Effect of a novel rotation coordinating device on registered horizontal condylar guidance of nonarcon semi-adjustable articulators

Background

Horizontal condylar guidance (HCG) is registered by protrusive interocclusal records but in nonarcon articulators, these records can affect the accuracy. The present study aimed to evaluate the effect of a novel rotation coordinating device (RCD) on condylar guidance setting with protrusive interocclusal records.

Materials and Methods

The study was designed as a comparative in-vitro investigation. Stone maxillary and mandibular casts were mounted on a fully adjustable instrument as the patient. Duplicate casts were mounted on an arcon and a nonarcon articulator with corresponding face bow records and in maximum intercuspation relation. Five different condylar guidance inclinations for both sides (20°, 30°, 40°, 50°, and 60°) were set on the fully adjustable instrument and 16 protrusive interocclusal records were established at each setting. HCG was set for arcon, nonarcon articulators, and nonarcon articulators with RCD. Data were analyzed using one-sample t-test to compare with actual HCG and one-way analysis of variance (α =0.05).

Results

Mean HCG for studied articulators was 35.40 for arcon, 30.31 for nonarcon without RCD, and 35.61 for nonarcon with RCD which were significantly different from actual HCG (P < 0.05). HCG of the nonarcon with RCD showed no significant difference with arcon articulator (P = 0.71) while both were significantly different from nonarcon without RCD (P < 0.001).

Conclusion

"The RCD" compensates the condylar guidance inclination difference between arcon and nonarcon articulators. The device precisely transfers the hinge movement of the upper member of the articulator to the condylar track.

Lithium metasilicate glass-ceramic fabrication using spark plasma sintering

Background

The digital dentistry, requires materials with wo opposite properties of machining ability and also enough hardness. The main objective of this experimental study was to investigate the fabrication feasibility of the lithium metasilicate glass-ceramic in partially crystalized stated using the spark plasma sintering (SPS) method.

Materials and Methods

In this study, SPS for the first time was used to fabricate primary lithium metasilicate glass-ceramic (LMGC) blocks. The raw materials were mixed and melted and then quenched in water and the resulted frits were grinded. The resulting powder was sintered by SPS at 660, 680, and 700°C.

Results

Scanning Electron Microscope (SEM), X-ray diffraction (XRD), and Vicker's microhardness assay were used to evaluate the properties of samples. Statistical comparison of the obtained data was performed by ANOVA, followed by the post hoc test of Duncan. Microstructural studies by SEM and XRD showed that all samples were composed of lithium metasilicate phase in a glassy matrix. With increasing the sintering temperature, the number and size of lithium metasilicate particles increased and higher mechanical properties have been achieved. However, the sintered sample at 700°C has less processing ability than the samples sintered at 660 and 680°C.

Conclusion

The optimum sintering temperature for glass frit consolidation was determined by SPS at 680°C.

Marginal Accuracy of Lithium Disilicate Full-Coverage Single Crowns Made by Direct and Indirect Digital or Conventional Workflows: A Systematic Review and Meta-Analysis

PURPOSE

Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium disilicate crowns is not well-established, yet. The purpose of this study was to systematically review available publications on marginal fit of single-unit, full-coverage, tooth-supported lithium disilicate restorations.

METHODS

Pubmed, Web of Science, Cochrane, EMBASE, and Scopus were electronically searched along with a manual search. After critical appraisal, data from selected studies were extracted and mean marginal difference with a 95% confidence interval was calculated. Meta-analysis of the collected data was conducted using STATA software.

RESULTS

The meta-analysis revealed similar marginal gap values in intraoral scanners with conventional groups (p>0.05) and in intraoral scanners with extraoral canners (p>0.05).

CONCLUSION

No significant difference was seen between digital and conventional impressions or intra- and extraoral scanners for marginal accuracy of lithium disilicate crowns.

Clinical performance of implant supported mandibular overdentures with cantilever bar and stud attachments: A retrospective study

BACKGROUND

Treatment of edentulous patients with implant-supported over-dentures improves denture's retention and stability. Published data concerning implant-supported overdenture with cantilever bars that claimed that can affect the survival and bone loss of implants are scarce.

PURPOSE

The purpose of this study was to evaluate 5-year clinical performance of mandibular implant-supported over-dentures with different attachment systems.

MATERIALS AND METHODS

In this retrospective study, 103 patients who had received mandibular over-dentures supported by two implants were evaluated in a 5-year follow up. Studied groups were patients with Spherblock ball attachment (58 patients), Dolder bar with cantilever (36 patients), and Locator attachment (9 patients). Marginal bone-loss around implants, prosthetic complications, soft tissue status of the implants (gingival index, plaque index, pocket depth, and bleeding on probing) were used to compare studied groups. Visual Analogue Scale (VAS) criteria was used to assay patient's satisfaction. One-way ANOVA, Scheffe, Kruskal-Wallis, Mann-Whitney, and Fisher's exact tests, were used for the data analysis (α = 0.05).

RESULTS

One hundred and three patients (46 male, 57 female, mean age 64.7 ± 8.6) with 206 implants (Strauman) were studied. The implant survival rate was 100% with mean bone loss of 0.22 mm around implants in 5 years. Prosthetic complications including attachment wear and denture fracture occurred more often with ball attachments. The number of attachment replacement, and post insertion appointments were significantly less in patients with bar attachments (p < 0.05). Pocket depth and gingival index were less in the ball attachment (p < 0.05).

CONCLUSION

Mandibular overdenture supported by two implants can be considered a successful treatment in edentulous patients. The frequency of prosthetic complication is higher in unsplinted than splinted superstructures.

Comparing the color match of monolithic CAD-CAM dental ceramics with the VITA Classical shade guide

STATEMENT OF PROBLEM

Matching the shade selected and the final color of a ceramic restoration is challenging, and studies on matching monolithic ceramics to the shade selected are lacking.

PURPOSE

The purpose of this in vitro study was to compare the color match of monolithic lithium disilicate (LDS), zirconia-reinforced lithium silicate (ZLS), presintered zirconia-reinforced lithium silicate (PS-ZLS), polymer-infiltrated ceramic network (PICN), and multilayer zirconia with the 3 modes of the VITA Classical shade guide.

