Evaluation and comparison of stress distribution around periodontally compromised mobile teeth splinted with different materials: Three-dimensional finite element analysis

Background: Progressive attachment loss around the teeth because of periodontal disease can result in increased tooth mobility. This adversely affects patient's comfort, function, and esthetics. Periodontal splinting helps in accomplishing stability by redistributing the functional and parafunctional forces. There are various materials that have been used for periodontal splinting. Fiber-reinforced composite, composite resin, and metal-reinforced composite are often used as splinting materials for periodontally compromised teeth. In our study, a comparison was done among these materials for their ability to distribute the stresses at different bone levels in mobile lower incisors splinted together with canines. Materials and Methods: Five patients of age group 25–50 years with Grade 2 and 3 mobile incisors having 40% or more bone loss and firm canines with optimal bone support were selected. From the computed tomography scan of each patient, three models were developed demonstrating splinting of mandibular incisors and canines with metal-reinforced composite, fiber-reinforced composite, and composite resin. So in total, 15 models were developed and each one of them was subjected to vertical and transverse loads of 150 N. Pattern of stress distribution was observed in these models using three-dimensional finite element analysis. Results: After splinting, the stress on the canine increased when bone levels around incisors decreased while stress on incisors reduced. Conclusion: Tested splinting materials were successful in stress distribution, and metal-reinforced composite was found to be better than the other splinting materials.

Comparison of adhesive strength of resinous teeth splinting materials according to enamel surface treatment

PURPOSE: The purpose of this study is to compare and analyze the shear bond strength and fracture pattern in different enamel tooth surface treatments for resin splinting materials. MATERIALS AND METHODS: G-FIX and LightFix were used as tooth splinting materials. Twenty bovine mandibular incisors were used for the preparation of the specimens. The exposed enamel surface was separated into four parts. Each tooth was treated with 37% phosphoric acid, 37% phosphoric acid + adhesive resin, 37% phosphoric acid + G-premio bond, and G-premio bond for each fraction. Shear bond strength was measured using a universal testing machine. After measuring the shear bond strength, the fractured surface of the specimen was magnified with a microscope to observe the fracture pattern. Two-way ANOVA was used to verify the interaction between the material and the surface treatment method. Oneway ANOVA was used for comparison between the surface treatment methods of each material and post-hoc test was conducted with Scheffe's test. An independent t-test was conducted to compare shear bond strengths between materials in each surface treatment method. All statistics were conducted at 95% significance level. RESULTS: G-FIX, a tooth splinting resin, showed similar shear bonding strength when additional adhesive resins were used when material was applied after only acid etching, and LightFix showed the highest shear bonding strength when additional adhesive resins were used after the acid etching. In addition, both G-FIX and LightFix showed the lowest shear bond strength when only self-etching adhesive was applied without additional acid etching. Verification of interactions observed interconnection between resins and surface treatment methods. Most of the mixed failure was observed in all counties. CONCLUSION: When using G-FIX and LightFix, which are tooth-splinting materials, it is considered that sufficient adhesion will be achieved even after applying only acid etching as instructed by the manufacturer.

Evaluation of polymerization ability of resin-based materials used for teeth splinting

PURPOSE: The aim of this study was to evaluate the polymerization ability of resin-based materials used for teeth splinting according to the thickness of cure. MATERIALS AND METHODS: For this study, the Light-Fix and G-FIX developed for resinous splinting materials and the G-aenial Universal Flo, the high-flowable composite resin available as restorative and splinting material, were used. Ten specimens of the thickness of 2, 3, 4 and 5 mm and 5 mm in diameter for each composite resin (total 120) were prepared. The microhardness of top and bottom surfaces for each specimen was measured by the Vickers hardness testing machine. The polymerization ability of the composite resin for each thickness was statistically analyzed using independent T-test at a 0.05 level of significance. RESULTS: There was no difference of polymerization ability regardless of the thickness in the Light-Fix and G-FIX. The G-aenial Universal Flo showed significantly low polymerization ability from the thickness of the 3 mm (P < 0.05). CONCLUSION: The Light-Fix and G-FIX, which are resin-based materials used for teeth splinting, are expected to be suitable for light curing up to 5 mm in thickness.

