Precision of the milled full-arch framework fabricated using pre-sintered soft alloy: A pilot study.

PURPOSE: This study aimed to evaluate the marginal discrepancy of full-arch frameworks in implant-supported prostheses fabricated using pre-sintered soft alloy (PSA). MATERIALS AND METHODS: Full-arch metal frameworks were fabricated on the edentulous implant model using casting alloy (CA), fully-sintered hard alloy (FHA), and PSA (n = 4 in each group). To evaluate the misfit of the framework to the abutments, the absolute marginal discrepancy (AMD) values of the frameworks were measured in cross-sectional images that had been drawn as part of the triple-scan protocol. The AMD values were compared among the tested alloy groups using the Kruskal-Wallis test, with a post hoc Mann-Whitney U test (α=.05). RESULTS: The FHA and PSA groups showed lower marginal discrepancies than the CA group (P<.001). However, the FHA group did not differ significantly from the PSA group. CONCLUSION: Soft alloy milling is comparable to hard alloy milling, and it is more precise than casting in terms of the marginal fit of implant-supported, full-arch prostheses.

Clinical outcome of immediately and early loaded implants with laser treated surface: a 3-year retrospective study.

PURPOSE: The marginal bone loss of implants with laser treated surface was investigated after six weeks of loading after implant installation to the mandible molar area. MATERIALS AND METHODS: A total of 23 implants were placed in the edentulous molar area of the mandible: 13 implants were immediately loaded and 10 implants were early loaded. The implants used were made of titanium grade 23, screw shaped, 4.2 mm in diameter, and 10 mm in length. Patients were evaluated with resonance frequency analysis at implant fixture installation and 1, 2 (final prosthesis installation), 3, 5, 8, and 14 months later. X-rays were taken at 2 months after fixture installation and 1, 2, 3 years after to measure the marginal bone loss. RESULTS: The mean ISQ value measured at the implant installation was over 70 at all-time points. The average of marginal bone loss was average 0.33 mm. CONCLUSION: Immediate implant loading for laser treated implants would be possible.

Comparison of removal torques between laser-etched and modified sandblasted acid-etched Ti implant surfaces in rabbit tibias.

PURPOSE: The purpose of this study was to analyze the effects of two different implant surface treatments on initial bone connection by comparing the Removal Torque Values (RTQs) at 7 and 10 days after chemically modified, sandblasted, large-grit and acid-etched (modSLA), and Laser-etched (LE) Ti implant placements. MATERIALS AND METHODS: Twenty modSLA and 20 LE implants were installed on the left and right tibias of 20 adult rabbits. RTQs were measured after 7 and 10 days in 10 rabbits each. Scanning electron microscope (SEM) photographs of the two implants were observed by using Quanta FEG 650 from the FEI company (Hillsboro, OR, USA). Analyses of surface elements and components were conducted using energy dispersive spectroscopy (EDS, Horiba, Kyoto, Japan). RESULTS: The mean RTQs were 12.29 ± 0.830 and 12.19 ± 0.713 Ncm after 7 days (P=.928) and 16.47 ± 1.324 and 16.17 ± 1.165 Ncm after 10 days (P=.867) for LE and modSLA, respectively, indicating no significant inter-group differences. Pore sizes in the LE were 40 µm and consisted of numerous small pores, whereas pore sizes in the modSLA were 5 µm. In the EDS analysis, Ti, O, and C were the only three elements found in the LE surfaces. Na, Ca, Cl, and K were also observed in modSLA, in addition to Ti, O, and C. CONCLUSION: The implants showed no significant difference in biomechanical bond strength to bone in early-stage osseointegration. LE implant can be considered an excellent surface treatment method in addition to the modSLA implant and can be applied to the early loading of the prosthesis clinically.

Comparison of Removal Torques for Implants With Hydroxyapatite-Blasted and Sandblasted and Acid-Etched Surfaces.

