International Journal of Prosthodontics最新文献

Purpose: To evaluate the fracture strength of endodontically treated molars filled with different composite resins with vs without fiber reinforcement.

Materials and methods: A total of 60 intact mandibular molars were selected and endodontically treated. A standardized mesio-occlusal-distal cavity was prepared with cervical margins 1 mm above the cementoenamel junction and oral and buccal walls with 1.5-mm thickness. Universal adhesive was used in all specimens in etch-and-rinse mode. Specimens were divided into four groups (n = 15 each) according to restoration technique: group CSM = adhesive overlay with hybrid ceramic; group EXP = direct restoration with short fiber-reinforced composite; group ESU = direct restoration with nanohybrid composite; and group EST = direct restoration with nanohybrid composite reinforced with horizontal bidirectional glass fibers placed over the pulpal chamber floor. After 7 days of storage in water, samples were loaded until fracture using a universal testing machine. The maximum breaking loads were recorded in Newtons, and statistical analysis was then conducted with two-way ANOVA and post hoc Tukey test. Fragments were analyzed using scanning electron microscopy.

Results: Mean fracture resistance values were: CSM = 1,428.91 ± 316.90 N; EXP = 1,874.57 ± 299.47 N; ESU = 1,557.44 ± 355.65 N; and EST = 1,870.27 ± 145.11 N. The CSM and EXP groups showed the highest strength values when compared to the other groups. The variable fiber insertion did not significantly alter the fracture resistance. The origin of the fracture was always located on the occlusal surface, mainly in the major contact loading area.

Conclusion: The use of fiber-reinforced composite showed great improvement in fracture resistance, similar to a cuspal coverage restoration. However, only short fiber-reinforced composites showed a favorable fracture pattern. Int J Prosthodont 2023;36:603-611.

Purpose: To verify the parameters and characteristics evaluated in 3D-printed complete denture (CD) bases and how they influence CD properties.

Materials and methods: This work was registered in Open Science Framework (osf.io/4um6v) and followed the PRISMA Extension for Scoping Reviews. A search of peer-reviewed articles published up to April 9, 2020, was performed on the PubMed, LILACS, Cochrane Library, and Science Direct databases. The review question based on the PCC (population, concept, and context) was: What printing parameters and characteristics of CD bases can influence their properties?

Results: The database search resulted in 1,945 articles, and the initial screening was carried out in 1,390 articles, 17 of which were selected for inclusion in this review. The present authors verified that cleaning the prosthesis with alcohol after printing followed by a postcuring cycle influences biocompatibility and residual monomers. The printing angle influences physicomechanical properties, microbial adhesion, and tissue adaptation. Accuracy is influenced by layer thickness and manufacturing technique, which also influences retention and tissue adaptation. The incorporation of antimicrobial agents influences physicomechanical properties and antimicrobial activity. The method of union between the denture base and teeth influences mechanical strength.

Conclusions: Printed denture bases showed good adaptation to tissues and accuracy with 100-µm layer thickness, but the base must be cleaned in ethanol followed by postcuring for better biocompatibility. Nano- and microparticles can be added to provide antimicrobial activity and better resistance. The printing angle and mechanical properties must be better evaluated. Int J Prosthodont 2023;36:620-629.

Purpose: To evaluate different protocols for recementation of dislodged glass fiber posts (GFPs).

Materials and methods: The root canals of 50 bovine incisors were prepared to receive GFPs that were conditioned with 24% hydrogen peroxide, silanized, and cemented with a self-adhesive resin cement. After light curing, the specimens were submitted to a pullout test. The dislodged GPFs were distributed into five experimental groups (n = 10) for the recementation surface treatment: NT = no treatment; SI = silane; ET = 92.8% ethanol/silane; HP = 24% hydrogen peroxide/silane; and AL = airborne-particle abrasion (50 μm alumina)/silane. The GFPs were recemented with the same self-adhesive resin cement, and specimens were submiLed to a second pullout test. Data were analyzed with Student t test and one-way ANOVA (α = .05).

Results: For all groups, the recementation bond strength was higher than the strength obtained after the first cementa4on (P < .05). There were no statistical differences among the experimental recementation protocols (P = .096).

Conclusions: All recementation protocols might be reliably applied because they led to higher bond strength than the first cementation. Int J Prosthodont 2023;36:e74-e87.

Purpose: To evaluate the effect of three different curing protocols based on different ratios of self-curing and light-curing periods on the bond strength and nanoleakage of fiber posts luted with dual-curing self-adhesive cements.

Materials and methods: A total of 48 single-root teeth were endodontically treated and obturated, and an 8-mm post space was prepared with dedicated drills. Specimens were randomly divided into two groups according to the self-adhesive cement employed: group 1 (G1) = PANAVIA SA Plus (Kuraray Noritake), and group 2 (G2) = Bifix SE (VOCO). The specimens were further divided into three subgroups (n = 8 each) according to the light-curing protocol applied: no light-curing (SG1), 20 seconds of light-curing 20 seconds after cement injection (SG2), and 20 seconds of light-curing 120 seconds after cement injection (SG3). Slices of 1-mm thickness were prepared for the pushout test and nanoleakage analyses of the coronal and apical regions after 24 hours of storage in artificial saliva. Results were statistically analyzed with three-way ANOVA and Tukey post hoc tests. Statistical significance was set for P < .05.