Influence of water absorption on flexural strength and elastic modulus in several resinous teeth splinting materials

PURPOSE: The purpose of this study was to compare flexural strength and elastic modulus of several splinting materials dependent on water absorption. MATERIALS AND METHODS: Three different materials; LightFix, G-FIX, G-aenial Universal Flo; were used in this study. Thirty rectangular bar specimens (25 × 2 × 2 mm) of each materials were prepared. Fifteen specimens of each materials were stored in 100% relative humidity atmosphere, 37℃ for 24 hours. The other specimens were stored in distilled water, 37℃ for 30 days. Flexural strength and elastic modulus were calculated using Universal testing machine. One-way ANOVA and Scheffe's post hoc test at 95% level of significance were used on all test results. RESULTS: In LightFix, flexural strength and elastic modulus were significantly decreased after aging. In G-FIX, there was no significant change in flexural strength and elastic modulus after aging. In Gaenial Universal Flo, flexural strength was significantly decreased, but elastic modulus did not change significantly. Statistical analysis reveals that flexural strength and elastic modulus increased in the order of LightFix, G-FIX, G-aenial Flo in both 24 hours and 30 days. CONCLUSION: It could be deduced from this study that flexural strength and elastic modulus of some resins could be changed when it aged in oral environment. Thus this should be considered when choosing a resin to perform a resin-bonded splint.

Comparison of flexural strength and modulus of elasticity in several resinous teeth splinting materials

PURPOSE: Direct splinting material should have high flexural strength to withstand force during mastication and low modulus of elasticity to provide some movement while force applied for relief of stress. The purpose of this study was to compare flexural strength and modulus of elasticity of several resinous splinting materials. MATERIALS AND METHODS: Four materials; Super-Bond C&B, G-FIX, G-aenial Universal Flo, FiltekTM Z350 XT; were used in this study. Fifteen rectangular bar specimens of each material were prepared. Three-point bending test were performed to determine physical properties. Maximum load at fracture was recorded and flexural strength and modulus of elasticity were calculated. One-way analysis of variance (ANOVA) and Scheffe's tests at a 0.05 level of significance were conducted on all test results. RESULTS: Statistical analysis reveals that Super-Bond C&B had significant low mean value for flexible strength and the other three materials showed no significant difference. For modulus of elasticity, Super-Bond C&B exhibited statistically lower modulus of elasticity. G-FIX presented intermediate result, showing statistically higher modulus of elasticity than Super-Bond C&B but lower than G-aenial Universal Flo and FiltekTM Z350 XT. There was no significant difference on modulus of elasticity between G-aenial Universal Flo and FiltekTM Z350 XT. CONCLUSION: Using a G-FIX, the newly commercially available splinting material, which shows higher fracture resistance properties comparable to flowable and restorative composite resin and a relatively flexible nature might be a beneficial for stabilizing teeth mobility.

Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis

PURPOSE: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. METHODS: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. RESULTS: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. CONCLUSIONS: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.

Elimination of palatoradicular groove: a combined endo-perio effort.

Palatoradicular groove is an anomaly which is found more frequently in upper lateral and central incisors. This condition may lead to endo-perio lesions. A 19- year- old female presented with chief complaint of swelling and pus discharge from the gums of the right side of the upper front teeth and she also complained of loose tooth and intermittent pain. On clinical examination, probing pocket depth of 10 mm, grade II mobility and extrusion of the tooth was found. A combined endo-perio treatment was performed and elimination of the groove, pain and reduction in probing pocket depth and mobility was achieved. The purpose of this case is to highlight an interdisciplinary approach towards the management of an anomaly which may affect the endodontic status of the tooth and periodontal health of the patient.

Clinical comparison of fiber-reinforced composite and stainless steel wire for splinting periodontally treated mobile teeth / Comparação clínica de contenção periodontal com resina composta reforçada por fibra de vidro ou fio de aço inoxidável em dentes com mobilidade

Objective: This clinical study evaluated the success of two different splint materials bonded on periodontally treated mobile teeth. Material and Methods: A total of 14 patients were included in the study. Patients were randomly assigned to the groups to receive either with wire composite splint (WCS) or fiber-reinforced composite splint (FCS). Clinical periodontal parameters were performed and periotest values were recorded at baseline, and after 6 and 12 months. Patients were asked to complete a self-administered questionnaire after the splinting procedures. Failure types for the splints were categorized. Results: Baseline Plaque index (PI) values showed significant decrease at 6 month follow up in the WCS (p = 0.0019) and FCS (p < 0.0001) groups and remained stable after 12 months (WCS; p = 0.36, FCS; p = 0.63). During the course of the study, PD and RD values exhibited no change between and within groups. Clinical parameters including Pocket depth (PD), Gingival recession (GR), PI and Bleeding on probing (BOP) were stable at 6 and 12 months follow-up period. In 6 patients (4 FCS, 2 WCS), reparable failures occurred during the observation period. In four patients (3 FCS, 1 WCS) splints failed completely and were removed. The periotest values of the failing teeth ranged between 47.3 and 50. In 3 patients in the WCS and 1 patientin the FCS group, periotest values were ≥ 40 but no splint failures were observed. Conclusion: FCS tends to show increased mechanical limitations compared to WCS. Teeth with periotest values above 40 may be more prone to splint failures independent of the splint material.

