Evaluation of the Bioactivity of Surface Modified Polyetheretherketone (PEEK) as an Implant Material: An In Vitro Study.

PURPOSE: The purpose of this study was to evaluate the bioactivity of polyetheretherketone (PEEK) used as an implant material after surface modification by electron beam deposition of titanium. MATERIALS AND METHODS: Twenty-two samples of PEEK were obtained from a single manufacturer, water jet sectioned, and divided randomly into two groups of eleven each (Group I and Group II). Eleven PEEK samples from Group II were coated with Grade II commercially pure titanium by electron beam deposition technique. One representative sample from each group was evaluated for surface roughness, topography and composition using three dimensional surface profilometer, scanning electron microscope coupled with energy dispersive X-ray (SEM-EDX) analysis. Simulated body fluid (SBF) was prepared and calcium (Ca) content in it was quantitatively analyzed by inductively coupled plasma mass spectrometry (ICP-MS) technique. Ten samples from each group were then immersed in SBF for a period of 21 days and amount of calcium depletion was analyzed to determine the bioactivity of two groups. Surface characteristics and elemental composition of immersed samples were analyzed by SEM-EDX and correlated with results of ICP-MS tests. The data obtained were then subjected to statistical analysis using independent t-test. RESULTS: Group II samples showed a significant increase in surface roughness compared to Group I (P < 0.02). There were significant differences in Ca depletion of Group I and Group II samples when compared to preimmersion Ca content (P < 0.001). When compared between two Groups, Group II samples showed higher Ca depletion (P < 0.001). CONCLUSION: Within the limitations of this study, it was concluded that PEEK dental implants which were surface modified by electron beam deposition of titanium had enhanced bioactivity when compared to unmodified PEEK. Hence, they can serve as a valuable alternative to conventional dental implant materials.

Comparative evaluation of the wear resistance of two different implant abutment materials after cyclic loading - An in vitro study.

PURPOSE: To comparatively evaluate the wear resistance of two different implant abutment materials with titanium implants after cyclic loading. METHODOLOGY: Two groups utilizing 20 titanium implants secured in resin blocks, in which 10 titanium implants are connected with titanium abutments (Group I, n = 10) and the other 10 titanium implants are connected with Polyether ether Ketone (PEEK) abutments (Group II, n = 10). Abutments are cyclically loaded for 550,000 cycles. Surface profilometry, scanning electron microscopy (SEM), and energy-dispersive X-ray spectrometry (EDS) are carried out for all the abutment in both Group I and Group II before and after cyclic loading. The abutment surface at the implant-abutment interface is analyzed for wear. RESULTS: On comparison using independent "t"-test, it was found that the mean difference values of pre- and post-cyclic loading surface roughness (Ra value) of Group I (premachined titanium straight abutments) (-0.073 µm) was lower than the Group II test samples (premachined PEEK straight abutments) (-0.0004 µm), and this was found to be statistically insignificant (P = 0.272). SEM micrographs and EDS results also corroborate with the results of surface profilometry. CONCLUSION: The new concept in this study is Group II (PEEK abutments) are connected with titanium implants, to prove its compatibility and aesthetics. Within the limitations of the study, the surface roughness values before and after cyclic loading of two different abutment materials revealed that the wear resistance of titanium abutments is more than PEEK abutments, but the difference was found to be statistically insignificant.

Comparative evaluation of the effect of electrolyzed oxidizing water on surface detail reproduction, dimensional stability and Surface texture of poly vinyl siloxane impressions.

AIM: The aim of this in vitro study was to comparatively evaluate the effect of chemical disinfectants on the surface detail reproduction, dimensional stability and surface texture of polyvinyl siloxane (PVS) impressions. MATERIALS AND METHODS: The impressions were then divided into five groups (fifteen samples per group) and subjected to a ten minutes immersion with 2% glutaraldehyde (Group I), 1% sodium hypochlorite (Group II), freshly prepared electrolyzed oxidizing water (EOW) with different pH values - acidic (Group III), alkali (Group IV) and neutral (Group V). The samples were examined pre and post-immersion under visual observation for surface detail reproduction, travelling microscope for measurement of dimensional stability and surface profilometer (3D) for evaluation of surface texture. A standardized master die was fabricated and seventy-five PVS test samples were made. The samples were subjected to immersion disinfection and studied for surface detail reproduction, dimensional stability and surface texture. Post-hoc test, paired t test and ANOVA were used to analyze dimensional stability statistically both within and between the test groups. RESULTS: The surface detail reproduction was satisfactory with both pre and post-immersion test samples. A statistically significant dimensional change was observed post-immersion in Groups II, III and V test samples and a statistically insignificant dimensional change was observed in Groups I and IV test samples. There was a negligible change in surface texture post-immersion in Groups I, III, IV and V test samples with a slight increase in surface roughness post-immersion in Group II samples. CONCLUSION: In this study, all the test disinfectants produced satisfactory surface detail reproduction on Polyvinyl siloxane impressions. 2% glutaraldehyde and electrolyzed oxidizing water (alkali) have resulted in statistically insignificant dimensional change, while 1% sodium hypochlorite, electrolyzed oxidizing water (acidic) and electrolyzed oxidizing water (neutral) have resulted in statistically significant dimensional changes. All the test disinfectants except 1% sodium hypochlorite showed a reduction in surface roughness (Ra) values.

