Commercial oral hygiene products and implant collar surfaces: Scanning electron microscopy observations.

Background: The use of medicated mouthwashes and gels in the home care maintenance of dental implants is controversial due to the possibility of residue deposition on the implant collar. The aim of this in vitro study was to analyse, by means of scanning electron microscopy (SEM), the amount of residues on dental implant collars treated with various commercial home dental care products. Methods: Gel and mouthwash products were tested on 10 implants. The gels included sodium fluoride, amine fluoride, and sodium hyaluronate products. The mouthwashes tested contained triclosan, nimesulide, stannous fluoride, amine fluoride, and hexetidine-chlorobutanol. The SEM observations were performed at different magnifications in double modality SE (secondary electrons) and BSE (backscattered electrons) to qualitatively assess any residual products. The image quantitative analysis was performed by Image J® software to assess areas occupied by residuals. All results were analysed by the same researcher with experience in electron microscopy. Results: The fluoride-based gel products left wider areas occupied by residuals than the mouthwash products. In particular the fluoride-based and hyaluronate products left the highest amount of residues. Among mouthwashes, fluoride-based and triclosan products showed the highest amount of residuals deposition. Discussion: Oral hygiene procedures and related professional products are fundamental to the prevention, treatment, and control of microorganisms. In the case of implants, mechanical and chemical plaque control strategies are even more important since the potentially harmful biofilm covers abiotic titanium surfaces. In situ fixture maintenance is crucial for dental implant therapy success. Correct recommendation of home care products for bacterial control is fundamental to the health of implants and their surrounding tissues. Conclusions: Data from this experimental study showed that home care commercial products in gel formulation, especially those containing fluoride, leave more residuals on titanium smooth surfaces than mouthwash products. The longer permanence of the products may lead to a more effective plaque control than other products.

Contexte: L'utilisation de bains de bouche et de gels médicamentés lors des soins d'entretien à domicile des implants dentaires porte à controverse en raison de la possibilité de dépôts de résidus sur le collet de l'implant. La présente étude in vitro visait à analyser par microscopie électronique à balayage (MÉB) la quantité de résidus sur les collets d'implants dentaires traités in vitro avec divers produits commerciaux de soins dentaires à domicile. Méthodologie: Les produits de gels et de bains de bouche ont été testés sur 10 implants. Les gels comprenaient les produits de fluorure de sodium, de fluorure d'amine et de hyaluronate de sodium. Les bains de bouche évalués contenaient du triclosan, de la nimésulide, du fluorure d'étain et du hexétidine-chlorobutanol. Les observations par MÉB ont été effectuées à diverses amplifications en modalité double SE (électrons secondaires) et BSE (électrons rétrodiffusés) pour évaluer de manière qualitative tout produit résiduel. L'analyse quantitative de l'image a été effectuée à l'aide du logiciel Image J® pour évaluer les zones ayant des résidus. Tous les résultats ont été analysés par le même chercheur expérimenté dans le domaine de la microscopie électronique. Résultats: Les produits de gels à base de fluorure ont laissé des résidus sur de plus vastes zones que les produits de bains de bouche. En particulier, les produits à base de fluorure et le hyaluronate ont laissé la plus grande quantité de résidus. Parmi les bains de bouche, les produits à base de fluorure et de triclosan ont révélé la plus grande quantité de dépôts de résidus. Discussion: Les procédures d'hygiène buccodentaire et les produits professionnels qui y sont liés sont essentiels à la prévention, au traitement et au contrôle des microorganismes. En matière d'implants, les stratégies de contrôle mécanique et chimique de la plaque sont encore plus importantes puisque le biofilm potentiellement nocif couvre les surfaces abiotiques du titane. L'entretien in situ du montage est primordial au succès de la thérapie de l'implant dentaire. La bonne recommandation de produits de soins à domicile pour le contrôle des bactéries est essentielle à la santé des implants et des tissus environnants. Conclusions: Les données de cette étude expérimentale ont montré que les produits commerciaux de soins à domicile en formule de gels, surtout ceux contenant du fluorure, laissent une plus grande quantité de résidus sur les surfaces lisses du titane que les produits de bains de bouche. La permanence plus longue des produits peut mener à un contrôle plus efficace de la plaque que d'autres produits.

