Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations.
Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram’s stain and biochemical reactions were used for identification of colonies.
Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found
to be significant (p < 0.05).
Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection.
JOURNAL CLUB: “Matching the Dimensions of Currently AvailableInstruments wit...Urvashi Sodvadiya
This micro-CT study investigated the largest original diameters of Vertucci type IV mandibular molar mesial root canals at 1-, 2-, 3-, and 4-mm levels short of the apical foramen. The diameters were then matched to currently available instrument sizes recommended for apical preparation. The study found that the original canal diameters were usually larger than recommended instrument sizes, making it impossible to fully shape most canals without risk of deviation, perforation, or root weakening. Approaches are needed to better determine optimal apical preparation size and address the problem of unprepared canal walls.
Assessment of Microbial Contamination of the Tooth Brush Head Used On Orthodo...inventionjournals
Introduction: Oral diseases can be greatly controlled by reducing the microbial load in the oral cavity and this can be achieved by maintaining proper oral hygiene.Tooth brushes are the most commonly used oral hygiene aid to promote oral health and prevent dental diseases. The insertion of fixed appliances alters the oral microbiological profile, thus increasing the risk for caries and gingivitis considerably. Aim: To assess the microbial growth of S.Mutans and Lactobacillus between and among the brushes. Setting and Study Design: A Hospital setting and Randomized Control study design Methods:A total of 56 (MB) patients aged 16-26 years received a toothbrush [Regular soft bristle design (group-A) and Orthodontic bristle design (group B)],A sterile gamma radiated pouch and checklist was distributed to each participant. After 2 weeks period the brushes were collected and placed in 5ml saline solution (0.05g Sodium Chloride). The suspension was incubated on selective agar plates and the amount of Streptococcus mutans and lactobacilli for each brush head was assessed. Results:The retention of S.Mutanswas found to be higher in group A, as compared to group B and was found to be statistically more significant between the two groups (P<0.001). The retention of Lactobacillus was also found to be higher in group A, as compared to group B and was found to be statistically significant between the groups (P= 0.001). However, there was no significant difference (P= 0.101) observedamong the microbial growth of S.Mutans and Lactobacillus in two bristle designs. Conclusions: Regular soft bristle design had a higher microbial load than those of subjects using orthodontic bristle design, a more frequent replacement of toothbrushes during t treatment may be advisable. Due to significant differences between the two bristle designs, the orthodontic toothbrush is recommended for patients undergoing orthodontic t appliances
This document discusses the history, mechanisms, and effects of dental bleaching. It begins with a brief history of bleaching, noting the introduction of chloride lime in 1848 and hydrogen peroxide in 1910. The most common bleaching agents are hydrogen peroxide, sodium perborate, and carbamide peroxide. Bleaching works via an oxidation reaction where reactive oxygen radicals interact with colored molecules in enamel and dentin. The document then discusses various bleaching techniques and their effects on tooth structure and restorations. Specifically, bleaching can cause decreased microhardness and changes to the bonding interface that impact restoration durability.
The document discusses bioceramic materials used in endodontics, focusing on mineral trioxide aggregate (MTA). It provides details on the composition, properties, and clinical applications of MTA. MTA has favorable biocompatibility and bioactivity, stimulating tissue regeneration. It forms an excellent seal with good marginal adaptation and push-out bond strength to dentin. MTA is useful for pulp capping, pulpotomies, apexification, and other procedures due to its ability to encourage hard tissue formation.
This document discusses the shortcomings of Black's classification of caries cavity localization, which was developed in the late 19th century. While revolutionary for its time in standardizing cavity preparation and filling methods, Black's classification is no longer suitable given modern restorative materials and minimally invasive techniques. The document argues that Black's principle of "extension for prevention" through wide cavity preparation actually increases the risk of complications like secondary caries and pulp damage. A new classification is needed that aligns with current principles of preventing unnecessary tooth structure removal and maximizing tooth preservation.
JOURNAL CLUB: Terminology of Dental Caries and Dental Caries Management: Cons...Urvashi Sodvadiya
Vita Machiulskienea, Guglielmo Campusb, c Joana Christina, Carvalhod Irene, Digee Kim, Rud Ekstrandf, Anahita Jablonski-Momenig, Marisa Maltzh, David J. ,Mantoni Stefania, Martignonj, k E. Angeles, Martinez-Mierl, Nigel B., Pittsj Andreas G., Schultem Christian, H. Spliethn, Livia Maria, Andaló Tenutao, Andrea Ferreira Zandonap, Bente Nyvade
CARIES RESEARCH; OCT 2019
The document discusses the endodontic pressure syringe technique for root canal obturation. It describes how the pressure syringe extrudes filling material from the apex to backfill the root canal in a controlled manner. The technique is indicated for large canals, internal resorption cases, and retrograde approaches. Advantages include precision and control, but drawbacks can include overfilling and difficulty with flexible needles in curved canals. Overall, the pressure syringe and lentulospiral techniques were found to be superior depending on canal shape and anatomy.
major advantages and unique features as well as its ability to overcome the disadvantages of other materials, biodentine has great potential to revolutionize the different aspects of managing both primary and permanent in endodontics as well as operative dentistry.
JOURNAL CLUB: “Matching the Dimensions of Currently AvailableInstruments wit...Urvashi Sodvadiya
This micro-CT study investigated the largest original diameters of Vertucci type IV mandibular molar mesial root canals at 1-, 2-, 3-, and 4-mm levels short of the apical foramen. The diameters were then matched to currently available instrument sizes recommended for apical preparation. The study found that the original canal diameters were usually larger than recommended instrument sizes, making it impossible to fully shape most canals without risk of deviation, perforation, or root weakening. Approaches are needed to better determine optimal apical preparation size and address the problem of unprepared canal walls.
Assessment of Microbial Contamination of the Tooth Brush Head Used On Orthodo...inventionjournals
Introduction: Oral diseases can be greatly controlled by reducing the microbial load in the oral cavity and this can be achieved by maintaining proper oral hygiene.Tooth brushes are the most commonly used oral hygiene aid to promote oral health and prevent dental diseases. The insertion of fixed appliances alters the oral microbiological profile, thus increasing the risk for caries and gingivitis considerably. Aim: To assess the microbial growth of S.Mutans and Lactobacillus between and among the brushes. Setting and Study Design: A Hospital setting and Randomized Control study design Methods:A total of 56 (MB) patients aged 16-26 years received a toothbrush [Regular soft bristle design (group-A) and Orthodontic bristle design (group B)],A sterile gamma radiated pouch and checklist was distributed to each participant. After 2 weeks period the brushes were collected and placed in 5ml saline solution (0.05g Sodium Chloride). The suspension was incubated on selective agar plates and the amount of Streptococcus mutans and lactobacilli for each brush head was assessed. Results:The retention of S.Mutanswas found to be higher in group A, as compared to group B and was found to be statistically more significant between the two groups (P<0.001). The retention of Lactobacillus was also found to be higher in group A, as compared to group B and was found to be statistically significant between the groups (P= 0.001). However, there was no significant difference (P= 0.101) observedamong the microbial growth of S.Mutans and Lactobacillus in two bristle designs. Conclusions: Regular soft bristle design had a higher microbial load than those of subjects using orthodontic bristle design, a more frequent replacement of toothbrushes during t treatment may be advisable. Due to significant differences between the two bristle designs, the orthodontic toothbrush is recommended for patients undergoing orthodontic t appliances
This document discusses the history, mechanisms, and effects of dental bleaching. It begins with a brief history of bleaching, noting the introduction of chloride lime in 1848 and hydrogen peroxide in 1910. The most common bleaching agents are hydrogen peroxide, sodium perborate, and carbamide peroxide. Bleaching works via an oxidation reaction where reactive oxygen radicals interact with colored molecules in enamel and dentin. The document then discusses various bleaching techniques and their effects on tooth structure and restorations. Specifically, bleaching can cause decreased microhardness and changes to the bonding interface that impact restoration durability.
The document discusses bioceramic materials used in endodontics, focusing on mineral trioxide aggregate (MTA). It provides details on the composition, properties, and clinical applications of MTA. MTA has favorable biocompatibility and bioactivity, stimulating tissue regeneration. It forms an excellent seal with good marginal adaptation and push-out bond strength to dentin. MTA is useful for pulp capping, pulpotomies, apexification, and other procedures due to its ability to encourage hard tissue formation.
This document discusses the shortcomings of Black's classification of caries cavity localization, which was developed in the late 19th century. While revolutionary for its time in standardizing cavity preparation and filling methods, Black's classification is no longer suitable given modern restorative materials and minimally invasive techniques. The document argues that Black's principle of "extension for prevention" through wide cavity preparation actually increases the risk of complications like secondary caries and pulp damage. A new classification is needed that aligns with current principles of preventing unnecessary tooth structure removal and maximizing tooth preservation.