MATERIAL AND METHODS

This study was performed on 50 rectangular plates (14×12×1 mm) of 5 types of ceramics with A2 shade (n=10). Zirconia specimens were evaluated in 3 locations: incisal, medial, and cervical thirds. The color coordinates of the specimens of all 7 groups were measured on #3 and #8 Ivoclar Natural Die Color material by using a reflective spectrophotometer. The color coordinates of A2 VITA shade were measured in 5 modes: without backing placed in specimen holder, shade tab on the backgrounds #3 and #8, and 1-mm-thick shade tab on the backgrounds #3 and #8. The color difference of each specimen with 3 modes of A2 shade (without backing and on similar backgrounds) was calculated by using the ΔE00 formula, and comparison among groups was performed by using 2-way ANOVA and Tamhane post hoc tests. The comparison of ΔE00 between the values obtained from backgrounds #3 and #8 was performed by using the independent t test (α=.05).

RESULTS

In both backgrounds, statistically significant differences were found between the studied groups and VITA shade (P<.001). In most situations, the amount of color difference was lowest for the "shade tab on the backgrounds" mode. On background #3, the highest color difference was related to ZLS (6.48 ±0.23), and the lowest values were observed in the PICN group (1.02 ±0.31). On background #8, the highest color difference was related to ZLS compared with the "without backing" mode (8.62 ±0.27), and the lowest values were reported for ZLS compared with the "shade tab on the backgrounds" mode (1.27 ±0.44). The independent t test showed a statistically significant color difference on the 2 different backgrounds for all situations (P<.001).

CONCLUSIONS

Color selection of monolithic ceramics with the VITA Classical shade guide is improved by placing the VITA tabs on a similar background. Background color has a significant effect on the final shade of the monolithic ceramics. Choosing the correct color for LDS, ZLS, and PS-ZLS requires more care than for PICN and zirconia.

How the initial retentive force of implant-supported overdentures can be affected with splinted and unsplinted attachments systems

BACKGROUND

The aim of this study was to evaluate the retention of implant-supported overdentures with different attachment systems.

MATERIALS AND METHODS

In this in vitro study edentulous model with 2 Straumann implant in symphyseal region was used to make an overdenture with different attachment systems. (Dolder bar with 1 and 3 metal clips, Hader bar with 1 and 3 plastic clips, ball on bar with 2 and 4 plastic caps, Locator, Rhein plastic caps and Eleptical matrix). Retention values were recorded by universal testing machine with a cross speed of 50.8 mm/min in vertical, posteroanterior, and lateral direction. Repeated measure ANOVA and Duncan tests were used for the data analysis (α =0.05).

RESULTS

There was a statistically significant difference between the retention values of studied attachments in different dislodgment directions (P < 0.05). The highest and lowest retention were recorded for 4 balls on bar (56.71 N) and Rhein pink caps (27.89 N) in the vertical direction. Three metal clips (61.43 N) and Rhein pink cap (24.77 had the highest and lowest retention force in the posteroanterior direction. In the lateral direction, 4 balls on bar (62.68 N) and 1 plastic clip (32.27 N) showed the highest and lowest retention, respectively.

CONCLUSION

If the higher retention force has been considered for implant-supported overdenture attachment selection, the clinician can use splinted bar or ball on bar superstructure.

Comparison of translucency and opalescence among different dental monolithic ceramics

STATEMENT OF PROBLEM

Monolithic ceramic restorations designed by computer-aided design and computer-aided manufacturing are increasingly being used by clinicians. With the introduction of new materials, their optical characteristics also need to be investigated.

PURPOSE

The purpose of this in vitro study was to compare the translucency and opalescence of lithium disilicate, zirconia-reinforced lithium silicate, presintered zirconia-reinforced lithium silicate, polymer-infiltrated ceramic-network material, and multilayer zirconia.

MATERIAL AND METHODS

A total of 50 rectangular plates (14×12×1 mm) of 5 monolithic ceramics were prepared in this in vitro study (n=10). Each zirconia specimen was divided into 3 groups of incisal, middle, and gingival thirds. Each group was then evaluated separately. The color parameters of specimens were measured on 3 backgrounds, white, black, and #3 Ivoclar Natural Die Color material, by using a spectrophotometer. The translucency and opalescence of the specimens were determined by the relevant equations, and between-group comparisons were made. One-way ANOVA and Tamhane post hoc tests were used to compare groups (α=.05).

RESULTS

The difference among the groups was significant in translucency (F=137.346, df=6, P<.001), contrast ratio (F=134.148, df=6, P<.001), and opalescence parameters (F=128.028, df=6, P<.001). The 3 zirconia groups (10.87 ±0.54 to 11.88 ±0.26) had a significantly lower translucency than the other groups, and the zirconia-reinforced lithium silicate group (18.14 ±0.74) showed the highest translucency. Zirconia-reinforced lithium silicate (12.36 ±0.42) had the highest opalescence, and the lowest opalescence was found for polymer-infiltrated ceramic-network (5.43 ±0.28) and the incisal third of zirconia (5.45 ±1.06).

CONCLUSIONS

The zirconia-reinforced lithium silicate and presintered zirconia-reinforced lithium silicate specimens had the highest translucency and opalescence. The studied multilayer zirconia, which had different cubic phase values from incisal to gingival blank, showed similar translucency over the entire range, and differences among different regions were related to chromatic variables.

Five year clinical outcomes of metal ceramic and zirconia-based implant-supported dental prostheses: A retrospective study

OBJECTIVES

The implant-supported restorations can be made of all-ceramic materials. The purpose of this study was to compare five year clinical outcomes of zirconia-based and metal ceramic implant-supported fixed dental prostheses (FDPs).

METHODS

In this study, 114 posterior implant-supported FDPs including zirconia-based (52) or metal ceramic (62) restorations were made for 114 patients with a mean age of 59 ± 8.4 years and evaluated in a 5 year follow up. The modified California Dental Association (CDA) guidelines were used to assess the quality of the restorations. The soft tissue status was evaluated using gingival and plaque indices, probing depth and bleeding on probing. Additionally, the bone loss around implants was assessed by parallel priapical radiographs. The visual analogue scale was used regarding patients' satisfaction. The data analysis were performed by Kaplan-Meier, log rank test, Cox regression, Mann-Whitney U and Student's t-test. (α = 0.05).

