Journal of Contemporary Dental Practice最新文献

Aim: This study aimed to evaluate the fracture resistance of implant-supported fixed partial prostheses fabricated from monolithic zirconia with different pontic framework designs and anchored in different bone-like simulation models of two different densities.

Materials and methods: A total of 60 implants were anchored in two different in vitro bone simulation models of two different densities, namely, solid polyurethane foam blocks, 20 and 10 pounds per cubic foot (PCF) to construct implant-supported fixed partial dentures (FPDs), the pontic constructed to replace missing second premolar and first molar. Thirty models were constructed and then divided into two groups according to anchoring material D2 (n = 15) and D3 (n = 15). Each group of models was subdivided into three groups according to pontic design (n = 5). Each model was tested against fracture in a universal testing machine. The data were analyzed with a two-way univariate ANOVA and Tukey HSD test (α = 0.05). The results were statistically analyzed, and the values were considered significant at p≤0.05.

Results: The findings showed that neither change in pontic design nor change in bone type has a significant influence on the fracture resistance of the prostheses (p > 0.05). All the tested materials fell within the acceptable range for functioning under mastication, with a slight change in resistance when the pontic design was changed.

Conclusion: Zirconia is considered the material of choice when planning implant-supported FPDs because of its high fracture strength values. Within the limitations of this study, the pontic design and synthetic polyurethane bone-simulating model had no effect on the fracture resistance of four-unit implant-supported FPDs.

Clinical significance: This study postulated that any pontic design could be used in four units of implant-supported FPDs according to functional and aesthetic needs, as long as the histological nature of the alveolar bone falls within the D2 or D3 bone type. How to cite this article: Othman MS, Abu-Eittah MRH. The Influence of Different Pontic Designs on Fracture Resistance of Implant-supported Fixed Partial Dentures Anchored in Polyurethane Simulating Bone-blocks of Two Different Densities: An In Vitro Study. J Contemp Dent Pract 2024;25(7):684-690.

Aim: The aim of this study was to compare a second-generation bioactive glass putty biomaterial (Novabone putty) against demineralized freeze-dried bone allograft (DFDBA) in mandibular grade II furcation defects.

Materials and methods: Fifteen systematically healthy individuals in the age range of 38-50 years were selected for this split-mouth study. Group I consisting of 15 sites, was treated with DFDBA and group II consisting of 15 sites was treated with Novabone putty (NB putty). The clinical parameters recorded at 0, 3 and 6 months included plaque index (PI), gingival index (GI), probing pocket depth (PPD), relative vertical attachment level (RVAL) and relative horizontal attachment level (RHAL). Standardized intraoral periapical radiographs were taken at all 30 sites pre-and 6 months post-operatively.

Results: Probing pocket depth reduced significantly (p = 0.001) when baseline values were compared to 3 and 6 months postoperatively. In group II mean RVAL changed from 6.56 ± 1.44 at baseline to 4.80 ± 1.14 at 3 months and 4.80 ± 1.33 at 6 months which was found to be highly significant (HS) (p = 0.001). The mean RHAL also showed a significant difference when baseline values were compared to 6 months post-operatively in both the groups. With respect to defect depth and bone density, no significant difference was found between the two groups.

Conclusion: Significant improvement of the clinical parameters were seen in both the groups. As both the groups showed increase in defect fill and bone density, it can be summarized that NB putty seems to have comparable regeneration property to that of DFDBA when used for mandibular grade II furcation defects.

Clinical significance: The ease of use and higher level of biological performance of second-generation bioactive glass putty make it an ideal graft material. How to cite this article: Sen A, Rajan P, Kumar V, et al. Case-control Study: Comparative Evaluation of Bio active Glass (Novabone Putty) and Demineralized Freeze-dried Bone Allograft in the Treatment of Mandibular Furcation Defects. J Contemp Dent Pract 2024;25(7):696-702.

Aim: This study aimed to assess and evaluate the quality of root canal fillings (RCFs) conducted on mandibular first molars performed by endodontists in the Asir region, Saudi Arabia.