JOURNAL CLUB: Terminology of Dental Caries and Dental Caries Management: Cons...Urvashi Sodvadiya
Vita Machiulskienea, Guglielmo Campusb, c Joana Christina, Carvalhod Irene, Digee Kim, Rud Ekstrandf, Anahita Jablonski-Momenig, Marisa Maltzh, David J. ,Mantoni Stefania, Martignonj, k E. Angeles, Martinez-Mierl, Nigel B., Pittsj Andreas G., Schultem Christian, H. Spliethn, Livia Maria, Andaló Tenutao, Andrea Ferreira Zandonap, Bente Nyvade
CARIES RESEARCH; OCT 2019
The document discusses the endodontic pressure syringe technique for root canal obturation. It describes how the pressure syringe extrudes filling material from the apex to backfill the root canal in a controlled manner. The technique is indicated for large canals, internal resorption cases, and retrograde approaches. Advantages include precision and control, but drawbacks can include overfilling and difficulty with flexible needles in curved canals. Overall, the pressure syringe and lentulospiral techniques were found to be superior depending on canal shape and anatomy.
major advantages and unique features as well as its ability to overcome the disadvantages of other materials, biodentine has great potential to revolutionize the different aspects of managing both primary and permanent in endodontics as well as operative dentistry.
In vitro tests of adhesive and composite dental materialsSilas Toka
The document summarizes a review article on the relevance of in vitro tests of adhesive and composite dental materials. It discusses how laboratory tests are standardized according to ISO protocols to evaluate properties like depth of cure, flexural strength, water sorption and solubility. While laboratory tests provide useful data on material properties, they do not replace clinical studies. Some laboratory recommendations did not prove superior to simpler techniques in clinical trials. Additionally, unexpected clinical problems may arise that were not anticipated by laboratory testing alone, emphasizing the need to augment laboratory studies with long-term clinical evaluations.
The document summarizes a clinical study that compared the performance of a two-step self-etching adhesive system (Clearfil Protect Bond) and a one-step self-etching adhesive system (Xeno III) over one year. 163 restorations were placed in noncarious cervical lesions in 35 patients using the two adhesive systems. The restorations were evaluated at baseline and 3, 6, 9, and 12 months using criteria such as color matching, marginal adaptation, retention, etc. At one year, the retention rate was 100% for the two-step system and 96% for the one-step system. Both systems showed excellent performance during the one-year clinical trial, though the two-step system
This document provides an overview of various materials that can be used for root repair, including root-end fillings, perforation repair, and root regeneration. It discusses both traditional materials like amalgam, gutta percha, and zinc oxide eugenol, as well as more recent bioactive materials like mineral trioxide aggregate (MTA) and Biodentine. MTA has become the material of choice for many root repair procedures due to its biocompatibility and ability to stimulate hard tissue formation. The document provides details on the composition and setting reaction of MTA and reviews its advantages and limitations for different clinical applications in root repair.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Buccal pad fat for cyst Indian Jr SCT volume 2, issue 1, April 16Avinash Gandi
A 14-year-old boy presented with a swelling on the right side of his face and upper jaw caused by a large dentigerous cyst. The cyst involved the area where his impacted right maxillary canine and other teeth were located. The patient's buccal pad of fat was harvested and processed to isolate the stromal vascular fraction (SVF) stem cells. After removing the cyst surgically, the SVF cells were administered to the bone defect area to aid bone regeneration and support orthodontic tooth movement. At 16 months post-operatively, good bone regeneration was observed and the patient was undergoing orthodontic treatment to align the impacted canine.
JOURNAL CLUB: The effect of two types chewing gum containingcasein phosphope...Urvashi Sodvadiya
Daily chewing of gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or xylitol can significantly reduce the level of Streptococcus mutans bacteria in saliva. A study of 60 participants who chewed gum containing either CPP-ACP or xylitol for 3 weeks found that both reduced S. mutans, but CPP-ACP gum reduced levels more than xylitol gum. CPP-ACP and xylitol have properties that inhibit the growth and attachment of S. mutans to teeth, thereby reducing the risk of dental caries.
1) The study evaluated and compared the adhesion of two self-etch adhesive systems (OptiBond XTR and Bond Force) on normal and sclerotic dentin using scanning electron microscopy (SEM) and transmission electron microscopy (TEM).
2) SEM examination showed that on normal dentin, both adhesives formed hybrid layers of varying thickness, with OptiBond XTR penetrating dentinal tubules and Bond Force not penetrating. On sclerotic dentin, hybrid layers were thinner but OptiBond XTR still penetrated tubules.
3) TEM examination revealed that on normal dentin, Bond Force penetrated tubules as well, but not on sclerotic dentin. Hybrid
This document summarizes properties and clinical applications of mineral trioxide aggregate (MTA). MTA was introduced in 1993 and can be used for pulp capping, repair of root perforations, apexification, and as a root-end filling material. MTA sets in the presence of moisture and has antibacterial properties due to its high pH. It stimulates tissue regeneration and has good biocompatibility and sealing ability. Gray and white MTA are similar but white MTA lacks iron and is tooth-colored. MTA has advantages over other materials but also limitations such as a long setting time and difficult handling.
Objective: In order to reduce complications accompanied with dental implant restoration, this study strives to prepare a novel sealant and lubricant that can be used in dental implant systems as well as to evaluate its characteristics.
Study Design: Chitosan (CS), β-glycerophosphate pentahydrate (β-GP), and nano silver (nAg) were used to prepare thermosensitive hydrogel. According to the different volume ratios of CS to β-GP, 3 experimental groups were established, namely 16/4, 13/7, and 10/10 groups. Their morphology, composition, and chemical properties were analyzed via SEM, EDS, and FTIR. In addition, the effect of the hydrogel on the stability of dental implant-abutment connection was investigated by removal torque test combined with dynamic cyclic loading experiment. The maximum fracture load was measured under different lubricating conditions by electronic universal testing machine. The cytotoxicity and in vitro antibacterial effect of the hydrogel were examined respectively by CCK-8 test and the spread plate method.
Results: The CS/β-GP/nAg thermosensitive hydro-gel was successfully prepared in this study, which was found to be a porous structure through SEM. The removal torque test and the dynamic cyclic loading experiment showed that the removal torque of the experimental group was greater than that of the control group. Furthermore, the single load-to-fracture test indicated that the 16/4 group had the greatest maximum bearing load. The in vitro cytotoxicity test using rat bone marrow stromal cells (rBMSCs) and human gingival fibroblast cells (hGFCs) showed no cytotoxicity in all 3 groups. The 3 experimental groups had obvious antibacterial effects against E. coli, S. aureus, and P. gingivalis.
Conclusion: A nontoxic antibacterial CS/β-GP/nAg thermosensitive hydrogel for lubricating purpose was successfully fabricated. When the volume ratio of CS to β-GP was 16/4, this thermosensitive hydrogel demonstrated better sealing and lubricating abilities and had a positive influence on the reliability of dental implant-abutment connection.
Keywords: abutment, dental implant, dental implant restoration, dental sealant, lubrication, thermosensitive hydrogel
This document summarizes mineral trioxide aggregate (MTA), including its introduction, indications, composition, properties, advantages, disadvantages, and clinical applications. MTA was introduced in 1993 and approved for human use in 1998. It has many endodontic applications and is biocompatible, with advantages like good sealing ability and promotion of hard tissue healing. Clinical studies found MTA to be superior to other materials for root-end fillings and perforation repairs due to its ability to regenerate tissues.
This document provides an overview of various non-surgical periodontal therapy approaches including air-powder polishing, photodynamic therapy, lasers, biofilm decontamination, perioprotect, ozone therapy, and more. It summarizes several studies that evaluated the efficacy, safety and outcomes of these therapies. The document finds that air-powder polishing is effective and safe for removing subgingival biofilm when used as recommended. Photodynamic therapy shows potential as an adjunct to scaling and root planing but more high-quality studies are still needed. Biofilm decontamination approaches using desiccants also show promise but require more research.
Journal club on Connective tissue graft associated or not with low laser ther...Shilpa Shiv
Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial, Fernandes-Dias SB, de Marco AC, Santamaria Junior M et al.
JCP 2015.
