Analysis of the Pulpal Blood Flow Microdynamics during Prosthetic Tooth Preparation Using Diamond Burs with Different Degrees of Wear.

Pulpal modifications taking place during prosthetic tooth preparation using worn-out burs may represent a risk for the vitality of the dental pulp. The aim of this in vivo study was to evaluate whether the wear of diamond burs has an influence on the vascular microdynamics at the level of the dental pulp, during vertical preparation for zirconia crowns. The study was performed with a split-mouth design and included 32 vital permanent monoradicular teeth (20 maxillary and 12 mandibular), from six subjects, aged between 20 and 50 years. The teeth were randomly assigned to two study groups of 16 teeth each. For prosthetic preparation, new burs were used in the first group, and burs at their 5th use were used in the second group. Four consecutive determinations of the pulpal blood flow by Laser Doppler flowmetry (LDF-laser Doppler MoorLab instrument VMS-LDF2, Moor Instruments Ltd., Axminster, UK) were taken for each tooth included in the study: before the preparation (control values), immediately, at 24 h, and at 7 days after the prosthetic preparation. A four-way ANOVA statistical analysis was applied to analyze the effect of four considered factors (bur wear degree, time of measurement, tooth number, and tooth location) on the pulpal blood flow (PBF). A significant increase in pulpal blood flow compared to the baseline was recorded immediately after preparation (p < 0.01), at 24 h (p < 0.01), and at 7 days (p < 0.05) in both groups, but more pronounced in the case of burs at the 5th use. The blood flow was significantly higher in upper jaw teeth, irrespective of the measurement time. In conclusion, the use of worn-out diamond burs produces lasting modifications in the pulpal blood flow of teeth that undergo prosthetic crown preparation. ISRCTN registry: ISRCTN49594720.

Intaglio surface trueness of dentures bases fabricated with 3D printing vs. conventional workflow: a clinical study.

The latest generation of intraoral scanners can record the prosthetic field with relative ease, high accuracy and comfort for the patient, and have enabled fully digital protocols for designing and manufacturing complete dentures. The present study aims to examine the intaglio surface trueness of 3D printed maxillary dentures produced by fully digital workflow in comparison with dentures produced by analogue clinical and laboratory prosthetic workflow. The edentulous maxillary arch of 15 patients was scanned with an intraoral scanner as well as the intaglio of the delivered conventional denture. The scan of the edentulous arch was imported into a dental design software to produce the denture base which was then 3D printed. The intaglio surface of the finished 3D printed denture bases was digitized and used to assess the trueness of the printed denture bases compared to the intaglio surface of the conventional dentures as well as performing a trueness comparison in relation to the scanned edentulous arches. The dataset (n = 30) was subjected to Kruskal-Wallis test analysis, the significance level being established at α = 0.05. The results of the study showed that the printed group displayed better trueness values with a median of 176.9 µm while the analogue group showed a median of 342 µm. Employing a fully digital workflow to produce 3D-printed denture bases yields a consistent and precise manufacturing method when accounting for the intaglio surface of the denture.

Optical properties of zirconia-reinforced lithium silicate veneers obtained with CAD/CAM milling and hot-pressing techniques: a comparative in vitro study.

Background and aims: Dental veneers have become increasingly required among patients, but little is known about the optical properties of veneers obtained from the same ceramic material through different processing techniques. Methods: In this study we compared the translucency and the opalescence parameters of zirconia-reinforced lithium silicate (ZLS) veneers restorations fabricated through CAD/CAM milling and hot-pressing techniques on the upper central incisor. Eighty specimens divided into 8 groups (n=10) were sectioned (Celtra Duo) and heat pressed (Celtra Press) to obtain 0.8 mm thickness. The optical parameters were calculated from the color difference against different backgrounds. Analysis of variance, one way ANOVA and post-hoc multiple comparison tests were used to evaluate and compare the optical properties of the same material, with a significance level of p < 0.05. Results: The processing method had significant effect on optical parameters. Celtra Duo HT proved to be the material with the highest transparency degree. The hot-pressing technique led to higher opacity than CAD/CAM milling technique. Conclusions: For a bio-mimetic aesthetic prosthetic restoration, the ceramic materials must have the same translucency and opacity as the real tooth. The results of this study revealed that high translucency ZLS obtained through hot pressing technique was the material of choice, as it fulfilled these requirements.