Participants and methods: A cross-sectional radiographical study was conducted among patients over 18 years old from both genders treated by endodontists with different qualifications and experiences. The treatments were carried out under similar operating field, materials, and equipment. The quality of the X-rays was evaluated according to the international standards in the form of length, density, and taper. Those radiographs were assessed by two evaluators with similar certificates. Intraexaminer agreements were calculated. Chi-square or Fisher's exact tests were used to test the significant difference between groups and the quality parameters. p < 0.05 was considered a cutoff point for statistical significance.

Results: A total of 74 mandibular molars with 224 root canals treated were assessed in this radiographic study. The recorded adequate percentages were 77, 93, and 91% for the quality of RCF taper, density, and taper, respectively, with acceptable overall RCF quality of 87%. Significant differences were recorded between the right and left sides in terms of taper (p = 0.035), as well as between different years of experiences and different locations of the canals in terms of density (p = 0.040 for both variables).

Conclusion: The quality of RCFs performed by endodontist with different type of certificates performed in mandibular first molars were high in terms of density and taper but moderate in length. The overall RCF quality was acceptable.

Clinical significance: Evaluation of the postoperative preapical X-rays for the endodontically treated teeth is a positive point in maintaining high standard services of patients. It should be followed as mentioned in the recommended textbooks in relation to length, taper, and density. How to cite this article: Almnea RA. Radiographic Assessment of the Quality of Root Canal Filling of Mandibular First Molars Performed by Endodontists in Asir Region, Saudi Arabia. J Contemp Dent Pract 2024;25(7):624-630.

Aim: The ridge-splitting technique is considered one of the common solutions for horizontal ridge augmentation. The study evaluated implant stability and marginal bone loss after two vs three staged ridge-splitting technique.

Materials and methods: Twelve dental implants were inserted into 10 patients through staged ridge-splitting approach. In group I, six dental implants were inserted through a full mucoperiosteal flap reflection and bony incision. After 3 weeks, a closed buccal plate expansion and grafting were done, with sequential implant insertion 3 months later. While in group II, six dental implants were inserted through the same procedure as the first stage. Then bone expansion, grafting, and implant insertion were made at the second stage. All implants were loaded after 3 months and assessed clinically regarding implant stability and radiographically through marginal bone loss.

Results: One-way ANOVA test was used. Implant stability quotient (ISQ) values showing highly significant difference (p = 0.003) were recorded at implant placement. In contrast, no statistically significant differences were recorded among the studied groups at the other assessment time intervals (p = 0.219, 0.366, and 0.394, respectively). Meanwhile, group II reported lower marginal bone loss values than group I with a highly significant difference between both groups over all assessment time intervals (p = 0.001, 0.008, and 0.002, respectively).

Conclusion: Two staged ridge-splitting technique offered a shorter treatment time with lower marginal bone loss and comparable implant stability.

Clinical significance: Two-staged ridge-splitting technique provided less patients' recall visits with a less surgical intervention than the three-staged technique. This may be prospectively reflected in further research for its clinical merits. How to cite this article: Elsaieed MT, El-belasy FA, Ibraheim SA, et al. Implant Stability and Marginal Bone Changes Associated with Different Staged Ridge-splitting Techniques Using Piezoelectric Surgery in Atrophic Posterior Mandible: A Comparative Study. J Contemp Dent Pract 2024;25(7):661-668.

Aim: This study assesses the impact of surface treatment with sandblasting and Z-primer on the adhesion efficacy of fixed lingual retainers.

Materials and methods: Dead soft stainless steel wire 0.016 × 0.022-inch (n = 120) was treated by different techniques and classified into four groups equally (n = 30) according to surface treatment. Group I wire without treatment, group II wire treated with sandblasting, group III wire treated with Z-primer alone, and group IV wire treated with sandblasting with Z-primer. The stainless steel wire (n = 40) was bonded to 80 extracted premolars in pairs mounted in acrylic. Other stainless steel wires (n = 80) are embedded into acrylic blocks. All groups were divided into two subgroups according to thermocycling teeth samples were assessed by shear bond strength (SBS) A stereomicroscope was used to calculate the adhesive remnant index (ARI), while the acrylic block was by pull-out test. Finally, data were analyzed by IBM-SPSS (V 27, 2020). Mann-Whitney U-test; Kruskal-Wallis H-test and, two-way ANOVA were utilized to assess for SBS and pull-out.