PURPOSE: Sandblasted and acid-etched (SLA) implants are widely known and used by many practitioners. A resorbable blasting media (RBM) surface is produced by blasting with bioceramic particles. We studied the correlation between the particle sizes of the media and the biomechanical force, evaluating the removal torque of hydroxyapatite-blasted implants. MATERIALS AND METHODS: Commercial SLA implants comprised the control group, and RBM surface-treated implants of the same size and design comprised the experimental group. These implants were installed on both sides of rabbits' tibiae. Four weeks after the implants were installed, the implant removal torque was measured using a digital torque device. The roughness of the implant surface was analyzed using field-emission scanning electron microscopy and confocal laser scanning microscopy. RESULTS: Both groups of surface textures exhibited a regular porosity. The 2 groups exhibited different surface roughness. No significant differences in removal torques were observed between the control and experimental groups. CONCLUSION: There were no significant differences in our measures of osseointegration between hydroxyapatite-blasted and SLA implants.

Comparison of alkaline phosphatase activity of MC3T3-E1 cells cultured on different Ti surfaces: modified sandblasted with large grit and acid-etched (MSLA), laser-treated, and laser and acid-treated Ti surfaces.

PURPOSE: In this study, the aim of this study was to evaluate the effect of implant surface treatment on cell differentiation of osteoblast cells. For this purpose, three surfaces were compared: (1) a modified SLA (MSLA: sand-blasted with large grit, acid-etched, and immersed in 0.9% NaCl), (2) a laser treatment (LT: laser treatment) titanium surface and (3) a laser and acid-treated (LAT: laser treatment, acid-etched) titanium surface. MATERIALS AND METHODS: The MSLA surfaces were considered as the control group, and LT and LAT surfaces as test groups. Alkaline phosphatase expression (ALP) was used to quantify osteoblastic differentiation of MC3T3-E1 cell. Surface roughness was evaluated by a contact profilometer (URFPAK-SV; Mitutoyo, Kawasaki, Japan) and characterized by two parameters: mean roughness (Ra) and maximum peak-to-valley height (Rt). RESULTS: Scanning electron microscope revealed that MSLA (control group) surface was not as rough as LT, LAT surface (test groups). Alkaline phosphatase expression, the measure of osteoblastic differentiation, and total ALP expression by surface-adherent cells were found to be highest at 21 days for all three surfaces tested (P<.05). Furthermore, ALP expression levels of MSLA and LAT surfaces were significantly higher than expression levels of LT surface-adherent cells at 7, 14, and 21 days, respectively (P<.05). However, ALP expression levels between MSLA and LAT surface were equal at 7, 14, and 21 days (P>.05). CONCLUSION: This study suggested that MSLA and LAT surfaces exhibited more favorable environment for osteoblast differentiation when compared with LT surface, the results that are important for implant surface modification studies.

Comparison of removal torques of SLActive® implant and blasted, laser-treated titanium implant in rabbit tibia bone healed with concentrated growth factor application.

PURPOSE: The purpose of this study was to compare the removal torques of a chemically modified SLActive implant and a blasted, laser-treated (BLT) implant, which were soaked in saline for 2 weeks after their surface modifications. The removal torques of the two implants were measured 4 weeks after their implantation into the bone defect area in rabbit tibias with concentrated growth factor (CGF) application. MATERIALS AND METHODS: To make artificial bone defects in the cortical layers of both tibias, an 8-mm diameter trephine bur was used. Then, prepared CGF was applied to the bony defect of the left tibia, and the bony defect of the right tibia was left unfilled. Four weeks later, the surgical sites of 16 rabbits were re-exposed. For 8 rabbits, the SLActive implants (Straumann, Switzerland) were inserted in the left tibia, and the BLT implants (CSM implant, Daegu, Korea) were inserted in the right tibia. For other rabbits, the BLT implants were inserted in the left tibia, and the SLActive implants were inserted in the right. Four weeks afger the insertion, torque removal was measured from 4 rabbits exterminated via CO2 inhalation. RESULTS: No significant difference was observed between removal torques of the BLT implant and the SLActive implant (P>.05). CONCLUSION: It was found that BLT surface modification exhibited excellent osseointegration. In addition, CGF application did not affect the insertion and removal torque of the implants.