Comparative Evaluation of the Masking Ability of Lithium Disilicate Ceramic with Different Core Thickness on the Shade Match of Indirect Restorations over Metallic Substrate: An In vitro Study.

PURPOSE: The purpose of this in vitro study was to comparatively evaluate the masking ability of lithium disilicate ceramic with different core thickness on the shade match of indirect restorations over metallic substrate. MATERIALS AND METHODS: A total of 30 heat pressed lithium disilicate ceramic discs of low translucency were fabricated with diameter 10mm and thickness of 1 mm, 1.3 mm and 1.6mm with each thickness consisting of 10 samples to be used in the study. Thirty Ni-Cr metal discs of diameter 10mm were used to simulate metallic substrates .The colour difference of the lithium disilicate ceramic disc before and after cementation were measured using CIE LAB system. RESULTS: The mean colour difference (ΔE) of Group I,Group II, Group III before cementation with the Ni-Cr metal discs was 17.32,13.01 and 11.73 respectively. The mean colour difference (ΔE) of Group I,Group II, Group III after cementation with the Ni-Cr metal discs was 16.32,12.10, 11.05 respectively. CONCLUSION: The mean colour difference of the three groups were found to be more than the clinically acceptable perceptibility threshold (ΔE < 3.3) indicative of reduced masking ability of all the three groups of ceramic discs over metallic substrate used in this study.

Comparative Evaluation of the Antimicrobial Efficacy of Three Immersion Chemical Disinfectants on Clinically Derived Poly(Vinyl Siloxane) Impressions.

PURPOSE: To comparatively evaluate the antimicrobial efficacy of freshly prepared electrolyzed oxidizing water (EOW) with that of 2.4% glutaraldehyde (GA) and 1% sodium hypochlorite (SH) on clinically derived poly vinyl siloxane (PVS) impressions. MATERIALS AND METHODS: Four clinically derived PVS impressions each were obtained from 10 subjects. One impression from each subject was randomly kept as control (group I), without disinfection. The remaining three impressions were randomly disinfected by immersion in either 2.4% GA (group II), 1% SH (group III), or freshly prepared EOW (group IV). The samples were subjected to microbial culture individually on brain heart infusion (BHI) agar medium. The organisms isolated were confirmed by visual examination and gram staining. Mean colony forming units (CFU) were counted, log10 reduction obtained and compared. Data were statistically analyzed using one-way ANOVA, followed by multiple comparisons using Tukey-HSD post hoc tests (p < 0.05). RESULTS: Streptococci, Staphylococci, Pseudomonas, Candida, Proteus, Klebsiella, and E. coli were isolated from all impressions including the controls, except those disinfected by EOW. All three disinfectants showed significant reduction in CFU and log10 reduction values as compared to the controls. EOW showed significantly higher reduction in log10 values compared to GA and SH, whereas GA and SH showed similar reductions. EOW, GA, and SH showed kill rates of 100%, 99.60%, and 99.82%, respectively. CONCLUSION: EOW showed significant antimicrobial efficacy as evidenced by reduction in log10 values when used as an immersion disinfectant for PVS impressions when compared with the results obtained using GA and SH. These results need further investigation. CLINICAL IMPLICATIONS: EOW shows high antimicrobial efficacy when used as an immersion disinfectant as compared to GA and SH for clinically derived PVS impressions.

Comparative evaluation of shear bond strength of two different chairside soft liners to heat processed acrylic denture base resin: An in vitro study.

