Journal of Dentistry of Tehran University of Medical Sciences最新文献

Objectives: The use of zirconia as a framework for prosthetic restorations is increasing due to its favorable mechanical properties. Zirconia also has remarkable aesthetic properties when used as a framework and covered with a layer of cosmetic ceramic. The aim of this study was to compare the fracture toughness of three types of aesthetic ceramics, namely VITA VM®9, ceraMotion® Zr, and IPS e.max® Ceram.

Materials and methods: Three groups of aesthetic ceramics (n=10) were subjected to three-point bending tests. The force leading to fracture was recorded for each sample to measure the impact of the ceramic type on the solidity of the framework. The type of fracture has not been studied in this work. One-way analysis of variance (ANOVA) was used to statistically analyze the results.

Results: The statistical analysis showed significantly different fracture toughness values among the three groups. IPS e.max® showed the lowest fracture toughness (25.42 MPa) compared to VITA VM®9 and ceraMotion® Zr (respectively 40.39 MPa; P<0.001, and 48.78 MPa; P<0.005).

Conclusions: Within the limitations of the present study, it can be concluded that aesthetic ceramics play an important role in the fracture toughness of all-ceramic restorations.

This article describes the prosthetic treatment of a patient suffering from a hemimaxillary defect after surgical resection of an adenoid cystic carcinoma (ACC) in the palate. The patient had also received therapeutic irradiation. One year after radiotherapy, three implants were placed in the remaining maxillary bone without any bone augmentation. One of the implants failed during the osseointegration period. The implant replacing the failed one also failed during prosthetic procedures. The patient was unwilling to undergo another surgical episode, and the final prosthesis was completed on the two remaining implants.

Objectives: This study aimed to analyze functional stresses around short and long implant-supported prostheses with different crown heights.

Materials and methods: Four three-dimensional (3D) models were designed with SolidWorks 2015. In models 1 (control) and 2, three dental implants (second premolar 4.1×8 mm, molars: 4.8×8 mm) were placed. In models 3 and 4, three dental implants (second premolar 4.1×4 mm, molars: 4.8×4) were placed. Residual bone height was 10 mm in groups 1 and 2 (grafted bone) models and 6 mm in groups 3 and 4. The crown heights were modeled at 11.5 mm for groups 1 to 3, and 15 mm for group 4. The applied oblique force was 220 N to simulate chewing movements. The maximum von Mises and principal stresses on the implants and the supporting tissues were compared using the 3D finite element method.

Results: In all models, the highest stress value was seen within the most coronal part of bone (crestal bone), which was cortical or grafted bone. The highest stress values in the bone supporting the implant neck were seen in the premolar region of each model, especially in model 4 (291.16 MPa). The lowest stress values were demonstrated in the molar region of model 3 (48.066 MPa). The model 2 implants showed the highest von Mises stress concentrated at their neck (424.44 MPa).

Conclusions: In atrophic posterior mandible with increased crown height space, short implants with wider diameter seem to be a more feasible approach compared to grafting methods.

Objectives: The aim of this study was to investigate the stress distribution of different post and core materials in radicular dentin by three-dimensional finite element analysis (3D FEA).

Materials and methods: Twelve 3D models of a maxillary central incisor were simulated in the ANSYS 5.4 software program. The models were divided into three groups; the first group included: 1-Gold post and core and 2-Nickel-chromium (Ni-Cr) post and core restored with metal-ceramic restorations (MCRs). The second group included: 1-Stainless steel post, 2-Titanium post, 3-Carbon fiber post, 4-Glass fiber post, and 5-Quartz fiber post with composite cores and MCRs. The third group included: 1-Zirconia post and core, 2-Zirconia post, 3-Carbon fiber post, 4-Glass fiber post, and 5-Quartz fiber post; the last four models had composite cores restored with all-ceramic restorations (ACRs). Each specimen was subjected to a compressive load at a 45-degree angle relative to its longitudinal axis at a constant intensity of 100 N. The models were analyzed with regard to the stress distribution in dentin.