Evaluation of the Pulp Chamber Temperature during Tooth Veneer Preparation Using Burs with Different Degrees of Wear-A Preliminary In Vitro Study.

The heat produced during tooth preparation could be a source of damage for dental pulp, and many variables are involved in this process. The aim of this in vitro study was to evaluate whether the different degrees of wear of the diamond burs significantly influenced the temperature changes in the pulp chamber during tangential veneer preparation. The sample comprised 30 intact permanent monoradicular teeth, randomly assigned to three study groups of 10 teeth each, of which 5 had the pulp tissue preserved and 5 had thermoconductive paste in the pulp chamber. For prosthetic preparation, we used new burs in the first group, burs at their fifth use in the second group, and burs at their eighth use for the third group. The pulp chamber temperature was evaluated at the start, after one minute, and after three minutes of preparation, using a k-type thermocouple. The results of the three-way ANOVA and Tukey post hoc comparisons showed a highly significant effect of the time of measurement, while the pulp condition and the degree of wear of the burs had no effect. In conclusion, the different degrees of wear of conventional diamond burs do not produce statistically significant different changes in the pulp chamber temperature.

Marginal fit of milled versus different 3D-printed materials for provisional fixed dental prostheses: an in vitro comparative study.

Introduction: Provisional dental prostheses are used as interim restorations to help patients perform oral functions between the time of tooth preparation and the placement of the final restoration. A provisional dental prosthesis should protect the abutment from pulpal and gingival aggressions, adapt correctly to keep healthy gingival tissues, be durable, and have a low price. The purpose of this in vitro study was to compare the marginal adaptation of different types of provisional fixed dental prostheses (PFDP), fabricated using 3D printing technology versus the milling (computer-aided manufacturing [CAM]) technique. Method: Two resin teeth (second premolar and second molar) on a typodont were prepared for three-unit provisional fixed dental prostheses. Thirty models were 3D-printed after a digital model was created using an intraoral scanner. Then, 30 provisional fixed dental prostheses (PFDPs) were made from a variety of materials using a digital design of a 3-unit PFDP and STL files delivered to a milling machine and a 3D printer, respectively. Ten PFDP were milled (CAM), and two sets of ten each, were fabricated with 3D printing technology (stereolithography), using two different materials. All restorations were analyzed under a microscope, and marginal gap was then measured using the software Image J. Results: The milled group presented the best marginal gap values (ranging from 86 to 108 µm) and a median value of 93 µm, followed by GC group with (110-251 µm) with a median value of 205 µm and the PR group with median value of 316.5 µm. Conclusion: According to the findings of this in vitro study, the milling (CAM) technique and SLA technology provides acceptable marginal fit values to fabricate provisional fixed partial dentures.

The Influence of Hydrofluoric Acid Temperature and Application Technique on Ceramic Surface Texture and Shear Bond Strength of an Adhesive Cement.

All-ceramic restorations are the foundation of modern esthetic dentistry. Clinical approaches for preparation, durability, aesthetics, and repair have been reformed by the idea of adhesive dentistry. The aim of the study and the objective question was to evaluate the impact of heated hydrofluoric acid pretreatment and the application technique's influence on the surface morphology and roughness of leucite-reinforced glass-ceramic materials (IPS Empress CAD, Ivoclar Vivadent), which is fundamental for understanding the adhesive cementation process. Scanning electron microscopy was used to observe the effectiveness of the two HF (Yellow Porcelain Etch, Cerkamed) application techniques and the HF's temperature impact on the surface topography of the ceramic. Based on surface conditioning methods, the adhesive cement (Panavia V5, Kuraray Noritake Dental Inc., Tokyo, Japan) was applied to the conditioned ceramic samples and light-cured. Shear bond strength values were correlated with the micro-retentive surface texture of the ceramic. With universal testing equipment at a 0.5 mm/min crosshead speed, SBS values between the resin cement and the ceramic material were assessed until failure. Analyzing the fractured surfaces of the specimens by digital microscopy, the failure modes were divided into three categories: adhesive, cohesive, and mixed failure. Analysis of variance (ANOVA) was used to statistically analyze the collected data. The results show that alternative treatment methods affected the material's surface characteristics and have an influence on the shear bond strength.

The Influence of a Novel, Crenelated Design of CAD-CAM Ceramic Veneers on the Debonding Strength.

