorations were examined by one operator using modified FDI criteria. Statistical analysis was performed with the Wilcoxon Mann–Whitney U test and Wilcoxon exact matched-pairs test with a significance level of p = 0.05. Bonferroni–Holm with an adjusted significance level of alpha = 0.05 was applied. With the exception of approximal anatomical form, significantly worse scores were seen for six out of seven criteria at the second follow-up evaluation. There was no significant difference in the first and second follow-up evaluations in the grades of the restorations with regard to having been placed in the maxilla or mandible, as well as for one-surface or multiple-surface restorations. The approximal anatomical form showed significantly worse grades at the second follow-up when having been placed in molars. In conclusion, the study results show that significant differences regarding FDI criteria in posterior composite restorations occur after more than 23 years of service. Further studies with extended follow-up time and at regular and short time intervals are recommended.

Background: This study aimed to evaluate the penetration depth of 445 and 970 nm diode lasers using both initiated and non-initiated fibers on bovine gingiva in an ex vivo model. Methods: In this in vitro experiment, 445 nm and 970 nm diode lasers were compared in pulsed (35 Hz, duty cycle: 50%) and continuous mode with both initiated and non-initiated tips. All experimental groups had laser output settings of 2 Watts with a 320 μm thick glass fiber utilized for delivery. Two posterior teeth were randomly selected from four bovine mandibles for each group. The teeth were irradiated for 30 s buccal and 30 s lingual before the gingiva was harvested for histological evaluation. Samples were fixed in 10% formalin and stained via elastin Van Gieson. Sections were examined microscopically to evaluate collagen denaturation due to thermal effects, which were measured and compared using a mixed-effect model with Tukey adjustment. Results: The 445 nm wavelength groups displayed significantly higher penetration depths when compared to the 970 nm wavelength groups. The initiated tip groups tended to display a lower penetration depth than non-initiated groups; however, these values were similar (p > 0.05) for the 445 nm pulsed lasers (initiated vs. non-initiated). Conclusions: We can conclude that the 445 nm laser wavelength displayed greater thermal denaturation in bovine gingiva ex vivo when compared to the 970 nm wavelength. Additionally, the pulsed settings displayed less thermal penetration depth when compared to the continuous emission modes of the same power output. However, additional studies are necessary to better compare initiated and non-initiated tips using the novel blue laser light.

This study aims to evaluate the grid of Merz and ImageJ methods for histometric quantification, verifying which is more reliable and defining which is most suitable based on the time required to perform. Thirty histological samples of maxillary sinuses grafted with xenografts were evaluated using an optical light microscope attached to an image capture camera and connected to a microcomputer. The images were digitalized and recorded as a TIFF image, and the new bone formation was evaluated using the grid of Merz and ImageJ. The Bland–Altman analysis was used to identify the agreement between the methods and determine suitable future research options. The timing of the quantification was also performed to identify a possible advantage. The mean value for the quantification analysis timing for the grid of Merz was 194.9 ± 72.0 s and for ImageJ was 871.7 ± 264.4, with statistical significance between the groups (p = 0.0001). The Bland–Altman analysis demonstrated a concordance between the methods, due to the bias being next to the maximum concordance (−1.25) in addition to the graphic showing the scattering points next to the mean of differences and inside of limits of agreement. Thus, it was demonstrated that the grid of Merz presents reliable outcomes and advantages over the ImageJ methodology regarding the time spent to contour the areas of interest.