Results: Two stress concentration sites were detected in the models. The first group showed the lowest stress levels in the cervical region, while the stress levels detected in the second group were higher than those in the first group and lower than those found in the third group. Fiber-reinforced posts induced a higher stress concentration between the middle and cervical thirds of the root compared to other posts.

Conclusions: According to the results, since cast posts induce lower stresses in dentin, they are recommended for clinical use. Fiber-reinforced posts and ACRs caused the maximum stresses in dentin.

Objectives: The healing of bone defects in the craniofacial region is an important clinical issue. We aimed to compare the effects of octacalcium phosphate (OCP) and the combination of OCP/gelatin (OCP/Gel) on calvarial bone regeneration in rats.

Materials and methods: In this study, 72 male Sprague Dawley rats were randomly assigned to the OCP (n=24), OCP/Gel (n=24), and control groups (n=24). Lesions with a diameter of 9 mm were created in the parietal bone and were filled with 9-mg OCP and OCP/Gel disks. In the control group, no substance was implanted in the defect. Sampling was performed on days 10, 14, 21, and 28 after the implantation. After tissue processing, 5-μm sections were prepared and stained by hematoxylin and eosin (H&E) stain. The sections were studied, and the volume fraction of the newly formed bone was assessed by Kruskal-Wallis test at a significance level of 0.05.

Results: In the experimental groups, new bone formation was detected at the margins of the defects 10 days after the implantation. With the progression of the healing process, the newly formed bone covered greater areas of the defects and developed a more mature structure. In the control group, the defects were primarily filled with a dense connective tissue with small islands of new bone. The results of histomorphometric assessments showed that the volume of the newly formed bone in the experimental groups had a significant statistical difference with that in the control group (P<0.001).

Conclusions: The OCP/Gel composite can be useful in the healing process of calvarial bone defects.

Objectives: The aim of this study was to evaluate the retention strength of zirconia crowns luted with two types of resin cement under environmental pressure changes.

Materials and methods: Thirty zirconia crowns were fabricated by using computer-aided design/computer-aided manufacturing (CAD/CAM) system and were cemented by Panavia F2.0 (PAN), hand-mixed RelyX Unicem (UNH), or auto-mix RelyX Unicem Aplicap (UNA) cements on the corresponding extracted human molars. The samples were randomly divided into three groups according to the cement type. After 3000 thermal cycles, the cemented crowns were subjected to 24 pressure cycles (0 to 5 atmospheres). The retention force (N) of the specimens was measured in a universal testing machine. To normalize the retentive force, the recorded force was divided by the surface area of each tooth for measuring the retentive strength (MPa). The mean retention strengths (and forces) of the groups were compared by using one-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) test (α=0.05). The failure modes were also examined by using a stereomicroscope.

Results: The retention values related to the evaluated resin cements were significantly different; the UNA group showed the highest retention strength (6.45±0.35 MPa) followed by the UNH (4.99±0.47 MPa) and PAN (4.45±0.39 MPa, P<0.001) groups. The adhesive failure mode was predominant in all the groups.

Conclusions: The choice of resin cements and their mixing methods, which lead to differences in porosity, may affect the retention strength of zirconia crowns.

Objectives: The retentive properties of implant-retained overdentures (IRO) may be influenced by the type of attachments. The aim of this research was to compare the retention of two dental implant systems with compatible ball attachments, namely Straumann® system (SS) and Rhein83 SRL system (RS) after fatigue testing.

Materials and methods: Two laboratory models consisting of two parallel Straumann® fixtures at a distance of 22 mm were prepared. Five pairs of each systems' ball attachments were examined (n=5). The samples were soaked in artificial saliva. The retention strength values (RSV) were recorded before the fatigue test and after 1100, 2200, 3300, 4400, and 5500 insertion and removal cycles at a speed of 51 mm/minute with a 50-N load cell in a universal testing machine. The data were analyzed by repeated measures analysis of variance (ANOVA) followed by independent sample t-test with Bonferroni corrections.

Results: There was a decrease in the RSV in both systems after 5500 cycles of insertion and removal. There was a significant statistical difference between the RSV of the normal Sphero Block of the RS (17.52±0.68 N) and that of the Spare Lamella retention inserts of the SS (19.72±0.74 N, P=0.001).