Objetivo: Este estudo clínico avaliou a permanênciade dois materiais diferentes utilizados para contenção de dentes com mobilidade tratados periodontalmente. Material e Métodos: Um total de 14 pacientes foram incluídos no estudo. Os pacientes foram distribuídos aleatoriamente em grupos para receber contenção com fio de aço inoxidável (FA)e resina ou resina reforçada por fibra de vidro (FV). Os parâmetros clínicos periodontais foram realizados e os valores do Periotest foram registrados no início do estudo e após 6 e 12 meses. Os pacientes foram convidados a preencher um questionário após os procedimentos de contenção. Foram classificados os tipos de falhas para as contenções. Resultados: Os valores de índice de placa de base (IP) apresentaram diminuição significativa aos 6 meses de acompanhamento nos grupos FA (p = 0,0019) e FV (p < 0,0001) e manteve-se estável após 12 meses (FA, p = 0,36, FV, p = 0,63). Durante o período do estudo, a profundidade de sondagem (PS), recessão gengival (RG) e nível clínico de inserção (NCI) não apresentaram mudança entre e dentro dos grupos. Os parâmetros clínicos incluindo PS, RG, NCI, IP e sangramento a sondagem ficaram estáveis em 6 e 12 meses de período de acompanhamento. Em 6 pacientes (4 FA, 2 FV), ocorreram falhas reparáveis. Em quatro pacientes (3 FV, 1 FA) a contenção falhou completamente e foram removidos. Os valores Periotest dos dentes que as contenções falharam variaram entre 47,3 e 50. Em 3 pacientes no grupo FA e 1 paciente no grupo FV, os valores Periotest foram ≥ 40, mas não foram observadas falhas na contenção. Conclusão: O grupo FV tendeu a mostrar aumento das limitações mecânicas em relação ao FV. Dentes com Periotest valores acima de 40 podem ser mais propensos a falhas de contenção independentes do material utilizado.

Total idiopathic root resorption of permanent dentition / Reabsorción idiopática total de la dentición permanente

Idiopathic external root resorption (IERR) is an infrequent pathology with few accounts in the literature. Treatment has been discussed by various authors but with no consensus. The aim of this article is to describe a new and severe case of IERR in an indigenous 21-year-old woman who came to the Dental Clinic at the Universidad de La Frontera presenting differing degrees of mobility in several teeth, which was increasing progressively with no signs or symptoms of periodontal disease and with no history of former dental treatment, dental trauma or other dentoalveolar pathology; she also did not relate any history of syndromes or systemic diseases. The panoramic x-ray showed varying degrees of external root resorption. To the best of our knowledge, only 3 cases of IERR have ever reported in the literature indicating different treatments; for this patient the treatment indicated was osseointegrated implants in the upper anterior region. Unknown etiology and treatments without consensus make research associated with genetics and molecular biology necessary.

La reabsorción radicular externa Idiopática (IERR) es un fenómeno patológico poco frecuente, con pocos relatos en la literatura. La terapia para esta patología ha sido discutida sin consenso por diferentes autores. El objetivo de este articulo es describir un caso severo de IERR en una mujer indígena de 21 años de edad que concurre a la Clínica Dental de la Universidad de la Frontera debido a la presencia de diferentes grados de movilidad en varios dientes, acentuándose de forma progresiva, sin signos o síntomas de enfermedad periodontal, sin antecedentes de tratamiento de ortodoncia previo, trauma dental u otra patología dentoalveolar, ni antecedentes de síndromes o enfermedades sistémicas. La evaluación radiográfica con imagen panorámica expone diversos grados de reabsorción radicular externa. De nuestro conocimiento solo 3 casos de IERR han sido reportados en la literatura señalando distintos tratamientos; para esta paciente ha sido indicado el tratamiento con implantes oseointegrados en el sector anterosuperior. La etiología desconocida y los tratamientos sin consenso, hacen necesaria la investigación asociada a estudios de genética y biología molecular.

The use of silane-coated industrial glass fibers in splinting periodontally mobile teeth.