Results: Three-way ANOVA analysis showed that the factors of cement (P = .02) and curing protocol (P < .001) had a significant influence on bond strength. Tukey post hoc test reported that light-curing 120 seconds after injection showed higher bond strength compared to both no light-curing and photoactivation after 20 seconds.

Conclusion: To achieve the highest bond strength with self-adhesive cements, photoactivation with a 120-second delay after mixing is required. There is no difference between light-curing immediately and light-curing 20 seconds after mixing.

Purpose: To assess oral health-related quality of life (OHRQoL) and patient satisfaction with a three-implant-retained mandibular overdenture.

Materials and methods: In this randomized crossover clinical trial, 20 edentulous patients received a new set of conventional complete dentures (CDs; baseline). Subsequently, three implants were placed in the anterior mandible: two were placed in the canine regions bilaterally and one in the midline. After successful osseointegration, CDs were attached to the implants using resilient attachments. The overdenture was retained either by three implants (test group) or two implants (control group). The sequence of treatment was randomized such that each patient experienced both treatment options for 6 months each. OHRQoL was assessed at baseline and after 6 months of function for each treatment option using the Oral Health Impact Profile (OHIP-14) and visual analog scale (VAS) scores. Statistical analyses were performed using Friedman and Wilcoxon signed rank tests.

Results: CD resulted in significantly higher OHIP-14 and VAS scores (25.25 + 6.42, 8.55 + 1.73) compared to both the control group (11.15 + 5.39, 4 + 2; P < .001) and the test group (6.25 + 4.02, 2.06 + 1.48; P < .001). Similarly, significantly higher mean OHIP-14 and VAS scores were noted for the control group compared to the test group (P < .001).

Conclusions: Overdentures retained by three implants resulted in better OHRQoL scores and higher patient satisfaction compared to overdentures retained by two implants and CDs. Int J Prosthodont 2023;36:554-56.

Purpose: To evaluate and compare the changes in brain activity for individuals with a single missing mandibular molar replaced with a removable dental prosthesis (RPD) and a fixed tooth-supported implant prosthesis in the static and postmasticatory phases.

Materials and methods: In total, 24 patients with a unilateral missing mandibular first molar were rehabilitated with a removable dental prosthesis and divided into two groups of 12 each; Group A was rehabilitated with implants and Group B with 3-unit tooth-supported fixed partial dentures (FPDs). An electroencephalogram (EEG) was taken during the three phases of assessment: (1) before insertion of any prosthesis (N0), (2) after insertion of an RPD (N1), and (3) after cementation of an FPD or implant crown (F2). The effect of bite force with RPD (N1M) and FPD or implant prosthesis (F2M) on alpha waves was evaluated by recording EEG immediately after chewing gum for 30 seconds.

Results: The improvement of the amplitude of alpha waves before and after prosthesis insertion showed a significant difference between Group As and B (P < .05) with the highest mean values of 158.3 µV, 147.9 µV, and 182.1 µV occurring in pairs F2-N0, F2-N1, and F2M-N1M, respectively, for Group A. Similarly, for the power of alpha waves between group A and B, a statistically significant difference (P < .05) with the highest mean values of 30.3 dB, 28.9 dB, 36.9 dB, and 11.2 dB in pairs F2-N0, F2-N1, F2M-N1M, and F2M-F2 ,respectively, was observed for Group A. There was no statistically significant increase in pair N0-N1 (P > .05).

Conclusions: Replacement of a single missing tooth enhanced brain activity and was highest with an implant-supported crown. Int J Prosthodont 2023;36:563-569.

Purpose: To assess if the implant-retained prostheses produced with laser-sintering technique present an accuracy and passive fit comparable to their milled counterpart.

Materials and methods: Two regular neck Straumann analogs were placed in a block of PMMA 15 mm apart and parallel to each other. The PMMA block was then scanned and two groups of cobalt-chromium, screw-retained, three-unit implant prostheses were fabricated using milling (control) and laser-sintering (test) techniques. The prostheses were then screwed on the PMMA block and the vertical marginal gap between the prostheses and the analogs at the implant-abutment junction was measured twice, (1) when only one screw was tightened, and (2) when both screws were fully tightened. The average of each marginal gap measurement was compared to assess the difference in term of passive fit between the laser-sintered and the milled prostheses.

Results: The mean marginal gap of the milled and the laser-sintered groups were 23.18 µm (SD = 6.2) and 23.71 µm (SD = 19.5) respectively.

Conclusions: Laser-sintered prostheses presented a marginal fit comparable to their milled counterpart and represent a clinically valid alternative to their milled counterpart. Int J Prosthodont 2023;36:e53-e60.