BACKGROUND: Chairside softliners are used more frequently than is reported and studies regarding the bond strength of chairside softliners to heat-polymerized denture base resin are few and limited. Hence, this study was conducted to comparatively evaluate the shear bond strength of two chairside soft relining materials viz., autopolymerizing plasticized acrylic resin liner and a silicone-based liner bonded to heat polymerized polymethyl methacrylate denture base resin and to analyze the mode of interfacial bond failure. MATERIALS AND METHODS: Forty test specimens (n = 40) were prepared by bonding plasticized acrylic- and silicone-based soft liner to heat polymerized acrylic resin blocks. Twenty specimens, ten from each group, were subjected to thermal cycling and later to shear bond strength testing. The debonded specimens were then qualitatively analyzed for the mode of failure using scanning electron microscopy. The results obtained were tabulated and statistically analyzed. RESULTS: The mean shear bond strength values obtained for acrylic-based soft liner before and after thermal cycling were 0.3365 ± 0.025 MPa and 0.3164 ± 0.04 MPa, respectively. The mean shear bond strength values obtained for silicone-based soft liner before and after thermal cycling were 0.4159 ± 0.025 MPa and 0.4335 ± 0.02 MPa, respectively. Silicone-based soft liner showed higher shear bond strength than the acrylic-based both before and after thermal cycling (P = 0.0001). Scanning electron microscopy analysis showed a predominantly mixed mode of failure with silicone-based liner and predominantly adhesive mode of failure with acrylic-based soft liner. CONCLUSION: The silicone-based soft liner showed higher shear bond strength to heat polymerized acrylic resin than acrylic-based soft liner both before and after thermal cycling.

Comparative evaluation of the effect of denture cleansers on the surface topography of denture base materials: An in-vitro study.

AIMS: The aim was to evaluate and compare the effects of three chemically different commercially available denture cleansing agents on the surface topography of two different denture base materials. MATERIALS AND METHODS: Three chemically different denture cleansers (sodium perborate, 1% sodium hypochlorite, 0.2% chlorhexidine gluconate) were used on two denture base materials (acrylic resin and chrome cobalt alloy) and the changes were evaluated at 3 times intervals (56 h, 120 h, 240 h). Changes from baseline for surface roughness were recorded using a surface profilometer and standard error of the mean (SEM) both quantitatively and qualitatively, respectively. Qualitative surface analyses for all groups were done by SEM. STATISTICAL ANALYSIS USED: The values obtained were analyzed statistically using one-way ANOVA and paired t-test. RESULTS: All three denture cleanser solutions showed no statistically significant surface changes on the acrylic resin portions at 56 h, 120 h, and 240 h of immersion. However, on the alloy portion changes were significant at the end of 120 h and 240 h. CONCLUSION: Of the three denture cleansers used in the study, none produced significant changes on the two denture base materials for the short duration of immersion, whereas changes were seen as the immersion periods were increased.

Influence of Surface Modifications of Acrylic Resin Teeth on Shear Bond Strength with Denture Base Resin-An Invitro Study.

BACKGROUND: Debonding of artificial teeth from the denture base is an important issue for edentulous patients rehabilitated with conventional or implant supported complete dentures. AIM: The purpose of this study was to evaluate shear bond strength between denture base resin and acrylic resin denture teeth subjected to three different surface modifications on the ridge lap area as compared to unmodified denture teeth. MATERIALS AND METHODS: Forty acrylic resin central incisor denture teeth were selected and randomly divided into four test groups. The teeth in each group were subjected to one of the three different surface modifications, namely, chemical treatment, sandblasting and placement of retentive grooves on the ridge lap area respectively, prior to packing of the denture base resin. The group with unmodified teeth served as control. Forty acrylic resin test blocks thus obtained were tested for shear bond strength between acrylic resin teeth and denture base resin in Universal Testing Machine. Data obtained was statistically analysed using one-way ANOVA and Student- Newman- Keul's test (p< 0.05). RESULTS: Analysis of shear bond strength revealed that retentive grooves on the ridge lap area showed highest bond strength values followed by sandblasting and both were statistically significant compared to the control and chemically treated groups. Unmodified surface of the resin teeth showed the least bond strength. CONCLUSION: Within the limitations of this invitro study the placement of retentive grooves or sandblasting of the ridge lap area showed highly significant improvement in shear bond strength compared to the unmodified surface. Chemical treatment did not result in any significant improvement in the shear bond strength compared to the unmodified surface.

Comparison of the effect of implant abutment surface modifications on retention of implant-supported restoration with a polymer based cement.

