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The aim of this study was to test the fracture load of ceramic and composite three-unit full-contour fixed dental prostheses (FDPs) fabricated with additive and subtractive computer-aided design (CAD)/computer-aided manufacturing (CAM) technology. A newly developed alveolar socket replica model for a three-unit FDP replacing one molar was used in this study. Five CAD/CAM materials were used for fabrication of three-unit FDPs (each n = 12). The subtractive CAD/CAM fabrication method was used for groups BC (BRILLIANT Crios), TC (Telio CAD), EX (e.max CAD), and TZ (inCoris TZI C), and the additive method was used for group 3D (els 3D resin even stronger). FDPs were adhesively seated to the abutment dies (PANAVIA V5 system). Thermomechanical loading was performed prior to fracture testing with a universal testing machine. The data for maximum fracture load values was analyzed with one-way ANOVA and post hoc Scheffe test (α = 0.05). All FDPs survived the thermomechanical loading test. Statistically significant differences were found for the fracture load of three-unit FDPs fabricated from different CAD/CAM materials (p

Inflammation is an integral part of the pathogenesis of periodontitis and sleep disorders. The aim of the present study was to review systematically the current evidence relating to the association between periodontal diseases and non-apnea sleep disorder. Systematic searches were performed in MEDLINE, PsycINFO, Cochrane library, Web of Science, and Scopus without any limitation. Following preliminary screening, the quality of the remaining selected papers was appraised using the Newcastle-Ottawa Scale. Due to substantial heterogeneity among the selected articles, main outcomes were reported in a qualitative manner. Following screening and evaluation, a final set of 13 studies was selected for inclusion. These studies examined the association between periodontal disease and short sleep duration, long sleep duration, poor sleep quality, or non-specific sleep disorders. The majority (N = 12/13) reported an association or trend between one type of sleep abnormality and periodontal or gingival parameters. Despite the respective limitations of the articles included in this systematic review, an association between periodontal diseases and sleep disturbances was apparent. Adequate management of periodontal disease requires that a patient’s lifestyle factors be taken into consideration in treatment planning. One such factor is sleep initiation and maintenance. An obvious association between sleep disturbances and periodontitis exists. Sleep disorders may induce systemic inflammation, which, in turn, could influence the development of periodontitis.

To provide a systematic overview on the efficacy of green tea catechin as an adjunct to scaling and root planing (SRP) in terms of probing pocket depth (PPD). A systematic literature search was performed using electronic databases in PubMed, Scopus, Medline, Cochrane, CINAHL, and Web of Science on randomized clinical trials up to January 2017. The research question was posed in accordance with PRISMA guidelines. The search provided 234 studies. After analyzing the full texts, five studies were included, with four studies qualifying for meta-analysis. Mean PPD reduction was significantly higher (α = 0.05) when green tea catechin was used as an adjunct to SRP (test group) than with SRP alone (control group). The difference in the reduction was 0.74 mm [0.35–1.13; 95% CI]. The local application of green tea catechin as an adjunct to SRP may result in a beneficial reduction in PPD. Due to the highly heterogeneous data and some risk of bias, however, this data still needs to be interpreted with caution. The finding suggests that green tea catechin may be a topical adjunct to SRP without negative side effects.

