Efficacy of a new sonic powered toothbrush versus a manual toothbrush in a young population. A randomized cross-over clinical trial.

OBJECTIVE: To compare the effectiveness of dental plaque removal between a new sonic toothbrush and a manual toothbrush. METHODS: In total, 75 healthy dental students participated in this randomized double-blind crossover clinical trial. Subjects were randomly assigned to one of the two groups (manual or sonic toothbrush) and underwent a single toothbrushing exercise. Seven days after, patients were asked to repeat the same procedure with the other toothbrush. Plaque scores were recorded before and after brushing. RESULTS: A significant mean reduction in the full-mouth plaque index was observed after the use of both type of brushes: 46.2% ± 0.28% (p = 0.000) and 50.5% ± 0.24% (p = 0.000) for the manual and sonic toothbrush, respectively. However, there were no statistically significant differences between the two types of brushes (p = 0.277). Regarding plaque reduction on the distinct tooth surfaces, differences between the groups reached statistical significance in favour of the sonic toothbrush only on the buccal sites (p = 0.003). CONCLUSIONS: Both devices lead to similar plaque score reduction after a single tooth brushing.

Fracture Resistance in Non-Vital Teeth: Absence of Interproximal Ferrule and Influence of Preparation Depth in CAD/CAM Endocrown Overlays-An In Vitro Study.

There is ample evidence to support the use of endocrowns to restore endodontic teeth. However, the influence of the position of the interproximal margins on fracture strength has not yet been studied. The aim was to determine the relationship between the apicocoronal position of the interproximal restorative margins and fracture resistance in nonvital teeth restored with CAD/CAM endocrown overlays. Forty extracted human maxillary premolars were prepared for endocrown overlay restorations without ferrule on the interproximal aspects and classified according to the position of the interproximal restoration margins in relation to the alveolar crest: 2 mm (group A), 1 mm (group B), 0.5 mm (group C), and 0 mm (group D). Fracture strength was measured using a universal testing machine applying a compressive force to the longitudinal tooth axis. Group A had a mean fracture resistance of 859.61 (±267.951) N, group B 1053.9 (±333.985) N, group C 1124.6 (±291.172) N, and group D 780.67 (±183.269) N, with statistical differences between groups. Group C had the highest values for fracture strength compared to the other groups (p < 0.05). The location of the interproximal margins appears to influence the fracture resistance of CAD/CAM endocrown overlays. A distance of 0.5 mm between the interproximal margin and the alveolar crest was associated with increased fracture resistance.

Influence of subcrestal implant placement compared with equicrestal position on the peri-implant hard and soft tissues around platform-switched implants: a systematic review and meta-analysis.

AIM: The aim of this article is to systematically review the effect of subcrestal implant placement compared with equicrestal position on hard and soft tissues around dental implants with platform switch. MATERIAL AND METHODS: A manual and electronic search (National Library of Medicine and Cochrane Central Register of Controlled Trials) was performed for animal and human studies published up to December 2016. Primary outcome variable was marginal bone level (MBL) and secondary outcomes were crestal bone level (CBL), soft tissue dimensions (barrier epithelium, connective tissue, and peri-implant mucosa), and changes in the position of soft tissue margin. For primary and secondary outcomes, data reporting mean values and standard deviations of each study were extracted and weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated. RESULTS: A total of 14 publications were included (7 human studies and 7 animal investigations). The results from the meta-analyses have shown that subcrestal implants, when compared with implants placed in an equicrestal position, exhibited less MBL changes (human studies: WMD = - 0.18 mm; 95% CI = - 1.31 to 0.95; P = 0.75; animal studies: WMD = - 0.45 mm; 95% CI = - 0.66 to - 0.24; P < 0.001). Furthermore, the CBL was located at a more coronal position in subcrestal implants with respect to the implant shoulder (WMD = - 1.09 mm; 95% CI = - 1.43 to - 0.75; P < 0.001). The dimensions of the peri-implant mucosa seem to be affected by the positioning of the microgap and were greater at implants placed in a subcrestal position than those inserted equicrestally (WMD = 0.60 mm; 95% CI = 0.26 to 0.95; P < 0.001). While the length of the barrier epithelium was significantly greater in implants placed in a subcrestal position (WMD = 0.39 mm; 95% CI = 0.19 to 0.58; P < 0.001), no statistical significant differences were observed between equicrestal and subcrestal implant positioning for the connective tissue length (WMD = 0.17 mm; 95% CI = - 0.03 to 0.36; P = 0.10). CONCLUSION: This systematic review suggests that PS implants placed in a subcrestal position have less MBL changes when compared with implants placed equicrestally. Furthermore, the location of the microgap seems to have an influence on the dimensions of peri-implant soft tissues. Clinical relevance When compared with PS placed in an equicrestal position, subcrestal implant positioning demonstrated less peri-implant bone remodeling.

Coronally Advanced Flap for Root Coverage: A 2-Year Case Series Follow-up.

The coronally advanced flap (CAF) has demonstrated controversial results in the treatment of gingival recession (GRs). The hypothesis of this study was that the CAF can partially reduce GR values over time. Root coverage (RC) in 24 Miller Class I GRs treated with a CAF by one experienced operator is presented with several periodontal parameters and postoperative morbidity. The mean percentage of RC was 80.35% at 3 months and 58.56% at 24 months; these differences were statistically significant. Keratinized gingival width, keratinized papillary gingival height, and gingival thickness were related to RC at 6 months. Postoperative pain was not statistically different over time. The CAF is not a predictable treatment for Miller Class I GRs after a 2-year follow-up period.