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The aims of the present study were to clinically and histologically evaluate human fresh frozen bone (FFB) grafts used to treat severe maxillary horizontal defects prior to dental implant placement. Ten patients were treated with FFB onlay grafts. Measurements using computed tomography scans were recorded preoperatively and at 5 months. Six core biopsies were retrieved and processed for light microscopy. At baseline, thickness of the maxillary alveolar ridge measured 2.3 ± 0.4 mm; it measured 6.8 ± 0.5 mm after reconstruction. All implants were successful after 24 months. Histologic results showed that FFB blocks and new bone were integrated perfectly. Histomorphometry revealed a mean percentage of bone of 57.5% ± 24.7%. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of 0.2% and 2% chlorhexidine (CHX) used as a therapeutic primer on the long-term bond strengths of two etch-and-rinse adhesive systems. Materials and Methods: Adper Scotchbond 1XT (SB1) and XP-Bond (XPB) were evaluated. Etched dentin substrates were assigned to 6 treatment groups: (1) 0.2% CHX + SB1; (2) 2% CHX + SB1; (3) SB1 (control); (4) 0.2% CHX + XPB; (5) 2% CHX + XPB; (6) XPB (control). Composite buildups were made and beams prepared for microtensile bond strength testing. Beams were divided into 3 subgroups and either immediately pulled to failure or stored in artificial saliva for 6 or 12 months prior to testing. Data were evaluated with three-way ANOVA. Additional adhesive interfaces were prepared to investigate nanoleakage expression by TEM. Results: SB1 and XPB showed similar immediate bond strength values with or without CHX pretreatment (p > 0.05). After 12 months, bonds fell from 43.9 ± 9.5 MPa to 20.1 ± 5.4 MPa and from 39.6 ± 9.4 MPa to 14.2 ± 5.0 MPa in control specimens for SB1 and XPB respectively, while bond fell only from 41.9 ± 9.6MPa to 33.2 ± 8.3 MPa and 38.3 ± 8.9 MPa to 26.5 ± 10.9 (for SB1 and XPB, respectively) when 0.2% CHX was previously used. CHX concentration did not affect bond strength values (0.2% vs 2%, p > 0.05). Nanoleakage increased during aging in controls, but reduced silver deposits were found in CHX-treated specimens. Conclusion: Chlorhexidine significantly reduced the loss of bond strength seen in control bonds. Since no bacterial growth was present in the aging conditions, the results of this study suggest that endogenous factors thought to degrade the adhesive interface can be inhibited by CHX. Further in vivo trials should confirm the role of CHX in bond durability. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate whether an electrical device for dental adhesive application (ElectroBond) influences bonding of two-step etch-and-rinse adhesives. Materials and Methods: Human teeth were selected and cut perpendicularly to their long axis to expose middle/deep dentin. Specimens were then longitudinally sectioned into halves (experimental and control halves) to create two similar bonding substrates. Experimental halves were bonded using an ElectroBond-assisted application, while control halves were bonded with disposable sponges. The adhesives tested were Adper Scotchbond 1XT and XPBOND. Bonded specimens were submitted to the microtensile bond strength test. Additional adhesive interfaces were prepared and processed for nanoleakage investigation involving TEM examination. Results: The microtensile bond test revealed higher values (p < 0.05) for both adhesives if ElectroBond was used during layering (55.5 ± 7.9 MPa for Adper Scotchbond 1XT and 54.7 ± 7.1 MPa for XP-BOND) compared to the conventional mechanical adhesive application technique (41.1 ± 6.1 MPa for Adper Scotchbond 1XT and 38.0 ± 7.8 MPa for XP-BOND). No difference between the two adhesives was found under the same application conditions. With electricity-assisted application, TEM micrographs revealed a significant decrease in nanoleakage expression compared to the controls. Conclusion: The use of an electric current produced by ElectroBond during the application of two-step etch-and-rinse adhesives may enhance resin impregnation, thus improving dentin hybridization. Further studies should be done to confirm that this device can similarly improve adhesive application in vivo. