A prospective comparative analysis of the survival rates of conventional vs no-prep/minimally invasive veneers over a mean period of 9 years.

OBJECTIVES: The present study compares the survival rates of 186 conventional and no-prep/minimally invasive porcelain veneers in 35 patients over a mean period of 9 years. MATERIALS AND METHODS: The veneers were placed on the incisors, canines, and premolars in 35 patients between January 2009 and December 2010. Fourteen patients received 84 conventional veneers, and 21 patients received 102 no-prep/minimally invasive veneers. The restorations were evaluated at baseline and after every 6 months until June 2019 based on modified United States Public Health Service criteria. The data was analyzed by using Wilcoxon-Breslow-Gehan and Taron-Ware tests. Kaplan-Meier survival and success curves were plotted for two groups of veneers. The results were compared by using the log rank test. A test probability of P < .05 was regarded as significant, while a test probability of P < .01 was considered to be statistically significant. RESULTS: The mean survival rate, according to the Kaplan-Meier estimator, was 9.67% for conventional veneers and 100% for the no-prep or minimal prep veneers. A total of ten absolute failures were observed in six patients: eight restoration chipping/fractures, one debonding, and one fracturing of the tooth. Mean success rate time for conventional veneers without absolute or relative failures was 9.32 years, and 10.28 years for no-prep/minimally invasive veneers. CONCLUSIONS: Over a mean observation period of 9 years, the survival rate of no-prep/minimally invasive veneers exceed that of conventional veneers. CLINICAL RELEVANCE: No-prep/minimally invasive veneers appear very effective and should always be considered in certain clinical situations.

Chitosan-Human Bone Composite Granulates for Guided Bone Regeneration.

The search for the perfect bone graft material is an important topic in material science and medicine. Despite human bone being the ideal material, due to its composition, morphology, and familiarity with cells, autografts are widely considered demanding and cause additional stress to the patient because of bone harvesting. However, human bone from tissue banks can be used to prepare materials in eligible form for transplantation. Without proteins and fats, the bone becomes a non-immunogenic matrix for human cells to repopulate in the place of implantation. To repair bone losses, the granulate form of the material is easy to apply and forms an interconnected porous structure. A granulate composed of ß-tricalcium phosphate, pulverized human bone, and chitosan-a potent biopolymer applied in tissue engineering, regenerative medicine, and biotechnology-has been developed. A commercial encapsulator was used to obtain granulate, using chitosan gelation upon pH increase. The granulate has been proven in vitro to be non-cytotoxic, suitable for MG63 cell growth on its surface, and increasing alkaline phosphatase activity, an important biological marker of bone tissue growth. Moreover, the granulate is suitable for thermal sterilization without losing its form-increasing its convenience for application in surgery for guided bone regeneration in case of minor or non-load bearing voids in bone tissue.

IN VIVO PERFORMANCE OF THE EXPERIMENTAL CHITOSAN BASED BONE SUBSTITUTE--ADVANCED THERAPY MEDICINAL PRODUCT. A STUDY IN SHEEP.

When evaluating a novel bone substitute material, advanced in vivo testing is an important step in development and safety affirmation. Sheep seems to be a valuable model for human bone turnover and remodeling activity. The experimental material composed with the stem cells is an advanced therapy medicinal product (acc. to EC Regulation 1394/2007). Our research focuses on histological differences in bone formation (guided bone regeneration--GBR) in sheep maxillas after implantation of the new chitosan/tricalcium phosphate/alginate (CH/TCP/Alg) biomaterial in comparison to the commercially available xenogenic bone graft and a/m enhanced with the stem cells isolated from the adipose tissue. Twelve adult female sheep of BCP synthetic line, weighing 60-70 kg were used for the study. The 11 mm diameter defects in maxilla bone were prepared with a trephine bur under general anesthesia and then filled with the bone substitute materials: CH/TCP/Alg, BioOss Collagen, Geistlich AG (BO), CH/TCP/Alg composed with the stem cells (CH/S) or left just with the blood clot (BC). Inbreeding cycle of the animals terminated at 4 months after surgery. Dissected specimens of the maxilla were evaluated histologically and preliminary under microtomography. Histological evaluation showed early new bone formation observed around the experimental biomaterial and commercially available BO. There were no features of purulent inflammation and necrosis, or granulomatous inflammation. Microscopic examination after 4 months following the surgery revealed trabecular bone formation around chitosan based bone graft and xenogenic material with no significant inflammatory response. Different results--no bone recreation were observed for the negative control (BC). In conclusion, the tested materials (CH/TCP/Alg and BO) showed a high degree of biocompatibility and some osteoconductivity in comparison with the control group. Although the handiness, granules size and setting time of CHffCP/Alg may be refined for future clinical tests. The relevant beneficial influence of using the adipose derived stem cells in GBR was not confirmed in this model.

Cytotoxicity Evaluation and Crystallochemical Analysis of a Novel and Commercially Available Bone Substitute Material.

