Fear of the Relapse: Effect of Composite Type on Adhesion Efficacy of Upper and Lower Orthodontic Fixed Retainers: In Vitro Investigation and Randomized Clinical Trial.

The aim of this laboratory and clinical study is to determine the reliability of the flowable nanocomposite Filtek Supreme XTE (FL) for the adhesion of orthodontic retainers, compared to highly filled orthodontic resin Transbond XT (XT). Portions of a round section multistranded wire (Ortosmail Krugg) were bonded to 40 bovine incisors with Scotchbond Universal in total-etch modality. For group one (XT, 20 samples), the orthodontic resin was used, whereas in group two (FL, 20 samples), the flowable one. Specimens were placed into a universal testing machine which applied a shear force on retainers with a crosshead speed of one/minute. Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. In the clinical trial, 100 patients requiring a canine-to-canine palatal and lingual retainer were randomly divided into two groups, according to the resin used for bonding procedure: the orthodontic in group one (XT, 50 participants) and the flowable in group two (FL, 50 participants). Monthly visits were carried out over a 24-month follow up to assess any detachment occurring on teeth of both arches. All data were submitted to statistical analysis. In vitro, FL reported a significant lower mean SBS, whereas no significant differences in ARI were reported between the two groups which both showed a major frequency of scores "1" and "2". At the end of the 24-month follow up, FL reported significantly higher failure rates in both arches besides a significantly lower survival rate starting from the sixth month after retainers bonding. According to the results assessed in vitro and clinically, XT would be preferable to FL when performing retainers bonding procedure.

Computerized Casts for Orthodontic Purpose Using Powder-Free Intraoral Scanners: Accuracy, Execution Time, and Patient Feedback.

INTRODUCTION: Intraoral scanners allow direct images of oral situation, with fewer steps than conventional impressions. The purpose of this study was to compare the accuracy of digital impressions, traditional impressions, and digitalization of full-arch gypsum models, to evaluate timing of different methods and finally to study perception of patients about conventional and digital impression techniques. METHODS: Dental arches of fourteen patients were evaluated by alginate impression, titanium dioxide powder-free intraoral scanning (Trios, 3Shape), and digitalization obtained from gypsum models using the same scanner. Conventional and digital techniques were evaluated through measurements (lower and upper arch anteroposterior length, lower and upper intercanine distance, and lower and upper intermolar distance) with a caliber for analogic models and using a computer software for digital models (Ortho Analyzer, Great Lakes Orthodontics). In addition, chairside and processing times were recorded. Finally, each patient completed a VAS questionnaire to evaluate comfort. Statistical analyses were performed with ANOVA and Tukey tests for accuracy measurements and paired t-test for times and VAS scores. Significance was predetermined at P < 0.05. RESULTS: The measurements obtained with intraoral scanning, gypsum models after conventional impression, and digitalized gypsum models were not significantly different. Both chairside and processing times of digital scanning were shorter than the traditional method. VAS reporting patients comfort were significantly higher when evaluating digital impression. CONCLUSIONS: Intraoral scanners used for orthodontic applications provide useful data in clinical practice, comparable to conventional impression. This technology is more time efficient than traditional impression and comfortable for patients. Further evolution with more accurate and faster scanners could in future replace traditional impression methods.

Biological and physico-chemical properties of new root canal sealers.

BACKGROUND: The purpose of the present study was to compare the biological and the physico-chemical properties of bioceramic-based root canal sealers, calcium hydroxide-based, MTA-based and epoxy resin-based root canal sealers. MATERIAL AND METHODS: Two bioceramic-based sealers, one calcium hydroxide-based sealer, one MTA-based sealer and two epoxy resin-based sealers were tested. RESULTS: EasySeal and MTA Fillapex showed severe citotoxic activity, AH Plus and SealapexTM moderate cytotoxicity, BioRoot™ RCS and TotalFill BC Sealer were both cytocompatible. Except for TotalFill BC Sealer, all root canal sealers caused inhibition zones when tested with E. faecalis. The highest inhibition zone was observed for EasySeal, followed by AH Plus. BioRoot™ RCS, SealapexTM and MTA Fillapex showed the lowest inhibition zone. All the tested materials showed different degree of antibacterial activity by using direct contact test (DCT). The highest values were observed for BioRoot™ RCS, TotalFill BC Sealer and EasySeal, followed by MTA Fillapex and SealapexTM. Except for BioRoot RCS and TotalFill BC Sealer, all the root canal sealers fulfilled the requirements of the ISO 6876 standard, demonstrating a weight loss less than 3%. Bioroot RCS, TotalFill BC Sealer and SealapexTM exhibited high alkaline pH with an increase both for BioRoot™ RCS and TotalFill BC Sealer after 24 hours. CONCLUSIONS: The new bioceramic-based sealers showed acceptable physico-chemical properties, but BioRoot™ RCS and TotalFill BC Sealer seems to be too soluble, not respecting ISO 6876 requirements. Key words:Antibacterial activity, cytoxicity, pH, root canal sealers, solubility.