Results: Kruskal-Wallis H-test showed a non-significant difference in ARI between all groups, while in two-way mixed ANOVA demonstrated a significant difference in SBS between group III (sandblasting/Z-primer) vs group I and group IV Z-primer (p = 0.028) and control (p = 0.016), and a significant difference between group II sandblasting vs both group I and group IV Z-primer (p = 0.024) and control (p = 0.014). The two-way mixed ANOVA tests showed a significant difference in pull-out between sandblasting/Z-primer vs Z-primer (p = 0.012).

Conclusion: Using of mixed surface treatment for fixed retainer as sandblasting with Z-primer is considered as the best method to increase adhesion efficacy between wire and composite and improve the quality of orthodontics fixation when compared with single treatment (sandblasting alone or Z prime). On the other hand, the sue of sandblasting alone for fixed retainer surface treatment is better than Z-primer alone but both treatments are better than fixed retainer without treatment.

Clinical application: Developed and examined new and traditional techniques used to treat the surface of wire used as a retainer after orthodontics treatment to improve patients' treatment and life quality and decrease the chance of relapse. How to cite this article: Naji SM, Mohammad MH, Enan ET, et al. Different Wire Surface Treatments on Adhesion Efficacy of Orthodontic Fixed Retainer: An In Vitro Study. J Contemp Dent Pract 2024;25(7):677-683.

Aim: This systematic review was undertaken to compare the quality of autogenous bone graft harvested from two different mandibular donor sites, that is, from the chin region and from posterior mandibular region for maxillary alveolar ridge augmentation and success after implant placement.

Materials and methods: Systematic searches were performed using PubMed, MEDLINE, and Cochrane electronic databases, which reported on the quality of autogenous harvested bone graft of the recipient site in maxillary alveolar ridge augmentation from a period of January 1995 to December 2020 using PRISMA guidelines. Studies were included if: They reported on bone grafts harvested from the chin and body region of the mandible. Time and nature of postoperative complications were reported. Quality comparison of autogenous bone graft from both chin and posterior mandible was done from the analysis of extracted data of all articles. The risk of bias was assessed by the Cochrane risk of bias tool and Newcastle-Ottawa Scale.

Results: Out of the eight studies that have been included, five studies concluded that graft from the retromolar region of the mandible produced better quality bone graft compared with graft from the chin region. In contrast, two studies showed the opposite that graft from the chin is better in quality than the graft from the retromolar region. Whereas one study mentioned not being able to find any significant difference in the quality of two grafts. The implant placement also showed a maximum success rate in the retromolar region compared with the chin region in four studies whereas in one study, the success rate was better in the chin region and in three studies, no significant difference could be found in the success rate of implant placement in two different graft regions taken from two different donor sites of the mandible.

Conclusion: This systematic review demonstrates that the retromolar group has shown better results for ridge augmentation in the maxilla compared with the chin group. The retromolar group also produces better and more successful implant placement with fewer chances of failure compared with the chin group.

Clinical significance: In oral surgery, the use of dental implants for partial and complete edentulous jaw rehabilitation is standard procedure. Both hard and soft tissues must be present in adequate quantity and quality for implant dentistry to produce the best results. Patients with resorbed jaws can receive implant-supported restorations by a variety of reconstructive methods, such as tissue regeneration and the use of vascularized or nonvascularized grafts. How to cite this article: Mondal C, Mohanty R, Rana P, et al. Quality and Success of Bone Graft from Two Different Mandibular Sites Compared for Maxillary Ridge Augmentation: A Systematic Review. J Contemp Dent Pract 2024;25(7):703-710.

Aim: To evaluate tramadol hydrochloride, an atypical opioid with potential analgesic properties, as a viable alternative to lignocaine hydrochloride in supraperiosteal anesthesia for dental implants.

Materials and methods: A split-mouth, double-blind, randomized controlled trial was conducted in patients requiring maxillary dental implants. Patients meeting inclusion criteria received either 5% tramadol hydrochloride with adrenaline or 2% lignocaine hydrochloride with adrenaline via supraperiosteal infiltration. Onset, duration of anesthesia, visual analog scale (VAS) pain scores, and adverse effects were recorded.