Biomechanical evaluation of laser-etched Ti implant surfaces vs. chemically modified SLA Ti implant surfaces: Removal torque and resonance frequency analysis in rabbit tibias.

PURPOSE: To compare osseointegration and implant stability of two types of laser-etched (LE) Ti implants with a chemically-modified, sandblasted, large-grit and acid-etched (SLA) Ti implant (SLActive(®), Straumann, Basel, Switzerland), by evaluating removal torque and resonance frequency between the implant surface and rabbit tibia bones. We used conventional LE Ti implants (conventional LE implant, CSM implant, Daegu, Korea) and LE Ti implants that had been chemically activated with 0.9% NaCl solution (LE active implant) for comparison with SLActive(®) implants MATERIALS AND METHODS: Two types of 3.3×8mm laser-etched Ti implants - conventional LE implants and LE active implants were prepared. LE implants and SLActive(®) implants were installed on the left and right tibias of 10 adult rabbits weighing approximately 3.0kg LE active implants and SLActive(®) implants were installed on the left and right tibias of 11 adult rabbits. After installation, we measured insertion torque (ITQ) and resonance frequency (ISQ). Three weeks (LE active) or 4 weeks (conventional LE) after installation, we measured removal torque (RTQ) and ISQ. RESULTS: In the conventional LE experiment, the mean ITQ was 16.99±6.35Ncm for conventional LE implants and 16.11±7.36Ncm for SLActive(®) implants (p=0.778>0.05). After 4 weeks, the mean of RTQ was 39.49±17.3Ncm for LE and 42.27±20.5Ncm for SLActive(®) (p=0.747>0.05). Right after insertion of the implants, the mean ISQ was 74.8±4.98 for conventional LE and 70.1±9.15 for SLActive(®) implants (p=0.169>0.05). After 4 weeks, the mean ISQ was 64.40±6.95 for LE and 67.70±9.83 for SLActive(®) (p=0.397>0.05). In the LE active experiment, the mean ITQ was 16.24±7.49Ncm for LE active implants and 14.33±5.06Ncm for SLActive(®) implants (p=0.491>0.05). After 3 weeks, the mean RTQ was 39.25±16.41Ncm for LE active and 41.56±10.41Ncm for SLActive(®) implants (p=0.698>0.05). Right after insertion of the implants, the mean ISQ was 58.64±10.51 for LE active implants and 53.82±15.36 for SLActive(®) implants (p=0.401>0.05). After 3 weeks, the mean ISQ was 63.82±5.88 for LE active and 66.27±6.53 for SLActive(®) (p=0.365>0.05). CONCLUSION: We observed no significant differences in biomechanical bond strength to bone or implant stability in bone between the conventional LE Ti implant surface and the surface of the SLActive(®) implant or between the chemically activated LE Ti implant surface and the surface of the SLActive(®) implant during the early stage of osseointegration.

The Use of Telescopic Crowns in Removable Partial Denture Treatment for Patients with Severe Periodontal Disease: Two Patient Case History Reports.

Two patient case histories are described as examples of treatment of severe periodontitis in severely compromised partial dentitions. Management consisted of periodontal treatment and telescopic crown support for removable partial dentures with friction pin retention.

Two-body wear comparison of zirconia crown, gold crown, and enamel against zirconia.

