A nouveau collagen scaffold to simplify lateral augmentation of deficient ridges between natural teeth.

The volume of the bone in a site past an extraction degrades significantly and thus it is imperative to evaluate the situation for implant placement. Besides the need for sufficient bone, the amount and quality of the soft tissue covering the bone in the missing tooth area and nature of the adjacent teeth must be carefully assessed. In anterior sites, reconstructive surgery is usually performed to restore these hard and soft tissues, mainly for esthetic reasons, but it is equally essential in posterior sites to ensure adequate functional support. In guided bone regeneration procedures, barrier membranes block the augmented areas, provide and maintain space for regenerative material, and protect the blood clot, allowing a normal wound stability process. Clinicians prefer using resorbable membranes in most cases, whereas a nonresorbable membrane is selected to correct large defects. This report proposes the use of a collagen scaffold as a core material for guided bone regeneration in the case of a missing tooth between two existing teeth, when there is sufficient bone to place an implant but a horizontal defect is present in the crestal ridge. The tested question is whether a thick, reinforced, resorbable collagen scaffold (Ossix Volumax) can provide a stable basis for restoring the lost volume of a deficient ridge. The regeneration procedure presented with the collagen scaffold resulted in restoration of the lost tissue volume and a favorable lifelike emergence profile for the implant-supported crown. This augmentation procedure is simpler to perform in certain cases than existing procedures with bone substitute material and/or an interpositional connective tissue graft harvested from a remote donor site, the harvest of which is not required.

Influence of jaw opening on occlusal vertical dimension between incisors and molars.

STATEMENT OF PROBLEM: Modification of the occlusal vertical dimension (OVD) is a significant procedure in prosthodontics. Improper estimation of the space available between opposing teeth may lead to an improper framework design. PURPOSE: The purpose of this clinical study was to evaluate the average opening ratio in the molar area in relation to the extent of opening in the incisor area. MATERIAL AND METHODS: A total 34 adults with a complete dentition and stable occlusion participated in the study. The change in vertical distance was evaluated in 3 areas: between the maxillary and mandibular central incisors, between the maxillary and mandibular canines, and between the maxillary and mandibular first molars. Digital photographs were made at the intercuspal position (ICP) and at a 2-mm and 8-mm OVD increase. The OVD opening was standardized with the aid of a Woelfel sliding guide device. The measurements were made by recording the distance between the maxillary and mandibular teeth at different openings. For calibration and quantitative evaluation of the photographs, image-processing analysis was used. RESULTS: The collected data showed that the average ratio of the opening between the first molars and the opening between the central incisors was 0.73. The average ratio of the opening between the canines and the opening between the central incisors was 0.95. The values were plotted, and a mathematical model was derived. CONCLUSIONS: A vertical dimension opening of 1 mm between the central incisors resulted in 0.73 mm of occlusal clearance in the first molar region and 0.95 mm in the canines.

Antibacterial Activity of Orthodontic Cement Containing Quaternary Ammonium Polyethylenimine Nanoparticles Adjacent to Orthodontic Brackets.

Enamel demineralization is a common problem found in patients using orthodontic devices, such as orthodontic braces. It was found that Streptoccocus mutans growth increases adjacent to orthodontic devices, which may result in caries development. Incorporated antibacterial quaternary ammonium polyethylenimine (QPEI) nanoparticles were previously shown to be highly efficacious against various bacteria. Combining antibacterial materials in orthodontic cement may be advantageous to prevent bacterial outgrowth adjacent to orthodontic brackets. The aim was to evaluate the efficiency of orthodontic cement containing QPEI nanoparticles in reducing S. mutans and Lactobacillus casei outgrowth adjacent to orthodontic brackets. Orthodontic brackets were bonded to the buccal surfaces of extracted lower incisors. The antibacterial effect on S. mutans and L. casei outgrowth of Neobond bracket adhesive orthodontic cement with and without QPEI nanoparticles was compared. The antibacterial effect was evaluated using crystal violet staining and bacterial count (CFU/mL). The teeth in the experimental group, with the QPEI nanoparticles cement, showed significantly lower optical density (OD) values and CFU counts of S. mutans and L. casei than the teeth in the control group (p < 0.05). Based on the results, it can be concluded that orthodontic cement containing QPEI nanoparticles significantly inhibits S. mutans and L. casei growth around orthodontic brackets.

Prosthetic rehabilitation of congenitally missing canines: a case series.

