Fiber-reinforced composite fixed dental prostheses: a retrospective clinical examination.

PURPOSE: To obtain survival data on 32 fiber-reinforced fixed dental prostheses which were inserted in our department and to rate the quality of these restorations on the basis of esthetic, biological, and functional parameters. MATERIALS AND METHODS: Thirty-two patients with fiber-reinforced fixed dental prostheses were included in the study. The fiber frameworks were made of a polymer-monomer-preimpregnated continuous unidirectional glass fiber material. The survival times, failure events, and clinical parameters were recorded. Restorations in function without previous failure were classified as "Overall Survival". The classification "Functional Survival" was assigned in the event of minor failure and subsequent repair. Loss of the restoration was regarded as "Failure". The quality rating was performed using modified USHPS/Ryge criteria. RESULTS: The follow-up interval ranged from 2 to 64 months with a median follow-up time of 18.2 months. Twenty-four restorations were classified as "Overall Survival", seven were classified as "Functional Survival", and one was classified as "Failure". The overall survival at the median follow-up time was 74.4%. For the majority, the quality rating (USHPS/Ryge criteria) yielded clinically excellent results in all categories. No restoration was rated as insufficient or poor. CONCLUSION: Fiber-reinforced composite fixed dental prostheses provide sufficient stability and very good esthetic, biological, and functional performance in the case of specific clinical indications.

A prospective clinical study to evaluate the effect of manual and power toothbrushes on pre-existing gingival recessions.

AIM: To evaluate gingival recession changes after six months of brushing with an oscillating-rotating power toothbrush (PT) or an ADA reference manual toothbrush (MT). METHODS AND MATERIALS: Healthy subjects with pre-existing recession were assigned to brush with either a PT (n=55) or an ADA reference MT (n=54) according to a prospective randomized, controlled, single-blind, parallel group design. Participants were asked to brush their teeth twice daily for two minutes each with the same fluoride toothpaste. Clinical attachment loss and probing pocket depths (PPDs) were measured at six sites per tooth to the nearest mm by one calibrated examiner at baseline and after six months. Gingival recession was calculated as the differences between clinical attachment loss and PPDs overall and separately at individual sites. RESULTS: As compared with baseline, overall recession at six months was reduced from 2.35 +/- 0.35 mm to 1.98 +/- 0.55 mm (p<0.001) in the PT group and from 2.26 +/- 0.31 mm to 1.90 +/- 0.45 mm (p<0.001) in the MT group. The data showed 40% (power) and 38% (manual) of all recession sites improved by at least 0.5 mm while 51% and 54% remained unchanged. Eight percent and 7% recessions increased over time. Differences between groups were not statistically significant at either timepoint. CONCLUSION: Both the PT and the MT significantly reduced pre-existing gingival recession after six months of brushing. This may have been due to improved brushing technique (i.e., Hawthorne effect). CLINICAL SIGNIFICANCE: Based on these six-month data, concern that power tooth brushing results in a higher risk for gingival recession is not warranted.

In vitro-cleaning efficacy of interdental brushes with different stiffness and different diameter.

PURPOSE: The aim of this study was to evaluate the cleaning efficacy of interdental brushes with different stiffnesses, e.g. soft and hard interdental brushes with identical brush diameter. MATERIALS AND METHODS: Cylindrical soft and hard interdental brushes with diameters of 2,3 and 5 mm each were tested. Sixteen extracted human molars were fixed in split cast models to simulate eight interdental spaces. After coating the teeth with a dye to simulate plaque, digital photographs were taken from the proximal surfaces in a highly standardised set-up. The teeth were repositioned and the proximal surfaces were cleaned in a standardised manner. Post-brushing digital photographs were taken as before. After digital subtraction, the cleaned area was measured by pixel count and the relative cleaning efficacy was calculated. RESULTS: The cleaning efficacy values of soft and hard interdental brushes of corresponding size in extra-small, small, medium and large interdental spaces as well as overall showed no statistically significant difference. In small, medium and large interdental spaces, increasing brush diameters resulted in higher cleaning efficacy; these differences were statistically significant. Irregular values were seen in extra-small interdental spaces. CONCLUSION: Both hard and soft interdental brushes cleaned the proximal tooth surfaces effectively. The filament stiffness had no statistically significant influence on the cleaning efficacy.

In vitro cleaning efficacy and resistance to insertion test of interdental brushes.

The aim of this study was to compare the resistance to insertion forces and cleaning efficacy values of triangular interdental brushes (TIB) and conventional round interdental brushes (RIB). Extracted human teeth were fixed in a socket and matched to pairs simulating interdental spaces. Before and after standardized cleaning of the proximal surfaces, the pre- and postbrushing situations were registered with a digital camera. The cleaning efficacy was quantified by digital image subtraction. The forces necessary for insertion were measured with a load cell. The ratio between the relative cleaning efficacy and the forces necessary for insertion was calculated. The results of our study revealed that the relative cleaning efficacies of round and TIB were equal. There were no statistically significant differences. TIB showed significantly lower resistance to insertion values. Consequently, at identical resistance to insertion the TIB cleaned more effectively compared with the RIB, which means that the same effectiveness was reached by significantly lower forces at insertion. TIB showed a more favorable ratio between relative cleaning efficacy and resistance to insertion than RIB.