PROBLEM STATEMENT: Full zirconia crowns have recently been used for dental restorations because of their mechanical properties. However, there is little information about their wear characteristics against enamel, gold, and full zirconia crowns. PURPOSE: The purpose of this study was to compare the wear rate of enamel, gold crowns, and zirconia crowns against zirconia blocks using an in vitro wear test. MATERIALS AND METHODS: Upper specimens were divided into three groups: 10 enamels (group 1), 10 gold crowns (group 2, Type III gold), and 10 zirconia crowns (group 3, Prettau(®)Zirkon 9H, Zirkonzahn, Italy). Each of these specimens was wear tested against a zirconia block (40×30×3mm(3)) as a lower specimen (30 total zirconia blocks). Each specimen of the groups was abraded against the zirconia block for 600 cycles at 1Hz with 15mm front-to-back movement on an abrading machine. Moreover, the load applied during the abrading test was 50N, and the test was performed in a normal saline emulsion for 10min. Three-dimensional images were taken before and after the test, and the statistical analysis was performed using the Krushal-Wallis test and Mann-Whitney test (p=0.05). RESULTS: The mean volume loss of group 1 was 0.47mm(3), while that of group 2 and group 3 was 0.01mm(3). CONCLUSION: The wear volume loss of enamels against zirconia was higher than that of gold and zirconia crowns. Moreover, according to this result, zirconia crowns are not recommended for heavy bruxers.

The overuse of the implant motor: effect on the output torque in overloading condition.

BACKGROUND: The overloading of the motor affects its performance. The output torque of the implant motor under overloading condition has not been reported. PURPOSE: The purpose of this study was to determine the reliability and the tendency of the output torque when an implant motor is consecutively used. MATERIALS AND METHODS: Three implant motors were evaluated: SurgicXT/X-SG20L (NSK), INTRAsurg300/CL3-09 (KaVo), and XIP10/CRB26LX (Saeshin). The output torque was measured using an electronic torque gauge fixed with jigs. For the 40 and 50 Ncm torque settings, 300 measurements were taken at 30 rpm. Repeated measures of analysis of variance (ANOVA) and one-way ANOVA were used to compare the torque values within each group and between the groups. RESULTS: As repeating measures, the output torque values decreased gradually compared with the baseline. In within-group analysis, the different torque value from the first measurement appeared earliest in NSK motor, followed in order by Saeshin and KaVo motors. NSK motor showed a different torque decrease between 40 and 50 Ncm settings (p < .05). Intergroup analysis revealed Saeshin motor to have the least deviation from the baseline, followed by KaVo motor. NSK motor had the most inconsistent torque at the 6, 8, 9, and 10 repeat counts (p < .05). CONCLUSION: The actual torque decreases when the surgical motor is continuously used. The NSK motor showed more significant decreases in torque than KaVo and Saeshin motors in overloading condition.

Comparison of removal torques between laser-treated and SLA-treated implant surfaces in rabbit tibiae.

PURPOSE: The purpose of this study was to compare removal torques and surface topography between laser treated and sandblasted, large-grit, acid-etched (SLA) treated implants. MATERIALS AND METHODS: Laser-treated implants (experimental group) and SLA-treated implants (control group) 8 mm in length and 3.4 mm in diameter were inserted into both sides of the tibiae of 12 rabbits. Surface analysis was accomplished using a field emission scanning electron microscope (FE-SEM; Hitachi S-4800; Japan) under ×25, ×150 and ×1,000 magnification. Surface components were analyzed using energy dispersive spectroscopy (EDS). Rabbits were sacrificed after a 6-week healing period. The removal torque was measured using the MGT-12 digital torque meter (Mark-10 Co., Copiague, NY, USA). RESULTS: In the experimental group, the surface analysis showed uniform porous structures under ×25, ×150 and ×1,000 magnification. Pore sizes in the experimental group were 20-40 mm and consisted of numerous small pores, whereas pore sizes in the control group were 0.5-2.0 mm. EDS analysis showed no significant difference between the two groups. The mean removal torque in the laser-treated and the SLA-treated implant groups were 79.4 Ncm (SD = 20.4; range 34.6-104.3 Ncm) and 52.7 Ncm (SD = 17.2; range 18.7-73.8 Ncm), respectively. The removal torque in the laser-treated surface implant group was significantly higher than that in the control group (P=.004). CONCLUSION: In this study, removal torque values were significantly higher for laser-treated surface implants than for SLA-treated surface implants.

