Influence of attaching mechanical retentive devices onto frameworks on fracture resistance of implant-supported zirconia crowns.

This study investigated the fracture load of implant-supported zirconia crowns (IZCs), in which indirect composite resin or feldspathic porcelain was layered onto zirconia frameworks with mechanical retentive devices. Three different zirconia frameworks were assessed: attaching mechanical retentive devices on glaze and opaque porcelain materials (GL and OP groups, respectively), and no attaching mechanical retentive devices (ND group). The frameworks were layered using feldspathic porcelain (FP veneer) and indirect composite resin (IC veneer). Fracture load of the specimens was measured. In FP veneer, the GL group recorded the highest fracture load. In the IC veneer, the GL and OP groups had significantly higher fracture load than the ND group. The fracture resistance of IZCs can be enhanced by applying glaze material before attaching mechanical retentive devices for porcelain layering. The mechanical retentive devices effectively yielded mechanical interlocking between the zirconia frameworks and the IC veneer in GL and OP groups.

Influence of different convergence angles of abutment teeth and cement spaces on internal adaptation of anterior CAD-CAM fixed dental prostheses.

PURPOSE: The aim of this study was to investigate the influence of different convergence angles of abutment teeth and different cement spaces on internal adaptation of anterior fixed dental prostheses (FDPs) fabricated with a computer-aided design-computer-aided manufacturing (CAD-CAM) system. METHODS: Composite resin FDPs for 99 standardized maxillary central incisors were fabricated according to nine parameters: three total convergence angles (4 [DG4], 12 [DG12], and 20 degrees [DG20]) and three cement space settings (10 [CS10], 50 [CS50], and 90 µm [CS90]). Internal space values were measured with a cement space replica technique. The Kruskal-Wallis and Steel-Dwass tests were used to evaluate differences in the total convergence angles and luting agent spaces, respectively (α = 0.05). RESULTS: For all three cement spaces tested, the median marginal gap values between abutment teeth and FDPs decreased significantly as the total convergence angle increased (P < 0.05). For the CS10 and CS50 groups, the internal space values at the axial area increased significantly as the total convergence angles increased (P < 0.05). CONCLUSION: Total convergence angles of the abutment teeth and cement spaces affected the marginal and internal adaptation of anterior FDPs fabricated with a CAD-CAM system.

Influence of an internal firing of feldspathic porcelain before or after sintering on adaptation of high-translucent zirconia laminate veneers.

The aim of the present study was to evaluate the influence of two different internal surface treatments, namely, the firing of feldspathic porcelain before or after zirconia sintering, on the marginal and internal adaptation of laminate veneers (LVs) made of high-translucent zirconia. A total of 33 zirconia LVs were fabricated using a CAD/CAM system and divided into three groups based on the internal surface treatment method: the pre-firing (PRE) group involved firing feldspathic porcelain before zirconia sintering, the post-firing (POS) group involved firing feldspathic porcelain after zirconia sintering, and the no treatment (NT) group involved no application of feldspathic porcelain. The adaptation of the LVs was measured using a silicone replica technique. Data were analyzed using the Kruskal-Wallis and Steel-Dwass tests (α = .05). The POS group showed significantly higher marginal discrepancy values than the PRE group across all sites. The internal space values of the PRE groups were significantly lower than those of the NT group at all sites. The internal firing of feldspathic porcelain before zirconia sintering resulted in better marginal adaptation of the high-translucent zirconia LVs than the internal firing of feldspathic porcelain after zirconia sintering. The internal firing of feldspathic porcelain before zirconia sintering can achieve uniform internal adaptation of high-translucent zirconia LVs.

Mechanical characterization of aesthetic orthodontic brackets by the dynamic indentation method.

The objective of this study is to investigate the mechanical properties, such as the dynamic hardness and indentation elastic modulus, of commercially available aesthetic orthodontic brackets, such as ceramic and plastic brackets, by the dynamic micro-indentation method. Five ceramic brackets, which were made of alumina (both monocrystalline and polycrystalline forms) or zirconia, and two plastic brackets, which were made of glass fiber-reinforced polycarbonate or polyamide, were tested. There were significant differences in the mechanical properties of the monocrystalline and polycrystalline alumina brackets. The mechanical properties of the glass fiber-reinforced plastic bracket were significantly superior to these of the non-glass-fiber-reinforced plastic bracket. The differences in the crystal structures of the ceramic brackets surface affected the dynamic hardness and indentation elastic modulus. Furthermore, the short glass fibers contained in the plastic bracket might contribute to the improvement of the mechanical properties.