A Rationale for Postsurgical Laser Use to Effectively Treat Dental Implants_F...DrCarlosIICapitan
This document describes two case reports that demonstrate how using a laser after regenerative surgery for peri-implantitis can lead to improved outcomes. In the first case, the initial surgery was only partially successful in treating advanced peri-implant bone loss. Five months later, the area was treated with an Nd:YAG laser, along with soft tissue curettage and antibiotics. One year later, the clinical outcomes had greatly improved with reduced soft tissue inflammation and probing depths within normal limits. The second case similarly showed improved results after using a CO2 laser following an initial unsuccessful regenerative surgery. The cases suggest that lasers may help treat peri-implantitis by removing titanium particles and cement remnants that can persist after other
Assessment of Microbial Contamination of the Tooth Brush Head Used On Orthodo...inventionjournals
Introduction: Oral diseases can be greatly controlled by reducing the microbial load in the oral cavity and this can be achieved by maintaining proper oral hygiene.Tooth brushes are the most commonly used oral hygiene aid to promote oral health and prevent dental diseases. The insertion of fixed appliances alters the oral microbiological profile, thus increasing the risk for caries and gingivitis considerably. Aim: To assess the microbial growth of S.Mutans and Lactobacillus between and among the brushes. Setting and Study Design: A Hospital setting and Randomized Control study design Methods:A total of 56 (MB) patients aged 16-26 years received a toothbrush [Regular soft bristle design (group-A) and Orthodontic bristle design (group B)],A sterile gamma radiated pouch and checklist was distributed to each participant. After 2 weeks period the brushes were collected and placed in 5ml saline solution (0.05g Sodium Chloride). The suspension was incubated on selective agar plates and the amount of Streptococcus mutans and lactobacilli for each brush head was assessed. Results:The retention of S.Mutanswas found to be higher in group A, as compared to group B and was found to be statistically more significant between the two groups (P<0.001). The retention of Lactobacillus was also found to be higher in group A, as compared to group B and was found to be statistically significant between the groups (P= 0.001). However, there was no significant difference (P= 0.101) observedamong the microbial growth of S.Mutans and Lactobacillus in two bristle designs. Conclusions: Regular soft bristle design had a higher microbial load than those of subjects using orthodontic bristle design, a more frequent replacement of toothbrushes during t treatment may be advisable. Due to significant differences between the two bristle designs, the orthodontic toothbrush is recommended for patients undergoing orthodontic t appliances
Osseo-integrated dental implants have been widely used for the rehabilitation of tooth loss. Although dental implants
are considered an available treatment in the paradigm shift from traditional dental therapies, such as fixed dental bridges and
removable dentures, the fundamental problems must be overcome prior to their clinical use in young patients who are still
undergoing jawbone growth. A bio-engineered functional bio-hybrid implant that is combined with adult-derived periodontal
tissue and attached with bone tissue can act as a substitute for cementum. This bio-hybrid implant was successfully engrafted
and it restored physiological function, including bone remodelling, regeneration and appropriate responsiveness to noxious
stimuli. Thus, this article reviews the functional bio-hybrid implant’s potential for clinical use as a next-generation dental
implant using adult-derived tissues.
Introduction. The differences in the supporting structure of the implant make them more susceptible to inflammation and bone
loss when plaque accumulates as compared to the teeth. Therefore, a comprehensive maintenance protocol should be followed
to ensure the longevity of the implant. Material and Method. A research to provide scientific evidence supporting the feasibility
of various implant care methods was carried out using various online resources to retrieve relevant studies published since 1985.
Results.The electronic search yielded 708 titles, out of which a total of 42 articles were considered appropriate and finally included
for the preparation of this review article. Discussion. A typicalmaintenance visit for patients with dental implants should last 1 hour
and should be scheduled every 3 months to evaluate any changes in their oral and general history. It is essential to have a proper
instrument selection to prevent damage to the implant surface and trauma to the peri-implant tissues. Conclusion. As the number
of patients opting for dental implants is increasing, it becomes increasingly essential to know the differences between natural teeth
and implant care and accept the challenges of maintaining these restorations.
In vitro tests of adhesive and composite dental materialsSilas Toka
The document summarizes a review article on the relevance of in vitro tests of adhesive and composite dental materials. It discusses how laboratory tests are standardized according to ISO protocols to evaluate properties like depth of cure, flexural strength, water sorption and solubility. While laboratory tests provide useful data on material properties, they do not replace clinical studies. Some laboratory recommendations did not prove superior to simpler techniques in clinical trials. Additionally, unexpected clinical problems may arise that were not anticipated by laboratory testing alone, emphasizing the need to augment laboratory studies with long-term clinical evaluations.
The document summarizes a clinical study that compared the performance of a two-step self-etching adhesive system (Clearfil Protect Bond) and a one-step self-etching adhesive system (Xeno III) over one year. 163 restorations were placed in noncarious cervical lesions in 35 patients using the two adhesive systems. The restorations were evaluated at baseline and 3, 6, 9, and 12 months using criteria such as color matching, marginal adaptation, retention, etc. At one year, the retention rate was 100% for the two-step system and 96% for the one-step system. Both systems showed excellent performance during the one-year clinical trial, though the two-step system
This document provides an overview of various materials that can be used for root repair, including root-end fillings, perforation repair, and root regeneration. It discusses both traditional materials like amalgam, gutta percha, and zinc oxide eugenol, as well as more recent bioactive materials like mineral trioxide aggregate (MTA) and Biodentine. MTA has become the material of choice for many root repair procedures due to its biocompatibility and ability to stimulate hard tissue formation. The document provides details on the composition and setting reaction of MTA and reviews its advantages and limitations for different clinical applications in root repair.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Buccal pad fat for cyst Indian Jr SCT volume 2, issue 1, April 16Avinash Gandi
A 14-year-old boy presented with a swelling on the right side of his face and upper jaw caused by a large dentigerous cyst. The cyst involved the area where his impacted right maxillary canine and other teeth were located. The patient's buccal pad of fat was harvested and processed to isolate the stromal vascular fraction (SVF) stem cells. After removing the cyst surgically, the SVF cells were administered to the bone defect area to aid bone regeneration and support orthodontic tooth movement. At 16 months post-operatively, good bone regeneration was observed and the patient was undergoing orthodontic treatment to align the impacted canine.
JOURNAL CLUB: The effect of two types chewing gum containingcasein phosphope...Urvashi Sodvadiya
Daily chewing of gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or xylitol can significantly reduce the level of Streptococcus mutans bacteria in saliva. A study of 60 participants who chewed gum containing either CPP-ACP or xylitol for 3 weeks found that both reduced S. mutans, but CPP-ACP gum reduced levels more than xylitol gum. CPP-ACP and xylitol have properties that inhibit the growth and attachment of S. mutans to teeth, thereby reducing the risk of dental caries.
1) The study evaluated and compared the adhesion of two self-etch adhesive systems (OptiBond XTR and Bond Force) on normal and sclerotic dentin using scanning electron microscopy (SEM) and transmission electron microscopy (TEM).
2) SEM examination showed that on normal dentin, both adhesives formed hybrid layers of varying thickness, with OptiBond XTR penetrating dentinal tubules and Bond Force not penetrating. On sclerotic dentin, hybrid layers were thinner but OptiBond XTR still penetrated tubules.
3) TEM examination revealed that on normal dentin, Bond Force penetrated tubules as well, but not on sclerotic dentin. Hybrid
This document summarizes properties and clinical applications of mineral trioxide aggregate (MTA). MTA was introduced in 1993 and can be used for pulp capping, repair of root perforations, apexification, and as a root-end filling material. MTA sets in the presence of moisture and has antibacterial properties due to its high pH. It stimulates tissue regeneration and has good biocompatibility and sealing ability. Gray and white MTA are similar but white MTA lacks iron and is tooth-colored. MTA has advantages over other materials but also limitations such as a long setting time and difficult handling.
Objective: In order to reduce complications accompanied with dental implant restoration, this study strives to prepare a novel sealant and lubricant that can be used in dental implant systems as well as to evaluate its characteristics.
Study Design: Chitosan (CS), β-glycerophosphate pentahydrate (β-GP), and nano silver (nAg) were used to prepare thermosensitive hydrogel. According to the different volume ratios of CS to β-GP, 3 experimental groups were established, namely 16/4, 13/7, and 10/10 groups. Their morphology, composition, and chemical properties were analyzed via SEM, EDS, and FTIR. In addition, the effect of the hydrogel on the stability of dental implant-abutment connection was investigated by removal torque test combined with dynamic cyclic loading experiment. The maximum fracture load was measured under different lubricating conditions by electronic universal testing machine. The cytotoxicity and in vitro antibacterial effect of the hydrogel were examined respectively by CCK-8 test and the spread plate method.
Results: The CS/β-GP/nAg thermosensitive hydro-gel was successfully prepared in this study, which was found to be a porous structure through SEM. The removal torque test and the dynamic cyclic loading experiment showed that the removal torque of the experimental group was greater than that of the control group. Furthermore, the single load-to-fracture test indicated that the 16/4 group had the greatest maximum bearing load. The in vitro cytotoxicity test using rat bone marrow stromal cells (rBMSCs) and human gingival fibroblast cells (hGFCs) showed no cytotoxicity in all 3 groups. The 3 experimental groups had obvious antibacterial effects against E. coli, S. aureus, and P. gingivalis.
Conclusion: A nontoxic antibacterial CS/β-GP/nAg thermosensitive hydrogel for lubricating purpose was successfully fabricated. When the volume ratio of CS to β-GP was 16/4, this thermosensitive hydrogel demonstrated better sealing and lubricating abilities and had a positive influence on the reliability of dental implant-abutment connection.
