Treatment of grade III furcation lesion by tunneling in a smoker patient: Clinical Case Report

The aim of this study is to describe a case report of lower molar treatment with grade III furcation by the tunneling technique in a heavy smoker patient. Case presentation: In the present study, a 40-year- -old man, a heavy smoker (> 20 cigarettes / day) presented a grade III furcation injury on dental element 46 after a clinical and radiographic examination. After non-surgical periodontal therapy, the patient was treated with the execution of the tunneling of the furcation of the tooth 46, which was effective in the control of the disease and in the maintenance of the dental element after 12 months of follow up. Final considerations: The tunneling technique was effective in the control of periodontal disease in a heavy smoking patient, with a good standard of hygiene and motivation, and good clinical results were maintained after 12 months of follow-up

Graphene-based nanomaterials for tissue engineering in the dental field

The world of dentistry is approaching graphene-based nanomaterials as substitutes for tissue engineering. Apart from its exceptional mechanical strength, electrical conductivity and thermal stability, graphene and its derivatives can be functionalized with several bioactive molecules. They can also be incorporated into different scaffolds used in regenerative dentistry, generating nanocomposites with improved characteristics. This review presents the state of the art of graphene-based nanomaterial applications in the dental field. We first discuss the interactions between cells and graphene, summarizing the available in vitro and in vivo studies concerning graphene biocompatibility and cytotoxicity. We then highlight the role of graphene-based nanomaterials in stem cell control, in terms of adhesion, proliferation and differentiation. Particular attention will be given to stem cells of dental origin, such as those isolated from dental pulp, periodontal ligament or dental follicle. The review then discusses the interactions between graphene-based nanomaterials with cells of the immune system; we also focus on the antibacterial activity of graphene nanomaterials. In the last section, we offer our perspectives on the various opportunities facing the use of graphene and its derivatives in associations with titanium dental implants, membranes for bone regeneration, resins, cements and adhesives as well as for tooth-whitening procedure

Periodontitis in the Developmental Age: Pathogenesis, Epidemiology, Differential Diagnosis and Treatment. A Narrative Review

Periodontal disease is one of the most widespread diseases in the world and is, as a prevalence, immediately after diseases..

CAD/CAM monolithic materials: wear resistance and abrasiveness, and the effect of grinding and polishing on their roughness and fracture resistance.

This thesis consists of two studies, both investigating the computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials. First study. Aim. The wear resistance and abrasiveness of Lava Ultimate, Vita Enamic, Vita Suprinity, IPS e.max CAD, and Lava Plus, as well as some properties that might be related to, were analyzed. Methods. Specimens from these materials had their roughness, hardness, and coefficient of friction evaluated, respectively in confocal microscope, microdurometer, and tribometer. The 2-body wear test, wherein the materials acted as abraders and, together with bovine enamel, also as antagonists, was also carried out. The wear rate was determined with surface profilometer and the worn surfaces were observed by scanning electron microscopy (SEM). Results. Vita Enamic and Lava Ultimate showed the highest roughness, whereas IPS e.max CAD and Vita Suprinity, the lowest. The hardness result was Lava Plus > (Vita Suprinity=IPS e.max CAD) > Vita Enamic >Lava Ultimate. Lava Ultimate exhibited a higher coefficient of friction than IPS e.max CAD and Lava Plus. Lava Plus and IPS e.max CAD showed significantly higher potential to wear Lava Ultimate. These two materials, together with Vita Suprinity, provided the highest wear of enamel and Vita Enamic. Vita Suprinity and IPS e.max CAD exhibited the highest wear against Lava Plus, and the inverse also occurred. Vita Enamic and Lava Ultimate were among the materials that caused the lowest wear of enamel and all other evaluated materials. Conclusion. The nanofilled composite resin and polymer-infiltrated ceramic were more antagonist-friendly (whether enamel or CAD-CAM material) than glass-ceramics and zirconia. Care should be taken when selecting the material that will contact mainly with glass-ceramics. Hardness should also be considered when selecting a material. Second study. Aim. To evaluate the effect of grinding and polishing on the roughness and fracture resistance of Lava Ultimate, Vita Enamic, Vita Suprinity, and IPS e.max CAD, submitted to mechanical aging. Methods. Disks from these materials were analyzed for roughness: 1) after polishing with silicon carbide papers (Lava Ultimate and Vita Enamic) or glazing (IPS e.max CAD and Vita Suprinity) (control); 2) after grinding with 30-μm grit diamond rotary instruments; 3) and after grinding and polishing with the polishing kit Ceramiste Polishers. For fracture resistance, a simplified tri-layer model consisting of restorative disk, epoxy resin disk, and a steel ring was used. The bonded tri-layer disks received the same conditions described for the roughness analysis. Half of the specimens underwent mechanical aging for 1×106 cycles. All specimens were loaded until failure. The Weibull modulus was calculated. Results. Among the control groups, no significant difference was found between the IPS e.max CAD and Vita Suprinity and between the Lava Ultimate and Vita Enamic, which were rougher than the glass-ceramic materials. After grinding, this behavior was maintained, except for the Vita Enamic, whose roughness was similar to that of the IPS e.max CAD. After polishing, the Vita Enamic showed the highest roughness, whereas the other materials were not statistically different. IPS e.max CAD and Vita Suprinity showed the lowest roughness in the control groups. For Lava Ultimate and Vita Enamic, polishing provided the lowest roughness. Grinding followed or not by polishing, and mechanical aging, did not adversely affect fracture resistance or the reliability of the materials. Conclusions. Polishing did not recover the initial roughness of the glass-ceramic materials. Fracture resistance was not affected by grinding, followed or not by polishing, even after mechanical aging