Evaluation of the mechanical behavior of bulk-fill and conventional flowable resin composites using dynamic micro-indentation.

The purpose of this research was to investigate the mechanical behavior of commercially available bulk-fill and conventional flowable resin composites using the dynamic micro-indentation method. The effect of inorganic filler content on mechanical properties was also assessed. Weight percentages of the inorganic filler in the resin composite were measured using the ashing technique. The results showed that dynamic hardness and elastic modulus tended to increase with inorganic filler content. Furthermore, the differences in mechanical properties between top and bottom surfaces were less pronounced in bulk-fill flowable resin composites compared with conventional flowable resin composites. In conclusion, the mechanical properties of bulk-fill flowable resin composites are affected by filler content. Moreover, bulk-fill flowable resin composites have a higher polymerization depth than conventional flowable resin composites when sample thickness is 4 mm.

A study on the characteristics of resin composites for provisional restorations.

In this study, we evaluated the characteristics of five commercial resin composites used for provisional restorations. The inorganic filler contents of the resins were measured, and three-point bending, wear, surface hardness, water absorption, and staining tests were performed. The specimens underwent additional three-point bending tests after water storage and undergoing thermal stresses at 5°C and 55°C (10,000 cycles). Data were analyzed using one- or two-way analysis of variance and Bonferroni post-hoc tests. Pearson's correlation coefficient was used for pairwise comparisons. Each resin composite presented with different mechanical properties, based on variations in the inorganic filler content. The flexural strength of each resin composite was significantly decreased after water storage. There has a positive correlation between flexural strength and dynamic hardness but a negative correlation between flexural strength and maximum wear depth. The types and contents of the inorganic fillers, the composition of the monomer in the resin matrix, and the addition of plasticizers can affect the properties of the material.

Effect of the demineralisation efficacy of MDP utilized on the bonding performance of MDP-based all-in-one adhesives.

OBJECTIVES: The amounts of calcium salt of 10-methacryloyloxydecyl dihydrogen phosphate (MDP-Ca salt) and dicalcium phosphate dihydride (DCPD) with an amorphous phase produced by the demineralisation of enamel and dentin were determined using commercial MDP-based 2-hydroxyethyl methacrylate (HEMA)-containing and HEMA-free all-in-one adhesives. The effect of the amount of MDP-Ca salt produced on bonding performance to enamel and dentin was then characterized. METHODS: Three types of commercial HEMA-containing adhesives (Scotchbond Universal Adhesive, Clearfil Tri-S Bond ND, Clearfil Tri-S Bond ND Quick), a commercial HEMA-free adhesive (G-Bond Plus) and an experimental HEMA-free adhesive were used. The reactant residues of each adhesive were prepared after interacting with enamel and dentin samples for 60 s. The amounts of MDP-Ca salt and amorphous DCPD produced were determined using a phosphorous-31 nuclear magnetic resonance technique. Enamel and dentin bond strengths were measured for each adhesive, with and without thermocycling. RESULTS: The amounts of MDP-Ca salt and amorphous DCPD formed after interacting with enamel and dentin differed among the five adhesives and were independent of their pH values. Enamel showed a strong positive-correlation of the bond strength of the all-in-one adhesives to the amount of MDP-Ca salt produced, however, the dentin showed a weak negative-correlation. CONCLUSION: The HEMA-free all-in-one adhesives showed a greater efficacy to demineralise the enamel and dentin than the HEMA-containing all-in-one adhesives. The dentin showed a different effect of the amount of MDP-Ca salt produced on the bonding performance compared with enamel. CLINICAL SIGNIFICANCE: The enamel bond strength of MDP-based all-in-one adhesives strongly contributes to the demineralisation efficacy by the incorporation of MDP, in contrast to the dentin bond strength. However, the efficacy of MDP-based all-in-one adhesives to demineralise the enamel and dentin is not directly related to the pH value of the MDP-based all-in-one adhesive.

Monophosphoryl lipid A enhances nontypeable Haemophilus influenzae-specific mucosal and systemic immune responses by intranasal immunization.