The objective of this study was to evaluate the clinical and radiographic behavior of a novel triangular neck implant configuration in partially edentulous patients. Sixteen patients with a mean age of 58.3 years, were rehabilitated with 25 implants inserted in the healed sites of the maxilla and mandible; implant diameter was Ø3.3 and 3.9 mm. Clinical and radiographic measurements were first performed at prosthesis delivery that served as baseline; they were further evaluated after a mean period of 15.6 months. The interproximal peri-implant bone levels were the primary outcome; the mesial and distal data were recorded and a mean value was calculated. Secondary outcomes included peri-implant probing depth (PPD) and bleeding on probing (BoP). The paired t-test was used to compare the radiographic and clinical outcomes between baseline and follow-up. The mean bone levels at the mesial and distal aspects at baseline were 0.45 (0.47) and 0.57 (0.69), respectively; at follow-up they were 0.59 (0.42) and 0.78 (0.59), respectively. The differences were not statistically significant. Similarly, no significant differences were found for the clinical parameters. Within the limitations of the present study, it could be concluded that this new triangular neck bone level implant macro-design was used successfully to treat partially edentulous patients. Larger controlled clinical studies are warranted to confirm the present radiographic and clinical findings.

There are different avenues for obtaining postgraduate doctoral/Ph.D. degrees in Germany and abroad. Depending on their interests and career plans, candidates can choose a postgraduate doctorate/Ph.D. that focuses on a career in academia or a doctorate that does not involve all elements of a Ph.D. and is obtained for the title’s sake. Germany offers this type of diversity and flexibility, whereas the USA postgraduate doctorate model presents a more structured doctorate. The current article provides insight regarding various and more flexible pathways for obtaining a postgraduate doctorate by comparing the German and the American model. The diversity of academic degrees in dentistry and medicine, such as postgraduate doctoral degrees and the higher postdoctoral degrees available in Germany for graduates interested in academia, makes educational evaluation processes and credentials recognition challenging. The lack of transparency and a systematic approach for the academic acknowledgment of the different scientific values of each doctorate type is creating confusion, primarily when German postgraduate doctorate holders pursue academic careers internationally. The current article aims to enhance the knowledge about the different academic degrees and facilitate the educational evaluations, specialty applications, and employment processes. Understanding the additional scientific value of each doctorate type offered in Germany is imperative for their credential recognition internationally.

Bone graft materials from synthetic, bovine, and human sources were analyzed and tested for in vitro cytotoxicity on dental pulp stem cells (DPSCs) and osteosarcoma cells (Saos-2). Raman spectroscopy indicated significant amounts of collagen only in human bone-derived materials, where the mineral to protein ratio was 3.55 ± 0.45, consistent with bone. X-ray fluorescence revealed tungsten (W) concentrations of 463 ± 73, 400 ± 77, and 92 ± 42 ppm in synthetic, bovine, and human bone chips, respectively. When these chips were added to DPSCs on tissue culture plastic, the doubling times after two days were the same as the controls, 16.5 ± 0.5 h. Those cultured with synthetic or bovine chips were 96.5 ± 8.1 and 25.2 ± 1.4 h, respectively. Saos-2 was more sensitive. During the first two days with allogeneic or bovine graft materials, cell numbers declined. When DPSC were cultured on collagen, allogeneic and bovine bone chips did not increase doubling times. We propose cytotoxicity was associated with tungsten, where only the concentration in human bone chips was below 184 ppm, the value reported as cytotoxic in vitro. Cells on collagen were resistant to bone chips, possibly due to tungsten adsorption by collagen.

The null hypothesis was that there is no difference in primary stability (PS) of Multiple Condensing Thread Designed (MCTD)-implants placed in simulated type-IV bone by trainee and experienced operators. The aim was to compare the performance of a novice and an expert clinician in assessing the PS of MCTD-implants placed in simulated type-IV bone-blocks using the ridge expansion (spreading) and bone condensation techniques. The MCTD (n=120) implants were placed in cellular rigid polyurethane foam bone-blocks by an undergraduate student (n=60 implants) and an expert (n=60 implants), respectively. Each operator independently performed the osteotomies, which were sub-classified into three groups (20 implants/group): Group-1—Conventional osteotomy; Group-2: Osteotomy and condensation with a tapered osteotome; and Group-3—osteotomy condensed with cylindrical osteotomes. The PS was measured using insertion torque (IT), resonance frequency analysis (RFA) and Periotest values (PTV). P