Hypodontia is a relatively common finding, although rarely are the canines the missing teeth. Congenitally missing canines are challenging to treat because of their unique role in the masticatory system and the fact that they are in the esthetic zone. This article discusses two patients with missing permanent canines, various treatment planning considerations, and the provided prosthetic solutions.

Efficiency and thermal changes during implantoplasty in relation to bur type.

BACKGROUND: Implantoplasty is one of the options in treating peri-implantitis. The efficacy of the dental bur used can reduce the time needed for the procedure and, as a consequence, minimize the risk of overheating that can negatively affect the remaining bone surrounding the implant. PURPOSE: The aim of this study was to evaluate the efficacy of three dental burs in removing implant substance (titanium) and to determine the amount of heat generated by each bur. MATERIALS AND METHODS: Four burs with different surface properties (diamond, diamond - Premium Line, carbide, and smooth bur - control [Strauss Co., Raanana, Israel]) were attached to a high-speed handpiece and applied to a titanium implant for a total of 60 seconds after cooling by water spray. Variations in temperature were recorded every 5 seconds, and the amount of implant substance removed (reduction in weight of the implant) was evaluated. RESULTS: The diamond Premium Line bur removed 59.24 mg; carbide, 29.39 mg; diamond, 11.35 mg; and smooth bur (control) 0.19 mg, statistically significant. Only minimum thermal changes (∼1.5°C) were recorded for all four burs. CONCLUSIONS: There are considerable differences in efficiency of different burs working on titanium. Selecting the proper bur can reduce working time. Under proper cooling conditions, implantoplasty does not generate excess temperature increases that can damage soft tissue or bone surrounding the treated implant.

Existing concepts and a search for evidence: a review on implant occlusion.

The prevalence of dental implant treatment raises the question: What factors may challenge osseointegration? The dental literature presents two main approaches, which are well-documented: loss of bone around the implant due to infection and a presumed association between implant load and bone loss. This article discusses the effect of load or overload on the bone loss around dental implants. The dental literature is reviewed to assess the scientific evidence related to the effect of occlusal load on osseointegration. Recommendations found in the literature for occlusal schemes for implant-supported prostheses are examined and discussed, and statements regarding implant occlusion are assessed for their validity today, after more than four decades of implants service in prosthetic dentistry.

Forced eruption as an alternative to tooth extraction in long-term use of oral bisphosphonates: review, risks and technique.

BACKGROUND: Osteonecrosis of the jaw (ONJ) is a painful condition secondary to bisphosphonate (BP) therapy. It occurs at a much higher rate in patients receiving intravenous (IV) versus oral BP treatment. BPs are prescribed in the treatment of bone diseases such as osteoporosis, multiple myeloma, cancer metastases and Paget disease. Patients' risk of developing ONJ is of concern to medical and dental teams alike and requires open communication between the disciplines. If dental surgery is indicated, it must be performed before commencement of IV BP therapy, and it should be considered for patients receiving oral BP therapy. However, the dental literature pertaining to the two therapeutic modalities stresses the low risk of ONJ's developing in patients receiving oral BP therapy (especially in the early stages) compared with that in patients receiving IV administration. CASE DESCRIPTION: The authors used forced eruption to extrude hemisected hopeless distal roots of first and second mandibular molars from within their alveolar sockets in a patient receiving long-term oral BP therapy. Just before the extraction, they placed orthodontic separating bands around the distal roots to further exfoliate the roots. This so-called bloodless extraction is an alternative treatment for patients at risk of developing ONJ. CLINICAL IMPLICATIONS: The combination of orthodontic extrusion and bloodless extraction is aimed at minimizing trauma and enhancing the health of the surrounding tissues in patients at risk of developing ONJ or when the patient refuses to undergo conventional tooth extraction.

Reinforced composite restoration following trauma to a mandibular tooth: technique and follow-up treatment.

The loss of an entire tooth in the anterior region is accompanied by impairment of esthetics, function, phonetics, and self-esteem. It is common knowledge that treatment with implants during childhood or early adolescence is not an option. Splinting of adjacent teeth during growth and development may interfere with the independent process of teeth realignment and repositioning during that phase of life. Other creative solutions must be offered, such as free-standing composite buildup restorations on compromised broken teeth or single wing/cantilevered restorations adhered to one neighboring tooth during the growth period. The positive effects of reinforced composite materials were researched and presented in the literature. Their use is clearly indicated for interim and economical restorations. Long-term follow-up on a mandibular incisor that experienced trauma, losing its clinical crown and vitality when the patient was 12 years of age, is discussed with all the various aspects of material selection, future considerations, and long-term follow-up to adulthood, when a conventional crown was prepared and delivered.