PURPOSE. To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS. A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non- quantitatively. RESULTS. All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION. The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.
Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.
Park, Se-Ung;Kim, Sung-Hoon;Kwon, Hye-Mee;Koh, Gi-Ho;Nam, Gi-Byoung;Karm, Myong-Hwan;Kim, Wook-Jong;Ku, Seung-Woo
Journal of Dental Anesthesia and Pain Medicine
/
v.18
no.3
/
pp.189-193
/
2018
A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.
Park, Jong-Hyun;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
Journal of Dental Rehabilitation and Applied Science
/
v.24
no.1
/
pp.41-56
/
2008
The methods of surface modification of commercial implants were various according to the manufacturer. Surface modification of implant may produce diverse physical and chemical surface characteristics resulted from the treatment method and treatment condition. As a result, the bone response might be different. Even though surface modified implants have been used clinically, most researches are focusing on the bone response of surface modified implants comparing to machined implants rather than surface modified commercial implants. This study compare and analyze bone responses of 4 surface modified commercial implants with different shapes and surfaces. Eighty surface modified commercial implants with 4 different surface characteristics were installed in the tibia of white Newzealand rabbits. Biomechanical stability tests and histomorphometric evaluation were done. The results were as follows: 1. Surface modified commercial implants showed stable osseointegration at 6 weeks after installation. 2. Histomorphometric evaluation showed that there was no significant differences in bone to implant contact among 4 different commercial titanium implants. In comparing the implants with different shape the measurement of bone growth in subcortical area would be more reliable than entire bone to implant contact length. 3. Resonance Frequency Analysis showed that there was no significant differences among 4 types of implants, even though they were significantly different in installation. 4. There was significant differences in interfacial shear strength among 4 type of implants. 5. It is difficult to observe accurate bone to implant interface using Micro-CT. However, it is possible to measure the entire contact length of the implant to the bone.
Purpose: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. Materials and methods: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. Results: During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. Conclusion: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.
Kim, Jong-Wan;Cho, Il-Sik;Lee, Shin-Jae;Kim, Tae-Woo;Chang, Young-Il
The korean journal of orthodontics
/
v.36
no.1
s.114
/
pp.55-62
/
2006
Orthodontic mini-implants, despite its usefulness as anchorage, have some limits such as loosening. Therefore, various shapes and lengths have been studied. The aim of this study is to analyze the shape and length of mini-implants mechanically. The shapes of mini-implants (1.6 mm, Dual Top, Jeil Medical Co., Seoul, Korea) were cylindrical and taper. The lengths of mini-implants were 6 mm and 8 mm. The tested groups were 5 groups (cylindrical 6 mm, cylindrical 8 mm, taper 6 mm, taper 8 mm and taper 8 mm modified whose thread is reduced from the middle to upper part). All were inserted and removed on the polyurethane foam with the torque measured. During insertion and removal, the taper shape needed higher torque than the cylindrical shape, and the 8 mm length than the 6 mm length (p<0.001). The taper 6mm group showed superior insertion torque (p<0.001) and similar removal torque to the cylindrical 8 mm group. The taper 8 mm modified group with gradually reduced threads, showed continuous high removal torque after the peak. The initial mechanical stability can be provided by the tapered shape and also, affected by length and thread design.