RESULTS

Five year Kaplan-Meier survival rate of the zirconia-based and metal ceramic FDPs were 98.1 % and 100 % respectively with no significant difference (P = 0.12). The success rates were 81.6 % for zirconia-based and 81.0 % for metal ceramic restorations (P = 0.85). The CDA rating of both studied groups was not significantly different except the marginal gap which was better in zirconia-based FDPs (P < 0.001). Fracture of veneering ceramics occurred in 2.7 % of metal ceramic and 6.4 % of zirconia-based FDPs, which were not considered as failure. Soft tissue status was not affected by the type of restorations except for plaque index which was more favorable for zirconia-based FDPs (P < 0.001). No significant difference was found between marginal bone loss of the two groups (P = 0.30 mesial, P = 0.46 distal).

CONCLUSIONS

Zirconia-based and metal ceramic FDPs showed similar promising clinical performance in the 5-year follow-up.

CLINICAL SIGNIFICANCE

Zirconia-based implant-supported FDPs might be a successful restorative method with acceptable survival rate and patient's satisfaction.

Biodegradable Magnesium Bone Implants Coated with a Novel Bioceramic Nanocomposite

Magnesium (Mg) alloys are being investigated as a biodegradable metallic biomaterial because of their mechanical property profile, which is similar to the human bone. However, implants based on Mg alloys are corroded quickly in the body before the bone fracture is fully healed. Therefore, we aimed to reduce the corrosion rate of Mg using a double protective layer. We used a magnesium-aluminum-zinc alloy (AZ91) and treated its surface with micro-arc oxidation (MAO) technique to first form an intermediate layer. Next, a bioceramic nanocomposite composed of diopside, bredigite, and fluoridated hydroxyapatite (FHA) was coated on the surface of MAO treated AZ91 using the electrophoretic deposition (EPD) technique. Our in vivo results showed a significant enhancement in the bioactivity of the nanocomposite coated AZ91 implant compared to the uncoated control implant. Implantation of the uncoated AZ91 caused a significant release of hydrogen bubbles around the implant, which was reduced when the nanocomposite coated implants were used. Using histology, this reduction in the corrosion rate of the coated implants resulted in an improved new bone formation and reduced inflammation in the interface of the implants and the surrounding tissue. Hence, our strategy using a MAO/EPD of a bioceramic nanocomposite coating (i.e., diopside-bredigite-FHA) can significantly reduce the corrosion rate and improve the bioactivity of the biodegradable AZ91 Mg implant.

The effect of the nano- bioglass reinforcement on magnesium based composite

Nano-bioceramic particles serving as a reinforcement can improve the mechanical and biological properties of magnesium implants, but they might have some side effects, that must be addressed. In this research, magnesium composites including 10 wt% nano-bioglass (nBG) were fabricated using powder metallurgy (PM10) and spark plasma sintering (SPS10) methods for bone reconstruction purposes. The results of the compression test indicated that the SPS10 sample had higher mechanical properties, in comparison to the PM10 sample, and nBG had more reinforcing effect on the mechanical properties of magnesium matrix. X-ray difractometery indicated that nBG was chemically reacted with magnesium in the PM10 sample, and resulted in some extra phases (MgO and Mg₂Si) formation, while there was no detectable extra phases in the SPS10 sample. However, a higher in vitro degradation rate was observed for PM10 sample, because of multi-phase formation at the magnesium matrix. To inhibit the chemical reaction between magnesium and nBG kinetically, a short time sintering process can be, therefore, recommended.

Improvement of in vitro behavior of an Mg alloy using a nanostructured composite bioceramic coating

Magnesium (Mg) alloys as a new group of biodegradable metal implants are being extensively investigated as a promising selection for biomaterials applications due to their apt mechanical and biological performance. However, as a foremost drawback of Mg alloys, the high degradation in body fluid prevents its clinical applications. In this work, a bioceramic composite coating is developed composed of diopside, bredigite, and fluoridated hydroxyapatite on the AZ91 Mg alloy in order to moderate the degradation rate, while improving its bioactivity, cell compatibility, and mechanical integrity. Microstructural studies were performed using a transmission electron microscope (TEM), scanning electron microscope (SEM), X-ray diffraction (XRD) analysis, and energy dispersive spectroscopy (EDS). The degradation properties of samples were carried out under two steps, including electrochemical corrosion test and immersion test in simulated body fluid (SBF). Additionally, compression test was performed to evaluate the mechanical integrity of the specimens. L-929 fibroblast cells were cultured on the samples to determine the cell compatibility of the samples, including the cell viability and attachment. The degradation results suggest that the composite coating decreases the degradation and improves the bioactivity of AZ91 Mg alloy substrate. No considerable deterioration in the compression strength was observed for the coated samples compared to the uncoated sample after 4 weeks immersion. Cytotoxicity test indicated that the coatings improve the cell compatibility of AZ91 alloy for L-929 cells.

Effect of cleaning methods on retentive values of saliva-contaminated implant-supported zirconia copings

OBJECTIVE

The aim of this study was to evaluate the effect of different cleaning regimens on retentive strength of saliva-contaminated implant-supported zirconia copings.

MATERIAL AND METHODS

Seventy solid titanium abutments with 5.5 mm height (Straumann) were attached to the regular neck implant analogs (Straumann). The abutment-analog complex was mounted vertically in an autopolymerized T-shaped acrylic resin block. Seventy zirconia copings with an occlusal loop were made. The copings were contaminated with fresh human saliva for 1 min (except the control group). Afterward, the specimens were washed with water spray for 15 s and dried for 15 s. The copings were divided into seven groups according to cleaning methods (n = 10). Group 1: no contamination (control group); Group 2: water spray rinsing; Group 3: airborne particle abrasion; Group 4: immersion in 96% isopropanol; Group 5: applying Ivoclean (Ivoclar Vivadent); Group 6: applying 1% sodium hypochlorite; and Group 7: applying Monobond Plus (Ivoclar Vivadent). The copings were luted with a resin luting agent (RelyX Unicem; 3M ESPE). After 5,000 thermal cycles, the retentive values of the restorations were tested using universal testing machine. The dislodging forces were analyzed using one-way analysis of variance and the Tukey's HSD tests (α = 0.05).

RESULTS

The copings, which were cleaned with Ivoclean and 96% isopropanol, showed the highest retentive values (204.79 ± 44.49 and 232.65 ± 71.36, respectively). There was a significant difference between the studied groups (F = 2.735; p = .02). Tukey's HSD showed that there was no significant difference between the different cleaning procedures and control group except water rinsing group (p = .14). The lowest retentive value was related to the saliva-contaminated group, which were only cleaned with water rinsing method.