Titanium wear is a growing area of interest within dental implantology. This study aimed to investigate titanium and zirconium wear from dental implants at the time of insertion using X-ray-fluorescence spectrometry (XRF) and an in vitro protocol utilizing artificial bovine bone plates. Five groups were analyzed using XRF-spectrometry: groups 1–4 (titanium implants) and group 5 (zirconia implants). The implants were inserted into two bone blocks held together by a vice. The blocks were separated, and the insertion sites were analyzed for titanium (Ti) and zirconium (Zr). Statistical descriptive analyses of Ti and Zr concentrations in the coronal, middle and apical bone interface were performed. A comparative analysis confirmed differences between the implant’s surface stability and Ti accumulation within the insertion sites of the bone block. There was a direct relationship between implant length and the quantity of titanium found on the bone block. The data generally indicates greater quantities of titanium in the coronal thirds of the implants, and less in the apical thirds. The titanium and zirconium found in the bone samples where the group 5 implants were inserted was not of statistical significance when compared to control osteotomies. The results of this study confirm wear from metallic, but not ceramic, dental implants at the time of insertion.

The aim of the present case report was to demonstrate the vertical gain in the posterior resorbed mandible utilizing the use of an Allograft Customized Bone Block. The case presents a 66-year-old healthy female nonsmoker who lost her right mandibular molars long time ago. In the past, she had an implant placement, which failed due to a fracture of the implant. Due to the high risk of mandibular nerve damage, the implant was left in the jaw and was completely covered with bone. Since the jaw was completely atrophic and short implants were not an option, a vertical ridge augmentation was required. This case report presents the use of an Allograft Customized Bone Block as a good option in patients with an atrophic mandible, showing no vertical bone resorption five months after placement and great osseointegration of the placed implants.

The aim of this study was to assess the effect of application of a recently developed bio-adhesive (Impladhesive) to abutment screw threads on the removal torque value and rotational misfit at the implant–abutment junction. This in vitro study evaluated 20 implant fixtures and 20 straight abutments. Specimens were randomly divided into two groups (n = 10) with/without adhesive application. In the adhesive group, the abutment was dipped in Impladhesive before torquing. In the control group, the abutment was torqued conventionally without adhesive application. The removal torque value was recorded after completion of the cyclic loading of 500,000 cycles with 2 Hz frequency and 75 N load. Rotational misfit was recorded using a video measuring machine. After applying the torque, the change in the bisector angle on the abutment hex was recorded for each implant. The biocompatibility of Impladhesive was evaluated using a MTT cell vitality assay. Normal distribution of data was assessed using the Kolmogorov–Smirnov test. Data were analyzed using a t-test and Pearson’s correlation coefficient The application of Impladhesive at the implant–abutment interface resulted in significantly greater mean removal torque value compared to the control group (p = 0.008). In addition, the mean rotational misfit at the implant–abutment interface was significantly lower in the use of Impladhesive compared to the control group (p = 0.001). In addition, the cell vitality was found to be greater than 80% at all evaluated time points. It can be concluded that the application of Impladhesive on the abutment screw significantly decreased rotational misfit and increased the removal torque value. Future studies are needed to evaluate the efficacy of this bio-adhesive an in vivo setting.

The objective of this review was to analyze the process of wear of implants leading to the shedding of titanium particles into the peri-implant hard and soft tissues. Titanium is considered highly biocompatible with low corrosion and toxicity, but recent studies indicate that this understanding may be misleading as the properties of the material change drastically when titanium nanoparticles (NPs) are shed from implant surfaces. These NPs are immunogenic and are associated with a macrophage-mediated inflammatory response by the host. The literature discussed in this review indicates that titanium NPs may be shed from implant surfaces at the time of implant placement, under loading conditions, and during implant maintenance procedures. We also discuss the significance of the micro-gap at the implant-abutment interface and the effect of size of the titanium particles on their toxicology. These findings are significant as the titanium particles can have adverse effects on local soft and hard tissues surrounding implants, implant health and prognosis, and even the health of systemic tissues and organs.

