The platform switching approach to optimize split crest technique.

The split crest technique is a reliable procedure used simultaneously in the implant positioning. In the literature some authors describe a secondary bone resorption as postoperative complication. The authors show how platform switching can be able to avoid secondary resorption as complication of split crest technique

Odontorizectomie: un case series a 12 anni

The study evaluates whether root amputation may be considered a valid alternative to or support for implant treatment in the long term. The series comprised 20 patients, observed from 1997 to 2007; all cases were of mandibular molars in which the distal root was preserved. Causes of the operation were: failure of orthograde therapy with fracture of mesial root, perforation of pulp chamber floor and internal-external mesial root resorption. After 10 years, the success rate was 70%. The encouraging results indicate that root amputation is still an effective method. From both biologic and economic standpoints, it may be considered as an alternative to and/or support for more expensive treatments, but must be employed following precise clinical indications

Debridement effectiveness of two different techniques using negative pressure irrigation system

Summary Objectives To evaluate the cleaning efficacy of two apical negative pressure irrigation techniques compared to needle irrigation. Materials and Methods Eighty extracted human single canal teeth were shaped and assigned to 3 experimental groups (n = 20) according to the irrigation technique performed and two negative control groups (n = 10) as follows: 1) NI (Max-I-Probe side-vented needle irrigation); 2) EV (EndoVac system); 3) EVM (EndoVac-modified technique); 4) EV-C (EndoVac-negative control); 5) NI-C (needle irrigation-negative control). A scanning electron microscopic evaluation was performed. The presence of debris and smear layer at all levels (coronal, middle, apical) was evaluated. Results and conclusions A new irrigation protocol, using EndoVac System resulted in better removal of the smear layer at all levels

In Vitro Screening of the Apatite-Forming Ability, Biointeractivity and Physical Properties of a Tricalcium Silicate Material for Endodontics and Restorative Dentistry

Aim: Calcium silicate-based materials are hydraulic self-setting materials with physico-chemical properties suitable for endodontic surgery and good biological/clinical outcomes. The study aim was to evaluate the bio-properties (biointeractivity and apatite-forming ability) and selected physical properties (porosity, water sorption, solubility, and setting time) of Biodentine, a tricalcium silicate material for endodontics and restorative dentistry, compared to that of ProRoot MTA (Mineral Trioxide Aggregate) as gold standard material. Methods: Biodentine and ProRoot MTA pastes were prepared and analyzed for calcium release and alkalinizing activity (3 h–28 days), setting time, water sorption, porosity, solubility, surface microstructure and composition, and apatite-forming ability in simulated body fluid. Results: Biodentine showed higher calcium release, alkalinizing activity, and solubility but higher open and apparent porosity, water sorption, and a markedly shorter setting time. Calcium phosphate (CaP) deposits were noted on material surfaces after short ageing times. A CaP coating composed of spherulites was detected after 28 days. The thickness, continuity, and Ca/P ratio of the coating differed markedly between the materials. Biodentine showed a coating composed by denser but smaller spherulites, while ProRoot MTA showed large but less dense aggregates of spherulitic deposits. Conclusions: Biodentine showed a pronounced ability to release calcium and extended alkalinizing activity interlinked with its noticeable porosity, water sorption, and solubility: open porosities provide a broad wet biointeractive surface for the release of the calcium and hydroxyl ions involved in the formation of a CaP mineral. Biodentine is a biointeractive tricalcium silicate material with interesting chemical-physical properties and represents a fast-setting alternative to the conventional calcium silicate MTA-like cements

Influence of laser-lok surface on immediate functional loading of implants in single-tooth replacement: a 2-year prospective clinical study.

