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Objective: To investigate the effect of the accelerated aging process on the color stability of feldspathic ceramic treated with dual ion exchange, overglaze, polishing, and autoglaze surface treatments. Method and Materials: A total of 40 disks (15 mm in diameter and 2 mm thick) of feldspathic ceramic were made in an A2 shade according to the manufacturer's recommendations. The samples were randomly divided into 4 groups: dual ion exchange, overglaze, polishing, and autoglaze. The samples were subjected to conditions in an accelerated aging machine for 150 and 300 hours. Differences in color before and after accelerated aging were calculated using spectrophotometric analyses. Overall color difference (DE) was determined using the CIE L*a*b* system for measuring small color differences. Scanning electron microscopy was used to evaluate the surface texture of samples. Color difference data were evaluated statistically by Kruskal-Wallis and Mann-Whitney U tests, with a significance level of .05. Results: After 150 and 300 hours of accelerated aging, color changes of the 4 surface treatment groups ranged between 0.35 and 1.31 DE units. All DE values were below a quantitative level that would be considered clinically acceptable. Autoglazed samples were the most color stable, followed by ion exchanged, overglazed, and polished test samples. Conclusions: All groups demonstrated color stability below a quantitative level that would be considered clinically acceptable, but long-term clinical studies are necessary to verify these findings. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effect of oral moisturizing agents, denture adhesives, and surface treatments on the retention of an acrylic resin test base dislodged from the maxillary alveolar ridges of xerostomic radiotherapy patients. Acrylic resin test bases prepared for 10 edentulous xerostomia patients were subjected to 8 surface treatment methods: method 1 = untreated dry surface; method 2 = use of Biotène oral moisturizer; method 3 = use of Protefix denture adhesive; method 4 = combination of Biotène and Protefix; method 5 = sandblasting of test bases; method 6 = use of Biotène on sandblasted surface; method 7 = use of Protefix on sandblasted surface; method 8 = combination of Protefix and Biotène on sandblasted surface. After each treatment, a tensile testing apparatus was used to dislodge the inserted test bases, and force values (N) were recorded. A significant difference in retentive force was observed between the 4 Protefix groups and those that did not use denture adhesive (P < .001). There were no differences among the 4 combinations of denture adhesive treatments (P > .05). Sandblasting the denture surfaces did not increase retentive forces alone or in combination with any other treatments. Biotène oral moisturizing agent was used in 4 treatment methods, but only had a significant effect on increasing retentive force when used with a nonsandblasted surface (P < .05). Biotène had no effect on retentive force compared to a nonsandblasted surface without moisturizer or when it was used in combination with any other methods. Protefix denture adhesive offered the greatest improvement in retentive force. Sandblasting the intaglio surface did not improve retentive force. Biotène was reported to improve patient comfort but had minimal effect on retentive force; however, Biotène can be assumed to be a more advantageous method of increasing retention compared to sandblasting (P < .05). [ABSTRACT FROM AUTHOR]

This study aimed to compare the effect of precementation desensitizing laser treatment and conventional desensitizing agents on crown retention. Crowns were fabricated for 50 molar teeth, and specimens were assigned to 5 groups based on treatment method: untreated control group (CON), laser group (LAS), sodium fluoride group (FLU), Oxagel oxalate group (OXA), and Gluma primer group (GLU). All crowns were luted with glass-ionomer cement. Tensile force was applied for crown dislodgement. Recorded forces and calculated retentive strengths were as follows: CON (261 N) > LAS (223 N) = FLU (208 N) > GLU (161 N) = OXA (147 N) (P < .05). The differences in force magnitudes between all groups were significant (P < .05), except for LAS versus FLU and GLU versus OXA. The retention decrease was 15% for LAS, 20% for FLU, 38% for GLU, and 44% for OXA. Laser treatment had a less negative effect on retention for crowns luted with glass-ionomer cement than the other treatment modalities, and it may be a more suitable desensitization method if crown retention can be moderately sacrificed. [ABSTRACT FROM AUTHOR]