(1) Background: Aesthetic dentistry has become one of the most dynamic fields in modern dental medicine. Ceramic veneers represent the most appropriate prosthetic restorations for smile enhancement, due to their minimal invasiveness and highly natural appearance. For long-term clinical success, accurate design of both tooth preparation and ceramic veneers is of paramount importance. The aims of this in vitro study were to assess the stress in anterior teeth restored with Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) ceramic veneers and compare the resistance to detachment and the fracture of ceramic veneers prepared using two different designs. (2) Methods: Sixteen lithium disilicate ceramic veneers were designed and milled using the CAD-CAM technology and divided into two groups according to the preparations (n = 8): Group 1, conventional (CO), with linear marginal contour and Group 2, crenelated (CR), the latter with our novel (patented) sinusoidal marginal design. All samples were bonded to anterior natural teeth. The mechanical resistance to detachment and fracture was investigated by applying bending forces on the incisal margin of the veneers in order to determine which type of preparation leads to better adhesion. An analytic method was employed, as well, and the results of the two approaches were compared. (3) Results: The mean values of the maximum force recorded at the veneer detachment were 78.82 ± 16.55 N for the CO group and 90.20 ± 29.81 N for the CR group. The relative increase, equal to 14.43%, demonstrated that the novel CR tooth preparation provided higher adhesive joints. In order to determine the stress distribution within the adhesive layer, a finite element analysis (FEA) was performed. The statistical t-test showed that the mean value of the maximum normal stresses is higher for the CR-type preparations. (4) Conclusions: The patented CR veneers represent a practical solution to augment the adhesion and mechanical properties of ceramic veneers. The obtained results demonstrated that CR adhesive joints triggered higher mechanical and adhesive forces, which subsequently led to a higher resistance to detachment and fracture.

Impact of unilateral removable partial dentures versus removable partial dentures with major connector on oral health-related quality of life of elder patients: a clinical study.

OBJECTIVE: This study aimed to establish the survival rate of unilateral removable partial dentures (u-RPD) comparative with bilateral RPD (bi-RPD) with major connector in elder patients, as well as to determine both their treatment satisfaction and oral health. METHODS: The study sample included 17 patients treated with u-RPD and 17 patients treated with bi-RPD with a major connector. The patients were followed over five years with recalls every 6 months. A 5- points Likert scale was used to determine the satisfaction of the patients. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to evaluate their oral health after each type of administrated treatment. The local oral examined aspects included the maintenance of the abutment teeth periodontal health, the fractures of the removable dentures, the fractures of the connectors, the chipping of the aesthetic material. Kaplan-Meier survival analysis was conducted to evaluate the performance of the two treatments. RESULTS: The mean survival time in years was 4.882 ± 0.114, 95% CI (4.659; 5.106) and 4.882 ± 0.078, 95% CI (4.729; 5.036), for the u-RPD and the bi-RPD, respectively. The five-year survival rates for the two dentures were 94.1% for u-RPD vs. 88.2% for bi-RPD with a major connector, without a statistically significant difference between them (Log-rank test χ2(1) = 0.301, p = 0.584). The patients receiving u-RPD presented significantly higher satisfaction scores compared to the patients receiving bi-RPD, 4.88 ± 0.48 vs. 4.41 ± 0.62, Mann-Whitney U test, p = 0.026. CONCLUSION: Patients receiving u-RPD presented higher levels of treatment satisfaction and better oral health than patients receiving bi-RPD. The survival rates of the treatments u-RPD and bi-RPD were similar.

The Biological Activity of Fragmented Computer-Aided Design/Manufacturing Dental Materials before and after Exposure to Acidic Environment.

Three ceramic and composite computer-aided design/computer-aided manufacturing (CAD/CAM) materials from different manufacturers (Cerasmart (CS)-nanoceramic resin; Straumann Nice (SN)-glass ceramic and Tetric CAD (TC)-composite resin) were tested to investigate the biocompatibility and sustainability on human fibroblasts and keratinocytes cells. Each type of CAD/CAM blocks restorative materials with fine and rough surfaces was exposed to an acidic environment for one month. After that, various powders were obtained by milling. In parallel, powders were also prepared from each restorative material, which were not exposed to the acidic environment. The cytotoxic effects were investigated by means of MTT and LDH assays, as well as nitric oxide production on two human normal cell lines, namely, fibroblasts (BJ) and keratinocytes (HaCaT). In addition, the degree of adhesion of fibroblast cells to each CAD/CAM material was evaluated by scanning electron microscopy (SEM). The results showed that the two samples that were exposed to an acidic environment (CS and SN) induced a reduction of mitochondrial activity and plasma membrane damage as regards the fibroblast cells. A similar effect was observed in TC_fine-exposed material, which seemed to induce necrosis at the tested concentration of 1 mg/mL. No oxidative stress was observed in fibroblasts and keratinocytes treated with the CAD/CAM materials. Regarding the adhesion degree, it was found that the fibroblasts adhere to all the occlusal veneers tested, with the mention that the CS and SN materials have a weaker adhesion with fewer cytoplasmic extensions than TC material. With all of this considered, the CAD/CAM restorative materials tested are biocompatible and represent support for the attachment and dispersion of cells.