CONCLUSION

The retentive values of zirconia-based restorations were adversely affected by saliva contaminations. These restorations can be cleaned by Ivoclean, 96% isopropanol, airborne particle abrasion, 1% sodium hypochlorite, or applying Monobond Plus before luting procedures.

Prevention of Cross-contamination Risk by Disinfection of Irreversible Hydrocolloid Impression Materials with Ozonated Water

Background:

Disinfection of dental impression is mandatory for preventing the cross infection between dental staff and dental laboratory. Ozone as a disinfectant can be used in various ways in dentistry. The aim of this study was to evaluate the efficacy of ozonated water for disinfection of irreversible hydrocolloid impression materials and preventing cross-contamination.

Methods:

Thirty-two circular specimens (1 cm diameter and 2 mm thickness) of irreversible hydrocolloid impression material were made. Thirty specimens were contaminated with Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 51299), and Candida albicans (PTCC 5027). Except control samples (n = 2), the other specimens were immersed in ozonated water for 5 and 10 min (5 sample each group). Trypsin was used for separating microorganisms. Diluted microbial solution was analyzed microbiologically for colony-forming units (CFUs). Two-way repeated measure ANOVA and Scheffe post hoc test were used for data analysis (α = 0.05).

Results:

The number of CFUs after disinfection with ozonated water was decreased significantly (11.84%, 61.55%, and 20.27% after 5 min and 11.03%, 14.50%, and 16.99% after 10 min for P. aeruginosa, S. aureus, and C. albicans, respectively) (P < 0.001). Increasing the time of disinfection resulted in significant reduction in a number of S. aureus only (P < 0.001) although they did not vanish microorganisms completely.

Conclusions:

Immersion of irreversible hydrocolloid impression material in ozonated water for 10 min will not lead to complete disinfection but decreases the microorganisms to a level that can prevent infection transmission.

Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (part I)

BACKGROUND

Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures.

OBJECTIVES

This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO).

METHODS

In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19-item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal-Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05).

RESULTS

Eighty-six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post-delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery.

CONCLUSION

The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures.

Relationship between Tooth Loss, Functional Dyspepsia and Gastro-Esophageal Reflux Disorder among Isfahani Adults

BACKGROUND

Few studies have assessed the relationship between tooth loss and upper gastro-intestinal (GI) disorders including functional dyspepsia (FD) and gastro-esophageal reflux disease (GERD). This study aimed to investigate the relation between dental status and FD, its components and GERD among a large group of Isfahani adults.

METHODS

In a cross-sectional study from April to May 2010, the dental status of 4109 Isfahani adults was evaluated using a self-administered questionnaire. Participants were categorized into three main groups: those with full dentition, individual who had lost 1-5 teeth and those who had lost >5 teeth. FD, its components and GERD were defined using Rome III criteria. Multivariable logistic regression was used to examine the relationship between dental status and gastrointestinal disorders.

RESULTS

After adjustment for potential confounders, we found no significant association between dental status, FD and GERD. However, individuals who had lost 1-5 teeth and >5 teeth had 34% and 109% greater odds for early satiation, respectively. In addition, individuals who had lost 1-5 teeth were 24% likely to have postprandial fullness and epigastric pain. Stratified analyses by gender also revealed a significant association between dental status and GERD as well as FD in females; such that those who had lost 1-5 teeth had 33% greater chance for GERD and those who had lost >5 teeth were 101% more likely to have FD compared with those with full dentition.

CONCLUSION

We found significant positive associations between tooth loss, GERD and FD in women, but not in men. We also found significant relations between tooth loss and components of FD, especially early satiety in the entire population.

The evaluation of prepared microgroove pattern by femtosecond laser on alumina-zirconia nano-composite for endosseous dental implant application

Ceramic dental materials, especially alumina (20 %vol)-yttrium stabilized tetragonal zirconia poly crystal (A-Y-TZP20), have been considered as alternatives to metals for endosseous dental implant application. For increasing the bone-to-implant contact as well as the speed of bone formation, a new surface modification can be effective. The aim of this study was to design microgroove patterns by femtosecond laser on A-Y-TZP20 nano-composite disks for endosseous dental implant application. The phase composition and the morphology of the A-Y-TZP20 nano-composite samples were characterized using X-ray diffraction and Scanning electron microscopy equipped with energy dispersive X-ray spectroscopy techniques. Statistical analysis was submitted to Kolmogorov-Smirnov test and Student's t test for independent variables, with a 5 % significance level. EDAX analysis revealed a significant decrease in the relative content of contaminants like carbon (p < 0.05) in laser surface-treated group as compared to non surface-treated group. X-ray diffraction did not show any change in the crystalline structure induced by laser processing. It was concluded that the femtosecond laser is a clean and safe method for surface modification of A-Y-TZP20.

Prenatal metal exposure in the Middle East: imprint of war in deciduous teeth of children

In war zones, the explosion of bombs, bullets, and other ammunition releases multiple neurotoxicants into the environment. The Middle East is currently the site of heavy environmental disruption by massive bombardments. A very large number of US military bases, which release highly toxic environmental contaminants, have also been erected since 2003. Current knowledge supports the hypothesis that war-created pollution is a major cause of rising birth defects and cancers in Iraq. We created elemental bio-imaging of trace elements in deciduous teeth of children with birth defects from Iraq. Healthy and naturally shed teeth from Lebanon and Iran were also analyzed for trace elements. Lead (Pb) was highest in teeth from children with birth defects who donated their teeth from Basra, Iraq (mean 0.73-16.74 (208)Pb/(43)Ca ppm, n = 3). Pb in healthy Lebanese and Iranian teeth were 0.038-0.382 (208)Pb/(43)Ca ppm (n = 4) and 0.041-0.31 (208)Pb/(43)Ca ppm (n = 2), respectively. Our hypothesis that increased war activity coincides with increased metal levels in deciduous teeth is confirmed by this research. Lead levels were similar in Lebanese and Iranian deciduous teeth. Deciduous teeth from Iraqi children with birth defects had remarkably higher levels of Pb. Two Iraqi teeth had four times more Pb, and one tooth had as much as 50 times more Pb than samples from Lebanon and Iran.

Effect of the processing cycle on dimensional changes of heat-polymerized denture base resins

Background:

The second processing cycle for adding the artificial teeth to heat-polymerized acrylic resin denture bases may result in dimensional changes of the denture bases. The aim of this study was to evaluate the dimensional changes of the heat-polymerized acrylic resin denture bases with one and two-cycle processing methods.