Keywords: abutment, dental implant, dental implant restoration, dental sealant, lubrication, thermosensitive hydrogel
This document summarizes mineral trioxide aggregate (MTA), including its introduction, indications, composition, properties, advantages, disadvantages, and clinical applications. MTA was introduced in 1993 and approved for human use in 1998. It has many endodontic applications and is biocompatible, with advantages like good sealing ability and promotion of hard tissue healing. Clinical studies found MTA to be superior to other materials for root-end fillings and perforation repairs due to its ability to regenerate tissues.
This document provides an overview of various non-surgical periodontal therapy approaches including air-powder polishing, photodynamic therapy, lasers, biofilm decontamination, perioprotect, ozone therapy, and more. It summarizes several studies that evaluated the efficacy, safety and outcomes of these therapies. The document finds that air-powder polishing is effective and safe for removing subgingival biofilm when used as recommended. Photodynamic therapy shows potential as an adjunct to scaling and root planing but more high-quality studies are still needed. Biofilm decontamination approaches using desiccants also show promise but require more research.
Journal club on Connective tissue graft associated or not with low laser ther...Shilpa Shiv
Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial, Fernandes-Dias SB, de Marco AC, Santamaria Junior M et al.
JCP 2015.
A Rationale for Postsurgical Laser Use to Effectively Treat Dental Implants_F...DrCarlosIICapitan
This document describes two case reports that demonstrate how using a laser after regenerative surgery for peri-implantitis can lead to improved outcomes. In the first case, the initial surgery was only partially successful in treating advanced peri-implant bone loss. Five months later, the area was treated with an Nd:YAG laser, along with soft tissue curettage and antibiotics. One year later, the clinical outcomes had greatly improved with reduced soft tissue inflammation and probing depths within normal limits. The second case similarly showed improved results after using a CO2 laser following an initial unsuccessful regenerative surgery. The cases suggest that lasers may help treat peri-implantitis by removing titanium particles and cement remnants that can persist after other
Assessment of Microbial Contamination of the Tooth Brush Head Used On Orthodo...inventionjournals
Introduction: Oral diseases can be greatly controlled by reducing the microbial load in the oral cavity and this can be achieved by maintaining proper oral hygiene.Tooth brushes are the most commonly used oral hygiene aid to promote oral health and prevent dental diseases. The insertion of fixed appliances alters the oral microbiological profile, thus increasing the risk for caries and gingivitis considerably. Aim: To assess the microbial growth of S.Mutans and Lactobacillus between and among the brushes. Setting and Study Design: A Hospital setting and Randomized Control study design Methods:A total of 56 (MB) patients aged 16-26 years received a toothbrush [Regular soft bristle design (group-A) and Orthodontic bristle design (group B)],A sterile gamma radiated pouch and checklist was distributed to each participant. After 2 weeks period the brushes were collected and placed in 5ml saline solution (0.05g Sodium Chloride). The suspension was incubated on selective agar plates and the amount of Streptococcus mutans and lactobacilli for each brush head was assessed. Results:The retention of S.Mutanswas found to be higher in group A, as compared to group B and was found to be statistically more significant between the two groups (P<0.001). The retention of Lactobacillus was also found to be higher in group A, as compared to group B and was found to be statistically significant between the groups (P= 0.001). However, there was no significant difference (P= 0.101) observedamong the microbial growth of S.Mutans and Lactobacillus in two bristle designs. Conclusions: Regular soft bristle design had a higher microbial load than those of subjects using orthodontic bristle design, a more frequent replacement of toothbrushes during t treatment may be advisable. Due to significant differences between the two bristle designs, the orthodontic toothbrush is recommended for patients undergoing orthodontic t appliances
Osseo-integrated dental implants have been widely used for the rehabilitation of tooth loss. Although dental implants
are considered an available treatment in the paradigm shift from traditional dental therapies, such as fixed dental bridges and
removable dentures, the fundamental problems must be overcome prior to their clinical use in young patients who are still
undergoing jawbone growth. A bio-engineered functional bio-hybrid implant that is combined with adult-derived periodontal
tissue and attached with bone tissue can act as a substitute for cementum. This bio-hybrid implant was successfully engrafted
and it restored physiological function, including bone remodelling, regeneration and appropriate responsiveness to noxious
stimuli. Thus, this article reviews the functional bio-hybrid implant’s potential for clinical use as a next-generation dental
implant using adult-derived tissues.
Introduction. The differences in the supporting structure of the implant make them more susceptible to inflammation and bone
loss when plaque accumulates as compared to the teeth. Therefore, a comprehensive maintenance protocol should be followed
to ensure the longevity of the implant. Material and Method. A research to provide scientific evidence supporting the feasibility
of various implant care methods was carried out using various online resources to retrieve relevant studies published since 1985.
Results.The electronic search yielded 708 titles, out of which a total of 42 articles were considered appropriate and finally included
for the preparation of this review article. Discussion. A typicalmaintenance visit for patients with dental implants should last 1 hour
and should be scheduled every 3 months to evaluate any changes in their oral and general history. It is essential to have a proper
instrument selection to prevent damage to the implant surface and trauma to the peri-implant tissues. Conclusion. As the number
of patients opting for dental implants is increasing, it becomes increasingly essential to know the differences between natural teeth
and implant care and accept the challenges of maintaining these restorations.
Evaluation of role of periodontal pathogens in endodontic periodontal diseasesDr. Anuj S Parihar
Aim: This study aimed to correlate periodontal pathogens in endodontic periodontal diseases. Methodology: This study was conducted on 40 patients of both genders. All the participants were obtained from department of endodontics and periodontology with history of endo‑perio lesion in same teeth. Polymerase chain reaction was performed and correlation was established. Results: This study included 18 males and 22 females. The mean age of male was 42.5 years and female was 41.3 years. Specimens of Tannerella forsythia were isolated from 94% endodontium and 92% periodontium, Porphyromonas gingivalis from 71% endodontium and 55% periodontium,
Aggregatibacter actinomycetemcomitans from 12% endodontium and 58% periodontium. The difference was significant (P < 0.05). Bacteria in endodontic‑periodontal infection confirmed statistically significant correlation between absolute quantitation of T. forsythia and P. gingivalis (r = 0.412, P < 0.05), P. gingivalis and A. actinomycetemcomitans (r = 0.524, P < 0.05), and T. forsythia and A. actinomycetemcomitans (r = 0.427, P < 0.05). Conclusion: There was correlation between targeted bacterial species levels from concurrent endodontic‑periodontal diseases. Thus, it can be suggested that dentinal tubules may be the pathway for spread of bacteria.
Treatment of gingival recession using coronally advanced flapShruti Maroo
This document describes a case study evaluating the efficacy of the coronally advanced flap technique for treating gingival recession. A 27-year old male patient presented with Miller's Class I gingival recession on teeth 22 and 23, along with sensitivity. The coronally advanced flap procedure was performed, involving incisions and elevation of a partial-thickness flap. One month and three months post-operatively, the patient showed uneventful healing and 100% root coverage, with reduction in sensitivity and no probing defects. The coronally advanced flap technique alone can successfully treat gingival recession when residual gingiva is thick and wide, resulting in good esthetic and functional outcomes.
This document discusses implant maintenance, including plaque biofilm and its role in peri-implant diseases like mucositis and periimplantitis. It describes the implant maintenance appointment procedure and criteria for assessing implant health, such as probing depth and bleeding. Factors that can contribute to crestal bone loss and early or late implant failures are also outlined. The importance of establishing a baseline, evaluating occlusion, and taking annual radiographs is emphasized for monitoring implant health over time.
The document discusses diagnosis and treatment of peri-implant disease. It begins by introducing the history of dental implants and defines peri-implant mucositis and peri-implantitis. The main causes are bacterial infection and biomechanical overload. Treatment involves non-surgical and surgical approaches to arrest disease progression and maintain the implant site. The document then examines the histology and microbiology of healthy and diseased peri-implant tissues.