Compressive strength evaluation of thin occlusal veneers from different CAD/CAM materials, before and after acidic saliva exposure.

In the present study are depicted valuable observations for practitioners, obtained from an in vitro study which aims to evaluate the compressive strength of occlusal veneers fabricated from 3 type of restorative materials, before and after 1 month of acidic artificial saliva exposure (pH = 2.939). In this context, 90 extracted human molars were prepared to receive computer-aided design/computer-aided manufacturing (CAD/CAM) occlusal veneers. The restorative materials considered in this study were: Cerasmart; Straumann Nice and Tetric CAD. The occlusal veneers were designed, milled and cemented with an adhesive dual-cure resin cement. From all the extracted human molars, only sixty specimens were immersed in acidic artificial saliva, for 1 month, at 37 °C ± 1 °C and part of this specimens were also thermo-cycled, between 5 and 55 °C ± 2 °C, before compressive strength test. The results showed a lower compressive strength for both the samples exposed to acidic artificial saliva as well as for the samples exposed to acidic artificial saliva and thermo-cycled. Scanning electron microscopy (SEM) showed that after compressive strength, all the specimens non-exposed to acidic artificial saliva, present extensive cracks formation at the surface of the restorations, and after exposure to acidic artificial saliva for 1 month, the surface damage was characterized by longitudinal and profound fractures of the restoration, as well as the fracture of the tooth structure. Between CAD/CAM materials tested, nanoceramic resin shows more favorable fracture patterns, both before and after acidic artificial saliva exposure.

Effect of Different Etching Times with Hydrofluoric Acid on the Bond Strength of CAD/CAM Ceramic Material.

The objective of this study was to evaluate the influence of hydrofluoric acid (HF) and conditioning time on the micro-shear bond strength (µSBS) between dual-cure resin cement and glass-ceramic materials, such as lithium disilicate ceramic (IPS e.max CAD, Ivoclar Vivadent) (EX) and leucite-reinforced ceramic (IPS Empress CAD, Ivoclar Vivadent) (EP), and also a hybrid ceramic (Vita Enamic, Vita Zahnfabrik) (VE). Eighteen sections with 1 mm thickness were cut from each CAD/CAM material and randomly divided into three groups, according to the surface etching time (30 s, 60 s, 90 s). The surface treatment was performed using 9.5% HF acid gel, then resin cement was applied on the prepared ceramic plates and light cured. µSBS values between resin cement and the ceramic material were measured with a universal testing machine at a crosshead speed of 0.5 mm/min until the failure occurred. The fractured surfaces of specimens were microscopically evaluated, and failure modes were classified as: adhesive between resin cement and ceramic, cohesive within ceramic or cement and mixed failure. Surface roughness of etched samples was examined using a scanning electron microscope. Obtained data were statistically analysed using one-way analysis of variance (ANOVA) and Bonferroni post hoc test with a level of significance α = 0.05. The results of the statistical methods applied indicate that µSBS mean difference for leucite-reinforced ceramic (EP) was statistically significant (p < 0.05). However, µSBS values for hybrid ceramic (VE) and lithium disilicate ceramic (EX) were not affected, from a statistical point of view, by the conditioning time (p > 0.05).

Assessment of Different Techniques for Adhesive Cementation of All-Ceramic Systems.