Materials and Methods:

A metal edentulous maxillary arch was used for making 40 stone casts. Maxillary complete dentures were made with heat-polymerized acrylic resins (Meliodent and Acropars) with one and two stage processing methods (n = 10 for each group). Linear dimensional changes in anteroposterior and mediolateral distances and vertical changes in the first molar region were measured following each processing cycle, using a digital caliper. Mean percentage of the dimensional changes were subjected to two-way analysis of variance and Tukey honest significant difference tests (α = 0.05).

Results:

Postpolymerization contraction occurred in both anteroposterior and mediolateral directions in all studied groups; however, the vertical dimension was increased. Acropars acrylic resin showed the highest dimensional changes and the second processing cycle significantly affected the measured distances (P < 0.05). Meliodent acrylic resin was not significantly influenced by the processing method.

Conclusion:

Reheating of the acrylic resin denture bases for the addition of denture teeth result in linear dimensional changes, which can be clinically significant based on the acrylic resin used.

Recording the Tilt of a Cast on a Surveyor

Some patients are not satisfied with removable partial dentures (RPDs), when it is not stable during mastication.A dental surveyor can be used to prevent problems related to production of RPDs. Determining the best path of insertion and removal is an initial and fundamental step in RDPs planning. The path of insertion record enables the technician to reproducing the cast in the same position on a surveyor that the dentist selected. This article describes new method for this purpose that could be useful for recording and reproducing the tilt of casts.

In vivo biocompatibility of Mg implants surface modified by nanostructured merwinite/PEO

Magnesium (Mg) alloys have been suggested as biodegradable bone implant materials due to their good intrinsic biocompatibility and great mechanical properties. Although magnesium has attractive properties as an orthopedic implant material, its quick degradation and low bioactivity may lead to the loss of mechanical integrity of the implant during the bone healing process. In this paper, we endeavor to surmount the abovementioned defects using the surface coating technique. We have recently coated AZ91 magnesium implants with merwinite (Ca3MgSi2O8) through the coupling of plasma electrolytic oxidation (PEO) and electrophoretic deposition method. In this work, we are specifically focused on the in vivo examinations of the coated implants in comparison with the uncoated one. For the in vivo experiment, the rod samples, including the uncoated and merwinite/PEO coated implants, were imbedded into the greater trochanter of rabbits. The results of the in vivo animal test indicated an improvement in biodegradability including slower implant weight loss, reduction in Mg ion released from the coated implants in the blood plasma, lesser release of hydrogen bubbles and an improvement in biocompatibility including an increase in the amount of bone formation and ultimately a mild bone inflammation after the surgery according to the histological images. In summary, proper surface treatment of magnesium implants such as silicate bioactive ceramics may improve their biocompatibility under physiological conditions to making them suitable and applicable for future clinical applications.

Relationship between subjective halitosis and psychological factors

OBJECTIVES

Subjective halitosis is a growing concern in the fields of dentistry and psychology. This study was designed to determine the association between subjective halitosis and contributing psychological factors.

METHODS

Data for this cross-sectional study were gathered from 4,763 participants who had answered questions on subjective halitosis and psychological factors (depression, anxiety, stress and personality traits) in the study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN). Binary logistic regression was used for data analysis.

RESULT

The mean age of all subjects was 36.58 years; and the majority of subjects were female (55.8%), married (81.2%) and graduates (57.2%). The prevalence of subjective halitosis was 52.8%. The majority of subjects with the complaint of subjective halitosis were married (P<0.001) and young (P=0.07). Participants with subjective halitosis were significantly more anxious [odds ratio (OR)=1.76, 95% confidence interval (95% CI): 1.38-2.24], stressed (OR=1.41, 95% CI: 1.17-1.71) and depressed (OR=1.31, 95% CI: 1.09-1.57). Among personality traits, neuroticism was a risk factor (tertile 1 vs. tertile 2: OR=1.29, 95% CI: 1.09-1.51; and tertile 1 vs. tertile 3: OR=1.74, 95% CI: 1.43-2.13) and conscientiousness was revealed to be a protective factor (tertile 1 vs. tertile 2: OR=0.82, 95% CI: 0.70-0.98; and tertile 1 vs. tertile 3: OR=0.65, 95% CI: 0.53-0.80).

CONCLUSION

It seems that psychological factors, such as anxiety, depression and stress, as well as some personality traits, can be considered as risk factors for subjective halitosis. Multidisciplinary efforts by dental and psychological professionals must be considered to address this problem.

Effects of biosurfactant produced by Lactobacillus casei on gtfB, gtfC, and ftf gene expression level in S. mutans by real-time RT-PCR

Background:

The Streptococci are the pioneer strains in plaque formation and Streptococcus mutans are the main etiological agent of dental plaque and caries. In general, biofilm formation is a step-wise process, which begins by adhesion of planktonic cells to the surfaces. Evidences show that expression of glucosyltransferase B and C (gtfB and gtfC) and fructosyltransferase (ftf) genes play critical role in initial adhesion of S. mutans to the tooth surface which results in formation of dental plaques and consequently caries and other periodontal disease.

Materials and Methods:

The aim of this study was to determine the effect of biosurfactants produced by a probiotic strain; Lactobacillus casei (ATCC39392) on gene expression profile of gftB/C and tft of S. mutans (ATCC35668) using quantitative real-time PCR.

Results:

The application of the prepared biosurfactant caused dramatic down regulation of all the three genes under study. The reduction in gene expression was statistically highly significant (for gtfB, P > 0.0002; for gtfC, P > 0.0063, and for ftf, P > 0.0057).

Conclusion:

Considerable downregulation of all three genes in the presence of the prepared biosurfactant comparing to untreated controls is indicative of successful inhibition of influential genes in bacterial adhesion phenomena. In view of the importance of glucosyltransferase gene products for S.mutans attachment to the tooth surface which is the initial important step in biofilm production and dental caries, further research in this field may lead to an applicable alternative for successful with least adverse side effects in dental caries prevention.

Evaluation of interleukin-1α, interleukin-10, tumor necrosis factor-α and transforming growth factor-β in the serum of patients with pemphigus vulgaris

Pemphigus is an autoimmune blistering disease characterized by a loss of cell adhesion result in acantholysis. Genetic factors and immunologic factors such as cytokines particularly IL-1α, IL-10, TNF-α, and TGF-β may counterpart to developing of Pemphigus. The aim of this study was to evaluate. The concentration of IL-1α, IL-10, TNF-α, TGF-β in serum of pemphigus vulgaris (PV) patients and normal individuals.