BACKGROUND: In cement-retained implant-supported restoration it is important to gain adequate retention of definitive restoration as well as retrievability of prosthesis. The surface of the abutment, alloy of the restoration and the type of cement used influences the retention of the restoration. There is a need to analyze the influence of surface modifications of abutments on the retentive capabilities of provisional implant cements. PURPOSE OF STUDY: To compare the effect of implant abutment surface modifications on retention of implant-supported restoration cemented with polymer based cement. MATERIALS AND METHOD: Thirty solid titanium implant abutments (ADIN), 8mm height, were divided into 3 groups. Ten abutments with retentive grooves (Group I) as supplied by the manufacturer, Ten abutments milled to 20 taper circumferentially (Group II), and Ten abutments milled and air-abraded with 110 µm aluminum oxide (Group III) were used in this study. Ni-Cr coping were casted for each abutment and polymer based cement was used to secure them to the respective abutments. Using a universal testing machine at a crosshead speed of 0.5 cm/minute, tensile bond strength was recorded (N). RESULTS: Mean tensile bond strength of Group I, II and III were found to be 408.3, 159.9 and 743.8 Newton respectively. The values were statistically different from each other (p<0.001). CONCLUSION: Abutments with milled and sandblasted surface provide the highest retention followed by abutments with retentive grooves and then by abutments with milled surface when cast copings were cemented to implant abutments with polymer based cement. CLINICAL IMPLICATIONS: Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves or particle abrasion can enhance retention especially in situation of short clinical crown.

Comparative Evaluation of Marginal and Internal Gap of Co-Cr Copings Fabricated from Conventional Wax Pattern, 3D Printed Resin Pattern and DMLS Tech: An In Vitro Study.

Accuracy of the fit of the restoration has always remained as one of the primary factors in determining success of the restoration. A well fitting restoration needs to be accurate both along its margins and internal surface. This study was conducted to comparatively evaluate the marginal gap and internal gap of cobalt-chromium (Co-Cr) copings fabricated by conventional casting procedures and with direct metal laser sintering (DMLS) technique. Among the total of 30 test samples 10 cast copings were made from inlay casting wax and 10 from 3D printed resin pattern. 10 copings were obtained from DMLS technique. All the 30 test samples were then cemented sequentially on stainless steel model using pressure indicating paste and evaluated for vertical marginal gap in 8 predetermined reference areas. All copings were then removed and partially sectioned and cemented sequentially on same master model for evaluation of internal gap at 4 predetermined reference areas. Both marginal gap and internal gap were measured in microns using video measuring system (VMS2010F). The results obtained for both marginal and internal gap were statistically analyzed and the values fall within the clinically acceptable range. The DMLS technique had an edge over the other two techniques used, as it exhibited minimal gap in the marginal region which is an area of chief concern.

Evaluation of accuracy of multiple dental implant impressions using various splinting materials.

PURPOSE: The aim of the present study was to compare the accuracy of casts obtained from nonsplinted and splinted direct impression techniques employing various splinting materials for multiple dental implants. MATERIALS AND METHODS: A reference model with four Nobel Replace Select implant replicas in the anterior mandible was fabricated with denture base heat-curing acrylic resin. Impressions of the reference model were made using polyether impression material by direct nonsplinted and splinted techniques. Impressions were divided into four groups: group A: nonsplinted technique; group B: acrylic resin-splinted technique; group C: bite registration addition silicone-splinted technique; and group D: bite registration polyether-splinted technique. Four impressions were made for each group and casts were poured in type IV dental stone. Linear differences in interimplant distances in the x-, y-, and z-axes and differences in interimplant angulations in the z-axis were measured on the casts using a coordinate measuring machine. RESULTS: The interimplant distance D1y showed significant variations in all four test groups (P = .043), while D3x values varied significantly between the acrylic resin-splinted and silicone-splinted groups. Casts obtained from the polyether-splinted group were the closest to the reference model in the x- and y-axes. In the z-axis, D2z values varied significantly among the three test groups (P = .009). Casts from the acrylic resin-splinted group were the closest to the reference model in the z-axis. Also, one of the three angles measured (angle 2) showed significant differences within three test groups (P = .009). Casts from the nonsplinted group exhibited the smallest angular differences. CONCLUSION: Casts obtained from all four impression techniques exhibited differences from the reference model. Casts obtained using the bite registration polyether-splinted technique were the most accurate versus the reference model, followed by those obtained via the acrylic resin-splinted, nonsplinted, and bite registration addition silicone-splinted techniques.

Prosthetic rehabilitation of orofacial donor site fistula following surgical reconstruction: a clinical report.

Orofacial defects can be either congenital or acquired. Rehabilitation of these patients can be done using a surgical and/or a prosthetic approach. In situations where surgical reconstruction is not possible, prosthetic management becomes the only option. This clinical report describes a simple, economical, and effective technique for the prosthetic rehabilitation of a patient with oro-cutaneous fistula due to donor site dehiscence following tumor defect reconstruction.