he purpose of this study was to evaluate the influence of a Laser-Lok microtexturing surface on clinical attachment level and crestal bone remodeling around immediately functionally loaded implants in single-tooth replacement. Seventy-seven patients were included in a prospective, randomized study and divided into two groups. Group 1 (control) consisted of non-Laser-Lok type implants (n = 39), while in group 2 (test), Laser-Lok type implants were used (n = 39). Crestal bone loss (CBL) and clinical parameters including clinical attachment level (CAL), Plaque Index (PI), and bleeding on probing were recorded at baseline examinations and at 6, 12, and 24 months after loading with the final restoration. One implant was lost in the control group and one in the test group, giving a total survival rate of 96.1% after 2 years. PI and BOP outcomes were similar for both implant types without statistical differences. A mean CAL loss of 1.10 ± 0.51 mm was observed during the first 2 years in group 1, while the mean CAL loss observed in group 2 was 0.56 ± 0.33 mm. Radiographically, group 1 implants showed a mean crestal bone loss of 1.07 ± 0.30 mm compared with 0.49 ± 0.34 mm for group 2. The type of implant did not influence the survival rate, whereas Laser-Lok implants resulted in greater CAL and in shallower radiographic peri-implant CBL than non-Laser-Lok implants

Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis

Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. Methods. This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann–Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). Results. FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone (P0.05). Conclusion. Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis

Cyst-like periapical lesion healing in an orthodontic patient: A case report with five-year follow-up

Abstract Aim To report the orthodontic movement of two central incisors through the healing site of a maxillary cyst-like lesion of endodontic origin after nonsurgical treatment. Case summary This report shows the treatment of a 18-year old patient, male, with a Class II division 2 malocclusion. He came to our attention seeking for orthodontic treatment. Radiographic examinations revealed a large cyst-like lesion in the maxillary anterior area, extending from the mesial surface of tooth 12 to the distal surface of tooth 21. The two upper incisors were nonresponsive to pulp sensitivity tests. Endodontic treatment was performed first. One week after root canal treatment had been completed with gutta-percha fillings, orthodontic treatment was started while the bone lesion healing was still underway. At the end of the orthodontic treatment, incisor retroclination was corrected, periapical lesion healing was completed and there were no signs of root resorption. The five-year follow-up revealed that occlusal relationship and dental alignment were kept stable and excellent radiographic resolution of the periapical lesion was obtained

The Predictability of Transverse Changes in Patients Treated with Clear Aligners

: Arch expansion might be used to correct buccal corridors, improve smile aesthetics, resolve dental cross bite, and gain space to resolve crowding. In clear aligner treatment, the predictability of the expansion is still unclear. The purpose of this study was to evaluate the predictability of dentoalveolar expansion and molar inclination with clear aligners. In the study, 30 adult patients (27 ± 6.1 years old) treated with clear aligners were selected (treatment time: 8.8 ± 2.2 months). The upper and lower arch transverse diameters were measured for canines, first and second premolars, and first molars on two different sides (gingival margins and cusp tips); moreover, molar inclination was measured. A paired t-test and Wilcoxon test were used to compare prescription (planned movement) and achieved movement. In all cases, except for molar inclination, a statistically significant difference was found between achieved movement and prescription (p < 0.05). Our findings showed a total accuracy of 64% for the lower arch, 67% at the cusp level, and 59% at the gingival level, with a total accuracy of 67% for the upper arch, 71% at the cusp level, and 60% at the gingival level. The mean accuracy for molar inclination was 40%. Average expansion was greater at cusps of canines than for premolars, and it was lowest for molars. The expansion achieved with aligners is mainly due to the tipping of the crown rather than bodily movement of the tooth. The virtual plan overestimates the expansion of the teeth; thus, it is reasonable to plan an overcorrection when the arches are highly contracted

Correction of multiple canine impactions by mixed straightwire and cantilever mechanics: a case report.

Background. This case report describes the orthodontic treatment of a woman, aged 17 years, with a permanent dentition, brachyfacial typology, Angle Class I, with full impaction of two canines (13,33), and a severe ectopy of the maxillary left canine. Her main compliant was the position of the ectopic teeth. Methods. Straightwire fixed appliances, together with cantilever mechanics, were used to correct the impaired occlusion and to obtain an ideal torque control. Results and Conclusion. The treatment objectives were achieved in 26 months of treatment. The impactions were fully corrected with an optimal torque. The cantilever mechanics succeeded in obtaining tooth repositioning in a short lapse of time. After treatment, the dental alignment was stable