Background and Objectives: Modern esthetic dentistry is based on all-ceramic restorations. Dentists still have reservations about using these restorations due to a lack of understanding of the cementation technique, which depends on the type of ceramic used. The aim of the study is to evaluate the approaches and practices of clinicians regarding the adhesive cementation of all-ceramic restorations. Materials and Methods: An online questionnaire regarding the use of all-ceramic restorations and their bonding methods was designed by distinguishing the cementation of oxide and silica-based ceramics. The survey included dentists practicing in Timiș County, Romania. The questionnaire and the evaluation of the answers were designed based on the techniques and evidence from the literature. Results: Considering the work experience, we obtained two groups: group 1-1 to 6 years and group 2-6 to 9+ years. The results revealed significant values when comparing the two groups in the surface protocol and decontamination (p = 0.005), type of cement used (p = 0.002), and isolation techniques (p = 0.002). Conclusions: The results show that many clinicians need additional training to improve their cementing technique and avoid the confusion caused by insufficient information about the interrelationship between the type of ceramic and the cementation procedure.

Scanning Distance Influence on the Intraoral Scanning Accuracy-An In Vitro Study.

Intraoral scanners (IOS) have reached a point where their impact in the dental office cannot be denied. The distance between the tip of the IOS and the preparation may have implications on the accuracy of the digital model. The objective of this study was to evaluate the differences in accuracy between digital impressions in the scenario of different scanning distances. Twenty consecutive scans were performed at five predetermined distances: 5 mm, 10 mm, 15 mm, 20 mm and 23 mm by a single operator. The scanning distance of 10 mm displayed the best accuracy with an overall trueness value of 23.05 µm and precision value of 4.2 µm. The drawn conclusion was that increased scanning distances can decrease the accuracy of a digital impression.

Micro-CT and Microscopy Study of Internal and Marginal Gap to Tooth Surface of Crenelated versus Conventional Dental Indirect Veneers.

Background and Objectives: Ceramic veneers represent the most appropriate treatment option for minimally invasive aesthetic rehabilitation. For long-term clinical success, the accurate marginal and internal adaptation of dental restorations are of paramount importance. The aim of this in vitro study is to assess the effect of a novel (patented) design of veneers compared to conventional ones on their marginal and internal gap to the prepared tooth surface. Materials and Methods: Twenty-four lithium disilicate ceramic veneers are obtained using Computer-Aided-Design (CAD) and then milled using Computer-Aided-Manufacturing (CAM). The samples are divided into two groups: 12 conventional (CO) veneers (i.e., with a linear marginal contour) and 12 crenelated (CR) veneers, the latter with the novel sinusoidal marginal design. All samples are bonded to frontal teeth, and the adhesive interfaces are analyzed using two methods, optical microscopy and micro-Computed Tomography (CT): the former for the accuracy of the marginal gap and the latter for the internal gap (as well as for the homogeneity of the luting cement) of ceramic veneers. Results: STATA and one-way ANOVA tests reveal significant differences between CO and CR veneers: (i) the marginal gap is smaller for CR (64 µm) than for CO veneers (236 µm); (ii) the internal adaptation is better for CR veneers: for a cement width of up to 120 µm, the covered surface for the CR group is 81.5%, while for the CO group it is 64.5%; (iii) the mean of the porosities within the cement is not significantly different (3.4·106 µm3 for CO and 3.9·106 µm3 for CR veneers), with a higher standard deviation for the CO group. Analytical modeling is achieved for internal gaps using the micro-CT results. The characteristic functions obtained allow us to compare the volume of luting cement for the two types of veneers. Conclusion: The novel veneers design produces an improvement in the marginal and internal adaptation of the restorations to the prepared tooth surface. Thus, it provides favorable premises for better clinical performances.

Development and Characterization of Fe3O4@Carbon Nanoparticles and Their Biological Screening Related to Oral Administration.

The current study presents the effect of naked Fe3O4@Carbon nanoparticles obtained by the combustion method on primary human gingival fibroblasts (HGFs) and primary gingival keratinocytes (PGKs)-relevant cell lines of buccal oral mucosa. In this regard, the objectives of this study were as follows: (i) development via combustion method and characterization of nanosized magnetite particles with carbon on their surface, (ii) biocompatibility assessment of the obtained magnetic nanoparticles on HGF and PGK cell lines and (iii) evaluation of possible irritative reaction of Fe3O4@Carbon nanoparticles on the highly vascularized chorioallantoic membrane of a chick embryo. Physicochemical properties of Fe3O4@Carbon nanoparticles were characterized in terms of phase composition, chemical structure, and polymorphic and molecular interactions of the chemical bonds within the nanomaterial, magnetic measurements, ultrastructure, morphology, and elemental composition. The X-ray diffraction analysis revealed the formation of magnetite as phase pure without any other secondary phases, and Raman spectroscopy exhibit that the pre-formed magnetic nanoparticles were covered with carbon film, resulting from the synthesis method employed. Scanning electron microscopy shown that nanoparticles obtained were uniformly distributed, with a nearly spherical shape with sizes at the nanometric level; iron, oxygen, and carbon were the only elements detected. While biological screening of Fe3O4@Carbon nanoparticles revealed no significant cytotoxic potential on the HGF and PGK cell lines, a slight sign of irritation was observed on a limited area on the chorioallantoic membrane of the chick embryo.