Purpose: To investigate the physical and mechanical behaviors of polyether ether ketone (PEEK) before and after thermocycling, as well as its potential use as a more durable prosthetic component for implant-supported and -retained removable dental prostheses (I-RDPs).

Materials and methods: Roughness and surface hardness were evaluated in specimens obtained using the subtractive method (n = 20) with a diameter of 9 mm and a thickness of 2 mm, and retention force was measured using attachments with a diameter of 4 mm and a height of 3 mm. For fatigue resistance testing, a polyurethane matrix with two ball abutment implants (MDL, Intra-Lock International) was used to simulate the mandibular alveolar ridge. A total of 40 attachments (n = 20 pairs) were placed in acrylic resin blocks using an analog technique for the direct clinical pickup of overdenture female attachments, then submitted to 2,900 insertion/removal cycles to simulate 24 months of overdenture use. Physical analyses were performed by Fourier-transform infrared spectroscopy (FTIR), x-ray diffraction (XRD), and differential scanning calorimetry (DSC) before and after thermocycling (5°C to 55°C for 10,000 cycles). After normal distribution was verified by Shapiro-Wilk test, one-way ANOVA was applied to analyze the surface roughness and hardness, and two-way ANOVA with Bonferroni adjustment was used to assess the retention force (α = .05).

Results: Thermocycling did not change the PEEK surface roughness or hardness (P > .05). As for the retention force, the highest average was observed after the thermocycling test (P = .006).

Conclusion: Based on the FTIR, XRD, and DSC results, PEEK crystallinity decreased after thermocycling, and the physical and mechanical behaviors of this polymer were compatible with the proposed application, suggesting that PEEK is a component of greater durability for I-RDPs. Int J Prosthodont 2023;36:612-619.

Purpose: To evaluate the application of chitosan as a cleanser in the control of biofilm formation on cobalt-chromium (Co-Cr) alloy and acrylic resin surfaces.

Materials and methods: In total, 172 Co-Cr discs and 172 acrylic resin discs (14 mm x 3 mm) were contaminated with Streptococcus mutans, Staphylococcus aureus, Candida albicans, or Candida glabrata and incubated for 48 hours. Then, specimens were randomly divided into groups and immersed in the following solutions for 15 minutes: solution without chitosan (WC/control); chitosan solution (CH: 5 mg/mL); chitosan nanoparticle solu.on (CN: 3.8 mg/mL); and effervescent tablet (ET). Biofilm recovery rates (n = 9) were evaluated by counting the colony-forming units (CFU/mL). Biofilm morphology was evaluated using scanning electron microscopy (SEM). Data were compared using the Kruskal-Wallis or ANOVA tests followed by the Tukey post hoc test.

Results: For acrylic resin, ET showed the lowest number of CFU for S aureus and S mutans (P < .001). CH exhibited intermediate values for S mutans, S aureus, and C albicans; CN exhibited intermediate values for S mutans and S aureus. For C glabrata, there was no sta.s.cal difference between the solu.ons (P = .264). For Co-Cr, ET showed the highest level of antimicrobial action against all microorganisms (P < .001), and CH showed an intermediate level of action against S mutans and S aureus. Against C albicans and C glabrata, there was no significant difference among CH, CN, and WC.

Conclusions: Although ET had a broader spectrum of antimicrobial action, CH showed promise as a denture cleanser. Int J Prosthodont 2023;36:e61-e73.

Purpose: To evaluate the efficacy of cleaning protocols for the decontamination of organic compounds from polished zirconium oxide samples.

Materials and methods: A total of 24 rectangular plate specimens were sintered from zirconium oxide. All samples were polished with commercially available polishers (coarse, fine, and superfine) and polishing paste. During the first step of the protocol, all specimens were cleaned with steam. Samples were then randomly assigned to one of three groups (n = 8 each): A, B, or C. In group A, no additional cleaning was performed, while specimens in group B underwent ultrasonic cleaning in distilled water. Group C specimens were cleaned in an ultrasonic bath with a special detergent solution. After washing, samples were subjected to energy-dispersive x-ray spectroscopy (EDX) and scanning electron microscopy (SEM) examination. In order to detect organic materials, the level of carbon atoms was measured.

Results: EDX analysis revealed that samples in group A had the highest percent of carbon atoms (9.57 ± 3.67) on the surface compared to other cleaning protocols. Following the Group B cleaning protocol resulted in lower carbon levels (4.73 ± 3.56), but this difference was not significant compared to group A (P = .439). None of the specimens in group C had detectable carbon atoms (0), which implies that all wax molecules were removed (P < .05).

Conclusion: Total decontamination of organic compounds from a polished zirconium surface can be expected only following the C cleaning protocol; therefore, it is advised to employ an ultrasonic bath with detergent solution for cleaning procedures of zirconium abutments before delivery. Int J Prosthodont 2023;36:588-594.