This case report describes the successful treatment of a 59-year-old edentulous female patient with a two-implant overdenture. Two implants were placed in the mandible using a surgical guide. After osseointegration was confirmed, ball abutments were attached to the implants and connected to an overdenture with O-rings. The patient was able to eat with the new prosthesis. Follow-ups showed good outcomes with minor gingivitis resolved with education. The report concludes two-implant overdentures provide an affordable option for edentulous patients.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
Clinical accuracy outcome of open and closed trayimpressionsNavneet Randhawa
This study was a randomized controlled trial that compared the use of toluidine blue dye to a placebo for oral cancer screening among individuals with high-risk oral habits. Over 7,000 participants were randomized to either receive toluidine blue during their oral exam or a placebo. Examiners found a higher rate of positive initial screens in the toluidine blue group, but after referral to a pathologist, there was no significant difference in detection of oral premalignant lesions or non-premalignant lesions between the groups. No difference was found in oral cancer incidence rates over 5 years of follow-up. The study concluded that toluidine blue did not significantly improve detection of asymptomatic oral premalignant lesions compared to
Of partial defects of the dental rows of dynamic study of the state of the mu...SubmissionResearchpa
Despite the rapid development of dentistry and advances in the prevention of diseases of the maxillofacial region, implantology, and the treatment of dental diseases, the number of patients who need prosthetics with removable orthopedic structures of dentures remains high, and only increases with age, due to the increasing rate of aging. society of the planet (M.Yu. Ogorodnikov, 2007; V.I.Shemonaev, 2012; E.S. Kalivradzhiyan, 2013; E.A.Zholudev, 2014; CE. Bragin, 2014; L.D. Veisheim, 2014). Among the reasons for the high demand for orthopedic treatment with removable dentures, the leading position is still held by insufficient sanitation of the oral cavity, untimely access of patients to the dentist. In addition, an important role is played by the problem of imperfection of materials and technologies used for the manufacture of dentures, leading to a deterioration in the condition of the dentition by A.Kh. Zhumaev 2020. Of partial defects of the dental rows of dynamic study of the state of the mucosa of the oral cavity in the new conditions of functioning. International Journal on Integrated Education. 3, 12 (Dec. 2020), 61-63. DOI:https://doi.org/10.31149/ijie.v3i12.913 https://journals.researchparks.org/index.php/IJIE/article/view/913/861 https://journals.researchparks.org/index.php/IJIE/article/view/913
This study evaluated the relationship between maxillary third molars and the maxillary sinus based on an analysis of 864 orthopantomograms. The proximity was categorized into three classes based on the amount of bone separating the root and sinus: Class I had 2+ mm bone, Class II had 0-2 mm bone, and Class III had roots within the sinus. The study found that Class II, with 0-2 mm of bone, was the most common relationship seen in both males and females. Roots present within the sinus (Class III) were most frequently observed in patients in their second and third decades of life. The findings provide information on maxillary third molar-sinus relationships that can aid treatment planning and the
This document summarizes a study on using natural nanotolith/bacterial cellulose scaffolds for dental tissue regeneration. Key findings include:
(b)
1) Bacterial cellulose and nanotolith gels were produced and combined to form bionanocomposite scaffolds.
2) Scanning electron microscopy showed the scaffolds had a 3D network of cellulose nanofibers.
3) Human dental pulp stem cells were cultured on the scaffolds. Cell adhesion was initially lower on scaffolds but viability increased over 28 days, showing the scaffolds support cell growth over time.
Clinical significance of junctional epitheliumJignesh Patel
The junctional epithelium forms the border between the tooth surface and gingival sulcus. It acts as a barrier against pathogenic bacteria through rapid turnover and the expression of antimicrobial molecules. Loss of integrity in the junctional epithelium can initiate pocket formation in periodontitis as bacteria colonize the exposed tooth surface. The junctional epithelium has a remarkable ability to regenerate after injury or probing within a few days through rapid cell division. Maintaining a healthy junctional epithelium is important to prevent periodontal diseases from developing at this site of bacterial accumulation.
A review on microfluidic immunoassays as rapid saliva based clinical diagnosticsRegine Labog
This document describes research on developing a microfluidic immunoassay device to rapidly detect and quantify levels of matrix metalloproteinase-8 (MMP-8), a biomarker for periodontal disease, in human saliva samples. The device, called a microchip electrophoretic immunoassay (μCEI), uses microfluidic channels to enrich and separate the MMP-8 antigen from saliva via competitive immunoassay and capillary electrophoresis. The μCEI shows potential for point-of-care diagnosis and monitoring of periodontal disease through a small, portable device that analyzes saliva, which could enable more frequent disease assessment.
Amato2019immediate loading of implant insertred throughMohamed Elsayed
This case series evaluated the survival rate and complications of immediately loading dental implants inserted through impacted teeth in the anterior maxilla or mandible. Seven patients received a total of 11 implants, which were immediately inserted using piezosurgery to drill through the impacted teeth. All implants integrated successfully without complications and were followed for 5-7 years. The results suggest this unconventional approach may be a viable option to avoid invasive procedures for removing impacted teeth. However, more studies are needed to validate this technique.
Similar to Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abutment Connections: An In Vitro Study (20)
Evaluation of effect of gestational diabetes mellitus on composition of the i...Dr. Anuj S Parihar
Background: Gestational diabetes mellitus (GDM) is one of the commonly occurring high‑risk obstetric complications that accounts for 4%–9% of total pregnancies. The present study
was an attempt to assess the effect of GDM on composition of the neonatal oral microbiota.
Materials and Methods: In this study, oral samples from 155 full‑term vaginally delivered newborns were collected with sterile swabs. Seventy‑five mothers diagnosed with GDM group and 80 were nondiabetic mothers (control). The oral microbiota was evaluated and analyzed by SPSS software.
Results: The mean gestational age in Group I was 38.1 weeks and in Group II was 39.6 weeks. Firmicutes was present in 38.1% in Group I versus 77.6% in Group II patients, Actinobacteria was seen in 15.2% in Group I and 7.4% in Group II, Bacteroidetes in 27.6% in Group I and 7.9% in Group II, Proteobacteria in 9.5% in Group I and 3.8% in Group II, and Tenericutes in 9.6% in Group I and 3.3% in Group II. There was a significant difference in major genera Prevotella, Bacteroidetes, Bifidobacterium, Corynebacterium, Ureaplasma, and Weissella in both groups (P < 0.05).
Conclusion: There was increased bacterial microbiota in neonates born to mothers with GDM as compared to neonates born to nondiabetic mothers. Assessment of initial oral microbiota of neonates could help in assessing the early effect of GDM on neonatal oral microbial flora.
Comparative Evaluation of Serum Tumor Necrosis Factor a in Health and Chronic...Dr. Anuj S Parihar
Background: Tumor necrosis factor‑alpha (TNF‑α), a “major inflammatory cytokine,” not only plays an important role in periodontal destruction but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF‑α in serum and its relationship to periodontal disease.
Aim: Our study aimed to compare the serum TNF‑α among the two study groups, namely, healthy controls and chronic periodontitis patients and establish a correlation between serum TNF‑α and various clinical parameters. Hence, an attempt is made to estimate the level of TNF‑α in serum, its relationship to periodontal disease and to explore the possibility of using the level of TNF‑α in serum as a biochemical “marker” of periodontal disease. Materials and Methods: Forty individuals
participated in the study and were grouped into two subgroups. Group A – 20 systemically and periodontally healthy controls. Group B – twenty patients with generalized chronic periodontitis.
The serum samples were assayed for TNF‑α levels by enzyme‑linked immunosorbent assay method.
Results: The mean serum TNF‑α cytokines for Group B Generalized chronic periodontitis (GCP) was 2.977 ± 1.011, and Group A (healthy) was 0.867 ± 0.865. The range of serum TNF‑α was from (0.867 to 2.977). Serum TNF‑α cytokines had highly significant correlation with all clinical parameters (plaque index, probing pocket depth, clinical attachment loss, and gingival index) among all study participants (P = 0.001). Conclusion: These observations suggest a positive association
between periodontal disease and increased levels of TNF‑α in serum. It can be concluded that there is a prospect of using the estimation of TNF‑α in serum as a “marker” of periodontal disease in future. However, it remains a possibility that the absence or low levels of TNF‑α in serum might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease “activity” and “inactivity” could suggest the possibility of using
TNF‑α in serum as an “Indicator” of periodontal disease.
This document provides an overview of the nervous system and several cranial nerves. It begins with an introduction to the nervous system and its organization into the central and peripheral nervous systems. Key terms like neuron, nucleus, tract, nerve, and plexus are defined. The 12 pairs of cranial nerves are then introduced, and five specific cranial nerves - V (trigeminal), VII (facial), IX (glossopharyngeal), X (vagus), and XII (hypoglossal) are examined in more detail, including their nuclear connections, functional components, course through the body, and branches. Clinical testing and applied anatomy are also discussed for each nerve.
Oral Health–Related Quality of Life in Children and Adolescents of Indian pop...Dr. Anuj S Parihar
Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on
the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14).
Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations.
Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)
Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
A must read seminar on Dental Implants for Under-Graduates and Post-Graduates.
If you have any doubts regarding Dental Implants or any topic if you are unable to understand then do feel free to contact me on my Email address: Dr.anujparihar@gmail.com
Periodontally accelerated osteogenic orthodontics: A perio-ortho ambidextrous...Dr. Anuj S Parihar
The interdisciplinary collaboration of periodontics and orthodontics has allowed teeth to be moved 2–3 times faster, reducing the time required for traditional orthodontic therapy considerably. Periodontally accelerated osteogenic orthodontics (PAOO), also known as Wilckodontics, is a combination of a selective decortication facilitated orthodontics and alveolar augmentation. With this technique, there is no dependence on the pre‑existing alveolar volume. This case report describes the treatment of permanent mandibular molar protraction in a 14‑year‑old patient undergoing orthodontic therapy using PAOO with piezosurgery.