The bone integration effects of platelet-rich fibrin by removal torque of titanium screw in rabbit tibia.

Platelet-rich fibrin (PRF) is nowadays often used in various fields, but no removal torque studies have yet been done to evaluate the effects of the platelet-rich fibrin on the bone integration at the initial healing period. An experimental study have been performed in rabbits to evaluate whether the complete PRF clots can accelerate the bone integration of implants at the initial healing period after creating bone defects in tibias. The effect of the complete PRF clots on bone integration was studied in two rabbit groups, 4-week group (group A) and 6-week group (group B) after preparing bony defects. Artificial bony defects were prepared in the tibias of rabbits. The complete PRF clots was applied to the defects in the experimental group, whereas the defects were unfilled in the control group. Four weeks later, machined implants were installed into the rabbit tibias (group A). Six weeks after installation, the removal torque from nine rabbits was measured to examine the bone healing effect of PRF. In another rabbits (group B), 6 weeks after preparing bony defects, installation was performed, and another 6 weeks after installation, the removal torque from nine rabbits was measured. The authors found a positive significant effect of the complete PRF clots on bone integration (higher bone density) in group A installed at 4 weeks after preparing bony defects (p = 0.008; t-test), but not in group B installed at 6 weeks after preparing bony defects (p = 0.677).

The influence of systemically administered oxytocin on the implant-bone interface area: an experimental study in the rabbit.

PURPOSE: The purpose of this study was to assess the effect of systemically administered oxytocin (OT) on the implant-bone interface by using histomorphometric analysis and the removal torque test. MATERIALS AND METHODS: A total of 10 adult, New Zealand white, female rabbits were used in this experiment. We placed 2 implants (CSM; CSM Implant, Daegu, South Korea) in each distal femoral metaphysis on both the right and left sides; the implants on both sides were placed 10 mm apart. In each rabbit, 1 implant was prepared for histomorphometric analysis and the other 3 were prepared for the removal torque test (RT). The animals received intramuscular injections of either saline (control group; 0.15 M NaCl) or OT (experimental group; 200 µg/rabbit). The injections were initiated on Day 3 following the implant surgery and were continued for 4 subsequent weeks; the injections were administered twice per day (at a 12-h interval), for 2 days per week. RESULTS: While no statistically significant difference was observed between the two groups (P=.787), the control group had stronger removal torque values. The serum OT concentration (ELISA value) was higher in the OT-treated group, although no statistically significant difference was found. Further, the histomorphometric parameter (bone-toimplant contact [BIC], inter-thread bone, and peri-implant bone) values were higher in the experimental group, but the differences were not significant. CONCLUSION: We postulate that OT supplementation via intramuscular injection weakly contributes to the bone response at the implant-bone interface in rabbits. Therefore, higher concentrations or more frequent administration of OT may be required for a greater bone response to the implant. Further studies analyzing these aspects are needed.

Comparison of osseointegration between laser-etched and magnesium-incorporated oxidized implants in the rabbit femur.

PURPOSE: To compare the osseointegration of a laser-etched (LE) implant with a magnesium-incorporated oxidized (MgO) implant, evaluating their ability to enhance the bond strength between a titanium substrate and rabbit femur. MATERIALS AND METHODS: Two type of dental implants, LE (test, commercially pure [CP] titanium grade 4) and MgO (control, CP titanium grade 4) (length, 8 mm; diameter, 3.3 mm), were evaluated for the surface characteristics using a field emission scanning electron microscope (FE-SEM), an energy dispersive spectrometer (EDS), and an optical three-dimensional profiling system. After that, two types of dental implants were implanted at the right and left distal femoral metaphysis of 10 adult rabbits weighing approximately 3.0 kg. After 6 weeks, histomorphometric analysis, removal torque tests, and surface analysis of the torque-tested implants were performed. RESULTS: After surgery, the LE group showed thick bonelike materials within the pores observed using FE-SEM (magnifications ×500 and ×900). The mean removal torque was 40.72 ± 13.3 Ncm for the test (LE) implant and 22.26 ± 6.4 Ncm for the control (MgO) implant, respectively (P = .041). The mean bone-implant contact in the three best consecutive threads in the cortical region was 63.35% ± 16.44% in the LE group and 51.63% ± 5.09% in the MgO. CONCLUSIONS: In the beginning stage of cancellous bone healing, biomechanical properties of the LE implant could influence a more favorable bone response than that of MgO.