Results: Forty patients were included, with a mean age of 39.35 years, 62.5% male. No significant differences were observed in VAS pain scores between tramadol (2.08 ± 1.328) and lignocaine (2.05 ± 1.260) groups (p = 0.931). Onset of anesthesia showed no significant difference between the tramadol (128.00 ± 18.207 seconds) and lignocaine (128.30 ± 18.287 seconds) groups (p = 0.736). The duration of anesthesia was comparable between tramadol (59 ± 12.092 minutes) and lignocaine (59.90 ± 11.705 minutes) groups (p = 0.0736). Adverse effects included nausea in two tramadol and one lignocaine patient.

Conclusion: Tramadol hydrochloride demonstrated comparable local anesthetic efficacy to lignocaine hydrochloride in dental implant surgery Clinical significance: Both drugs provided effective pain control with similar onset and duration of anesthesia. Tramadol may offer an alternative for patients with lignocaine contraindications, although further studies are warranted to validate its safety and efficacy in dental procedures. How to cite this article: Parlawar AN, Mundada BP. Assessing Tramadol Hydrochloride as an Alternative to Lignocaine Hydrochloride in Dental Implant Procedures: A Randomized Trial. J Contemp Dent Pract 2024;25(7):639-644.

Aim: This study aimed to evaluate the impact of silibinin as a therapeutic agent on ligature-induced periodontitis in rats with liver cirrhosis.

Materials and methods: Twenty-five Wistar rats were enrolled in this study. Group A (Control) included eight rats. The other 17 rats received CCl4 to develop cirrhosis, which was confirmed by sacrificing one of the rats and performing a histological examination of its liver tissue. Periodontitis was induced in the remaining 16 rats then they were allocated into (n = 8) group B-periodontitis with cirrhosis and group C-silibinin-treated group, 5 times/week starting from week 11 till week 14. Animals of the three groups were euthanized, and biochemical analysis comprising of liver functions assessment (serum levels of glutamate-pyruvate transaminase, serum levels of glutamate-oxalate transaminase, TIMP1) and oxidative stress index [MDA, nitric oxide (NO), superoxide dismutase (SOD), and catalase (CAT)] and histological examination were conducted by the end of week 14.

Results: Group C revealed a more organized orientation of the periodontal ligament (PDL) collagen fibers with a marked regain of the alveolar bone height compared to group B. Biochemical analysis confirmed the potent therapeutic effect of silibinin manifested by a significant improvement in the biochemical parameters: tissue inhibitor of metalloproteinase-1, MDA, NO levels, and antioxidant enzymes.

Conclusion: Group B was associated with the most unfavorable biochemical findings and the maximum periodontal destruction. Group C demonstrated a positive osteogenic capacity and a noteworthy improvement in biochemical findings, which were comparable to those of group A, which displayed normal and healthy findings.

Clinical significance: The study highlights the potential use of silibinin as a natural remedy with minimal side effects for treating periodontitis in rats with liver cirrhosis. The findings could be translated to human clinical trials, which may lead to new treatment strategies using silibinin as a targeted therapy or as adjunctive therapy to conventional periodontal treatment for patients with liver cirrhosis who are more susceptible to periodontitis. How to cite this article: Shawky HA, Ahmed NM, Essawy MM, et al. Histological and Biochemical Evaluation of Silibinin in Treatment of Periodontitis Induced in Rats with Liver Cirrhosis. J Contemp Dent Pract 2024;25(7):631-638.

Aim: The purpose of this study was to evaluate the improvement in acoustic and nasalance in patients with maxillary obturators, using PRAAT software.

Materials and methods: The current study comprised a total of 16 patients who had acquired maxillary defects. Regardless of gender, the age range of these patients was 40-75 years old. The total number of patients were randomly divided into two groups (8 participants in each group) namely (A) Interim obturator group and (B) Definitive obturator group. Analysis was done using PRAAT software for two speech parameters namely nasalance and acoustic value. The first stage of speech analysis was completed without the use of an obturator, whereas the second stage involved inserting the obturator on the same day. The third stage occurred 2 months after the usage of the obturator. The data were recorded and statistically analyzed.