A 10 years retrospective study of assessment of prevalence and risk factors o...Dr. Anuj S Parihar
Aim: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome.
Materials and Methods: The present retrospective study was conducted on 826 patients who received 1420 dental implants in
both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded.
Results: In 516 males, 832 dental implants and in 310 females, 588 dental implants were placed. Maximum dental implant failure was seen with length <10 mm (16%), with diameter <3.75 mm, and with type IV bone (20.6%). The difference found to be significant (P < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by
hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%).
Conclusion: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers..
Assessment of correlation of periodontitis in teeth adjacent to implant and p...Dr. Anuj S Parihar
Aims: The present study was conducted to determine correlation between peri‑implantitis and periodontitis in adjacent teeth. Materials and Methods: The present study was conducted on 58 patients with 84 dental implants. They were divided into two groups, group I (50) was with peri‑implantitis and group II (34) was without it. In all patients, probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) was calculated around implant, adjacent to implant and on contralateral side. Obtained data were statistically analyzed using statistical software IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp with one‑way analysis of variance. Results: Males were 30 with 52 dental implants and females were 28 with 32 dental implants. CAL was 5.82 ± 0.52 in group I and 3.62 ± 0.63 in group II (P = 0.001) around implants. PD was 4.28 ± 1.26 in group I and 2.20 ± 0.52
in group II around adjacent teeth (P = 0.002). PD around contralateral teeth was significant (P = 0.05) in group I (3.18 ± 1.01) and group II (2.71 ± 0.73). Conclusion: Periodontitis has negative effect on implant success. Teeth adjacent to dental implant plays an important role in deciding the success or failure of implant. Maintenance of periodontal health is of paramount importance for successful implant therapy.
Crestal bone loss around dental implants after implantation of Tricalcium pho...Dr. Anuj S Parihar
Background and Aims: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year of implantation, an implant should have <0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the success rate of dental implants depends on the amount of the crestal bone around the implants. The main aim of this study was to evaluate and compare the crestal bone loss around implants placed with particulate β‑Tricalcium Phosphate Bone Graft and platelet concentrates. Methods: 50 individuals received hundred dental implants. Each individual received one dental implant in the edentulous site filled with β‑Tricalcium Phosphate Bone Graft along (β‑TCP) with Platelet‑ Rich Plasma (PRP)
(Group A) and another in edentulous site filled only with β‑Tricalcium Phosphate Bone Graft (Group B) in the posterior edentulous region. All the 100 implants were prosthetically loaded after a healing period of three months. Crestal bone loss was measured on mesial, distal, buccal and lingual side of each implant using periapical radiographs 3 months, 6 months and 9 months after implant placement. Results: The average crestal bone loss 9 months after the implants placement in Group A and Group B was 2.75 mm and 2.23 mm respectively, the value being statistically significant (P < 0.05). In both Group A and Group B, the average crestal bone loss was maximum on the lingual side followed by buccal, distal and mesial sides. Conclusion: β‑TCP is a promising biomaterial for clinical
situations requiring bone augmentation. However, the addition of PRP results in decreased bone loss around the dental implants.
Assessment of Lingual Concavities in Submandibular Fossa Region in Patients r...Dr. Anuj S Parihar
Aim: The present study was aimed at assessing the lingual concavities in the submandibular fossa region in patients requiring dental implants with the help of cone beam computed tomography (CBCT). Materials and methods: The present study included 140 patients who visited the department with the missing mandibular posterior teeth. CBCT images were obtained using planmeca machine. Cross sections of 1 mm of submandibular fossa in the region of 1st and 2nd molar were studied and Type I to III lingual concavities were analyzed by a radiologist. Results: Type I lingual concavity (< 2 mm) was seen in 23%, type II (2-3 mm) in 62% and Type III (> 3 mm) in 15% of patients. The difference was significant (p < 0.05). Males had slightly higher mean ± S.D value at 1st molar (2.6 mm ± 0.94) and 2nd molar (2.8 mm ± 0.90) on the left side and (2.7 mm ± 0.92) at 1st molar and (2.9 mm ± 0.93) at 2nd molar on the right side. The difference was nonsignificant (p > 0.05). Females had mean ± S.D value at 1st molar (2.3 mm ± 0.90) and (2.5 mm ± 0.92) at 2nd molar on the left side and (2.4 mm ± 0.91) at 1st molar and (2.8 mm ± 0.93) at 2nd molar. The difference was nonsignificant (p > 0.05. The difference between both genders was statistically nonsignifi-cant (p > 0.05). Conclusion: Type I bone is the best for placing an implant. The chances of complications are more in type II and III bone. CBCT provides necessary information before planning implant in the edentulous area. Clinical significance: Cone beam computed tomography (CBCT) is the best radiographic aid which is effective in delin-eating different types of bone in the mandibular posterior region.
Correlation of Clinical Attachment Level (CAL) and C - Reactive Protein (CRP)...Dr. Anuj S Parihar
Periodontal disease, caused mainly by bacteria, is characterized by inflammation and destruction of the attachment apparatus of the teeth. Periodontitis is a multi-factorial disease with microbial dental plaque as the initiator of periodontal disease. Studies indicate that the periodontal lesion is not strictly a localized process but may lead to systemic alterations in the immune function. The present study intends to evaluate the correlation of clinical attachment level and C-reactive protein levels in
smoker and non-smoker patients with chronic generalized periodontitis. A total of fifty patients were included in the study, and they were divided into two group. Group A consisting of 25 patients who are smokers and they are having chronic generalized periodontitis, while Group B consist of 25 patients who are nonsmokers and having chronic generalized periodontitis. In the study clinical parameters we checked were Oral hygiene index – Simplified (OHI-S), Gingival Index (GI), Probing pocket depth (PPD) and Clinical Attachment level (CAL). Furthermore, CRP was evaluated as well between
Group-A (Smokers with chronic generalized periodontitis) and Group-B (Nonsmokers with chronic generalized periodontitis). The results showed higher OHI – S, PPD, CAL and CRP levels in Group - A (Smokers having chronic generalized periodontitis) than Group - B (Nonsmokers having chronic generalized periodontitis). GI score was higher in Group - B as compared to Group - A. Increased levels of clinical attachment level
(CAL) were seen in smokers suffering from chronic periodontitis. Significantly an increased level of C - reactive protein (CRP) was seen in smokers suffering from chronic periodontitis. Correlation between Clinical attachment level (CAL) and Creactive protein levels (CRP) was very strongly positive and significant. Suggesting, as value of CAL increases, CRP also increases.
Healing Effects of Hydroalcoholic Extract of Guava (Psidium guajava) Leaf on ...Dr. Anuj S Parihar
Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an adverse effect of chemotherapy and radiotherapy. The aim of this study is to evaluate the healing effects of hydroalcoholic extract of Psidium
Guajava leaf on oral induced mucositis induced by 5-fluorouracil using histopathologic and tissue antioxidative markers assessment in male dark brown rats. In a prospective randomized double blind animal study, OM was induced in 64 male dark brown rats that allocated in 4 groups by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. Starting from day 12, gel base, topical form and 600 mg/kg dietry form of hydroalcoholic extract of Psidium Guajava leaf were administered per day. Pouch histopathology score, superoxide dismutase, glutathione peroxidase, total antioxidant capacity were evaluated on day 14 and 18. DPPH scavenging activity and total phenolic content also were measured. Histopathology scores of mucositis were lower in the systemic and topical treatment groups than the gel base and control groups (P<0.05). Higher activities of SOD, GPX and TAC were detected in the topical and systemic treatment groups in comparison to the others (P<0.05). The extract was rich in total phenolic content as antioxidant. The use of extract of Psidium Guajava leave may be associated with reduced intensity of OM, increased concentration of SOD, GPX and TAC on induced
OM in dark brown rats undergoing 5-FU consumption.
Assessment of Survival Rate of Dental Implants in Patients with Bruxism: A 5-...Dr. Anuj S Parihar
Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The
present study was conducted to assess complications in dental implants in bruxism patients.
Materials and Methods: This 5‑year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2015. Among these patients, 124 had bruxism habit. Dental radiographs or patients’ recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males
and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw‑type and 130 cemented‑type fixations
had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented‑type fixation and fracture of ceramic (85) in screw‑type fixation. The difference was statistically significant (P = 0.01). Forty‑two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among
genders was statistically nonsignificant (P = 0.21).
Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.
Prevalence,riskfactors and treatment needs of traumatic dental injuries to an...Dr. Anuj S Parihar
The document summarizes a study that assessed the prevalence of traumatic dental injuries (TDIs) to permanent anterior teeth among 6-15 year old schoolchildren in Bhopal, India. The study found an overall TDI prevalence of 8.6%. Boys had a higher prevalence than girls at a ratio of 2.22:1. Falls at home were the most common cause, and overjet greater than 5.5 mm and inadequate lip coverage were significant risk factors. Most fractured cases occurred with Class I malocclusion. While TDIs were common, many injuries went untreated.