Morphometric study on single-root premolars in a European population sample: an update on lengths and diameters

External dental root morphology knowledge is fundamental for the implication in periodontal and implant dentistry branches. So far the literature available presents a few and not updated studies regarding this particular topic. The aim of this study is to investigate the morphometry of external gross anatomy of single-rooted premolars, focusing on length and tapering parameters. One hundred seventy four extracted teeth of European origin were used to measure the root length and diameter on the 4 radicular surfaces, starting from the cement- enamel junction to the root apex. Data were statistically analyzed with descriptive measures and any statistical significance (p value <0.05) was evaluated by means of T-student test. The length of the single-root mandibular and maxillary premolars resulted to be higher than those reported in literature. The data regarding the tapering showed a pronounced lowering of the diameter root from the middle point of the root. In addition, the single-rooted premolar showed to own an oval-shaped root characterized, in both arches, by a high variability, confirming the data reported in literature. The present morphometric study providing analytical data regarding the length, the tapering and the high variability of the single-root premolar highlights the need of an accurate knowledge of the root anatomy for a correct therapeutic approach in the daily clinical practice

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Remineralization Strategies in Oral Hygiene: A Position Paper of Italian Society of Oral Hygiene Sciences-S.I.S.I.O. Working Group.

BACKGROUND/OBJECTIVE: The clinical conditions that lead to an alteration of the enamel structure are numerous. The diet high in sugars and acidifying substances, psychological stress that triggers parafunctional behaviors, the reduced intake of fiber-rich foods or alkalizing substances, together with other factors, contribute to demineralization of the tooth enamel. Dental mineralizing products on the current market are distinguished according to the dosage form, the active ingredient, the release technology, clinical indications and patient choice. Currently, it is necessary to propose to oral health professionals a guide to orient themselves in this chaotic choice, in order to prefer the most effective product for their own clinical target. METHODS: Italian Society of Oral Hygiene Sciences-S.I.S.I.O. is one of the leading scientific Italian societies representing those dental hygienists working with high-quality standards and in agreement with scientific evidence: in the last year, the SISIO working group has carried out a study focused on remineralizing agents in dentistry, in order to give an authoritative point of view to indicate a guideline in the decision process of the choice of a remineralizing agent. We will report the results pointed out from the last consensus meeting in 2017. RESULTS: We have reported the good the bad and the ugly have been discussed in a critical discussion of such topic. CONCLUSION: The SISIO experience has been reported in this position paper with the aim to serve as a useful aid in the daily choice of the clinical steps to perform, when dental professionals need to treat demineralized teeth.

Analysis of the root morphology of European anterior teeth.

Aim of this study was to investigate the gross anatomy of the root of European anterior teeth. A review of the dental literature shows that in the past the root morphology was investigated from the inner pulp chamber for endodontic therapies. In order to be admitted to the study, the teeth had to be undamaged. Each tooth was identified by a serial number and gauged by a millimeter tape (for the root length), a goniometer (for the root angle), and a millimeter gauge (for the root diameter). Furthermore, a statistical elaboration of the data was performed to underline the shape variations of the surface around the different sides of the root. At the end of the analysis, 12 parameters for each single-root tooth were described. The study highlights significant differences (p<0.01) only in two teeth of the maxillary arch (central incisor and canine) and in one tooth of the mandibular arch (central incisor). In both cases, the observed differences may be due to the sinuosity of the cement-enamel line. The Tables for each measured parameter were obtained for all examined classes of teeth, but a comparison with literature data was possible only for the "root length" parameter. This study can be considered innovative for the absence, in the scientific literature, of a statistical analysis of all parameters with the exception of the "root length". Moreover, it gives a detailed updating of the data relative to the European population creating a useful tool as well for surgical interventions during periodontal therapy (for example in the choice of the right ultrasonic handpiece) as for new CAD/CAM assisted implant manufacturing techniques.