Manufacturing processes of custom implant abutments may contaminate their surfaces with micro wear deposits and generic pollutants. Such particulate debris, if not removed, might be detrimental and provoke inflammatory reactions in peri-implant tissues. Although regulatory guidelines for adequate cleaning, disinfection, or sterilization exist, there does not appear to be a consistent application and data on the amount and extent of such contaminants is lacking. The aim of the present in vitro study was to evaluate the quality and quantity of processing-related surface contamination of computer-aided design/computer-aided manufacturing (CAD/CAM) abutments in the state of delivery and after ultrasonic cleaning. A total of 28 CAD/CAM monotype and hybrid abutments were cleaned and disinfected applying a three-stage ultrasonic protocol (Finevo protocol). Before and after cleaning, the chemical composition and the contamination of the abutments were assessed using scanning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX), and computer-aided planimetric measurement (CAPM). In the delivery condition, monotype abutments showed a significantly higher amount of debris compared to hybrid abutments (4.86 ± 6.10% vs. 0.03 ± 0.03%, p < 0.001). The polishing process applied in the laboratory after bonding the hybrid abutment components reduces the surface roughness and thus contributes substantially to their purity. The extent of contamination caused by computer-aided manufacturing of custom abutments can be substantially minimized using a three-stage ultrasonic protocol.

The stability of the implant–abutment interface is crucial for the maintenance of the implant index integrity. Several factors are capable of inducing deformation in implant–abutment connection, such as the actual insertion of the implant into the bone. This study aimed to evaluate the deformations produced in the connection after the insertion of the implant. Ten implants with two different implant carriers (Type A: carrier attached to platform and Type B: carrier attached inside the index-connection) were placed in artificial Type II bone, and volumetric changes were evaluated for different connection features with a 3D digital microscope. ANOVA (analysis of variance), Wilcoxon, and Tukey HSD post-test were used for statistical comparisons. Type A implants presented deformation at the platform level (inner slot angles and slot width), but no volumetric changes were observed inside the connection. Type B implants presented deformation in three parameters inside the connection (outer channel length, coronal step width, and coronal step length). Within the limitations of this study, we can conclude that more deformation is expected at the internal connection when the implant carrier engages this area. The engagement area should be as far away as possible from the index connection.

Roughness characteristics play an essential role in osseointegration. However, there is a concern about the susceptibility of those surfaces to bacterial colonization. New techniques for cleaning and surface treatment have appeared that could favor osseointegration without the need to create surfaces as rough. Such is the case of non-thermal low-pressure argon plasma (NTLP-ArP). One hundred and forty-four implants were placed in the tibiae of 36 Sprague Dawley rats, distributed in four experimental groups: I: mechanized surface; II: mechanized surface treated with NTLP-ArP, III: resorbable blast media (RBM) surface; and IV: RBM surface treated with (NTLP-ArP). Bone-to-implant contact (BIC) percentages were calculated by microtomographic evaluation and histological analysis at one, two, and four weeks after implant placement. ANOVA and Mann–Whitney tests were used for statistical analysis, establishing p < 0.05. No significant differences were found at one-week comparisons. The groups treated with NTLP-ArP obtained higher BIC% than those not treated at two and four weeks. Mechanized surfaces treated with NTLP-ArP obtained BIC values similar to RBM surfaces.