Gingival crevicular fluid turnover markers in premenopausal vs postmenopausal...Dr. Anuj S Parihar
1) The study evaluated levels of bone biomarkers RANKL and OPN in the gingival crevicular fluid of 50 women undergoing orthodontic treatment, dividing them into premenopausal (n=25) and postmenopausal (n=25) groups.
2) Baseline levels of RANKL and OPN were significantly different between the two groups but increased similarly with treatment in both.
3) Within each group, biomarker levels increased significantly from baseline to 24 hours after orthodontic force activation.
4) However, the changes in biomarker levels with treatment were not significantly different between the premenopausal and postmenopausal groups.
Local Drug Delivery Modalities in Treatment of Periodontitis: A ReviewDr. Anuj S Parihar
Periodontitis is an inflammatory disease that causes destruction of
tooth supporting tissues, characterized by multifactorial etiology
with pathogenic bacteria being the primary etiologic agents that
dwells the subgingival area. Local drug delivery system consists of
antimicrobial dosages that produces more constant and prolonged
concentration profiles within the subgingival tissue and provides
better access into the periodontal pockets. It addresses the critical
distress of exposing the patient to adverse effects of systemic
administration. This article reviews the literature and presents
novel trends such as osteoblast activators, growth factors, and
herbal products in the local drug delivery system.
This document discusses different types of bone grafts used in periodontics. It describes autografts, which are transplanted from one site to another within the same individual, as the gold standard due to their osteoinductive properties. Autografts can be obtained from both extraoral sites like the hip or iliac crest, as well as intraoral sites like the tuberosity, tori, or osseous coagulum collected from the surgical site. The document outlines the advantages and disadvantages of various graft materials and their properties like osteoinduction, osteoconduction, and osteogenesis that facilitate bone regeneration.
Dental Plaque
Soft deposits that form the biofilm adhering to the tooth surface or other hard surfaces in the oral cavity, including removable & fixed restorations”
Bowen , 1976
Bacterial aggregations on the teeth or other solid oral structures
Lindhe, 2003
Relationship between Severity of Periodontal Disease and Control of Diabetes ...Dr. Anuj S Parihar
Background: Both diabetes mellitus (DM) and periodontitis
are chronic diseases affecting large number of the population
worldwide. Changes in human behavior and lifestyle over the
last century have resulted in a dramatic increase in the incidence
of diabetes in the world. This study was designed to evaluate the
relationship between severity of periodontal disease and control of
diabetes (glycated hemoglobin [HBA1c]) in patients with Type 1
DM in a hospital based study.
Materials and Methods: Fifty patients (n = 50) with Type 1
diabetes were enrolled in the study. They were divided into three
groups based on the degree of glycemic control by measuring
HbA1c levels as: “Good” (HBA1c ≤7) Group A, fair (HBA1c = 7-8)
Group B and poor (HBA1c >8) Group C. All enrolled patients
underwent detailed history and dental checkup. Evaluation for
periodontal disease was done by measuring dental plaque (plaque
index), inflammation of gums (gingival index), probing pocket
depth (PPD), and clinical attachment level.
Results: Type 1 diabetics with poor glycemic control had
increased gingival inflammation (P < 0.05), more dental plaque
(P < 0.05), increased PPDs (P < 0.05) and attachment loss
(P < 0.05) as compared to those with fair and good glycemic
control, respectively.
Conclusion: Severity of periodontal disease increases with poor
glycemic control in patients with Type 1 DM.
Key Words: Glycated hemoglobin levels, periodontal disease,
Type 1 diabetes mellitus
Peripheral ossifying fibroma (POF) is a non-neoplastic enlargement of the gingival, which is one of the main
benign, reactive hyperplastic inflammatory lesions of the gingiva occurring in young adults. It has a very high
recurrence rate of around 7-45%. For this reason, a longer patient follow-up is very important in POF. Peripheral
ossifying fibroma comprises about 9% of all gingival growths. POF has similar clinical presentations with different
lesions which makes it difficult to reach at a correct diagnosis. In this article, we are reporting a case of peripheral ossifying fibroma (POF) in a 16-year-old female patient.
Key Words: Fibrous hyperplasia, Peripheral ossifying fibroma,
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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2. Microleakage and Microgap of Two Different Internal Implant–Abutment Connections
The Journal of Contemporary Dental Practice, Volume 21 Issue 6 (June 2020)684
obtainedfromethicscommitteeofinstitute,PeoplesDentalAcademy,
Bhopal.Itcomprised40dentalimplants(3.0mm×10mm;Biohorizon),
which were divided into two groups with 20 samples each. In group
I, the fixtures with a trilobe internal association were linked to 0.3
cm high abutments of 35 Ncm torque and in group II fittings with an
internal hexagonal geometry were associated with typical straight
abutments with a depth of 0.6 cm and a torque of 25 Ncm.
In present study, Staphylococcus aureus was used. A bacterial
suspension was prepared in brain–heart infusion (BHI) broth by
cultivating S. aureus and incubating it at 37°C for 24 hours. This
suspension was diluted in nutrient broth to attain a compactness
of 1 × 108
CFU per mL.
Microbial Sampling
Dentalimplantsweredetachedandheldinverticalpositiontoallow
firm torque action under strict sterilized conditions. Abutments
were then attached with dental implants. Tubes having sterile BHI
broth were used for the immersion of implant–abutment assembly
for 30 seconds. The tubes were then incubated at 37°C for 2 weeks.
Following this, the implant–abutment assembly was sunken
in test tubes having 4 mL of S. aureus broth culture and was
incubated at 37°C for 2 weeks. After 2 weeks of immersion, the
assembly was removed and held in 70% alcohol for 3 minutes.
After this, bacterial contamination was done using sterile paper
points along the inner surfaces of the implants. Sterile paper
points were inoculated in test tubes having sterile BHI broth.
Culture was done on blood agar plates from broth and incubated
at 37°C for 24 hours. The resultant colonies were noted using
Gram’s stain and biochemical response.
Microgap Assessment
The microgap was evaluated in all samples using an electron
microscope at a voltage of 15 kV. The extent of the microgap was
evaluated and measured at four points for each samples.
Results thus obtained were entered in Excel sheets. The SPSS
Statistical software version 21.0 was used. A comparison between
groups was done with Mann–Whitney U test and the microgap was
evaluated using Turkey’s honestly significant difference (HSD) test.
Results
Table 1 shows two types of implant systems: in group I, fixtures
were trilobe connection and in group II fixtures were of internal
hexagonal connection. Each group comprised 20 dental implants.
Table 2 shows that mean log10 CFU, which was 8.6 in group I and 9.3
in group II. The distinction between the two assemblies was found
to be considerable (p < 0.05). The mean microgap in group I was
7.2 μm and in group II 10.4 μm. The dissimilarity among the two
groups was found to be considerable (p < 0.05) (Tables 3 and 4).
Lower microleakage and microgap were observed; hence, lower
microbial CFU in group I as compared to group II.
Discussion
The microscopic space between implant and abutment can
act as a bacterial niche, favoring the loss of the peri-implant
mucosal seal.6,7
These microgaps may alter the clinical and
microbiologicalparametersoftissueswithincreaseinbacterialload
precipitating periodontal diseases, which in turn lead to failure in
osseointegration. It has been further postulated that these spaces
favorpenetrationoffluidsandsaliva,leadingtobacterialinvasion.8,9
Thegapsizesmayalterbacterialcontamination.Certainfactors
such as torque, precision of fit, and micromovement affects the
level of contamination. Broggini et al.10
found infiltration of white
blood cells around the implants, which vary according to the
implant design.
The present in vitro study was conducted to assess bacterial
seepage of two unlike internal implant abutment associates. In the
present study, 40 dental implants (3.0 mm × 10 mm; Biohorizon)
were divided into two groups of 20 samples each. Group I
equipped with a trilobe internal relationship was associated with
0.3 cm elevated abutments; and group II equipped with an internal
hexagonalgeometrywaslinkedtothestandardstraightabutments
with a height of 0.6 cm.
In present study, we used only internal hexagonal and trilobe
connection because both demonstrated different types of
connection,therebyshowingdifferentresponsetodynamicloading.
Saidin et al. stated from their study that internal conical
abutment resulted in higher degree of micromovement,
whereas the trilobe association resulted in the lower degree
of micromovement due to its polygonal profile.11
Hence, lower
microleakageandmicrogapwasobservedwithtrilobeconnection.
Therefore,inthepresentstudy,groupI(trilobeconnection)showed
lowermicroleakageandbacterialcontentthangroupII(connection
internal hexagonal connection).