OBJECTIVE: Acute otitis media (AOM) is one of the most common infectious diseases in children. Nontypeable Haemophilus influenzae (NTHi) is Gram-negative bacteria that are considered major pathogens of AOM and respiratory tract infections. In this study, we used monophosphoryl lipid A (MPL), a toll-like receptor (TLR) 4 agonist, as an adjuvant to induce mucosal immune responses against NTHi to enhance bacterial clearance from the nasopharynx. METHODS: Mice were administered 10 µg outer membrane protein (OMP) from NTHi and 0, 10, or 20 µg MPL intranasally once a week for 3 weeks. Control mice were administered phosphate-buffered saline alone. After immunization, these mice were challenged with NTHi. At 6 and 12 h after bacterial challenge, the mice were killed and nasal washes and sera were collected. The numbers of NTHi- and OMP-specific antibodies were quantified by enzyme-linked immunosorbent assay. RESULTS: The MPL 10 and 20 µg group produced a significant reduction in the number of bacteria recovered from the nasopharynx at 12 h after bacterial challenge compared to the control group. OMP-specific IgA titers were also augmented in the MPL groups compared to the control and OMP groups. CONCLUSION: MPL is suitable for eliciting effective mucosal immune responses against NTHi in the nasopharynx. These results demonstrate the possibility of an adjuvant that involves stimulation of the innate immune system by TLR4 agonists such as MPL for mucosal vaccination.

Repair of a large pharyngocutaneous fistula with a free jejunal patch flap after salvage laryngectomy: A case report.

Preoperative chemoradiation therapy increases the risk of pharyngocutaneous fistula (PCF) after laryngectomy. In this report, we describe the use of a free jejunal patch flap and a deltopectoral flap for surgical treatment of a large PCF. A 52-year-old man underwent salvage laryngectomy and right neck dissection after concurrent radiotherapy for laryngeal carcinoma. On postoperative day 5, a pharyngeal fistula and neck abscess occurred with the right internal jugular vein thrombosis. We sutured the pharyngeal mucosa to the cervical skin to avoid carotid artery exposure, and we also ligated the right internal jugular vein. The PCF developed afterwards. The patient was being fed through a nasogastric tube and the fistula had increased in size. At the time of surgery, the external orifice became 5 cm × 5 cm in size. We performed the repair with a free jejunal patch flap and a deltopectoral flap. The harvested jejunum was opened along its antimesenteric border to design a sufficient free jejunal flap to cover the large PCF. A deltopectoral pedicled flap was used to reconstruct the neck skin defect to resurface the free jejunal patch flap. Both flaps survived. The patient could resume an oral diet 2 weeks after surgery. At 1 month after surgery, the skin pedicle of the deltopectoral flap was divided. There was no contracture or stricture 3 years after surgery and he maintained a regular diet. Reconstruction with a free jejunal patch flap and a deltopectoral flap may be a suitable method for repair of a large PCF. © 2014 Wiley Periodicals, Inc. Microsurgery 37:61-65, 2017.

Shear bond strengths of an indirect composite layering material to a tribochemically silica-coated zirconia framework material.

This study evaluated shear bond strengths of a layering indirect composite material to a zirconia framework material treated with tribochemical silica coating. Zirconia disks were divided into two groups: ZR-PRE (airborne-particle abrasion) and ZR-PLU (tribochemical silica coating). Indirect composite was bonded to zirconia treated with one of the following primers: Clearfil Ceramic Primer (CCP), Clearfil Mega Bond Primer with Clearfil Porcelain Bond Activator (MGP+Act), ESPE-Sil (SIL), Estenia Opaque Primer, MR. Bond, Super-Bond PZ Primer Liquid A with Liquid B (PZA+PZB), and Super-Bond PZ Primer Liquid B (PZB), or no treatment. Shear bond testing was performed at 0 and 20,000 thermocycles. Post-thermocycling shear bond strengths of ZR-PLU were higher than those of ZR-PRE in CCP, MGP+Act, SIL, PZA+PZB, and PZB groups. Application of silane yielded better durable bond strengths of a layering indirect composite material to a tribochemically silica-coated zirconia framework material.

Effect of various surface preparations on bond strength of a gingiva-colored indirect composite to zirconia framework for implant-supported prostheses.

To evaluate the effects of various surface preparations on shear bond strength of a gingiva-colored indirect composite material and zirconia framework. Zirconia disks were prepared with one of nine surface treatments: hydrofluoric acid etching (HF), heating at 1,000°C for 10 min (HT), wet-grinding with 600- and 1500-grit SiC paper (SiC 600 and 1500), alumina-blasting at 0.1, 0.2, 0.4 and 0.6 MPa (AB 0.1, 0.2, 0.4, and 0.6), and no treatment (NT). An indirect composite material was bonded to zirconia. Shear bond strengths were measured. Bond strength was significantly higher in AB 0.2, 0.4, and 0.6 groups than in other groups at 0 and 20,000 thermocycles. Post-thermocycling bond strength was lower in NT, HF, and HT groups than in other groups. Alumina-blasting with 0.2 MPa or higher yielded sufficient durable bond strength between gingiva-colored indirect composite and zirconia frameworks. Hydrofluoric acid etching and heat treatment did not achieve durable bond strengths.