The objective is to compare the amount and content of publications regarding traditional or regenerative periodontal surgery in the years 1982/1983 and 2012/2013 in two leading periodontal journals of North America and Europe. The search was carried out in the Journal of Periodontology and Journal of Clinical Periodontology. Four reviewers screened the articles and allocated the topics with respect to periodontal surgery. The distribution of articles with respect to traditional or regenerative periodontal surgery was then compared between the journals and the respective time periods. Out of 1084 screened articles, 145 articles were included. Articles with periodontal surgery content amounted to 18% for the first time period and to 11% for the second time period. In the years 1982/1983, 7% of articles in the Journal of Periodontology and 8% in the Journal of Clinical Periodontology referred to traditional periodontal surgery, while 8% (Journal of Periodontology) and 5% (Journal of Clinical Periodontology) examined regenerative periodontal surgery. The distribution changed 30 years later, with 1% (Journal of Periodontology) and 3% (Journal of Clinical Periodontology) traditional periodontal surgery and 7% and 6% regenerative periodontal surgery content. While the clinical need for traditional periodontal surgery remained, research in this important field decreased. Publications rather tended to focus on adjunctive regenerative measures. Periodontal surgery with adjunctive regenerative measures is an established and well-documented clinical procedure. However, with respect to the dominance of horizontal bone loss in periodontally diseased patients, there is a need for ongoing research with focus on traditional periodontal surgery.

The aim of this paper is to evaluate the influence of the internal anatomy on the leakage of root canals filled with the thermoplastic technique. The upper central incisors (UCI) and mesial roots of the lower molars (MRLM) (n = 12 each) were tested regarding leakage using the gas-enhanced permeation test (GEPT) after root filling. The quality of the root fillings was assessed using micro-computed tomography (μCT) by superimposing scans before and after treatment to calculate unfilled volume. The calculated void volume was compared between the groups and correlated to the measured leakage values. Data were analyzed using t test and Pearson’s correlation tests (p

The aim of this study is to assess the effects of ultrasonic tip distance and orientation on the removal of a multispecies biofilm under standardized conditions in vitro.Six-species biofilms were grown on hydroxyapatite discs for 64 h and treated with a magnetostrictive ultrasonic tip (Cavitron) placed either on contact or at 0.25- and 0.5-mm distance. The treatment was performed for 15 s with either the tip at right angle or sideways. Biofilm removal was evaluated by assessing the viable bacteria in each supernatant and compared to respective controls. In the latter, biofilms were mechanically removed and evaluated in supernatants to assess adhering and floating bacteria. Colony-forming units (CFU) were determined by cultivation on solid media. Any remaining biofilm on the treated discs was also visualized after staining with green-fluorescent SYTO® 9 stain using a confocal laser scanning microscope (CLSM). Mann-Whitney U tests and Bonferroni correction were used to analyze the results between the groups.Sideways application of the ultrasonic tip at distances of 0.25 and 0.5 mm removed as many bacteria as present on the control discs compared to the tip on contact (p 0.05). All other application modes, especially the ultrasonic tip applied perpendicularly on contact, showed no statistical significance in removing biofilm.Overall, data indicated that bacterial detachment depended on tip orientation and distance, especially when the tip was applied sideways similar to the clinical setting.Biofilm removal by means of ultrasonic debridement remains a crucial aspect in the treatment of periodontal disease. To ensure sufficient biofilm removal, the tip does not necessarily require contact to the surface, but an application parallel to the surface on the side is recommended.

OBJECTIVES This study aimed to compare the trueness of one type of CAD/CAM milled complete removable dental prostheses (CRDPs) with injection-molding and conventionally manufactured CRDPs. MATERIALS AND METHODS Thirty-three CRDPs were fabricated by three different manufacturing techniques (group CAD/CAM (AvaDent™): n = 11; group injection molding (Ivocap™): n = 11; group flask-pack-press: n = 11) using a single master reference model and incubated in artificial saliva for 21 days. The trueness of the entire intaglio surface along with five specific regions of interest (vestibular-flange, palate, tuberosities, alveolar crest, and post-dam areas) was compared. Non-parametric tests were used with a level of significance set at p

