Evaluation of the quality of different endodontic obturation techniques by digital radiography.

OBJECTIVES: This study was aimed to evaluate different endodontic obturation techniques (Thermafil, lateral condensation, and Tagger's hybrid technique) regarding the homogeneity of the obturation radiopacity. MATERIALS AND METHODS: Seventy roots of human upper central incisors were filled using the Thermafil system, lateral condensation. and Tagger's hybrid technique. Radiopacity of the filling was evaluated based on mean of grey levels, and its homogeneity was assessed by the coefficient of variation (CV), analyzing the histograms obtained of digitized and digital radiographs. RESULTS: The increase in mean grey levels (p < 0.001) and reduction in the CV (p < 0.05) were higher for Tagger's hybrid technique compared with other methods. CONCLUSIONS: Tagger's hybrid technique provided better homogeneity of the obturation radiopacity and better apical sealing compared with lateral condensation technique. CLINICAL RELEVANCE: The results suggest that Tagger's hybrid technique provided the best compaction of the root canal filling material, an important factor for the sealing of obturations and, consequently, for the effectiveness of treatment.

Effects of radio-opacifier addition in dental impression material.

OBJECTIVE: The aim of this in vitro study was to determine the effects of barium sulfate addition in two dental impression materials previously proved as radiolucent. MATERIALS AND METHODS: An irreversible hydrocolloid (IH) and polyether (PE) were tested for optical density, linear dimension stability and detail reproduction. STATISTICAL ANALYSIS USED: The optical density data were submitted to Kolmogorov-Smirnov normality test and compared with two-way ANOVA and Tukey (alpha=0.05). RESULTS: The results of optical density (pixel) were: IH control 45.24 f (+/-7.6), PE control 54.93 e (+/-4.45), PE 5Wt% 60.43 d (+/-6.27), IH 1Wt% 61.54 cd (+/-5.3), PE 1Wt% 66.9 bc (+/-5.05), IH 5Wt% 67.17 b (+/-6.01), PE 10Wt% 84.55 a (+/-5.14), IH 10Wt% 85.33 a (+/-5.53). On detail reproduction, polyether control was able to copy the 6 microm line. Adding 1 or 5Wt% of barium sulfate have not change this characteristic. For the irreversible hydrocolloid, the control group was able to copy a line with 14 microm, however, adding 1Wt% barium sulfate, the capability decreased to 22 microm. Adding barium sulfate in the polyether promoted an increase in between the copied lines, for the control, the average distance was 931.6 microm, 936 microm to 1Wt% and 954.5 microm to 5 Wt%. For the IH, the control presented 975 microm in comparison to 987.25 microm for 1 Wt% samples. CONCLUSION: The addition of barium sulfate was capable of increasing significantly the optical density of tested material, have changed the linear dimension stability, however, have not interfered in detail reproduction only for PE.

Preload and torque removal evaluation of three different abutment screws for single standing implant restorations.

Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One), which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite). Ten screws of each type were attached applying a 30.07+/-0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72+/-8.98 N), followed by surface-treated titanium screws (97.78+/-4.68 N) and titanium screws (37.03+/-5.69 N). ANOVA (p<0.05) and Tukey's test (p<0.05) were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded.

A comparison between panoramic digital and digitized images to detect simulated periapical lesions using radiographic subtraction.

This study compared digital and digitized panoramic radiographs to detect incipient periapical lesions using the digital subtraction radiography (DSR) technique. Bone defects were created in 77 apical sites of dried human mandibles through the application of 70% perchloric acid. Conventional and digital radiographs were obtained twice at time zero and 2, 4, and 6 hours after application of the acid solution. Conventional radiographs were digitized by using the same attributes than direct digital radiographs. The baseline images were subtracted of the negative control and experimental groups and assessed by an experienced and blinded observer who assigned score 0 (normal) or 1 (mineral loss) to each image. The sensitivity of both modalities was statistically different in relation to experimental times. The percentage of correct responses significantly increased regarding experimental times. The specificity was high both for digitized and digital images. DSR of panoramic images, both digitized and digital, allows for the diagnosis of incipient-simulated periapical lesions with no differences in their performance.

Detection of proximal caries in conventional and digital radiographs: an in vitro study.