MATERIAL AND METHODS

In this analytic and descriptive study 25 patients with pemphigus vulgaris (in active phase) and 25 healthy per sons were examined. Serum samples of two groups were obtained and the level of IL-1α, IL-10, TNF-α and TGF-β were measured by ELISA technique. The data were analyzed statistically by independent T test (α = 0/05).

RESULTS

All cytokines tested, showed higher concentration in patient's sera comparing to healthy control individuals. The level of IL-1α (p = 0.004), TNF-α (p = 0.008) and TGF-β (p = 0.009) were statistically different in two experimental groups, There was no significant difference in IL-10 level (p = 0.605).

CONCLUSION

Cytokines such as IL-1α, IL-10, TNF-α and TGF-β probably have a role in pathogenesis of PV. Further comprehensive studies are suggested to confirm these findings.

In vivo study of nanostructured akermanite/PEO coating on biodegradable magnesium alloy for biomedical applications

The major issue for biodegradable magnesium alloys is the fast degradation and release of hydrogen gas. In this article, we aim to overcome these disadvantages by using a surface modified magnesium implant. We have recently coated AZ91 magnesium implants by akermanite (Ca2 MgSi2 O7 ) through the combined electrophoretic deposition (EPD) and plasma electrolytic oxidation (PEO) methods. In this work, we performed the in vitro and in vivo examinations of these coated implants using L-929 cell line and rabbit animal model. The in vitro study confirmed the higher cytocompatibility of the coated implants compare to the uncoated ones. For the in vivo experiment, the rod samples were implanted into the greater trochanter of rabbits and monitored for two months. The results indicated a noticeable biocompatibility improvement of the coated implants which includes slower implant weight loss, reduction in Mg ion released from the coated samples in the blood plasma, lower release of hydrogen bubbles, increase in the amount of bone formation and ultimately lower bone inflammation after the surgery according to the histological images. Our data exemplifies that the proper surface treatment of the magnesium implants can improve their biocompatibility under physiological conditions to make them applicable in clinical uses. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 1798-1808, 2015.

Effects of Lactobacillus reuteri-derived biosurfactant on the gene expression profile of essential adhesion genes (gtfB, gtfC and ftf) of Streptococcus mutans

Background:

Streptococci are the main causative agents in plaque formation and mutans streptococci are the principle etiological agent of dental plaque and caries. The process of biofilm formation is a step-wise process, starting with adhesion of planktonic cells to the surfaces. It is now a well known fact that expression of glucosyltransferases (gtfs) and fructosyltransferase (ftf) genes play a critical role in the initial adhesion of Streptococcus mutans to the tooth surface, which results in the formation of dental plaques and consequently caries and other periodontal diseases.

Materials and Methods:

In the present study, we have determined the effect of biosurfactants purified from Lactobacillus reuteri (DSM20016) culture on gene expression profile of gftB/C and fft of S. mutans (ATCC35668) using quantitative real-time polymerase chain reaction.

Results:

The application of biosurfactant caused considerable down-regulation of the expression of all three genes under study. The reduction in gene expression was statistically very significant (P > 0.0001 for all three genes).

Conclusions:

Inhibition of these genes by the extracted L. reuteri biosurfactant shows the emergence of a powerful alternative to the presently practicing alternatives. In view of the importance of these gene products for S. mutans attachment to the tooth surface, which is the initial important step in biofilm production and dental caries, we believe that the biosurfactant prepared in this study could be considered as a step ahead in dental caries prevention.

Surface microstructure and in vitro analysis of nanostructured akermanite (Ca2MgSi2O7) coating on biodegradable magnesium alloy for biomedical applications

Magnesium (Mg) alloys, owing to their biodegradability and good mechanical properties, have potential applications as biodegradable orthopedic implants. However, several poor properties including low corrosion resistance, mechanical stability and cytocompatibility have prevented their clinical application, as these properties may result in the sudden failure of the implants during the bone healing. In this research, nanostructured akermanite (Ca2MgSi2O7) powder was coated on the AZ91 Mg alloy through electrophoretic deposition (EPD) assisted micro arc oxidation (MAO) method to modify the properties of the alloy. The surface microstructure of coating, corrosion resistance, mechanical stability and cytocompatibility of the samples were characterized with different techniques including X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), electrochemical corrosion test, immersion test, compression test and cell culture test. The results showed that the nanostructured akermanite coating can improve the corrosion resistance, mechanical stability and cytocompatibility of the biodegradable Mg alloy making it a promising material to be used as biodegradable bone implants for orthopedic applications.

Effect of different chemical disinfectants on the flexural strength of heat-polymerized acrylic resins

The purpose of this study was to evaluate the effect of chemical disinfectants on flexural strength of denture base acrylic resins. A total of 176 rectangular specimens (65x10x3 mm) were made from four heat-polymerized acrylic resins (Triplex,QC-20, Meliodent and Acropars) (n=44). The specimens were thermal cycled for 5000 cycles 5-55 degrees C and randomly divided into four groups (n=11). The specimens were immersed in 1% sodium hypochlorite, 2% glutaraldehyde, 10% Micro 10 or water for 30 minutes. The flexural strength was evaluated using a universal testing machine at a crosshead speed of 5 mm/min. Data were subjected to 2-way ANOVA and Tukey HSD (alpha=0.05). The highest flexural strengths of denture base resins were achieved after immersion in water (Triplex=128.9+/-12.8, QC-20=125+/-11.8, Meliodent=96.2+/-11.4 and Acropars=78.1+/-12.3 MPa). Triplex and QC-20 showed the highest flexural strengths in all of the solutions (P<0.05). The flexural strength of denture base acrylic resins was significantly affected by immersion in disinfection solutions but the reduction in flexural strengths of Triplex, QC-20 and Meliodent after disinfection by %1 sodium hypochlorite, %2 glutaraldhyde and Micro 10 were clinically insignificant.

Evaluation of hardness and wear resistance of interim restorative materials

Background:

The interim restorative materials should have certain mechanical properties to withstand in oral cavity. The aim of this study was to evaluate the hardness and wear resistance of interim restorative materials.