In the past, direct stabilization and splinting of teeth using an adhesive technique required the use of wires, pins, or mesh grids. Problems with the current fiber reinforcement materials are their inherent thickness when embedded within composite resin, their availability in fixed widths and their high cost. This paper discusses the use of silane-coated industrial grade glass fibers, which can be bundled in the form of ribbon according to the required thickness and length. Of the three patients discussed in this paper, none has exhibited debonding or recurrent caries over 1-year period. By reinforcing composite splints with these industrial grade glass fibers, dentists can provide patients with restorations and splints that are economical, fracture resistant, and more durable than most alternative splinting materials of the past.

Longitudinal measurements of tooth mobility following orthodontic treatment / 대한치과교정학회지

OBJECTIVE: The aim of the present study was to evaluate the changes in tooth mobility following orthodontic treatment and to obtain information regarding the guideline of retainer wear duration during the post-treatment period. METHODS: The sample consisted of twenty patients who had been treated with edgewise appliances. The mobility of the maxillary teeth from the central incisor to the first molar was measured bilaterally by way of the Periotest(R), a non-invasive, electronic device that provides an objective measurement of the reaction of the periodontium to a defined impact load. Tooth mobility was monitored at the time of the removal of the orthodontic appliances and subsequently at three-month intervals during the two years following appliance removal. RESULTS: Tooth mobility decreased rapidly for the first six months and then decreased at a slower rate during the next six months; no statistically significant decrease in mobility was observed during the second year following appliance removal. CONCLUSIONS: The results of the present study suggest that adequate tooth stabilization is critical during the first six months following appliance removal and that continued wearing of retainers is recommended at least until twelve months after the completion of orthodontic treatment.

Comparative Study on the Tooth Mobility after Modified Widman Flap / 대한치주과학회지

Tooth mobility is an important part of a periodontal examination and represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate the changes of the tooth mobility over 4 week-period following surgical therapy on the periodontal disease. Thirty five patients presenting with moderate periodontal pockets were selected and tooth mobility was measured at weekly intervals using Periotest (Siemens Co., Germany) beginning at the pre-operation examination and ending four weeks following the modified Widman Flap. All data were statistically analyzed using the one-way ANOVA test. The results were obtained as follows; 1. All teeth exhibited the greatest change in mobility at 1 week post-op, mobility generally decreasing with time. 2. Comparison of the weekly tooth mobility data regarding the 1st premolars showed significant differences only between weeks 1 (9.94) and 4 (6.14) (p<0.05). 3. Comparison of the weekly tooth mobility data regarding the 1st molar showed significant changes in the intervals between pre-op (6.49) and week 1 (11.22), pre-op and week 2 (9.37), weeks 1 and 3 (7.65), weeks 1 and 4 (5.62), and weeks 2 and 4 (p<0.05). 4. Comparison of the weekly tooth mobility data regarding the 2nd premolar and 2nd molar showed significant differences between pre-op (6.91, 8.60) and week 1 (11.02, 12.62), weeks 1 and 3 (8.00, 8.05), weeks 3 ad 4 (6.22, 6.71), and weeks 2 (9.34, 11.01) and 4 (p<0.05).

Primary observation on tooth mobility parameters in people with normal health teeth / 实用口腔医学杂志

Objective: To obtaine the parameters of tooth mobil ity in people with normal health teeth . Methods:Tooth mob ility of 1 4, 1 4 in 12 subjects (7 males and 5 females, aged 21 to 23 years old) was measured by FX-1 tooth mobility measurement system 6 times a day for 5 days.The data were statisticaly analyzed. Results: The average tooth mobility parameters Q and R varied significantl y (P0.05).Conclusion: The tooth mo bility parameters of S,K,t1 and t2 can steadily reflect the changing of tooth mobility.

Clinical comparison of resorbable and nonresorbable Barrier in guided tissue regeneration of human intrabony defects / 대한치주과학회지

The purpose of this study was to compare the clinical results of guided tissue regeneration(GTR) using a resorbable barrier manufactured from an copolymer of polylactic acid (PLA) and polylactic-glycolic acid(PLGA) with those of nonresorbable ePTFE bdmer. Thirty two patients(25 to 59 years old) with one radiographically evident intrabony lesion of probing depth > or =6mm participated in a Gmonth controlled clinical trial. The subjects were randomly divided into three independent groups. The fist group(n=8) received a ePTFE barrier. The second group (n=12) received a resorbable PLA/PLGA barrier. The third group (n=12) received a resorbable PLA/PLGA barrier combined with an alloplastic bone graft. Plaque index (PI), gingival index(GI), probing depth(PD) , gingival recession, clinical attachment level(CAL), and tooth mobility were recorded prior to surgery and at 3,6 months postsurgery. Statistical tests used to analyze these data included independent t-test, paired t-test, one-way ANOVA. The results were as follows : 1. Probing depth was significantly reduced in all groups at 3,6 months postsurgery and there were not significant differences between groups. 2. Clinical attachment level was significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 3. There were not signifiicant differences in probing depth, clinical attachment level, gingival recession, tooth mobility between second group (PLA/PLGA barrier) and third group (PLA/RLGA barrier combined with alloplastic bone graft) 4. Tooth mobility was not significantly increased in all groups at 3,6 months postsurgery and there were not significant differences between groups. In conclusion, PLA/PLGA resorbable barrier has similar clinical potential to ePTFE barrier in GTR procedure of intrabony pockets under the present protocol.