Purpose: The aim of this study was to determine whether biphasic calcium phosphate (BCP) bone substitute with two different concentrations of Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) enhances new bone formation in a standardized rabbit sinus model and to evaluate the concentration-dependent effect of ErhBMP-2. Methods: Standardized, 6-mm diameter defects were made bilaterally on the maxillary sinus of 20 male New Zealand white rabbits. Following removal of the circular bony windows and reflection of the sinus membrane, BCP bone substitute without coating (control group) was applied into one defect and BCP bone substitute coated with ErhBMP-2 (experimental group) was applied into the other defect for each rabbit. The experimental group was divided into 2 subgroups according to the concentration of ErhBMP-2 (0.05 and 0.5 mg/mL). The animals were allowed to heal for either 4 or 8 weeks and sections of the augmented sinus and surrounding bone were analyzed by microcomputed tomography and histologically. Results: Histologic analysis revealed signs of new bone formation in both the control and experimental groups with a statistically significant increase in bone formation in experimental group 1 (0.05 mg/mL ErhBMP-2 coating) after a 4-week healing period. However, no statistically significant difference was found between experimental group 1 and experimental group 2 (0.5 mg/mL ErhBMP-2 coating) in osteoinductive potential (P<0.05). Conclusions: ErhBMP-2 administered using a BCP matrix significantly enhanced osteoinductive potential in a standardized rabbit sinus model. A concentration-dependent response was not found in the present study.
Purpose: This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Methods: Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). Results: PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Conclusions: Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.
Purpose: Ultrasonic scalers have been widely used for removing biofilm which is considered as major etiologic factor of periodontal disease. The purpose of this study was to evaluate the effect of working parameters of piezoeletric ultrasonic scaler with scaler tip (No. 1 tip) on casting gold alloy removal. Methods: Type III dental casting gold alloy (Firmilay$^{circledR}$, Jelenko Inc, CA, USA) was used as substitute for tooth substance. Piezoeletric ultrasonic scaler and No.1 scaler tip (P-Max$^{circledR}$, Satelec, France) were selected. The selected working parameters were mode (P mode, S mode), power setting (2, 4, 8) and lateral force (0.5 N, 1.0 N, 2.0 N). The effect of working parameters was evaluated in terms of ablation depth, ablation width and ablation area. Results: Mode influenced ablation depth and ablation area. Power also influenced ablation depth and ablation area. Especially, Power 2 and power 8 showed statistically significant difference. Lateral force had influence on ablation width, and 0.5 N resulted significant increase compared with 1.0 N and 2.0 N. Ablation depth was influenced by mode, power and lateral force and defect width was influenced by lateral force. Ablation area was influenced by mode and power. Conclusions: It can be concluded that the use of piezoelectric ultrasonic scaler with No. 1 scaler tip in S mode and high power may result in significant loss of tooth substance.
Based on current evidence in the literature, it is known that endotoxin is a weakly adherent surface phenomenon and that power-driven instruments can be used to accomplish definitive root detoxification and maximal wound healing without overinstrumentation of root and without extensive cementum removal. And one of the newly developed curette tips used with low power of piezoelectric ultrasonic scaler, is effective to remove calculus and not to remove the excessive cementum. The purpose of this study is therefore, to assess the influence of ultrasonic power and various working parameters on root substitute removal when instrumentation is performed with the curette tip on piezoelectric ultrasonic scaler. This study assessed defect depth, width and area resulting from instrumentation using a piezoelectric ultrasonic scaler with a curette type tip in vitro to acrylic resin block as a root substitute. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1 N, 2 N) and instrumentation time(5 sec, 10 sec, 20 sec) and power setting was adjusted 0,2,4,8 in P mode. Power setting had the greatest influence on defect depth compared to lateral force and instrumentation time(standardized regression parameter estimates${\pm}$standard error, $0.37{\pm}0.02$, $0.19{\pm}0.02$, $0.07{\pm}0.02$). The effects on defect area also greatest for power setting($0.57{\pm}0.03$) compared to lateral force and instrumentation time($0.33{\pm}0.03$, $0.12{\pm}0.03$). The effect of the power setting on the defect width($0.15{\pm}0.01$) is not so great as defect depth or defect area compared to lateral force($0.12{\pm}0.01$) and effect of instrumentation time is minimal($0.02{\pm}0.01$). It could be concluded that the power setting has the greatest influence on the defect depth and area in curette type tip with low power of piezoelectric ultrasonic device. Many parameters can be adjusted in various situation in clinical use of piezoelectric ultrasonic scaler but the power setting is the first parameter to be adjusted.
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