Denture teeth are used for removable prostheses and implant-supportive restorations. The purpose of this study was to analyze the surface of artificial teeth following exposure to different liquids. Mechanical wear and the cleaning of artificial teeth were also investigated. Two groups of resin teeth were used; original surface (Group A) and surface abrasion/wear (Group B). The teeth were exposed for 24 h to water (control), cola (Group 1), coffee (Group 2), tea (Group 3), chlorhexidine (Group 4), and red wine (Group 5). Baseline measurements of liquids were taken. An x-ray fluorescence spectrometric analysis was performed. Data were evaluated using semi-quantitative descriptive analysis. The data showed approximate increases of peak intensity for Group A1-2-fold Fe, 2-fold Ni, 2.2-fold Zn; for Groups A2 and A3- less than 1.5-fold Fe, Ni, and Zn. Group B yielded similar results; however, the increases in Fe, Ni, and Zn were significantly higher in Groups 1 and 2 (ranged 2-4-fold increases in intensity). Group B3 showed little increase in Fe, Ni, and Zn. Groups A4 and A5 showed intensity increases for Zn. Groups A1–A5 showed reductions in intensity following 30 s of cleaning. A pronounced accumulation of iron, nickel, and zinc was found after exposure to liquids, especially when artificial teeth were worn down. Peak intensities were reduced following 30 s of brushing.

Two-phase implants must be exposed to the external environment after the period of osteointegration has elapsed. For this purpose, a healing abutment is placed passing through the mucosa while forming the emergence profile. The continuous connection and disconnection can lead to an alteration in the tissue maturation, both because of the contact of bacterial plaque and because of the mechanical trauma that involves its manipulation, manifesting with different degrees of erythema or bleeding. To assess whether this epithelium disruption can be counteracted, a blinded study design was developed on 150 unitary implant patients divided into three groups (n = 50), applying chlorhexidine (group 1), ultraviolet C (UV-C) at a wavelength of 254 nm (group 2)and no treatment as a control group (group 3), during each of the disconnections and connections during the prosthodontic treatment (1 time per week for four weeks). All groups showed a better epithelium aspect at the end of the evaluation. Although there were no statistically significant differences in the degree of inflammation, the UV-C treated group had the lowest plaque accumulation, and the highest was for the chlorhexidine-treated group.

For a long time, Chlorhexidine digluconate (CHX) has been considered the most used mouth-rinse for reducing plaque and gingivitis. Sea4® Encias is a new seawater-based mouth rinse with a similar action to CHX. Its prolonged use produces fewer side effects. This study compared the effects of two oral rinses: Chlorhexidine 0.20% and Sea 4® Encias (seawater) for reducing plaque and gingivitis indices. This double-blind crossover study recruited and monitored 93 volunteer dental students, hygienists and doctors from the Universidad Católica de Murcia (UCAM), for 1 month, and compared the efficacy of Chlorhexidine 0.20% (Group A); Sea4® Encías (Group B); and a placebo saline solution (Group C) mouth-rinses for reducing plaque and gingivitis indices. Plaque and gingival inflammation (Löe and Silness test) were evaluated at baseline and after each study stage. Group A reduced plaque growth and gingivitis significantly compared with Groups B and C; Group B was more effective than Group C. The mean P.I. decreased similarly in groups A and B. However, Group A showed the statistically significant value compared with other groups. Group A and group B, showed greater reduction in Gingival Indexes compared with group C. The Sea4 mouthwash showed better inhibitory activity on plaque (1.32 ± 0.22) compared with CHX (1.97 ± 0.34) and saline (2.78 ± 0.11). Sea4 Encias and Chlorhexidine 0.20% mouth-rinses significantly reduce plaque growth and G.I. compared with saline mouth-rinse; Sea4 Encías mouth-rinse is more effective against plaque regrowth than Chlorhexidine in this pilot study.

