Disinfection/sterilization of extracted teeth for dental student use.

Extracted human teeth are used in many preclinical courses. While there has been no report of disease transmission with extracted teeth, sterilization of teeth used in the teaching laboratory should be a concern. The purpose of this study was to determine the effectiveness of different sterilization/disinfection methods of extracted human teeth using Bacillus stearothermophilus, a bacteria resistant to heat and frequently used to test sterilizers. In this study, 110 extracted molars with no carious lesions were collected and stored in buffered saline. An endodontic occlusal access preparation was cut into the pulp chamber of each tooth. Pulp tissue in the chamber was removed with a broach. Approximately 1 x 10(5) B. stearothermophilus endospores in culture medium were injected into the pulp chamber, sealed with Cavit G, and then placed in sterile saline for twelve hours. Ten teeth were placed into each of eleven groups. Seven groups were immersed for one week in one of the following solutions: a) sterile saline (control group), b) 5.25% NaOCl, c) 2.6% NaOCl, d) 1% NaOCl, e) 10% buffered formalin, f) 2% gluteraldehyde, g) 0.28% quaternary ammonium. Four additional groups were treated by h) 10% formalin for two days, i) 10% formalin for four days, j) autoclaving at 240 degrees F and 20 psi for twenty minutes, and k) autoclaving at 240 degrees F and twenty psi for forty minutes. Each tooth was then aseptically split and placed in an individual test tube with growth medium. Samples were examined for evidence of growth (turbidity) at forty-eight hours. Only autoclaving for forty minutes at 240 degrees F and 20 psi or soaking in 10 percent formalin for one week were 100 percent effective in preventing growth. A chi-square analysis of the data indicates these two methods were significantly better than all other methods (p<0.001).

Composite titanium dental implant fabricated by electro-discharge compaction.

An electro-discharge compaction (EDC) fabrication window was established for producing commercially pure porous titanium dental implants of 4 mm diameter and 7 mm length with a solid titanium cap. The optimum input energy was in the range of 0.58-0.87 kJ g-1 for a powder column of 0.500 g. Input energy greater than 0.58 kJ g-1 resulted in an implant torque strength exceeding 30 N-cm (the retaining screw tightening torque), while input energy greater than 0.72 kJ g-1 exceeded 46.7 N-cm torque strength (at this level the retaining screw failed prior to the implant). The integrity of the internally threaded hole and hexagonal head of the cap were maintained throughout the EDC process. The EDC process did not after the strength and/or microstructure of the components, and the bead-cap interface was stronger than the bead-bead interface. EDC implants produced within the aforementioned window have sufficient compressive strengths and other physical properties to meet the requirement for titanium dental implants.

Postmortem histologic evaluation of hydroxyapatite-coated cylinder and titanium alloy basket implants in situ for 37 months in the posterior mandible. Dental Implant Clinical Research Group.

Histologic examination of the tissues surrounding a titanium alloy basket implant and a hydroxyapatite-coated titanium cylinder implant from the mandible of a cadaver were examined. The 67-year-old man died 37 months after first-stage surgery from cardiovascular failure. Clinical and radiographic examinations indicated that the implants were functional, immobile, and integrated. Light microscopy revealed that the gingival tissues adjacent to the implants were healthy and, in general, free of inflammatory cells. The transmucosal area demonstrated a tight connective tissue apposition to the implants. The sulcular epithelial appearance was similar to that of a natural tooth. Histomorphometric analysis revealed that 72.2 percent of the basket implant and 75.3 percent of the hydroxyapatite-coated implant were in direct contact with bone. Generally, the bone along the surface of the basket implant was thicker than the bone along the surface of the hydroxyapatite-coated cylinder. Bone grew through the vent hole areas of both implants.

The influence of maxillary sinus augmentation on the success of dental implants through second-stage surgery.

An interim evaluation of the status of 102 implants placed in 42 augmented sinuses in 27 patients involved in an alternate category of the Dental Implant Clinical Research Group's long-term, randomized, prospective clinical investigation is presented. Autogeneic, allogeneic, and alloplastic sinus grafts were used, individually or mixed. Through second-stage surgery, 101 implants were found to be integrated. The mean Periotest value at uncovering was -3.36, with a standard deviation of 4.19. The results suggest that root form implants placed in augmented sinuses are successful through second-stage surgery, regardless of the augmentation material or implant design used.

Clinical procedure for stabilizing and connecting O-ring attachments to a mandibular implant overdenture.

Conventional overdentures can be made with or without attachments, whereas implant-supported overdentures require bar or stud type attachments. Accurate placement of the attachments in the overdenture is critical for the success of the prosthesis and implants. An improved procedure is presented for stabilizing the existing denture with vinyl polysiloxane impression material during the clinical incorporation of stud attachments to the implant-supported overdenture.

Preliminary silicone putty casts: diagnosis to final impression for complete dentures.

Silicone putty casts are useful for articulating existing dentures for evaluation and problem solving before relining procedures are performed or a new prosthesis is made. Tissue health may require significant modification of the existing dentures and treatment with tissue-conditioning material before final impressions are made. This practical procedure uses a functional impression that substitutes for a quality preliminary impression and combines tissue conditioning, a functional impression, silicone putty cast, custom final impression tray, and a final impression for a complete denture.

A comparison of infrared- and torch-soldering of Au-Pd and Co-Cr metal-ceramic alloys using a high-fusing solder.