A self-inflicted gunshot maxillofacial defect was restored with dental implants and various attachments. Following mandibular surgical reconstruction, a fixed full-arch implant-supported prosthesis was fabricated. The maxillary defect was restored with an obturator retained with bar-clip and ball attachments. Crowns with an unfavorable crown-to-root ratio were used to rectify a compromised unilateral interocclusal space. Functional rehabilitation was achieved without any pathologic sequelae and maintained over a 1-year observation period. Provision of a fixed implant-retained mandibular prosthesis opposing a specific design for a maxillary obturator provided short-term and optimistic prognosis in the management of a serious traumatic injury. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine the optimal thickness of protective oral radiation shields composed of an acrylic resin stent and a lead shield, which are used in head and neck radiotherapy to minimize undesired normal tissue radiomorbidity. MATERIALS AND METHODS: Intraoral acrylic resin stents and lead shields of different thicknesses were inserted into a specially designed human mandible phantom with thermoluminescent lithium fluoride dosimeter chips (TLD-100) placed on the buccal and lingual sites and exposed to irradiation of different energies. Fifty-cGy irradiation was performed and TLD-100 dose measurements were obtained for each irradiation type, acrylic resin stent thickness, and lead shield thickness. RESULTS: Acrylic resin stents with a 2-mm lead shield reduced 20% and 15% of the normal tissue dose for Co-60 and 6 MV X photon radiations, respectively, whereas the stents with a 4-mm lead shield achieved a higher reduction of the normal tissue dose (30% and 23% for Co-60 and 6 MV X photons, respectively). CONCLUSION: In protective oral radiation shields, acrylic resin stent thickness has little effect on the reduction of normal tissue dose, but lead shield thickness significantly effects the reduction of normal tissue dose. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this in vitro study was to demonstrate the dentinal tubule-occluding effect of desensitizing laser treatment on dentin surfaces using environmental scanning electron microscopy (E-SEM). MATERIALS AND METHODS: Ground dentin surfaces were divided into 5 areas. Each area received a different mode of laser irradiation (low potency [LP] versus high potency [HP] and short time [ST] versus long time [LT]). Lased dentin surfaces were viewed and graded under E-SEM at x5000 magnification. RESULTS: The tubule closure rates of 4 different irradiation modes were as follows: LP/LT (74%) > HP/ST (70%) > LP/ST (51%) > HP/LT (46%) > control (6%). CONCLUSION: It was demonstrated that desensitizing laser application was an efficient treatment option for the occlusion of dentinal tubule apertures. [ABSTRACT FROM AUTHOR]

Little information is available on the immunological basis for side-effects of dental materials. The objective of this study is to evaluate effects of pure metals, dental alloys and ceramic on cell viability and interleukin-1 beta (IL-1 β) release in three-dimensional human gingival fibroblast cultures as an indicator of their biological performance in gingival tissues. The gingival fibroblast cultures were exposed to test specimens fabricated from nickel, iron, molybdenum, copper, indium, gold, Ni–Cr–Mo alloy (Remanium CS), Au–Pt–In alloy (Pontostar) and a dental ceramic (In-ceram). Cell viability was determined by the MTT method 24 and 48 h after exposure. Assays for IL-1 β were carried out by ELISA. Statistical analysis was performed applying the non-parametric Mann–Whitney pairwise test. Dental ceramic and gold did not influence cell viability after 24 and 48 h. Cell viability was determined after 24 and 48 h to nickel (79–77%), iron (92–90%), molybdenum (86–83%), copper (48–36%), indium (90–90%), Remanium CS (83–80%), Pontostar (94–91%) compared with control cultures. Dental ceramic, Pontostar and gold had no significant influence on IL-1 β secretion. The highest amounts of IL-1 β (10-fold) levels were determined in cell cultures exposed to copper. Indium, molybdenum and iron induced twofold IL-1 β levels compared with untreated control cultures. These results support that some metals may alter immune responses and thereby contribute to a variety of dental pathological conditions and three-dimensional cell culture models for gingival fibroblasts appear to be suitable for in vitro studies. [ABSTRACT FROM AUTHOR]

The aim of this study was to present the use of retroauricular full-thickness skin grafts in vestibuloplasty surgeries for dental implant rehabilitation in vascularized fibula grafts. Two patients underwent mandibular reconstruction with vascularized fibula grafts due to mandibular gunshot injuries. Inadequate sulcus gaps secondary to mandibular soft tissue deficiencies were managed by full-thickness autologous skin grafts harvested from the retroauricular region. Dental rehabilitation was achieved by implants placed in free fibula grafts. In both cases, complete graft survival was achieved. Cosmetic and functional outcomes were satisfactory. Owing to its high resiliency and elasticity and its thin and hairless structure, full-thickness retroauricular skin graft is an effective treatment modality in the management of intraoral soft tissue deficiencies. Patients with gunshot injuries present great functional and esthetic demands, and every report presenting new treatment modalities is helpful in the management of the condition.

The purpose of this study was to investigate the flexural strength of all-ceramics with varying core thicknesses submitted to aging. In-Ceram Alumina (IC), IPS e.max Press (EM) and Katana (K) (n=40), were selected. Each group contained two core groups based on the core thickness as follows: IC/0.5, IC/0.8, EM/0.5, EM/0.8, K/0.5 and K/0.8 mm in thickness (n=20 each). Ten specimens from each group were subjected to aging and all specimens were tested for strength in a testing machine either with or without being subjected aging. The mean strength of the K were higher (873.05 MPa) than that of the IC (548.28 MPa) and EM (374.32 MPa) regardless of core thickness. Strength values increased with increasing core thickness for all IC, EM and K regardless of aging. Results of this study concluded that strength was not significantly affected by aging. Different core thicknesses affected strength of the all-ceramic materials tested (p<0.05).