BACKGROUND: Alloplastic biomaterials are an alternative for autologous transplants and xenografts in oral surgery and dental implantology. These non-immunogenic and resorbable materials are becoming the basis for complete and predictable guided bone regeneration in many cases. The chemical composition of a great majority of them is based on calcium phosphate salts. In vivo performance is often variable. OBJECTIVES: The objective was to evaluate the biological and chemical properties of an experimental bone substitute material. MATERIAL AND METHODS: The present research focuses on the cytotoxicity comparison and physiochemical characterization of two biomaterials: a novel chitosan/tricalcium phosphate/alginate composite (CH/TCP/Ag) and a commercially available synthetic bone graft made of HA (60%) and ßTCP (40%) (HA/TCP). The materials were evaluated according to PN-EN ISO 10993 Biological evaluation of medical devices i.e. cytotoxicity on mouse fibroblasts (L929) and, in addition, tests on human osteoblasts (hFOB1.19) and human osteosarcoma (MG-63) were conducted. The crystallochemical analysis was performed using the X-ray powder diffraction method. The Bruker-AXS D8 Advance diffractometer (Karlsruhe, Germany) was used to collect diffractograms. RESULTS: The tested materials showed a close resemblance in chemical composition and a considerable differentiation in cytotoxic response. CONCLUSIONS: The novel composite demonstrated a high degree of cytocompatibility, which is promising in future clinical trials.

Bone regeneration potential of the new chitosan-based alloplastic biomaterial.

Over the last few years, alloplastic bone substitute materials are raising much interest as an alternative to autologic transplants and xenogenic materials especially in oral surgery. These non-immunogenic and completely resorbable biomaterials are becoming the basis for complete and predictable guided bone regeneration in many cases. The objective of our research was to evaluate the dynamics of bone formation in rats' skulls after implantation of the new chitosan/tricalcium phosphate/alginate biomaterial in comparison to the commercially available alloplastic bone graft. A total of 45 adult male rats weighing 300-400 g were used for the study. The 85-mm-diameter defects in calvaria bone were prepared with a trephine bur, and then filled with the bone substitute materials: chitosan/tricalcium phosphate/alginate or easy-graft Classic (Degradable Solutions AG) (EA) or left just with the blood clot. Animals were sacrificed at 1 and 3 months for histological, histomorphometrical and micro-tomographic evaluations. Histological evaluation at 1 month showed early new bone formation, observed around the experimental biomaterial (CH/TCP/Alg). There were no features of purulent inflammation and necrosis or granulomatous inflammation. Microscopic examination after 3 months following the surgery revealed trabecular bone formation around chitosan-based bone graft with no significant inflammatory response. Less satisfactory and differing results were observed for the commercially available EA and control blood clot. The tested material (chitosan) showed a high degree of biocompatibility and osteoconductivity in comparison with the control groups. Additionally, it seemed to be a "user-friendly" material for oral surgeons.

Formation and preclinical evaluation of a new alloplastic injectable bone substitute material.

Alloplastic bone substitute materials are raising some more interest as an alternative for autologic transplants and xenogenic materials especially in oral surgery over the last few years. These non-immunogenic and completely resorbable biomaterials are the basis for complete and predictable guided bone regeneration. In the majority of cases, such a material is chosen because of its convenient application by surgeons. The main objective of our project was to design and fabricate an osteoconductive, injectable and readily tolerable by human tissues biomaterial for guided bone regeneration. For this purpose, a self-setting composite consisting of chitosan/tricalcium phosphate microparticles and sodium alginate was made. The material obtained was characterized by microsphere and agglomerate morphology and microstructure. Its features relating to setting time and mechanical properties were precisely investigated. Our material was also evaluated according to PN-EN ISO 10993 Biological evaluation of medical devices, i.e., the in vitro tests for genotoxicity and cytotoxicity were conduced. Then, the following examinations were performed: subchronic systemic toxicity, skin sensitization, irritation and delayed-type hypersensitivity and local effects after implantation. The material tested showed a high degree of cytocompatibility, fulfilled the requirements of International Standards and seemed to be a "user friendly" material for oral surgeons.

Shear bond strength of epoxy resin-based endodontic sealers to bovine dentin after ozone application.

The idea of using ozone to disinfect root canals is of recent origin. The wide acceptance of epoxy resin-based sealers lead us to investigate whether ozone can influence the adhesion to the dentin. In this study, we tested the shear bond strength of AH Plus and EZ Fill. Forty freshly extracted bovine teeth were randomly divided into 5 groups. 16 of these samples were treated with ozone for 60 seconds (HealOzone, Kavo). 8 samples were conditioned with the G Bond bonding system. The groups tested were: (1) AH Plus, (2) AH Plus and ozone, (3) EZ Fill, (4) EZ Fill and ozone, (5) AH Plus and G Bond. 48 hours after being prepared the specimens were tested for shear bond strength. Statistical analysis showed significant differences between materials (AH Plus > EZ Fill) and significant, positive influence of ozone and bonding agent on the shear bond strength.