OBJECTIVES: To compare digital images to conventional film radiography in the diagnosis of proximal caries. METHODS: Fifty-one molars and 24 premolars were studied and divided in groups of three teeth. They were fixed in silicone and radiographed using InSight film (Kodak) and the digital systems Digora (Soredex), DenOptix (Gendex) and CygnusRay MPS (Progeny). Twenty-five radiographs were obtained in each modality and four proximal surfaces were analyzed in each radiograph. Radiographs were interpreted individually by one observer at three different sessions for each imaging modality. Caries lesions were classified according to their depth: (0) absent; (1) restricted to enamel; (2) reaching the dentino-enamel junction; and (3) reaching the dentin. The teeth were sectioned and ground in order to obtain the gold standard and were examined histologically by stereomicroscopy. RESULTS: The Kendall test was employed and showed a good intra-observer agreement among the three evaluations implemented. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were all calculated, and there were no significant differences observed among the four imaging modalities studied (ANOVA, p< or =0.05). Besides, the ROC curve was determined for each modality and no statistically significant differences were observed when comparing the areas under the ROC curve at the 5% level of significance. CONCLUSIONS: The results demonstrate that the diagnostic accuracy of digital images is similar to that of conventional film radiography in the detection of proximal caries.

Measuring cortical thickness on panoramic radiographs: a validation study of the Mental Index.

OBJECTIVES: To validate the Mental Index assessment obtained from panoramic radiographs. STUDY DESIGN: Ten dried mandibles were selected, and standardized panoramic radiographs were obtained. The specimens were then perpendicularly sectioned at the mental foramen region, and the inferior mandibular cortical thickness was recorded using a digital caliper. Measurements of panoramic radiographs were compared with the dried mandibles. Four observers carried out twice the measurements for the panoramic radiographs. Two observers performed twice the measurements of the dried mandibles. Reliability was assessed by duplicate measurements. RESULTS: Agreement between the actual mandible measurements and the radiographic assessment was moderate for the noncorrected measurements. Agreement between anatomic and radiographic measurements improved remarkably after standard correction for magnification. CONCLUSIONS: Bone status reports based on measuring cortical thickness of the lower border of the mandible at the mental foramen based on panoramic radiographs, i.e., Mental Index, are accurate. Compensation for magnification, however, is necessary.

Effect of laser therapy on bone tissue submitted to radiotherapy: experimental study in rats.

OBJECTIVE: The aim of this study was to investigate the effect of laser therapy (lambda = 780 nm) on bone tissue submitted to ionizing radiation. BACKGROUND DATA: The biostimulation effect of laser in normal bone tissue has already been demonstrated successfully; however its effect on bone tissue submitted to radiotherapy has not yet been studied. METHODS: Twenty-two Wistar rats were randomly divided into four groups: group I, control (n = 4), submitted only to radiotherapy; group II, laser starting 1 day prior to radiotherapy (n = 6); group III, laser started immediately after radiotherapy (n = 6); group IV, laser 4 weeks after radiotherapy (n = 6). The source of ionizing radiation used was Cobalt 60, which was applied in a single dose of 3000 cGy on the femur. The laser groups received seven applications with a 48-h interval in four points per session of DE = 4 J/cm(2), P = 40 mW, t = 100 sec, and beam diameter of 0.04 cm(2). All animals were killed 6 weeks after radiotherapy. RESULTS: Clinical examination revealed cutaneous erosions on experimental groups (II, III, and IV) starting at the 6th week after radiotherapy. The radiographic findings showed higher bone density in groups II and IV (p < 0.05) compared to the control group. The results further showed an increase of bone marrow cells, and number of osteocytes and Haversian canals in experimental groups II and IV (p < 0.05). It was also found an increase of osteoblastic activity, in groups II, III, and IV (p < 0.05). CONCLUSION: Laser therapy on bone tissue in rats presented a positive biostimulative effect, especially when applied before or 4 weeks after radiotherapy. However, the use of laser in the parameters above should be used with caution due to epithelial erosions.

Primary stability of turned and acid-etched screw-type implants: a removal torque and histomorphometric study in rabbits.