Objective: Clinicians should reserve all-ceramics with high translucency for clinical applications in which high-level esthetics are required. Furthermore, it is unclear whether a correlation exists between core thickness and color change. The aim of this study was to examine the effects of different core thicknesses and artificial aging on the color stability of three all-ceramic systems., Materials and Methods: Ninety disc-shaped cores with different thicknesses (0.5 mm, 0.8 mm and 1.0 mm) were prepared from three all-ceramic systems, In-Ceram Alumina (IC), IPS e.max Press (EM) and Katana (K). The colors of the samples were measured with a spectrophotometer and the color parameters (L*, a*, b*, ΔE) were calculated according to the CIE L*a*b* (Commission Internationale de L'Eclairage) color system before and after aging., Results: The effects of aging on color parameters were statistically significant (p < 0.001), regardless of core thickness. For all systems, the CIE a* values increased as the thickness of the core increased. Conversely, such increases in core porcelain thickness were correlated with decreasing CIE L* and b* values. Core thickness had a statistically significant effect on color change among the groups., Conclusions: Different core thicknesses (from 1.0-0.5 mm) and artificial aging affected color stability of the all-ceramic materials tested.

This study was undertaken to evaluate the relation between bone quality and alterations of implant stability quotient values measured during the initial phase of healing. Nineteen patients treated with 106 implants were included in the current study. The mean bone density of the implant recipient area was measured using Simplant 11 software incorporated in the computerized tomography (CT) machine. Mean bone density measurements were recorded in Hounsfield units. The implant recipient sites were subdivided into 5 groups according to bone quality. The numbers of the structures on the recipient site belonging to D1 and D5 types showed no statistical significance and were excluded. Standard 2-stage surgical technique was utilized to prepare the surgical sites. The implant stability quotient (ISQ) value at implant placement was recorded and did not influence the treatment procedure. The ISQ was measured by an Osstell instrument. The ISQ was further registered on the 21st and 60th days. SPSS statistical software was used for the statistical analysis. In comparison with the time of insertion, the mean values of the ISQ were decreasing for the first 21 days. However, on subsequent days, the ISQ values of all bone types have increased and on the 60th day reached the values recorded at the time of insertion. Analysis of the relation between changes in stability and bone type does not reveal statistical significance. With knowledge of the current clinical study, it can be concluded that bone quality in the recipient bone site does not effect changes in implant stability at the early stages of the osseointegration process.

Objectives: The purpose of this study was to evaluate compressive and tensile stress values and patterns on implant-supported all-ceramic restorations applied in maxillary partially edentulous cases by utilizing the 3-dimensional (3-D) finite element stress analysis., Method and Materials: Two different 3-D finite element designs representing a maxillary implant-supported fixed partial denture (from maxillary canine to second premolar) were constructed with 3 different core materials (Inceram-Zirconia, IPS 2 disilicate glass-ceramic, cobalt-chromium). In the first design, the cross-sectional connector areas of the dentures were constructed to be 3.5 3 3.5 mm. In the second design, the cross-sectional areas were decreased to 2 3 2 mm. A load of 550 N was applied in oblique direction onto the pontic., Results: The compressive and tensile stress levels obtained in the second design were higher than the first one for all materials. The compressive and tensile stresses were higher when the loads were directly applied onto the cores and the framework than when they were applied onto the porcelain sets. The cross-sectional connector area between the abutment and the pontic component has a great effect on the success of all-ceramic implant-supported fixed partial dentures., Conclusions: All 3 materials seem to have sufficient characteristic strength for 3-unit posterior implant-supported fixed partial dentures. Only the tensile stress value obtained for IPS 2 disilicate glass core material in the second design was higher than the material's characteristic strength value when the load was applied directly onto the core.

