How Precise Is Dental Volumetric Tomography in the Prediction of Bone Density?

Objectives. The aim of this study was to review the bone density assessment techniques and evaluate the macroscopic structure of bone specimens scored by Hounsfield Units (HUs) and decide if they are always in congruence. Methods. The mandible of a formalin-fixed human cadaver was scanned by dental volumetric tomography (DVT) for planning of the specimen positions and fabrication of a surgical guide and a surgical stent was fabricated afterwards. Bone cylinders of 3.5 mm diameter and 5 mm length, were excised from the mandible using the surgical stent with a slow speed trephine drill. After removal of the cylinders two more scans were performed and the images of the first scan were used for the determination of the HU values. The removed bone cylinder was inspected macroscopically as well by micro-CT scan. Results. The highest HU values were recorded in the interforaminal region, especially in the midline (408–742). Posterior regions showed lower HU values, especially the first molar regions (22–61 for the right; 14–66 for the left first molar regions). Conclusion. Within the limitations of this pilot study, it can be concluded that HU values alone could be a misleading diagnostic tool for the determination of bone density

Is clinical experience important for obtaining the primary stability of dental implants with aggressive threads? An ex vivo study

The aim of this study was to investigate the clinicians? experience on maintaining the primary stability of implants with aggressive threads belonging to a novel dental implant system. Three hundred implants with aggressive threads were inserted in fresh bovine ribs mimicking Type IV bone by five clinicians which were classified according to their previous experience of total number of implant insertion. An independent examiner measured the primary stability of all implants after insertion by using resonance frequency analysis (RFA), electronic percussive testing (EPT) and removal torque methods. No significant differences were detected between the stability values measured by the clinicians (p0.05). Significantly higher stability values were detected in the secondary insertion of the non-experienced clinician as compared to her initial insertion values (p >0.05). No significant differences were detected between the first and second measurements of the other clinicians (p< 0.05). Within the limitations of this ex-vivo study, it may be concluded that experience does not play an important role in maintaining the stability of implants with aggressive threads

Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery-Retrospective Analysis of a Clinical Case Series.

The comprehensive treatment of periodontitis stage 2 to 4 aims at the resolution of periodontal inflammation and "pocket closure", which implies a residual probing depth of ≤4 mm and a negative BoP. However, supportive periodontal therapy (SPT) regularly leaves behind persistent periodontal pockets with 5 or more mm in residual PPD and sites that often re-colonize and re-infect. Various adjunctive options for subgingival instrumentation have been proposed to enhance the antimicrobial effects to better control the re-infection of these residual sites. The locally applied adjuncts, based on their anti-inflammatory effect, are sodium hypochlorite antiseptic cleaning gel and cross-linked hyaluronic acid (xHyA). Both recently moved into the focus of clinical research on non-surgical and surgical therapy for periodontitis. The surgical use of xHyA indicates regenerative potential, supporting periodontal regeneration. This case series retrospectively analyzes the clinical benefits of the consecutive flapless application of sodium-hypochlorite-based cleaning gel and xHyA at the SPT to achieve pocket closure, thereby reducing the need for periodontal surgery. In 29 patients, 111 sites received the treatment sequence. At 6-month re-evaluation, an overall PPD reduction exceeding 2 mm was achieved, associated with a similar CAL gain (2.02 mm); the bleeding tendency (BoP) was reduced by &gt;60%. Pocket closure occurred in almost 25% of all the sites. Within their limits, the present data suggest that the proposed combined adjunctive treatment of residual active periodontal sites yielded significant improvement in the clinical parameters. Further studies in RCT format are required to confirm these observations

Adhesion of conventional and self-adhesive resin cements to indirect resin composite using different surface conditioning methods

This study evaluated the adhesion of conventional and self-adhesive resin cements to indirect resin composite (IRC) using different surface conditioning methods. Cylindrical IRC specimens (N = 192) were randomly assigned to four surface conditioning methods (n = 8 per group): (a) Control group, (b) Hydrofluoric acid, (c) Tribochemical silica-coating, and (d) 50 μm Al2O3 air-abrasion. Specimen surfaces were finished using silicon carbide papers up to 600 grit under water irrigation, rinsed and dried. Direct composite blocks were bonded to IRC specimens using three conventional resin cements (Multilink, Panavia F2.0, and Resicem) and three self-adhesive resin cements (RelyX U100, Gcem, Speed Cem). Specimens were subjected to shear bond strength test in a Universal Testing Machine (0.5 mm/min). Failure types were categorized as mixed, adhesive and cohesive. Data were analyzed using 2-way ANOVA and Tukey’s tests. Two-parameter Weibull modulus, scale (m) and shape (0) were calculated. The bond strength results (MPa) were significantly affected by the surface conditioning method (p < 0.0001) and cement type (p < 0.001). For Panavia F2.0, Resicem, air-abrasion with 50 μm Al2O3 significantly increased the results (22.6 ± 6.5, 26.2 ± 6.5, respectively) compared to other conditioning methods (13.6 ± 1.4–21.9 ± 3.1) but for Multilink, hydrofluoric acid etching (20.5 ± 3.5) showed significantly higher results (p < 0.01). For the self-adhesive resin cements, air-abrasion with 50 μm Al2O3 significantly increased the results compared to other conditioning methods, except for RelyX U100 (p < 0.05). After air-abrasion with Al2O3, Gcem, (11.64), RelyX U100 (9.05), and SpeedCem (8.29) presented higher Weilbul moduli. Exclusively cohesive failure in the IRC was observed with RelyX U100 and Speedcem after Al2O3 air-abrasion