PURPOSE: This study evaluated the effect of primary stability on the osseointegration of turned and acid-etched screw implants in a rabbit model. MATERIALS AND METHODS: One pair of turned and acid-etched implants (3.75 in diameter, 5.5 mm long) was placed in each tibia of 15 rabbits. In the right tibial metaphysis the implants were inserted according to a standard surgical protocol. In the left tibia, the osteotomy sites were enlarged using a sequence of drills, and 2 implants were placed with reduction of primary stability. Animals were sacrificed 9 weeks after surgery. Histomorphometric and removal torque analyses were performed to evaluate bone-implant contact and strength of osseointegration. RESULTS: Surface texture had a significant effect on percentage of bone-implant contact (P = .001). Acid-etched implants with high primary stability showed the highest percentage of bone-implant contact (77%), followed by acid-etched implants with low primary stability (61%), turned implants with low primary stability (56%), and turned implants with high primary stability (46%). For removal torque, acid-etched implants had higher peak mean values than turned implant groups (P < .001). Reduction of primary stability was not significant to either percentage of bone-implant contact (P = .645) or removal torque values (P = .214). CONCLUSION: Acid-etched implants had higher bone response and implant fixation than turned implants, regardless of primary stability.

Comparação da densidade óptica de resinas compstas de alta viscosidade por meio do sistema digital DenoOptix / Comparison of the optical density of high-viscosity composite resins by DenOptix digital system

O objetivo deste estudo foi mensurar a densidade óptica de quatro resinas compostas de alta viscosidade (Fill Magic, P60, Solitaire e Surefil) nas espessuras de 1, 2, 3 e 4mm, utilizando o sistema digital DenOptix, e compará-las entre si. Foram utilizadas cinco placas de acrílico para cada uma das espessuras, cada uma contendo amostras de todas as resinas. Cada placa acrílica foi radiografada três vezes, sob técnica padronizada, usando uma placa óptica sob cada placa acrílica, totalizando sessenta exposição, as placas no sistema digital DenOptix, e fizeram-se três leituras ópticas consecutivas de cada imagem, totalizando 720 leituras. Os resultados, submetidos à análise estatística, permitiram concluir que os valores de densidade óptica aumentaram com o aumento das espessuras das amostras. Quando comparadas entre si, na espessura de 1mm, as resinas surefil e P60 não diferiram estatísticamnete entre si e apresentaram as maiores médias de densidade óptica, seguidas da resina Fill Magic e, por último, da resina Solitaire. Todas as resinas apresentaram diferenças estatisticas na espessura de 2 mm, sendo a Surefil a de maior expressão de densidade óptica, seguida, em ordem decrescente de densidade óptica, pelas resinas P60, Fill Magic e Solitaire. Nas espessuras de 3 mm e 4 mm, a resina Surefil apresentou a maior média de densidade óptica, seguida por P60 e Fill Magic, que não diferiram estatisticamente entre si e, por último, de Solitaire, que apresentou o menor valor médio de densidade óptica

Influence of soft tissues on mandibular gray scale levels.

The purpose of this study was to analyze the gray levels, expressed in pixels, of the mandibular retromolar region, with regard to the influence of muscular and fat soft tissues near this region. Fifteen dry mandibles were X-rayed with the presence of soft tissue simulators. The radiographs were digitized and evaluated by Digora software. A one cm thick layer of wax was used as a simulator of the muscular soft tissue. Animal fat samples of different thicknesses - 0.5, 1.0, 1.5 and 2.0 cm - were used as a simulator of the fat soft tissue. Results showed that the fat soft tissue simulator influenced the gray level values in pixels of the mandibular retromolar region when analyzed in different thicknesses using the Digora digitized image software.

Measurement of the optical density of packable composites: comparison between direct and indirect digital systems.

The aim of this study was to measure the optical density of four packable composite resins with widths of 1, 2, 3 and 4 mm, by means of Digora (direct) and DentScan DentView (indirect) digital imaging systems, in order to compare both methods. Twenty acrylic plates, with the proposed thicknesses, were used, each one containing a sample of each resin. Each acrylic plate was radiographed three times, under a standardized technique. For the Digora system, an optical plate was used under each resin sample, and, for the DentScan DentView system, occlusal films were employed, totalizing 60 exposures for each system. Optical plates and films were scanned and three consecutive optical readouts were carried out, totalizing 1,440 readouts. The results were submitted to statistical analysis and revealed that the average optical density of the four resins always increased as thickness increased. Regarding the comparisons between the composite resins, in both analysis the resin with the greater optical density was Surefil followed by Prodigy Condensable, Alert and Solitaire . The correlations between the results of Digora and DentScan DentView were significant for the different thicknesses and materials. The observed tendency is that as the values obtained with the Digora system increase, so do the values obtained with DentScan DentView . While thickness increased, the values of optical density in both Digora and DentScan DentView tended to approach each other. The Digora system presented smaller amplitude between the results obtained in adjacent thicknesses.