Faria et al. conducted an in vitro study and assessed bacterial
seepage beside the implant–abutment border, comparing three
types of associates: external hexagon (EH), Morse taper (MT), and
internal hexagon (IH).12
In this study, authors used apical portion of
abutment screws for the inoculation of colonies of Escherichia coli,
which later on were fixed to implants. Samples that had exterior
contamination were excluded, whereas residual specimens were
positioned in test tubes enclosing tryptic soy broth. In this study,
38 samples with external hexagonal, 40 with internal hexagonal,
and 41 with Morse taper connections were determined. The value
for external hexagonal was 10.53%, for internal hexagonal was
4.88%, and for Morse taper was 7.50% connections. There were no
differences between all connections (p > 0.05).
In present study, the mean log10 CFU in group I was 9.3 and in
group II 8.6. The disparity among both the groups was found to be
significant (p < 0.05). Nassar et al. conducted a study to estimate
the bacterial seepage of two dissimilar internal implant abutment
Table 1: Distribution of dental implants
Groups Group I Group II
Fixtures Trilobe connection Internal hexagonal connection
Number 20 20
Table 2: Comparison between log10 colony-forming unit in the both
groups
Groups Mean SD Median p value
Group I 8.6 0.2 8.4–8.8 0.05
Group II 9.3 0.4 9.1–9.5
Table 3: Assessment of microgap
Groups Mean (μm) SD Min. Max.
Group I 7.2 5.4 2.1 13.4
Group II 10.4 3.8 4.3 16.1
Table 4: Two-by-two comparisons of mean microgap by Turkey’s
honestly significant difference test
Groups Subset for α = 0.05 Significant
Group I 7.2 0.01
Group II 10.4
3. Microleakage and Microgap of Two Different Internal Implant–Abutment Connections
The Journal of Contemporary Dental Practice, Volume 21 Issue 6 (June 2020) 685
associations. They divided dental implants into two groups with 10
dental implants. Authors found significant higher mean log10 CFU
with internal hexagon implants as compared to trilobe implants.13
These findings are in association with our result.
We found that the mean microgap was 7.2 μm in group I and
10.4 μm in group II. The disparity among two groups was found to
be significant (p < 0.05).
Tesmer et al. conducted a study to determine bacterial
migration at the interface of dental implant fixture and abutment.
Thirty implants were categorized into three groups depending
on their microgap. Groups I and II consist of fixtures with internal
Morse taper associates and in group III consists of trichannel
internal connection in dental implants. Fixtures and abutments
were subjected to bacterial concentration of Aggregatibacter
actinomycetemcomitansandPorphyromonasgingivalis.Significantly
lower bacterial colonization was observed in group I compared to
groups II and III. They concluded that variation in implant designs
could influence the bacterial seepage.14
Koutouzis et al. evaluated the outcome of dynamic loading on
the microbial colonization in the fixture-abutment interface (FAI)
microgap of dental implants with internal Morse taper association.
TheyconcludedthatimplantswithinternalMorsetaperassociation
display least bacterial incursion and bacterial infiltration increases
with dynamic loading.15
Wachtel et al. evaluated the bacterial leakage of the implant-
abutment interface (IAI) of two-piece implant systems by using
suspension of Enterococcus faecium before abutment fixation.
There was bacterial leakage before the cyclic loading in three of
the seven implants.16
Rismanchian et al. evaluated microgap extent and microbial
seepage in the association area of four dissimilar abutments to
International Team for Implantology (ITI) implants. Authors found
significant mean microgap size in different types of abutments and
foundaveragenumberofseepoutcoloniesthroughtheassociation
of the implant and abutment surface.17
A broad range of microorganisms found to be penetrating
along the implant abutment interface such as gram-positive
cocci to gram-negative rods (Bacteroides species, Fusobacterium
species, and Peptostreptococcus micros), which are connected with
peri-implantitis. Various studies have shown that microleakage
at implant abutment interface can be evaluated using various
microorganism such as A. actinomycetemcomitans, P. gingivalis, E.
coli, Ent. faecium, or S. aureus.13–16,18
In the present study, we used
S. aureus to evaluate the microleakage.
Present implant systems may not completely avoid microbial
seepage and bacterial migration of the inner part of the implant.
Thediffusionoforalmicroorganismsthroughtheimplantabutment
border may create soft tissue inflammation and affects the clinical
success of implants.18
The present study indicates that microgap acts as the site
for penetration of bacteria leading to failure of implant. This
microgap should be avoided to improve the implant success
rate. Further studies are required to evaluate the microgap and
microleakage using different types of implant assembly with
dynamic loading.
Conclusion
Authors found that microscopic space between implant and
abutment may be the site of penetration of bacteria. Significantly
higher log10 CFU was observed in dental implant fixtures with an
internal hexagonal geometry compared to dental implant fixtures
with a trilobe internal connection.
References
1. Covani U, Marconcini S, Crespi R, et al. Bacterial plaque colonization
around dental implant surfaces. Implant Dent 2006;15(3):298–304.
DOI: 10.1097/01.id.0000226823.58425.19.
2. do Nascimento C, Barbosa RE, Issa JP, et al. Bacterial leakage along
theimplantabutmentinterfaceofpremachinedorcastcomponents.
Int J Oral Maxillofac Surg 2008;37(2):177–180. DOI: 10.1016/
j.ijom.2007.07.026.
3. Ribeiro CG, Maia ML, Scherrer SS, et al. Resistance of three implant-
abutment interfaces to fatigue testing. J Appl Oral Sci 2011;19(4):
413–420. DOI: 10.1590/s1678-77572011005000018.
4. O’Mahony A, MacNeill SR, Cobb CM. Design features that may
influencebacterialplaqueretention:aretrospectiveanalysisoffailed
implants. Quintessence Int 2000;31(4):249–256.
5. da Silva-Neto JP, Nobilo MA, Penatti MP, et al. Influence of
methodologic aspects on the results of implant-abutment interface
microleakage tests: a critical review of in vitro studies. Int J Oral
Maxillofac Implants 2012;27(4):793–800.
6. doNascimentoC,MianiPK,PedrazziV,etal.Leakageofsalivathrough
the implant-abutment interface: in vitro evaluation of three different
implant connections under unloaded and loaded conditions. Int J
Oral Maxillofac Implants 2012;27(3):551–560.
7. Cosyn J, Van Aelst L, Collaert B, et al. The peri-implant sulcus
compared with internal implant and suprastructure components:
a microbiological analysis. Clin Implant Dent Relat Res 2011;13(4):
286–295. DOI: 10.1111/j.1708-8208.2009.00220.x.
8. Gherlone EF, Capparé P, Pasciuta R, et al. Evaluation of resistance
against bacterial microleakage of a new conical implant-abutment
connection versus conventional connections: an in vitro study. New
Microbiol 2016;39(1):49–56.
9. Tsuge T, Hagiwara Y, Matsumura H. Marginal fit and micro gaps of
implant-abutmentinterfacewithinternalantirotationconfiguration.
Dent Mater J 2008;27(1):29–34. DOI: 10.4012/dmj.27.29.
10. Broggini N, McManus LM, Hermann JS, et al. Persistent acute
inflammation at the implant–abutment interface. J Dent Res
2003;82(3):232–237. DOI: 10.1177/154405910308200316.
11. SaidinS,AbdulKadirMR,SulaimanE,etal.Effectsofdifferentimplant-
abutment connections on micromotion and stress distribution:
prediction of microgap formation. J Dent 2012;40(6):467–474. DOI:
10.1016/j.jdent.2012.02.009.
12. Faria R, May LG, de Vasconcellos DK, et al. Evaluation of the bacterial
leakage along the implant-abutment interface. J Dent Implant
2011;1(2):51–57. DOI: 10.4103/0974-6781.91280.
13. Nassar HI, Abdalla MF. Bacterial leakage of different internal implant/
abutment connection. Fut Dent J 2015;1(1):1–5. DOI: 10.1016/j.
fdj.2015.09.001.
14. Tesmer M, Wallet S, Koutouzis T, et al. Bacterial colonization of
the dental implant fixture-abutment interface: an in vitro study.
J Periodontol 2009;80(12):1991–1997. DOI: 10.1902/jop.2009.
090178.
15. Koutouzis T, Mesia R, Calderon N, et al. The effect of dynamic loading
on bacterial colonization of the dental implant fixture–abutment
interface: an in vitro study. J Oral Implant. 2014;40(4):432–437. DOI:
10.1563/AAID-JOI-D-11-00207.
16. Wachtel A, Zimmermann T, Spintig T, et al. A novel approach to prove
bacterial leakage of implant-abutment connections in vitro. J Oral
Implant. 2016;42(6):452–457. DOI: 10.1563/aaid-joi-D-16-00065.
17. Rismanchian M, Hatami M, Badrian H, et al. Evaluation of microgap
size and microbial leakage in the connection area of 4 abutments
with straumann (ITI) implant. J Oral Implant 2012;38(6):677–685. DOI:
10.1563/AAID-JOI-D-11-00167.
18. Teixeira W, Ribeiro RF, Sato S, et al. Microleakage into and from two-
stage implants: an in vitro comparative study. Int J Oral Maxillofac
Implant 2011;26(1):56–62.