Quadrant impressions are commonly used as alternative to full-arch impressions. Digital impression systems provide the ability to take these impressions very quickly; however, few studies have investigated the accuracy of the technique in vivo. The aim of this study is to assess the precision of digital quadrant impressions in vivo in comparison to conventional impression techniques. Impressions were obtained via two conventional (metal full-arch tray, CI, and triple tray, T-Tray) and seven digital impression systems (Lava True Definition Scanner, T-Def; Lava Chairside Oral Scanner, COS; Cadent iTero, ITE; 3Shape Trios, TRI; 3Shape Trios Color, TRC; CEREC Bluecam, Software 4.0, BC4.0; CEREC Bluecam, Software 4.2, BC4.2; and CEREC Omnicam, OC). Impressions were taken three times for each of five subjects (n = 15). The impressions were then superimposed within the test groups. Differences from model surfaces were measured using a normal surface distance method. Precision was calculated using the Perc90_10 value. The values for all test groups were statistically compared. The precision ranged from 18.8 (CI) to 58.5 μm (T-Tray), with the highest precision in the CI, T-Def, BC4.0, TRC, and TRI groups. The deviation pattern varied distinctly depending on the impression method. Impression systems with single-shot capture exhibited greater deviations at the tooth surface whereas high-frame rate impression systems differed more in gingival areas. Triple tray impressions displayed higher local deviation at the occlusal contact areas of upper and lower jaw. Digital quadrant impression methods achieve a level of precision, comparable to conventional impression techniques. However, there are significant differences in terms of absolute values and deviation pattern. With all tested digital impression systems, time efficient capturing of quadrant impressions is possible. The clinical precision of digital quadrant impression models is sufficient to cover a broad variety of restorative indications. Yet the precision differs significantly between the digital impression systems.

Citric acid (CA) is a component in beverages responsible for dental erosion. The aim of this study was to examine the influence of CA with different pH, titratable acid and buffer capacity (ß), and the impact of the chelating effect of CA on development of enamel erosions.In a superfusion model, hydroxy apatite (HAp) dissolution of bovine enamel was measured in four experiments (EXP 1-4) with 27 experimental groups (n = 8 per group). The samples were superfused with different CA variations and respective controls. EXP-1: Dilution series of HCl (pH 2.15-3.02). EXP-2: Dilution series of natural CA (56-1.75 mmol l(-1); pH 2.15-3.02). EXP-3: CA solutions (56 and 14 mmol l(-1), ß: 39.7 and 10.2 mmol l(-1) pH(-1), respectively) with different titratable acidity at equal pH values. EXP-4: CA concentrations (56-1.75 mmol l(-1)) neutralized to pH 7.CA led to higher HAp-dissolution than HCl. With higher pH, the difference in HAp-dissolution rate between the two acids became increasingly smaller. At equal pH, HAp-dissolution was higher for the CA with the higher amount of titratable acid. However, no clear correlation between erosion and titratable acid or ß could be found. Only minimal amounts of HAp were dissolved by neutralized CA compared to CA with natural pH.Under the chosen conditions chelating effects of CA do not have a relevant influence of HAp-dissolution of enamel. Moreover, amount of HAp-dissolution by CA is not attributed to a single factor alone. The interplay between the different parameters of CA seems to be responsible for its erosive potential.The erosive potential of solutions containing citric acid with unknown concentrations could not be predicted using a single parameter alone, and should at best determined in experimental set-ups.

The aim of this study was to compare the occlusal morphology of partial crown reconstructions made by dental technicians with reconstructions made by a fully automatic software process (biogeneric tooth model) in relation to the original natural tooth shape.Stone replicas of natural teeth were measured three-dimensionally before preparing inlay and onlay cavities for ceramic restorations (n = 5). For each preparation, five reconstructions (in total n = 25) were made by five dental technicians. Additionally, reconstructions were calculated automatically by a software based on the biogeneric tooth model (Cerec 3D). In order to compare the two different kinds of reconstruction, an objective metrical similarity measure (shape similarity value, SSV) based on calculated volumes between compared datasets was used.In 22 of 25 cases, the reconstructions made by the CAD software were closer to the original situation than the reconstructions made by the technicians. Mean average SSV of reconstructions made by the technicians (310.2 ± 78.8 μm) was significantly higher (p0.05) than mean SSV of CAD reconstructions (biogeneric model) (222.0 ± 47.7 μm).In the design of naturally shaped occlusal inlay/onlay surfaces, a fully automatic CAD system can be at least as good as conventional wax-ups by dental technicians.The adjustment of a dental restoration to fit the morphology of surrounding tooth structures, still presents challenges for the dentist.