Buccolingual Inclination Control of Upper Central Incisors of Aligners: A Comparison with Conventional and Self-Ligating Brackets.

OBJECTIVE: The upper incisors torque expression is essential for the orthodontic treatment accuracy. Various orthodontic devices are claimed to have different inclination control capacity. The purpose of this retrospective study was to compare the radiographic buccolingual inclination of upper incisors in patients treated with three different orthodontic techniques. MATERIAL AND METHODS: Conventional brackets (Victory, 3M), self-ligating appliances (Damon Q, Ormco), and aligners (Invisalign, Align Technology) were tested. Cephalometric data of 25 patients with similar skeletal and dental pretreatment parameters were collected for each technique. Position changes of upper central incisors were assessed with radiographic evaluation before and after therapy. Three different parameters were considered: 11∧SnaSnp, 11∧Ocl and I+ TVL. All variables were measured before (T0) and after (T1) treatment and their variation over treatment was assessed. RESULTS: When evaluating angular measurements, 11∧SnaSnp and 11∧Ocl angles showed the highest numeric variation with conventional brackets. Lowest values were reported with aligners. However, the differences among various techniques were not significant for both angles (P>0.05). Also I+ TVL linear value variation did not show significant differences among the different groups tested (P>0.05). CONCLUSION: Conventional multibrackets appliance showed the highest incisal position variations over treatment, but the differences among various groups were not significantly different.

Antibacterial activity of different root canal sealers against Enterococcus faecalis.

BACKGROUND: The aim of the present study was to compare in vitro the antimicrobial activity of different root canal sealers against Enterococcus faecalis, prior and subsequent to setting. MATERIAL AND METHODS: Agar diffusion test (ADT) was used for evaluating the antibacterial activity of non-set sealer while the direct contact test (DCT) was used for after setting. RESULTS: ADT: Except for TotalFill BC Sealer all the others sealers tested showed antibacterial activity. BioRoot™RCS, MTA Fillapex and Sealapex Root Canal Sealer showed the lowest antibacterial activity, a significant increase in antibacterial effect for both Pulp Canal Sealer™ and AH plus sealers were found. Significantly higher were the mean diameters of the bacterial inhibition zone by both EasySeal or N2 sealers. DCT: AH plus and Sealapex Root Canal Sealer doesn't show any bactericidal effect after 6 min of contact. After 15 and 60 min of contact a significant increment for AH plus and for Sealapex Root Canal Sealer of the bactericidal effect was found. Significantly much higher was the antibacterial effect of Sealapex Root Canal Sealer compare to that observed for AH plus. BioRootTMRCS, MTA Fillapex, Pulp Canal Sealer™ and N2 showed at least means of the number of colonies formed in milliliter after 6 min of contact. Except for N2, a significant increase in bactericidal effect after 15 and 60 min for the other compared sealers (BioRootTMRCS, MTA Fillapex and Pulp Canal Sealer™). CONCLUSIONS: For every contact times considered, both TotalFill BC Sealer and EasySeal were bactericidal against E. faecalis and killed all bacteria. Key words:Agar diffusion test, antibacterial activity, direct contact test, Enterococcus faecalis, root canal sealer.

Biological and antibacterial properties of a new silver fiber post: In vitro evaluation.

BACKGROUND: The incorporation of nano silver particles (AgNPs) to improve antibacterial properties of dental materials has become increasingly common. The aim of the present study was to compare the antibacterial activity and cytotoxicity effects of different fiber posts: glass fiber post, quartz fiber post, nano fiber post and silver fiber post. MATERIAL AND METHODS: The antibacterial activity against S. mutans, S. salivarius and S. sanguis was evaluated by using the agar disc diffusion test (ADT). Four wells of 3x2 mm (one for each material) were made with a punch by removing the agar and filled with the materials to be evaluated. The size of the inhibition zone was calculated. An extract was made eluting the posts in cell culture medium using the surface area-to-volume ratio of approximately 1.25cm²/ml between the surface of the samples and the volume of medium. Cell cultures were then exposed to 100 µL of the extracts medium. After 24 h, cell viability was determined using the MTT assay. RESULTS: Silver fiber post was the only material showing a fair antibacterial effect against all the three streptococcal strains. The level of cytotoxicity of all the fiber posts tested was higher than 90% and therefore they were considered not cytotoxic. CONCLUSIONS: The new silver fiber post reported a fair antibacterial activity. On the other hand all the fiber posts tested (including the post with incorporated AgNPs) proved to be biocompatible, suggesting that their application does not represent a threat to human health. Key words:Antibacterial activity, agar disc diffusion test, biocompatibility, fiber post, MTT test.