Do the intracanal medicaments affect the marginal adaptation of calcium silicate-based materials to dentin?

Background/purpose: In order to prevent reinfection of the pulp canal space and dressing for regenerative purpose, the coronal seal should have a perfect marginal adaptation. Mineral trioxide aggregate (MTA) and Biodentine are among the most popular sealing materials. These are commonly used in combination with antibiotic medicaments, to ensure disinfection. Aim of the present study was to evaluate the effect of 3 different medicaments on the marginal adaptation of MTA and Biodentine to the dentin. Materials and methods: Teeth were divided into 4 groups (n = 20) that were treated with the following medicaments; triple antibiotic paste (TAP), double antibiotic paste (DAP), a calcium hydroxide (CH) and a control group. The specimens were then assigned into two subgroups (n = 10), which received a coronal barrier of MTA or Biodentine. The specimens were scanned using an ex vivo micro-CT scanner. The data were statistically analysed using one-way ANOVA and the unpaired Student's t-test (P TAP > Control > CH. In the Biodentine group, the percentage of voids was determined in the following order: TAP 65 DAP > CH > Control. Significantly lower percentage of voids was observed in the CH-medicated specimens in the MTA group when compared to all test groups (P = 0.04). Conclusion: The application of CH as an intracanal medicament reduced the void occurrence between the ProRoot MTA and root dentin. However, TAP and or DAP decreased the marginal adaptation in both ProRoot MTA and Biodentine

Long-term stability of autologous bone graft of intraoral origin after lateral sinus floor elevation with simultaneous implant placement

Background: Lateral approach to maxillary sinus floor elevation (LSFE) with autologous bone grafts and simultaneous implant insertion is a widespread technique for prosthetic rehabilitation of the atrophic maxilla. Purpose: To analyze implant survival and autologous bone graft resorption after LSFE, in patients with at least 5 years follow-up. Materials and Methods: Thirty-three patients (mean age 56 years, range 46-68 years) who had undergone LSFE with intraoral autologous bone graft from mandibular ramus and simultaneous implant insertion were included. A minimum of 5 years of follow-up was required. The total peri-implant bone height was measured at mesial and distal aspects of the implants immediately after surgery (T0) and after a period ranging from 5 to 11.5 years after surgery (mean 7.65 \ub1 1.80 years) (T1) on digital panoramic and periapical radiographs. Wilcoxon matched-pairs signed rank test was used to compare bone graft height at T0 and T1. The influence of patient-, surgery-, and implant-related factors on the outcomes was investigated. Results: Of the 58 implants placed, no one was lost. All prostheses were in function, and no biological or mechanical complications occurred. The residual ridge height at the involved sites averaged 6.48 \ub1 1.72 mm. The mean bone height at grafted regions was 12.05 \ub1 2.47 mm at T0 and 12.13 \ub1 2.39 mm at T1 (not statistically significant). Marginal bone level change at T1 averaged 121.22 \ub1 1.60 mm. None of the evaluated factors significantly affected the results. Conclusion: Autologous bone grafts from intraoral donor sites display excellent volume stability over time that may contribute to optimal outcomes of the procedure