Efficacy of Two Toothpaste in Preventing Tooth Erosive Lesions Associated with Gastroesophageal Reflux Disease

Patients suffering from acid reflux due to endogenous causes are often affected by gastroesophageal reflux disease which, in the oral environment, causes lingual and palatal enamel erosion. As enamel does not have the intrinsic ability to repair itself, the application of alloplastic materials, such as toothpastes is suggestable. The aim of this “in vitro” study was to compare the effectiveness of two different toothpastes in preventing erosion due to gastroesophageal reflux disease. Six tooth elements from bovine jaws were prepared using a high-speed diamond bur and water irrigation. Acid attack simulation was carried out using a 15% HCl hydrochloric acid solution. After that, two different toothpastes with or without fluoride, were brushed at the sample surface using an electric toothbrush at standard position and force. SEM and profilometer analysis were performed. Statistically significant difference was found in average tooth surface roughness after using toothpaste with or without fluoride after the acid attack, as the former offered a greater remineralization. No difference was found in long-term prevention. Fluoridated toothpastes offer a greater degree of remineralization at a first acid attack, however, there is no difference in long-term prevention independently from the toothpaste type

CAD/CAM monolithic materials: wear resistance and abrasiveness, and the effect of grinding and polishing on their roughness and fracture resistance.

This thesis consists of two studies, both investigating the computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials. First study. Aim. The wear resistance and abrasiveness of Lava Ultimate, Vita Enamic, Vita Suprinity, IPS e.max CAD, and Lava Plus, as well as some properties that might be related to, were analyzed. Methods. Specimens from these materials had their roughness, hardness, and coefficient of friction evaluated, respectively in confocal microscope, microdurometer, and tribometer. The 2-body wear test, wherein the materials acted as abraders and, together with bovine enamel, also as antagonists, was also carried out. The wear rate was determined with surface profilometer and the worn surfaces were observed by scanning electron microscopy (SEM). Results. Vita Enamic and Lava Ultimate showed the highest roughness, whereas IPS e.max CAD and Vita Suprinity, the lowest. The hardness result was Lava Plus > (Vita Suprinity=IPS e.max CAD) > Vita Enamic >Lava Ultimate. Lava Ultimate exhibited a higher coefficient of friction than IPS e.max CAD and Lava Plus. Lava Plus and IPS e.max CAD showed significantly higher potential to wear Lava Ultimate. These two materials, together with Vita Suprinity, provided the highest wear of enamel and Vita Enamic. Vita Suprinity and IPS e.max CAD exhibited the highest wear against Lava Plus, and the inverse also occurred. Vita Enamic and Lava Ultimate were among the materials that caused the lowest wear of enamel and all other evaluated materials. Conclusion. The nanofilled composite resin and polymer-infiltrated ceramic were more antagonist-friendly (whether enamel or CAD-CAM material) than glass-ceramics and zirconia. Care should be taken when selecting the material that will contact mainly with glass-ceramics. Hardness should also be considered when selecting a material. Second study. Aim. To evaluate the effect of grinding and polishing on the roughness and fracture resistance of Lava Ultimate, Vita Enamic, Vita Suprinity, and IPS e.max CAD, submitted to mechanical aging. Methods. Disks from these materials were analyzed for roughness: 1) after polishing with silicon carbide papers (Lava Ultimate and Vita Enamic) or glazing (IPS e.max CAD and Vita Suprinity) (control); 2) after grinding with 30-μm grit diamond rotary instruments; 3) and after grinding and polishing with the polishing kit Ceramiste Polishers. For fracture resistance, a simplified tri-layer model consisting of restorative disk, epoxy resin disk, and a steel ring was used. The bonded tri-layer disks received the same conditions described for the roughness analysis. Half of the specimens underwent mechanical aging for 1×106 cycles. All specimens were loaded until failure. The Weibull modulus was calculated. Results. Among the control groups, no significant difference was found between the IPS e.max CAD and Vita Suprinity and between the Lava Ultimate and Vita Enamic, which were rougher than the glass-ceramic materials. After grinding, this behavior was maintained, except for the Vita Enamic, whose roughness was similar to that of the IPS e.max CAD. After polishing, the Vita Enamic showed the highest roughness, whereas the other materials were not statistically different. IPS e.max CAD and Vita Suprinity showed the lowest roughness in the control groups. For Lava Ultimate and Vita Enamic, polishing provided the lowest roughness. Grinding followed or not by polishing, and mechanical aging, did not adversely affect fracture resistance or the reliability of the materials. Conclusions. Polishing did not recover the initial roughness of the glass-ceramic materials. Fracture resistance was not affected by grinding, followed or not by polishing, even after mechanical aging