Comparison of removal torques for laser-treated titanium implants with anodized implants.

PURPOSE: It is difficult to draw any firm conclusions regarding possible differences in implant surface performance in a clinical situation. The purpose of this study was to compare the removal torques of laser-treated (LT) surface of dental implants with TiUnite, which has porous rough anodized surface, evaluating their ability to enhance the bond strength between a titanium substrate and rabbit femur. METHOD: Two types of dental implants, LT (test, CP titanium grade 4) and commercial porous TiUnite (control, CP titanium grade 4) implants (length, 7 mm; diameter, 3.75 mm) were implanted on the right and left distal femoral metaphyses of 5 adult rabbits weighing 3.0 to 4.0 kg. After 8 weeks, removal torque was measured using a digital torque gauge. RESULTS: The mean (SD) removal torque was 32.83 (6.15) and 48.59 (8.07) N · cm for the control (anodized) and test (LT) screws, respectively. P = 0.0133 by paired t-test. CONCLUSIONS: The removal torque of the LT titanium implant embedded in rabbit femoral metaphysis for 8 weeks was stronger than that of the anodized titanium implant.

New bone formation following sinus membrane elevation without bone grafting: histologic findings in humans.

PURPOSE: To determine whether sinus membrane elevation alone can lead to new bone formation on the maxillary sinus floor. MATERIALS AND METHODS: Among patients who were to receive implant treatment, those who had 4 to 5 mm of bone height in the maxillary sinus floor (as measured radiographically) were selected as candidates for sinus membrane elevation. The lateral sinus wall was exposed through a buccal mucoperiosteal incision. The sinus membrane was elevated through a bone window, and the space underneath the membrane was filled with absorbable collagen sponge (Collaplug). In the presence of blood in the space, the collagen sponge was left to soak up the blood; in the deficiency of blood, the sponge was saturated with venous blood drawn from the brachial vein. The mucoperiosteal flap was repositioned and closed with interrupted silk sutures. The sinus was left to heal for 6 months. Core specimens of the maxillary sinus floor were obtained using a trephine bur at 6 months after sinus elevation in patients treated between January 2006 and June 2009. The trephined sites were used for implant placement. The biopsy specimens were analyzed histologically to identify the presence and amount of new bone tissue. RESULTS: Thirteen specimens from eight patients were included in the study. Microscopically, 11 specimens exhibited no recognizable new bone tissue. Two specimens exhibited a small amount of woven bone on the surface of the sinus floor. CONCLUSION: Within the limits of this study of eight patients, little to no new bone formation was observed on the maxillary sinus floor at 6 months following sinus membrane elevation and support with blood-soaked collagen sponges.

Retrospective chart analysis on survival rate of fixtures installed at the tuberosity bone for cases with missing unilateral upper molars: a study of 7 cases.