Six dentin adhesives were tested in vitro regarding their cytotoxicity on human fibroblasts. The adhesives Hybrid Bond, One-up Bond F Plus, AdheSE, Clearfil SE Bond, Optibond Solo Plus and Syntac were eluted with culture medium as single or sequentially applied adhesive part for 24 h. 75 Petri dishes were produced per group. They were evaluated triangulated, comprising the quantitative evaluation (105 ones) to determine “viable”, “dead” and “debris” cells with the use of a cell-counter and the reactivity index was also identified based on the qualitative assessment (420 ones). One-up Bond F Plus, AdheSE and Clearfil SE Bond showed a statistical difference of viable cells to the cell control. For One-up Bond F Plus, statistically, differences compared to hybrid bond and Syntac were also found. All the adhesives except One-up Bond F Plus showed significant differences between single and sequentially applied adhesive part regarding the quantitative evaluation. The test material showed a moderate grade of cytotoxicity. As a result, a statistically significant difference of the cytotoxicity between the self-etch and etch-and-rinse adhesives cannot be demonstrated regarding the qualitative evaluation and the reactivity index, but the differences between sequentially applied and single applied components can be proved.

A limited number of studies have reported an association between male factor infertility (MFI) and dental health status (DHS). The aim of the present study was to assess the association between DHS and MFI through a systematic review of indexed literature. To address the focused question—“Is there a relationship between DHS and MFI?”—indexed databases were searched up to March 2016 using various key words “infertility,” “periodontal disease,” “periodontitis,” “dental infection,” “caries,” and “odontogenic infection.” Letters to the editor, case reports, commentaries, historic reviews, and experimental studies were excluded. In total seven studies were included in the present systematic review and processed for data extraction. All the studies reported a positive association between MFI and DHS. The number of study participants ranged between 18 and 360 individuals. Results from six studies showed a positive association between chronic periodontitis and MFI. Three studies reported a positive relationship between MFI and odontogenic infections associated to necrotic pulp, chronic apical osteitis, and radicular cysts. One study reported a relationship between caries index and MFI. From the literature reviewed, there seems to be a positive association between MFI and DHS; however, further longitudinal studies and randomized control trials assessing confounders are needed to establish real correlation. Dentists and general practitioners should be aware that oral diseases can influence the systemic health. Andrological examination should include comprehensive oral evaluation, and physicians detecting oral diseases should refer the patient to a dentist for further evaluation.

Background. The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description. A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions. The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.

Background. The purpose of this systematic review was to accurately assess the procedural success of ridge preservation technique through the application of strict inclusion and exclusion criteria. Data Sources. A methodical search of PubMed of the US National Library of Medicine and the Cochrane Central Register of Controlled Trials was conducted for applicable articles. Only randomized controlled trials comparing ridge preservation treatment with a nongrafting control, ten-subject minimum sample size, and three or more months of follow-up were included in our study. Types of Studies Reviewed. In a screening between January 1980 and September 2017, articles meeting predetermined criteria were further examined in a qualitative data analysis. A thorough search of the databases provided 1876 articles. Of these records, 174 were assessed for eligibility through the systematic employment of inclusion and exclusion criteria. Results. Two records were appropriate for further data analysis. One study used a mixture of a deproteinized cancellous bovine bone and porcine collagen fibers in a block form (DBB/CF), while the other study used leukocyte-platelet-rich fibrin (L-PRF). The use of DBB/CF reduced the magnitude of vertical bone resorption, yet the study showed high risk of bias. The use of L-PRF reduced the magnitude of both the horizontal and vertical crestal bone resorption; however, the low sample size created wide standard deviations between the test and control groups. Inherent weaknesses were present in both studies. Through methodical analysis of both records, the dissimilarities prevented the conduction of a meta-analysis. Implications of Key Findings. Within the limitations of this systematic review, L-PRF reduced the magnitude of vertical and horizontal bone resorption, which places L-PRF as a potential material of choice for ridge preservation procedures. Conclusions. Within the limitations and weaknesses of both studies, the use of DBB/CF prevented the vertical crestal bone resorption while the L-PRF prevented both the horizontal and vertical crestal bone resorption. More randomized controlled clinical trials are needed to eliminate all the confounding factors, which bias the outcome of ridge preservation techniques.