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this prospective comparative clinical study was to evaluate the effect of oral anticoagulants on peri- and post-operative bleeding during simple single tooth extractions, comparing patients in treatment with vitamin K antagonists (VKAs) and patients assuming direct oral anticoagulants (DOACs). Materials and methods: Patients under oral anticoagulant therapy needing dental extraction were eligible for entering the study; patients were enrolled following inclusion and exclusion criteria and divided into VKAs and DOAC group according to the anticoagulation therapy. Included patients underwent a simple single dental extraction with elevators and forceps with a maximum surgical time of 15 minutes, without anticoagulation therapy discontinuation. All participants were assessed pre-operatively, during surgery, 30 min minutes and 7 days after surgery. Biological complications were registered and post-extraction bleeding was clinically defined according to Iwabuchi classification. Parametric and non-parametric tests were used to evaluate the variables between the groups. Results: Sixty-five patients per group were enrolled and 130 teeth were extracted. The two groups were comparable for pre-, peri-, and post-operative variables. Only 1 patient of DOAC group and 2 patients for VKA group needed medical evaluation for post-extractive bleeding. No statistically significant difference resulted in post-operative bleeding events between the groups (p = 0.425). Conclusions: DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction. Bleeding events were not statistically significant and not clinically relevant. Clinical relevance: Patients assuming DOACs can be treated similarly to patients in VKAs therapy with INR index between 2 and 3. Non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the extent of polymerization of four adhesive systems on whitened enamel immediately after bonding or delayed for 24 hours and 2 weeks. The effect of prolonged light-curing was also analyzed Methods: One adhesive of each class was investigated: Adper Scotchbond Multi-Purpose (three-step etch-and-rinse), One-Step (two-step etch-and-rinse), Clearfil Protect Bond (two-step self-etching) and Xeno III (one-step self-etching). Enamel fragments were treated with Opalescence Xtra Boost for 30 minutes, powdered and pressed into aluminum pans. Specimens were bonded immediately after bleaching, after 24 hours or after 14 days of storage in 100% humidity at 37°C. Unbleached enamel powder was prepared as control. Extent of polymerization of bonded interfaces was obtained with differential scanning calorimetry (DSC) at 20, 40 and 60 seconds and data were statistically analyzed with 3-way ANOVA and Tukey's post-hoc test. Results: The extent of polymerization obtained from DSC exotherms of adhesives applied immediately after bleaching was significantly lower compared to controls. Increased extent of polymerization after storage was confirmed for all adhesives and no difference with controls was found after 14 days. Prolonged irradiation time increased curing rate for all the tested adhesives. This study supported the hypothesis that polymerization of the adhesive is reduced after enamel bleaching and delayed adhesive application reverses the polymerization inhibition. Prolonged polymerization intervals may counteract the inhibition of polymerization due to the bleaching procedure; nevertheless further clinical studies should validate this hypothesis. [ABSTRACT FROM AUTHOR]

This study evaluated the morphological effects produced in vivo by two in-office bleaching agents on enamel surface roughness using a noncontact profilometric analysis of epoxy replicas. The null hypothesis tested was that there would be no difference in the micromorphology of the enamel surface during or after bleaching with two different bleaching agents. Eighteen subjects were selected and randomly assigned to two treatment groups (n=9). The tooth whitening materials tested were 38% hydrogen peroxide (HP) (Opalescence Xtra Boost) and 35% carbamide peroxide (CP) (Rembrandt Quik Start). The bleaching agents were applied in accordance with manufacturer protocols. The treatments were repeated four times at one-week intervals. High precision impressions of the upper right incisor were taken at baseline as the control (CTRL) and after each bleaching treatment (T0: first application, T1: second application at one week, T2: third application at two weeks and T3: fourth application at three weeks). Epoxy resin replicas were poured from impressions, and the surface roughness was analyzed by means of a non-contact profilometer (Talysurf CLI 1000). Epoxy replicas were then observed using SEM. All data were statistically analyzed using ANOVA and differences were determined with a t-test. No significant differences in surface roughness were found on enamel replicas using either 38% hydrogen peroxide or 35% carbamide peroxide in vivo. This in vivo study supports the null hypothesis that two in-office bleaching agents, with either a high concentration of hydrogen or carbamide peroxide, do not alter enamel surface roughness, even after multiple applications.