The change of tooth mobility following orthodontic tooth movement ; A short-term study / 대한치과교정학회지

The purpose of the present study was to evaluate the change of tooth mobility following orthodontic tooth movement. Six orthodontic patients which had been treated with edgewise appliance were used. Tooth mobility was measured with Periostest at the time of the removal of orthodontic appliance and 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24 weeks after appliance removal. Following results were obtained. 1. Tooth mobility upon the removal of orthodontic appliance showed individual variation while incisor showed greater mobility than the other teeth. 2. Tooth mobility showed continued decrease pattern until 24 weeks after appliance removal. 3. While maxillary incisors showed continued decrease pattern during the study period, the other teeth showed steep decline pattern during the first 12 weeks and gentle slope during the second 12 weeks. 4. The tooth mobility of the maxillary second premolar showed the most typical change in terms of the consistency of the decline. 5. There were no significant differences of tooth mobility between heavy and light-contacted anterior teeth during experimental period. The results of the present study suggested that periodontal reorganization is not completed even in 24 weeks following orthodontic tooth movement.

A study of teeth mobility in healthy chinese young people / 实用口腔医学杂志

?Objective: To study the difference in the mobility of health teeth between Chinese young male and female. Methods: Tooth mobility (TM) of all teeth at right side was measured with FX 1 TM measuring system in 100 young males and 100 young females of Han nationality.Slope (K) value was calculated from the measurements. Results: TM values of the teeth in the females were significantly heigher than those in males ( P 0.05) Conclusion: Difference in tooth mobility exists between healthy young male and female of Chinese Han nationality.

Relationship between tooth mobility and width of periodontal membrane / 实用口腔医学杂志

Objective: To obtain the parameters related to the width of periodontal membrane from tooth mobility signal. Methods: Signals elicited from a tooth model of human maxillary central incisor, periodontal membrane made of silicone rubber and alveolar bone made of resin,were processed utilizing FX-1 tooth mobility measurement system. Results: R value of wave range,slope K and time parameter t2 in the tooth mobility signals were reduced with the increase of the width of periodontal membrane; time parameter t1 was increased with the increase of the width of periodotal membrane;R value and time parameter t2 were negatively correlated. Conclusion: R value and t2 may be the paticular indications reflecting the changing of width of periodontal membrane.

The interrelationship between the severity of periodontitis and changes in the human dental pulp / 中国病理生理杂志

In order to analyze the association of the periodontitis severity withchanges of the human dental pulp, one hundred caries-free and restoration-free periodontallyinvolved teeth with different periodontic destruction were studied histologically. It wasfound that there was correlation between the severity of periodontitis and changes in thehuman dental pulp. The incidence of pulpal pathosis rose as the periodontic destructionbecame severe. Pulpal inflammation was related to periodontitis, but not to the severityof periodontitis. Pulpal necrosis was mostly found in the teeth with advanced periodonti-tis.

Study of the Holographic Measurement of Abutment Mobility in vitro / 昆明医科大学学报

The distribution and action of forces transmitted to the supporting tissue through com- ponents of the denture are related to denture design and material property.The studies of the effects of partial denture clasp design on the movement of abutthent teeth have been reported internally and abroad in many articles.But the studies of the effect of major connectors de- sign on the movement of abutment teeth have less reported. The present study has been carried out using double-exposure holography to measure the movement of abutment on Kennedy's Class I model. The dentures were different in major connector design.The artificial forces were designed in vertical,buccal and lingual direc tions.The results showed that linguoplate could widely distribute forces and the resistance to lateral forces was good,however,the lingual bar was not so good as the linguoplate.The plastic base connector could not distribute forces effectively and the abutiment tooth movement.Therefore it suggested that this kind of connector not be used. The method used in this study is sensitive and non-invasive.It can measure the tooth movement in three-dimensions.The repetition is good in the same condition.