Results: In definitive obturator group, mean value for relative nasalance increases from before prosthesis (60.93 ± 3.34 db) to after 2 months of prosthesis (70.53 ± 2.24 db) while in interim group increased from 57.55 ± 4.31 db (before prosthesis) to 63.77 ± 3.66 db (after 2 months of prosthesis). This improvement was more marked with definitive obturator than interim obturator. The F2-F1 comparative mean value changed from before prosthesis to immediate after prosthesis in definitive group for /a/, /e/, and /u/ vowels was 9.77, 22, and 24.38, respectively. F2-F1 comparative mean changes from before prosthesis to after 2 months of prosthesis was 102, 75.75, and 87 for three vowels /a/, /e/, and /u/, respectively. Similarly, F2-F1 mean value in interim prosthesis group changes from before to after 2 months of prosthesis was 62.25, 27.62, and 1.75 for /a/, /e/, and /u/, respectively.

Conclusion: On conclusion, the definitive obturators were well-tolerated by patients with major defects and the results show that maxillary resection significantly impairs speech and definitive obturator rehabilitation is effective in regaining nasalance and acoustic speech components.

Clinical significance: Speech disorders in maxillectomy patients are a significant clinical issue since the surgery results in hypernasality, which impairs a person's ability to understand their own speech. Either surgical techniques or prosthetic rehabilitation are used to correct these abnormalities. Certain people require prosthetics to fix their speech even after surgery. How to cite this article: Bhushan P, Thenumkal E, Khosla E, et al. Assessment of Acoustic and Nasalance Improvement in Maxillary Obturator Patients Using PRAAT Software: An In Vivo Study. J Contemp Dent Pract 2024;25(7):656-660.

Aim: The current investigation aimed to evaluate the crestal bone loss after placement of bone graft around the oral implant with/without platelet-rich plasma (PRP).

Materials and methods: Forty patients seeking for crown supported by dental implants to replace at least one lost tooth were included in the present study. The participants were divided into two groups at random (n = 20): Group I: Received tricalcium phosphate (TCP) along with PRP and group II: Received TCP without PRP. Digital radiographs were used to quantify the crestal bone levels on the mesial, distal, buccal, and lingual side of each implant after surgery, also at 3 months and 6 months follow-up period. Data were recorded and subjected to statistical analysis.

Results: After 3 months, the crestal bone level in TCP with PRP group, mesial side was 1.02 ± 0.18, distal was 1.14 ± 0.11, buccal was 1.18 ± 0.12 and lingual was 1.16 ± 0.16. In only TCP group, mesial side was 1.14 ± 0.02, distal was 1.24 ± 0.10, buccal was 1.38 ± 0.12 and lingual was 1.30 ± 0.08. There was a statistically significant difference between the two groups. After 6 months, the crestal bone level in TCP with PRP group, mesial side was 1.26 ± 0.02, distal was 1.38 ± 0.14, buccal was 1.44 ± 0.09, and lingual was 1.52 ± 0.12. In only TCP group, mesial side was 1.40 ± 0.10, distal was 1.56 ± 0.12, buccal was 1.62 ± 0.06, and lingual was 1.84 ± 0.04. There was a statistically significant difference between the two groups at 3 and 6 months.

Conclusion: On conclusion, considerable crestal bone loss was observed in both treatment regimens. But TCP bone graft with PRP group found decreased bone loss around the dental implants than only TCP bone graft group.

Clinical significance: The most important aspects of controlling crestal bone loss are choosing the right implant design and bone transplant materials. Also, platelet-rich fibrin plays an important role in accelerating the healing process, improving bone regeneration, and repairing as it contains a high amount of growth factors and inflammatory chemicals. How to cite this article: Jalaluddin M, Awasthi A, Aljulayfi IS, et al. Evaluation of Crestal Bone Loss after Placement of Bone Graft around the Oral Implant with/without Platelet-rich Plasma. J Contemp Dent Pract 2024;25(7):645-648.