Effects of framework design and layering material on fracture strength of implant-supported zirconia-based molar crowns.

OBJECTIVES: To evaluate the effects of framework design and layering material on the fracture strength of implant-supported zirconia-based molar crowns. MATERIAL AND METHODS: Sixty-six titanium abutments (GingiHue Post) were tightened onto dental implants (Implant Lab Analog). These abutment-implant complexes were randomly divided into three groups (n = 22) according to the design of the zirconia framework (Katana), namely, uniform-thickness (UNI), anatomic (ANA), and supported anatomic (SUP) designs. The specimens in each design group were further divided into two subgroups (n = 11): zirconia-based all-ceramic restorations (ZAC group) and zirconia-based restorations with an indirect composite material (Estenia C&B) layered onto the zirconia framework (ZIC group). All crowns were cemented on implant abutments, after which the specimens were tested for fracture resistance. The data were analyzed with the Kruskal-Wallis test and the Mann-Whitney U-test with the Bonferroni correction (α = 0.05). RESULTS: The following mean fracture strength values (kN) were obtained in UNI design, ANA design, and SUP design, respectively: Group ZAC, 3.78, 6.01, 6.50 and Group ZIC, 3.15, 5.65, 5.83. In both the ZAC and ZIC groups, fracture strength was significantly lower for the UNI design than the other two framework designs (P = 0.001). Fracture strength did not significantly differ (P > 0.420) between identical framework designs in the ZAC and ZIC groups. CONCLUSIONS: A framework design with standardized layer thickness and adequate support of veneer by zirconia frameworks, as in the ANA and SUP designs, increases fracture resistance in implant-supported zirconia-based restorations under conditions of chewing attrition. Indirect composite material and porcelain perform similarly as layering materials on zirconia frameworks.

In vitro comparison of fracture load of implant-supported, zirconia-based, porcelain- and composite-layered restorations after artificial aging.

This study evaluated fracture load of single-tooth, implant-supported, zirconia-based, porcelain- and indirect composite-layered restorations after artificial aging. Forty-four zirconia-based molar restorations were fabricated on implant abutments and divided into four groups, namely, zirconia-based all-ceramic restorations (ZAC group) and three types of zirconia-based composite-layered restorations (ZIC-P, ZIC-E, and ZIC groups). Before layering an indirect composite material, the zirconia copings in the ZIC-P and ZIC-E groups were primed with Clearfil Photo Bond and Estenia Opaque Primer, respectively. All restorations were cemented on the abutments with glass-ionomer cement and then subjected to thermal cycling and cyclic loading. All specimens survived thermal cycling and cyclic loading. The fracture load of the ZIC-P group (2.72 kN) was not significantly different from that of the ZAC group (3.05 kN). The fracture load of the zirconia-based composite-layered restoration primed with Clearfil Photo Bond (ZIC-P) was comparable to that of the zirconia-based all-ceramic restoration (ZAC) after artificial aging.

Phase-compensated averaging for analyzing electroencephalography and magnetoencephalography epochs.

Stimulus-locked averaging for electroencephalography and/or megnetoencephalography (EEG/MEG) epochs cancels out ongoing spontaneous activities by treating them as noise. However, such spontaneous activities are the object of interest for EEG/MEG researchers who study phase-related phenomena, e.g., long-distance synchronization, phase-reset, and event-related synchronization/desynchronization (ERD/ERS). We propose a complex-weighted averaging method, called phase-compensated averaging, to investigate phase-related phenomena. In this method, any EEG/MEG channel is used as a trigger for averaging by setting the instantaneous phases at the trigger timings to 0 so that cross-channel averages are obtained. First, we evaluated the fundamental characteristics of this method by performing simulations. The results showed that this method could selectively average ongoing spontaneous activity phase-locked in each channel; that is, it evaluates the directional phase-synchronizing relationship between channels. We then analyzed flash evoked potentials. This method clarified the directional phase-synchronizing relationship from the frontal to occipital channels and recovered another piece of information, perhaps regarding the sequence of experiments, which is lost when using only conventional averaging. This method can also be used to reconstruct EEG/MEG time series to visualize long-distance synchronization and phase-reset directly, and on the basis of the potentials, ERS/ERD can be explained as a side effect of phase-reset.