PURPOSE: The purpose of this study was to compare the bond strengths and fracture modes of soldered joints formed by infrared and gas-oxygen torch heating of a high-fusing, gold-based solder in two metal-ceramic alloys. MATERIALS AND METHODS: Pairs of half-dumbbell-shaped specimens of either an Au-Pd or a Co-Cr alloy were positioned with a 0.25-mm gap and were joined using a high-fusing, gold-based solder by either gas-oxygen torch heating or infrared heating. The resulting specimens were subjected to a heat treatment that simulated ceramic firing. Each specimen was fractured in tension at a loading rate of 0.5 cm/min, and its bond strength was measured. The halves of the specimen were rejoined using the other heating method and were heat treated, and the specimen's bond strength was again measured. Fractured cross-sections were examined at a magnification of 40x to determine the following: the fracture mode (adhesive, cohesive, or mixed); the percentage of adhesive fracture; the presence or absence of voids, porosities, or flux inclusions; and the percentage of the cross-section that was discolored. RESULTS: Three-factor analyses of variance showed that neither the heating method, the particular specimen tested, nor the order of testing significantly affected the bond strength (P < .05). For each alloy, significantly fewer infrared-heated joints than torch-heated joints contained voids, porosities, or flux inclusions visible at 40x (chi 2 test, P < .05). All fractures were either entirely cohesive in the solder or mixed cohesive and adhesive. When infrared heating was used, entirely cohesive fractures occurred more frequently in the Au-Pd alloy specimens than in the Co-Cr alloy specimens (chi 2 test, P < .05). The coefficients of variation of the bond strengths for the infrared-heated joints were smaller than those for the torch-heated joints. CONCLUSIONS: Although the two heating methods produced solder joints that had strengths that were not significantly different, infrared-heated joints showed less scatter in bond strengths. It was suggested that, in the hands of most technicians, fewer infrared-heated joints would contain defects visible at a magnification of 40x. The presence of such defects may increase the probability of in vivo failure caused by cyclic stresses.

A light and scanning electron microscopic evaluation of electro-discharge-compacted porous titanium implants in rabbit tibia.

This study used light and scanning electron microscopic (SEM) histomorphometric methods to quantitate the rate of osseointegration of totally porous titanium alloy (Ti-6Al-4V) implants prepared by a novel fabrication technique--electrodischarge compaction (EDC). EDC was used to fuse 150-250-micrometer spherical titanium alloy beads into 4 X 6 mm cylindrical implants through application of a 300-microsecond pulse of high-voltage/high-current density. Two sterilized implants were surgically placed into each tibia of 20 New Zealand white rabbits and left in situ for periods corresponding to 2, 4, 8, 12, and 24 weeks. At each time point, 4 rabbits were humanely killed, and the implants with surrounding bone were removed, fixed, and sectioned for light and SEM studies. The degree of osseointegration was quantitated by means of a True Grid Digitizing Pad and Jandel Scan Version 3.9 software on an IBM PS/2 computer. The total pore area occupied by bone was divided by the total pore area available for bone ingrowth, and a Bone Ingrowth Factor (BIF) was calculated as a percent. The light microscopic results showed BIFs of 4% at week 2, 47% at week 4, 62% at week 8, 84% at week 12, and greater than 90% at week 24. The SEM results showed BIFs of 5% at week 2, 34% at week 4, 69% at week 8, 75% at week 12, and in excess of 90% at week 24. The results of this study show that EDC implants are biocompatible and support rapid osseointegration in the rabbit tibia and suggest that, after additional studies, they may be suitable for use as dental implants in humans.

Treatment of a microvascular reconstructed mandible using an implant-supported overdenture: case report.

Oral rehabilitation of patients with mandibular discontinuity defects is a challenging problem facing both the surgeon and the dentist. Advances in microvascular surgery have provided the surgeon with methods to repair the partially resected mandible with vital bone grafts. Often, however, reconstruction of the bony defect alone does not guarantee an adequate foundation for successful conventional prosthetic rehabilitation. Osseointegrated implants placed into the microvascularized grafted bone offer an opportunity for improved function and patient satisfaction. The following case presentation reports the use of an implant-supported overdenture in a vascularized iliac bone graft to reconstruct a partially resected mandible.

Fabrication of a fixed partial denture in the Class II partial edentulous mandible using the UCLA abutment: a clinical report.

Several methods are currently available to restore the partially edentulous patient with osseointegrated implants. The UCLA abutment eliminates the unesthetic, traditional transmucosal abutment and can provide esthetic crowns, fixed prostheses, and subgingival porcelain margins without the need for excessive instrumentation and components. A clinical report for the fabrication of a direct, implant-borne fixed prosthesis using the UCLA abutment is presented.

An evaluation of electrodischarged prototype implants in rabbit tibia: a preliminary study.

This is the first in a series of biological investigations using a porous implant fabricated by a novel process known as electrodischarge compaction (EDC). This process uses Ti-6A1-4V powder and electrical energy to construct a beaded porous implant without any compromise in physical characteristics, often found with conventional sintering. The purpose of this study was to evaluate the bone response in rabbit tibia of a porous titanium prototype implant fabricated by this new technique. One hundred forty-four porous EDC-fabricated implants were placed into the tibia of 36 New Zealand rabbits. Animals were placed into one of six time periods (2, 4, 8, 12, 18, and 24 weeks). At the appropriate time period, animals were killed, and bone ingrowth was evaluated qualitatively by light and scanning electron microscopy. Bone/implant interface bond strength was also measured. Slight bone ingrowth was observed as early as the two-week time period and increased in depth at each time period for the duration of the study. Implant/bone bond strength was measurable at four weeks and continued until reaching a plateau at week 12. The results of this study suggest that this novel EDC implant may be suitable for continued development of an easily fabricated, cost-effective dental implant.