Objectives: This study aimed to determine the brushing forces applied during in vivo toothbrushing with manual and sonic toothbrushes and to analyse the effect of these brushing forces on abrasion of sound and eroded enamel and dentin in vitro. Materials and methods: Brushing forces of a manual and two sonic toothbrushes (low and high frequency mode) were measured in 27 adults before and after instruction of the respective brushing technique and statistically analysed by repeated measures analysis of variance (ANOVA). In the in vitro experiment, sound and eroded enamel and dentin specimens (each subgroup n = 12) were brushed in an automatic brushing machine with the respective brushing forces using a fluoridated toothpaste slurry. Abrasion was determined by profilometry and statistically analysed by one-way ANOVA. Results: Average brushing force of the manual toothbrush (1.6 ± 0.3 N) was significantly higher than for the sonic toothbrushes (0.9 ± 0.2 N), which were not significantly different from each other. Brushing force prior and after instruction of the brushing technique was not significantly different. The manual toothbrush caused highest abrasion of sound and eroded dentin, but lowest on sound enamel. No significant differences were detected on eroded enamel. Conclusion: Brushing forces of manual and sonic toothbrushes are different and affect their abrasive capacity. Clinical significance: Patients with severe tooth wear and exposed and/or eroded dentin surfaces should use sonic toothbrushes to reduce abrasion, while patients without tooth wear or with erosive lesions confining only to enamel do not benefit from sonic toothbrushes with regard to abrasion

Objective: This study tested the fracture load of milled and conventionally fabricated polymeric and glass-ceramic three-unit fixed dental prostheses (FDPs) after aging. Materials and methods: FDPs were fabricated (N = 1,050) from four computer-aided design and computer-aided manufacturing (CAD/CAM) resins: (1) AT (artBlock Temp); (2) TC (Telio CAD); (3) ZP (ZENO PMMA); (4) CT (CAD-Temp); two conventionally fabricated resins, (5) IES (integral esthetic press), (6) CMK (CronMix K), and a glass-ceramic (control) (7) PG (IMAGINE PressX). Specimens of each group were tested immediately after fabrication (n = 15 per material). Seventy-five FDPs per material type were stored in artificial saliva (37°C) and 15 of them were randomly selected after aging (1, 7, 28, 90, and 180days) for fracture load measurement. The remaining specimens (n = 60 per material) were subjected to chewing simulation (×120.000-1.200.000, 49N, 5°C/50°C). The data were analyzed using two-way and one-way ANOVA followed by Scheffé test. Results: The interactions between FDP materials and aging time in both storage media showed a significant impact on the results (p

The aim of the present study was to analyze in how far drying of eroded dentin and enamel surfaces influence the results of profilometrical determinations with a stylus profilometer. Each five dentin and enamel samples were eroded with HCl (pH 2.6, 2 min). Surface profiles of the samples were recorded with a stylus profilometer in three series. In series 1, the samples were measured while stored in water and in series 2, under ambient conditions (21 degrees C, 35% humidity). In series 3, samples were completely desiccated and then rewetted. Profilometry was conducted at various time intervals for a period of up to 181 min (series 1 and 2) and 72 h (series 3). Only the dentin samples were affected by the storage conditions. Stable profilometrical readings for the eroded dentin samples were only feasible when the specimens were stored in water during the complete period of the experiment, including the profilometrical measurement. Thus, for erosion experiments using profilometrical analysis with a stylus profilometer, it is advised to store and measure dentin samples under wet conditions.