PURPOSE: To evaluate the survival rate of implants placed in the maxillary tuberosity region using the fixed prosthesis in partially edentulous cases. MATERIALS AND METHODS: Of implant-treated patients who visited Kyung Pook National University Hospital, 7 partially edentulous patients (2 male and 5 female; mean age, 52.3 years; range, approximately 43 to 65) were selected according to the following criteria: 1) less than 3-mm thickness alveolar bone reaming at the first molar area and 2) 1 to 2 fixture premolars, with the additional implant at the maxillary tuberosity region. For the control group, patients who had nontuberosity areas were selected. After 1 to 7 years, marginal bone level, fixture mobility, and radiolucency of tuberosity fixtures of the fixed prostheses were evaluated by digital panorama (Starpacs, Infinitt, Seoul, Korea). RESULTS: None of the fixtures of the tuberosity-installed implants for 1 to 7 years failed. The marginal bone level around the implants of the maxillary tuberosity 1 to 6 years (average 3.4 years) after the final prostheses was approximately 0.6 to 1.3 mm, with an average of 0.94 mm. CONCLUSION: The fixture installation at the maxillary tuberosity using the unilateral partially edentulous implant-fixed prosthesis would be a clinically acceptable treatment module.

The effects of laser etching on shear bond strength at the titanium ceramic interface.

STATEMENT OF PROBLEM: The use of titanium has increased for metal ceramic restorations, as well as for use in titanium implants, with developments in CAD/CAM technology. Some surface treatments of titanium have been introduced to enhance the titanium bond strength to low-fusing porcelains; however, a more reliable, easily used dental laboratory method has not been established. PURPOSE: The purpose of this study was to compare the effect of laser etching as a titanium surface treatment with 3 other surface treatments (machining, airborne-particle abrasion, and acid etching), evaluating their ability to enhance the bond strength between a titanium substrate and porcelain. MATERIAL AND METHODS: A total of 64 specimen rods of commercially pure titanium (ASTM grade 2, 20 mm in length and 5.7 mm in diameter) were divided into 4 experimental groups (n=16) to receive different surface treatments: machined with no treatment (MS), airborne-particle abraded with alumina particles (250 microm) (APAS), acid etched with 10% HCl (AES), and laser etched (LES) using a neodymium-doped yttrium aluminum garnet laser (Nd:Y(3)AL(5)O(12), or Nd/YAG). Low-fusing porcelain (Triceram) was applied (4-mm thickness) to the treated titanium surfaces and fired. Shear bond strength testing was performed in a universal testing machine. All of the data were compared using 1-way ANOVA and the post hoc multiple range Tukey test (alpha=.05). Measurement of roughness (Ra value) and SEM analysis were also performed for 1 specimen of each group before and after the shear bond strength test to evaluate the nature of the fracture surface. RESULTS: Shear bond strength values for the APAS group (22.22 (4.04) MPa) and the LES group (21.22 (3.41) MPa) were significantly greater (P<.05) than for the MS group (13.76 (3.16) MPa) and the AES group (14.98 (3.26) MPa). The SEM image after debonding of MS and AES showed porcelain retained on the surface. However, there was no difference in appearance between the APAS and LES before and after debonding. CONCLUSIONS: Laser etching of titanium surfaces using an Nd/YAG laser was effective in improving bond strength with low-fusing porcelain, as compared to the acid-etching method. However, there was no significant difference between laser etching and airborne-particle-abrasion surface treatment.

Surface change of dental amalgam after treatment with 10% carbamide peroxide.

The aim of this study was to explore the effect of bleaching agents on the release of metal ions and change in physical and chemical characteristics of amalgams. Amalgam surface changes resulting from bleaching on amalgam were assessed with inductively coupled plasma atomic emission spectrophotometer, an automatic mercury analyzer, a colorimeter, and atomic force microscopy. Analysis of the release of metal ions indicated that the bleaching agent caused more copper, tin, and mercury ions to be released into the immersion solution. Furthermore, metal ion release increased progressively as immersion time was increased from 42 to 84 hours. Morphological examination revealed no significant effects of the 10% carbamide peroxide bleaching agent on the surface morphology of any of the amalgams tested. These results demonstrated that bleaching using 10% carbamide peroxide did not adversely affect the two types of amalgam tested. In other words, a 10% carbamide peroxide bleaching agent can be safely used on a short-term basis in dentist-monitored bleaching of the dental amalgam.