Conclusions: Although the RSVs of the RS and SS were almost similar before the fatigue test, as the number of insertion and removal cycles increased, the RSV decreased more significantly in the RS compared to the SS.

Objectives: The purpose of this research was to evaluate the effect of immediate placement of different restorative materials in comparison with a temporary restoration on the surface microhardness of mineral trioxide aggregate (MTA).

Materials and methods: Access cavities were prepared in 40 extracted human molars, and a 3-mm layer of MTA was placed in the pulp chamber. The samples were divided into eight groups (n=5). Ten minutes after the MTA placement, two groups were restored with Zonalin temporary restoration, while the other six groups were restored with glass-ionomer cement (GIC), resin-modified glass-ionomer (RMGI), or resin-based composite. In each group, the Vickers microhardness (VMH) of MTA was determined after 7 and 21 days. Data were entered into SPSS 17 software program and were analyzed by two-way analysis of variance (ANOVA). The significance level was set at 5%.

Results: The type of restorative materials had a statistically significant effect on the microhardness of MTA (P=0.002). However, the microhardness of MTA was neither significantly influenced by the timing of final restoration (P=0.246) nor by the time-material interaction (P=0.116).

Conclusions: Based on the results of the present study and by considering the limitations of laboratory studies, it is recommended to postpone the placement of final restorations until the underlying MTA is completely set. Otherwise, in the clinical conditions in which early covering of MTA is recommended, sufficient moist-curing and hydration should be guaranteed by selecting a restorative material with the lowest hydrophilic interaction energy.

Objectives: The aim of this study was to compare the intranasal premedication effect of newly introduced dexmedetomidine (DEX) versus midazolam on the behavior of uncooperative children in the dental clinic.

Materials and methods: This crossover double-blind clinical trial was conducted on 20 uncooperative children aged 2-6 years who required at least two similar dental treatment visits. The subjects were randomly given 1 μg/kg of DEX and 0.5 mg/kg of midazolam via the intranasal route. For the sedation protocol in the two groups, 0.25 mg/kg of atropine in combination with 0.5 mg/kg of midazolam added to 1-2 mg/kg of ketamine were used 30 minutes after premedication and transferring the patient to the operating room. Dental treatments were carried out by a pediatric dentist blinded to the type of the administered premedication. The sedative efficacy (overall success rate) of the agents was assessed by two independent pediatric dentists based on the Houpt scale. Data analyses were carried out according to Wilcoxon signed-rank test and paired t-test.

Results: There were no significant differences in the premedication efficacy of intranasal DEX and midazolam according to the Houpt scale (P>0.05).

Conclusions: Intranasal midazolam and DEX are satisfactory and effective premedication regimens for uncooperative children.

Objectives: Mucous retention pseudocyst (MRP) of the maxillary sinus is an incidental finding on radiographs. The radiographs taken for dental purposes provide an opportunity for dentists to recognize asymptomatic maxillary sinus anomalies. The purpose of this study was to determine the prevalence of MRP on panoramic and cone-beam computed tomography (CBCT) views and to evaluate the associated risk factors.

Materials and methods: In this study, 710 panoramic radiographs and 90 CBCT scans were examined with regard to the presence of MRP in the maxillary sinus during 2014-15. The MRP prevalence and some associated risk factors such as age, gender, season, smoking, allergy, asthma, chronic sinusitis, nasal polyp, mucosal thickening, and post-nasal drip (PND) were evaluated.

Results: The frequency of MRP was 2.4% on the 710 evaluated panoramic images and 43.3% on the 90 evaluated CBCT views. The frequency of MRP on the panoramic and CBCT views was higher in males than in females. There was a significant association between smoking and MRP on panoramic images (P=0.02) and CBCT views (P<0.001). There was a significant association between PND and MRP on CBCT views (P=0.02). The highest frequency of MRP was seen in spring (P=0.04) according to panoramic radiographs and in spring and summer (P=0.001) according to CBCT views.

Conclusions: The occurrence of MRP had a significant association with smoking and PND, and the highest frequency of MRP was detected in spring and summer. Also, CBCT scanning detects MRP more accurately than panoramic radiography.