There is a debate over the association between low testosterone levels in body fluids and the occurrence of chronic periodontitis (CP). The aim of the present systematic review was to assess whether low testosterone levels in body fluids reflect CP. In order to identify studies relevant to the focus question: “Is there a relationship between low testosterone levels in body fluids and CP?” an electronic search without time or language restrictions was conducted up to June 2016 in indexed databases using different keywords: periodontitis, chronic periodontitis, periodontal diseases, testosterone, and gonadal steroid hormones. A total of eight studies were included in the present systematic review. The number of study participants ranged from 24 to 1,838 male individuals with ages ranging from 15 to 95 years. Seven studies measured testosterone levels in serum, two studies in saliva, and one study in gingiva. Four studies reported a negative association between serum testosterone levels and CP. Two studies reported a positive association between decreased testosterone levels in serum and CP. Increased levels of salivary testosterone among patients with CP were reported in one study; whereas one study reported no significant difference in the concentration of salivary testosterone between patients with and without CP. One study identified significant increase in the metabolism of testosterone in the gingiva of patients with CP. Within the limits of the evidence available, the relationship between low testosterone levels and CP remains debatable and further longitudinal studies and control trials are needed.

It is hypothesized that there is no statistically significant impact of drilling speed (DS) on the primary stability (PS) of narrow-diameter implants (NDIs) with varying thread designs placed in dense and soft simulated bone. The aim of this in vitro study was to evaluate the impact of DS on the PS of NDIs with varying thread designs placed in dense and soft simulated bone. Two hundred and forty osteotomies for placement of various implant macro-designs were divided into three groups (80 implants per group): Group A (NobelActive, 3.0/11.5 mm); Group B (Astra OsseoSpeed-EV, 3.0/11 mm); and Group C (Eztetic-Zimmer, 3.1/11.5 mm) implants. These implants were placed in artificial dense and soft simulated bone using DSs of 800 and 2000 revolutions per minute (RPM). Resonance frequency analysis (RFA) and implant stability quotient (ISQ) were assessed. Group comparisons were performed using the one-way analysis of variance with Tukey’s post hoc tests. Level of significance was set at P < 0.05. In groups A and B, there was no difference in the ISQ for NDIs inserted in dense bone at 800 and 2000 RPM. In Group C, ISQ was significantly higher for NDIs placed in dense bone at 800 PRM compared to 2000 RPM (P < 0.05). In Group A, ISQ values were significantly higher for NDIs inserted in soft bone at 2000 RPM as compared to those inserted at 800 RPM (P < 0.05). For NDIs, a lower drilling speed in dense artificial simulated bone and a higher drilling speed in soft artificial simulated bone is associated with high primary stability.

The IPS e.max system by Ivoclar Vivadent, offering a variety of products and indications, is widely used for all-ceramic restorations. We analyzed the clinical track record of these products in daily clinical practice, associating their restorative survival rate with various parameters to define recommendations for long-term stability. A total of 1058 full-coverage crowns and fixed partial dentures (FPDs) were evaluated retrospectively over up to 66.48 (37.05 ± 18.4) months. All were made of IPS e.max Press, IPS e.max CAD, IPS e.max Ceram or IPS e.max ZirPress and had been delivered by a private dental practice within three years. Uses not recommended by the manufacturer were also deliberately included. The five-year cumulative survival was 94.22% (i.e., 94.69% or 90.58% for glass-ceramic crowns or FDPs and 100% or 90.06% for zirconia-based crowns or FDPs). Significantly superior outcomes emerged for conventional vs. adhesive cementation and for vital vs. non-vital abutment teeth, but not for recommended vs. non-recommended uses. Caution is required in restoring non-vital teeth, but the spectrum of recommended uses should generally be reconsidered and expanded, given our finding of high survival and success rates for IPS e.max ceramics, even for uses not currently recommended by the manufacturer.