Acrylic resin dentures may have cytotoxic effects on oral soft tissues. However, there is sparse data about the cytotoxic effect of fibre-reinforced acrylic resin denture base materials. The purpose of this in vitro study was to determine the effect of two fibre impregnation methods on the cytotoxicity of a glass and carbon fibre-reinforced heat-polymerized acrylic resin denture base material on oral epithelial cells and fibroblasts. One hundred acrylic resin discs were assigned to five experimental groups (n = 20). One of the groups did not include any fibre. Two groups consisted of silane and monomer treated glass fibres (Vetrolex) impregnated into acrylic resin (QC-20) discs. The other two groups consisted of silane and monomer treated carbon fibres (Type Tenox J, HTA). Untreated cell culture was used as positive control. The human oral epithelial cell line and buccal fibroblast cultures were exposed to test specimens. The cytotoxicity of the test materials was determined by succinic dehydrogenase activity (MTT method) after 24 and 72 h exposures. Data were analysed with a statistical software program (SPSSFW, 9.0). A one-way analysis of variance (anova) test and Bonferroni test were used for the comparisons between the groups. All statistical tests were performed at the 0.95 confidence level (P < 0.05). After 24 and 72 h incubation, cell viability percentages of all experimental groups showed significant decrease according to the positive control cell culture. Fibroblastic cell viability percentages of silane and monomer treated fibre-reinforced groups were lower than the unreinforced group. Cell viability of monomer-treated groups displayed the lowest percentages. Elapsed incubation time decreased epithelial cell viability in silane-treated groups. Fibroblastic cell viability was not influenced by elapsed time except the unreinforced group.

Objectives: In this study, quantification of backscatter doses between scattering titanium dental implant and the thermoluminescent dosimeter (TLD(100)) radiation detector at axial beam irradiation-angle range of 0-90 degrees in head and neck radiotherapy is done to evaluate irradiation angle dependency of dose enhancement contributing to osteoradionecrosis., Methods: A cylindrical titanium dental implant with diameter of 4 mm and length of 9 mm was implanted into a specially-designed human mandible phantom with a TLD100 chip placed on the buccal site and irradiated with 6 MV X, 25 MV X and Co-60 gamma sources at 19 different irradiation angles., Results: Dose enhancement on a buccal site of the titanium implant depends on the incident beam angle. At angles of 65 degrees, 60 degrees and 40 degrees the maximum detected scatter doses over the titanium implant are 36%, 32% and 23% for Co-60 gamma, 6 MV X-ray and 25 MV X-ray, respectively. The dose enhancement at different beam angles was less pronounced in 25 MV X and more pronounced in Co-60 gamma irradiation., Conclusions: For the different radiation beams studied, the irradiation angle between scattering titanium dental implants and the central axis does not significantly affect the total dose that may lead to osteoradionecrosis of the mandible.

Purpose: Patterns of von Mises stress values surrounding implants supporting fixed prostheses in the posterior edentulous maxilla were evaluated using 3-dimensional finite element analysis., Materials and Methods: Implants were placed in maxillary bone in 2 different configurations. In the first configuration, implants were placed in the first premolar, second premolar, and second molar regions; in the second configuration, implants were placed in the second premolar and second molar regions, and a mesial cantilever was extended to the space of the first premolar tooth on the superstructure. On the implant placed in the socket of the second molar, 3 different inclinations were used (0, 15, and 30 degrees). Loading was applied in the vertical, oblique, and horizontal axes., Results: Inclination of the implant in the molar region was found to result in increased stress. Significant increase in stress on the implant embedded in the premolar region was also seen in the design with the cantilever as compared to the conventional prosthesis design., Discussion: The stress concentrations observed at the neck of the implant were similar to results reported in the literature., Conclusion: The highest stress value obtained in the study was 194.2 MPa with oblique loading. This value did not exceed the endurance limit of pure titanium, which is 259.9 MPa.

Purpose: This study evaluated the validity of the color selection results obtained from digital cameras., Materials and Methods: Four observers matched the colors of 30 extracted maxillary incisors under daylight conditions. Two different digital cameras, with 1.5- and 5.0-megapixel resolutions, were used to select the color of the standardized circular area with 3 reference points on the same teeth; a spectrophotometer was also used, and the results were compared with the human and camera observations., Results: The highest significant agreement (60% agreement with the spectrophotometric values) was found with the 5.0-megapixel camera., Conclusion: It appears that the resolution capacity of a digital camera can increase the reliability of color selection.

Objective: The aim of the study was to examine the dose enhancement from scattered radiation at bone-dental implant interfaces during simulated head and neck radiotherapy., Study Design: Four cylindrical titanium dental implants with 3 different sizes and lengths were implanted into a human mandible in 4 different positions. Ionization measurements for 6 MV X, 25 MV X, and Co-60 gamma rays were done. Thermoluminescent dosimeter (TLD 100 ) chips were used to measure radiation dose enhancement due to the scattered electrons from titanium and electronic disequilibrium at the tissue-metal interface., Results: The results showed that for Co-60, there is a 21% maximum increase in dose to alveolar mandibular bone at the close proximity to the titanium. For 6-MV x-rays the dose enhancement increase was almost the same or slightly lower than for Co-60, while for 25-MV high-energy x-rays, dose enhancement was lower than that of others. This increase in dose enhancement fell off rapidly and became insignificant at 2 mm from the interface., Conclusion: Total dose that may lead to osteoradionecrosis risk of the mandible is slightly but not significantly affected by the scattered dose of the dental implants of lower jaw in the radiation field exposed to 3 different radiation beams.