Materials and Methods:

Fifteen identical rectangular shape specimens with dimensions of 2 mm × 10 mm × 30 mm were made from 7 interim materials (TempSpan, Protemp 3 Garant, Revotek, Unifast LC, Tempron, Duralay, and Acropars). The Vickers hardness and abrasive wear of specimens were tested in dry conditions and after 1 week storage in artificial saliva. The depth of wear was measured using surface roughness inspection device. Data were subjected to Kruskal–Wallis and Mann–Whitney tests. The Pearson correlation coefficient was used to determine the relationship between hardness and wear (α =0.05).

Results:

TempSpan had the highest hardness. The wear resistance of TempSpan (in dry condition) and Revotek (after conditioning in artificial saliva) was significantly higher (P < 0.05). There was no statistically significant correlation between degree of wear and hardness of the materials (P = 0.281, r = −0.31).

Conclusion:

Hardness and wear resistance of interim resins are material related rather than category specified.

Risk of Contamination of Different Areas of Dentist's Face During Dental Practices

BACKGROUND

Dental practice presents opportunities for cross-contamination. The dentist's face is at high-risk of infection transmission. The purpose of this study was to evaluate the risk of contamination in different areas of dentist's face during dental practices.

METHODS

The visible splashes of materials that accumulated on cellulose face shields during 144 prosthetics and periodontal procedures were evaluated. The splashes were detected on 14 areas (each 1 cm(2)) of the dentist's face including around nose, mouth, eyes, and zygoma by a magnifier (×2). One way Analysis of variance, Duncan and t-test were used for data analysis (α = 0.05).

RESULTS

Contamination of different areas of dentist's face was significantly different (P < 0.05). The areas around nose and the inner corner of eyes were the most contaminated areas. Zygoma was the least contaminated area. The contaminated areas during periodontal treatments were significantly more than prosthetic treatments (P < 0.05). There was no significant difference between contamination on left and right sides of the face.

CONCLUSIONS

During dental practice, central areas of the face such as inner part of the eyes and around the nose were most contaminated areas. These parts are the important areas for transmission of infection. It is recommended to use protective means like glasses, mask, and protective shield, which have more protection field in these areas.

Metal contamination and the epidemic of congenital birth defects in Iraqi cities

Between October 1994 and October 1995, the number of birth defects per 1,000 live births in Al Basrah Maternity Hospital was 1.37. In 2003, the number of birth defects in Al Basrah Maternity Hospital was 23 per 1,000 live births. Within less than a decade, the occurrence of congenital birth defects increased by an astonishing 17-fold in the same hospital. A yearly account of the occurrence and types of birth defects, between 2003 and 2011, in Al Basrah Maternity Hospital, was reported. Metal levels in hair, toenail, and tooth samples of residents of Al Basrah were also provided. The enamel portion of the deciduous tooth from a child with birth defects from Al Basrah (4.19 μg/g) had nearly three times higher lead than the whole teeth of children living in unimpacted areas. Lead was 1.4 times higher in the tooth enamel of parents of children with birth defects (2,497 ± 1,400 μg/g, mean ± SD) compared to parents of normal children (1,826 ± 1,819 μg/g). Our data suggested that birth defects in the Iraqi cities of Al Basrah (in the south of Iraq) and Fallujah (in central Iraq) are mainly folate-dependent. This knowledge offers possible treatment options and remediation plans for at-risk Iraqi populations.

Retentiveness of implant-supported metal copings using different luting agents

Background:

With regard to potential retrievability of cement-retained implant restorations, the retentive strength of the luting agents is critical. The aim of this study was to evaluate the retention values of implant-supported metal copings using different luting agents.

Materials and Methods:

Twenty ITI implant analogs and solid abutments of 5.5-mm height were embedded vertically in autopolymerizing acrylic resin blocks. Metal copings with a loop on the occlusal surface were fabricated using base metal alloy (Rexillium III). The copings were luted using eight cements with different retention mechanisms (Panavia F2.0, Fuji Plus, Fleck's, Poly F, Fuji I, Temp Bond, GC-free eugenol, and TempSpan) under static load of 5 kg (n=10). All specimens were incubated at 37°C for 24 hours, conditioned in artificial saliva for 7 days and thermocycled for 5000 cycles (5-55°C). The dislodging force was measured using a universal testing machine at a crosshead speed of 5 mm/min. Statistical analyses were performed using Kruskal-Wallis (α=0.05) and Mann-Whitney tests with Bonferroni correction (α=0.001).

Results:

Fuji Plus and TempSpan had the highest and the least mean retentive strength, respectively (320.97±161.47, 3.39±2.33). There was no significant difference between Fuji Plus, Fleck's, Ploy F, and Panavia F2.0. These cements were superior to provisional cements and Fuji I (P<0.001) which showed statistically same retentive strength.

Conclusion:

Within the conditions of this study, the resin modified glass ionomer, zinc phosphate, zinc polycarboxylate, and Panavia F2.0 had statistically the same retentive quality and are recommended for definitive cementation of single implant-supported restorations. The provisional cements and glass ionomer may allow retrievability of these restorations.

Edentulism and Tooth Loss in Iran: SEPAHAN Systematic Review No. 6

OBJECTIVES

Tooth loss appears to have an important role in the loss of mastication and esthetics. The aim of this systematic review was to investigate the prevalence of tooth loss and edentulism in the Iranian population.

METHODS

Studies reviewed in this article were primarily identified via search of the online bibliographic databases including PubMed and Iranian Biomedical Journals, by using "tooth loss", "edentulism", "epidemiology", and "Iran" as keywords. Studies potentially related to this topic were retrieved and the selection criteria applied. From the chosen studies the eligible articles were reviewed.

RESULTS

Of the studies identified after conducting the search, 10 eligible studies were extracted. The prevalence of tooth loss ranges between 0.3% in 3 to 5-year-old children to 70.7% in adults over 65. There is a lack of well-designed epidemiological studies on edentulism and tooth loss in Iran. The prevalence of tooth loss is high and it increases by aging.

CONCLUSIONS

It seems that the prevalence of tooth loss is high among adults in Iran. It is highly suggested that population-based studies should be established to investigate the epidemiology and risk factors of tooth loss in Iran. The results of such studies will be useful in the adoption of appropriate preventive strategies.

Effect of framework design on fracture resistance of zirconium oxide posterior fixed partial dentures

INTRODUCTION

The effect of framework design modifications in all-ceramic systems is not fully understood. The aim of this investigation was to evaluate the effect of different framework designs on fracture resistance of zirconium oxide posterior fixed partial dentures (FPD).