Can periodontal disease affect conception? A literature review

: Today periodontal health is considered as an integral part of systemic health itself and no longer as a single factor. The literature recognizes that the presence of periodontal disease can represent a risk factor for numerous systemic conditions such as heart disease and diabetes. In recent years, we have witnessed a progressive interest regarding the influence exerted by this condition on reproduction, as well as the possible repercussions on conception possibilities. Upon analyzing a limited number of studies available for the correlation between periodontal disease and female infertility, it could be inferred that this condition can be equated to the presence of a real outbreak of infection and therefore exert its influence, not only through bacterial translocation in the bloodstream, causing the systemic dissemination of pathogens, but also through the production of cytokines and immunoglobulins by inflammatory mediators. This situation limits bacterial growth, but it could cause damage to the fetus, to the reproductive system, and could hinder conception attempts. Although further research is needed to better clarify the mechanism underlying the possible correlation between periodontal disease and female infertility, the present article aims to review all the available literature on this topic. Lay summary: In recent years, interest regarding the influence of gum disease on conception has increased. Since serious gum disease (periodontitis) can be compared to an outbreak of infection, studies suggest that the bacteria that mediate inflammation do not remain confined only to the gum tissue, but can enter the bloodstream and spread, thus spreading the infection and having a whole-body effect. This situation could cause damage to the developing baby, to the reproductive system and could hinder conception attempts. Constant maintenance of oral health is definitely necessary. It is important for the professionals involved (gynecologists, obstetricians, dentists, etc.) to communicate and collaborate on these issues. Dentists could advise on the correct hygienic maintenance not only to pregnant women, but also to those who are planning a pregnancy in order to avoid the occurrence of unfavorable conditions

Implant-supported mandibular complete fixed prosthesis with conometric retention after 3 years of functional loading

Objective: The aim of the study was to assess the clinical performance of implant-supported mandibular complete fixed prostheses with conometric retention after 3 years of functional loading. Materials and methods: In this retrospective study, patients treated with implant-supported mandibular complete fixed prostheses with conometric retention were considered. Standardized radiographic examinations were performed to assess the marginal bone. Radiographs were acquired at the time of prosthesis insertion and at the 3-year follow-up, and marginal bone loss was calculated. The occurrence of implant failures, and biological and technical complications was registered. Results: Thirty-nine patients were selected. At the 3-year follow-up, 134 out of the 160 placed implants did not show any marginal bone loss and 4 of them had been lost. The percentage of restorations free of technical complications was 71.8% during the entire follow-up period. Complications: that occurred in restorations were as follows: veneer fracture (n = 4), framework fracture (n = 3), loss of retention (n = 2) and need for relining (n = 2). Mucositis was recorded in 1 patient and it was successfully treated. Conclusion: The clinical performance of implant-supported mandibular complete fixed prostheses with conometric retention after 3 years of functional loading showed a low rate of marginal bone loss and technical complications. Owing to the easy retrievability, all complications were successfully treated