MATERIALS AND METHODS

Thirty two posterior zirconia FPD cores were manufactured to replace a second premolar. The specimens were divided into four groups; I: 3 × 3 connector and standard design, II: 3 × 3 connector and modified design, III: 4 × 4 connector dimension, and standard design and IV: 4 × 4 connector dimension and modified design. After storing for one week in artificial saliva and thermocycling (2000 cycles, 5-55°C), the specimens were loaded in a universal testing machine at a constant cross-head speed of 0.5 mm/min until failure occurred. The Weibull, Kruskal-Wallis, and Mann-Whitney tests were used for statistical analysis (α = 0.05).

RESULTS

The mean fracture resistance of groups with 4 × 4 mm connector was significantly higher than groups with 3 × 3 mm connector (P < 0.001). Although, the fracture resistance of the modified frameworks was increased in the present study (1.1 times), they were not significantly different from anatomic specimens (P = 0.327).

CONCLUSIONS

The fracture resistance of the zirconia posterior-fixed partial dentures was significantly affected by the connector size; it was not affected by the framework modification.

Influence of surface modification techniques on shear bond strength between different zirconia cores and veneering ceramics

PURPOSE

Veneering porcelain might be delaminated from underlying zirconia-based ceramics. The aim of this study was the evaluation of the effect of different surface treatments and type of zirconia (white or colored) on shear bond strength (SBS) of zirconia core and its veneering porcelain.

MATERIALS AND METHODS

Eighty zirconia disks (40 white and 40 colored; 10 mm in diameter and 4 mm thick) were treated with three different mechanical surface conditioning methods (Sandblasting with 110 µm Al₂O₃ particle, grinding, sandblasting and liner application). One group had received no treatment. These disks were veneered with 3 mm thick and 5 mm diameter Cercon Ceram Kiss porcelain and SBS test was conducted (cross-head speed = 1 mm/min). Two and one way ANOVA, Tukey's HSD Past hoc, and T-test were selected to analyzed the data (α=0.05).

RESULTS

In this study, the factor of different types of zirconia ceramics (P=.462) had no significant effect on SBS, but the factors of different surface modification techniques (P=.005) and interaction effect (P=.018) had a significant effect on SBS. Within colored zirconia group, there were no significant differences in mean SBS among the four surface treatment subgroups (P=0.183). Within white zirconia group, "Ground group" exhibited a significantly lower SBS value than "as milled" or control (P=0.001) and liner (P=.05) groups.

CONCLUSION

Type of zirconia did not have any effect on bond strength between zirconia core and veneer ceramic. Surface treatment had different effects on the SBS of the different zirconia types and grinding dramatically decreased the SBS of white zirconia-porcelain.

The role of Helicobacter pylori in the development of recurrent aphthous stomatitis: SEPAHAN systematic review no. 9

Microbial factors may play a role in the pathogenesis of recurrent aphthous stomatitis (RAS). Because of similarities in the characteristics of peptic ulcers and oral aphthous ulcers, it seems reasonable to hypothesize that Helicobacter pylori (H. pylori) could play a role in the development of RAS. The aim of the present study was to determine the relationship between H. pylori and RAS using the results obtained in other related studies. In the present systematic review, all of the relevant papers up to December 2011 were screened. The search was done using PubMed and the Cochrane library and out of 33, 9 articles were selected via the keywords of stomatitis, aphthous and H. pylori. Nine of the studies met the inclusion criteria. Among the selected articles, 6 were inconsistent with the association of H. pylori infection and RAS and 3 agreed to this assumption. The results of the literature indicate that there is no association between H. pylori infection and recurrent aphthous stomatitis.

Current results and trends in platform switching

The platform switching (PLS) concept was introduced in the literature in 2005. The biological benefits and clinical effectiveness of the PLS technique have been established by several studies. In this article different aspects of PLS concept are discussed. Crestal bone loss, biologic width, and stress distribution in this concept are comprehensively reviewed. In this article the relative published articles from 1990 to 2011 have been evaluated by electronic search. Because of controversial results especially in immediate loading and animal studies, further modified research is needed to establish the mechanism and effect of the PLS technique. Essential changes in studies including using the control group for accurate interpretation of results and long-term observation, particularly through, randomized, prospective, multicenter trials with large numbers of participants, and implants are necessary.

Effect of casein phosphopeptide-amorphous calcium phosphate and acidulated phosphate fluoride gel on erosive enamel wear

BACKGROUND

Some studies have shown that casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and acidulated phosphate fluoride (APF) gel can protect teeth against erosion. The aim of this study was to assess whether CPP-ACP and fluoride could reduce enamel wear rates under erosive conditions simulating abrasion and acidic diet regimen.

MATERIALS AND METHODS

Enamel specimens consisted of 3 experimental groups (receiving CPP-ACP, APF or both) and a control group. Specimens were subjected to 5,000 wear cycles at a load of 30 N and a pH of 3 in a tooth wear machine. The amount of wear was determined by stereomicroscope. Data were analyzed using one-way analysis of variance and Tukey post hoc tests (α = 0.05).

RESULTS

Mean wear rate (mean±SD) was 194.6±49.2 micrometers in CPP-ACP group, 197.6±39.5 in APF group, 134.6±44.7 in combination group and 266.2± 22.7 in the control group. Statistical analysis indicated significantly higher wear rate in the control group than the experimental groups and also in the CPP-ACP and APF group than the combination group (P<0.05).

CONCLUSIONS

We concluded that although either CPP-ACP or APF can protect enamel against wear, their combination provides significant enamel wear reduction. These findings would lead to new strategies for the clinical management of tooth wear.

Gastroesophageal reflux disease and tooth erosion: SEPAHAN systematic review no. 10

Many systemic diseases affect oral health. The aim of this research was to conduct a systematic review on the association between dental erosion (DE) and gastroesophageal reflux disease (GERD) and the effect of saliva's flow rate, buffering capacity and oral microbial changes caused by GERD. All descriptive, analytical studies up to December 2011 that have relevant objectives, proper sampling method and sufficient results were included by searching PubMed and Scopus electronic data bases. Fifteen studies were selected according to our inclusion criteria (10 in adult and 5 in children population). There was a strong association between DE and GERD in the adult population, and the relationship in the children population was found to be of less importance. Early diagnosis and treatment of refluxed acid in both age groups through lifestyle changes and medications can prevent further damage and tooth loss.