Can Dental Office Lighting Intensity Conditions Influence the Accuracy of Intraoral Scanning?

The aim of this study was to evaluate the influence of different settings of ambient light intensity inside the dental office on the accuracy (trueness and precision) of an intraoral scanner (IOS). A full crown preparation was conducted on a resin molar which was scanned using a high resolution extraoral scanner to obtain a reference model. Six light settings were chosen based on the most clinically relevant light conditions inside the workspace, and the preparation was scanned using an intraoral scanner (PlanScan, Planmeca). The obtained data was analyzed using a professional 3D quality control software (Geomagic Control X). There was no statistically relevant difference between the groups when regarding trueness, although a slight influence of the light intensity could be observed on the trueness values. Regarding precision, the best results were obtained in the 3800 lux group, with the other groups presenting close values, excepting the extreme values (400 lux and 11 000 lux) groups that proved to be the most deficient.

Zirconia Minimally Invasive Partial Retainer Fixed Dental Prostheses: Up To Ten Year Follow-Up.

PURPOSE: To assess the survival rate of 3 mol % yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) minimally invasive anterior and posterior single and double partial retainer fixed dental prostheses (PRFDPs). MATERIALS AND METHODS: Twenty-three patients (18 women and 5 men, age range: 20 to 66 years) with single-tooth gaps received 28 3Y-TZP PRFDPs. Eight PRFDPs had two partial retainers and one pontic, two PRFDPs had two partial retainers and one pontic with a mesial cantilever, and 18 PRFDPs had one retainer and one cantilever. The abutment teeth were prepared following specific guidelines for all-ceramic restorations, considering existing direct restorations, carious processes, and occlusal conditions. The restorations were made of 3Y-TZP using CAD/CAM technology. Cementation was performed either conventionally, using resin-modified glass-ionomer (n = 6), or adhesively, using dual-polymerized resin cement (n = 22). Kaplan-Meier survival analysis was conducted. A P value of .05 was considered statistically significant. RESULTS: During the observation period (5.92 ± 1.74 years, minimum = 2 years, maximum = 10 years), three debondings occurred, all in the two-retainer group and the mandible. The survival rates for the two types of intervention were different, with 100% for a single retainer and 70% for a double retainer, but without a significant difference (log-rank test χ2(1) = 0.200, P = .655). CONCLUSION: The 3Y-TZP PRFDPs presented in this study showed no failure when bonded and not conventionally cemented. Therefore, they can be used in cases where implant therapy is not possible or indicated.

Efficacy of PerioTabs, a NitrAdine-based gingiva brushing solution, on periodontally affected patients treated with fixed partial dentures: a randomized controlled study.

Objectives: Recent data show that teeth prepared with horizontal finishing lines supporting crowns and fixed partial dentures present more periodontal disorders than untreated control teeth. Several studies have shown that NitrAdine (bonyf) induces a significant reduction of dental biofilm. The aim of this study was to demonstrate that 10-day use of PerioTabs (bonyf), a NitrAdine-based gingiva brushing solution, is effective in treating gingival inflammation of prosthodontic patients. Method and materials: Forty-nine subjects were instructed to brush their teeth, gingivae, and prostheses with the PerioTabs solution for 10 days (treatment group) and 49 with any toothpaste (control group). The initial and 11-day Plaque Index and Bleeding Index were recorded. A five-point Likert scale was used to evaluate the level of patient satisfaction. The Shapiro-Wilk statistical test was used to compare the results for the two groups. Results: Highly significant differences between the treatment and control group (P < .001) for the Plaque Index and Bleeding Index resulted. The treatment group patients' satisfaction was high: 31 (63.3%) reported the highest level, 5, on the Likert scale, and 18 (36.7%) declared they were satisfied (level 4). Conclusions: The use of a NitrAdine-based gingiva brushing solution (PerioTabs) was effective in reducing the gingival inflammation in periodontally affected patients treated with fixed partial dentures. Clinical relevance: The NitrAdine-based gingiva brushing solution (PerioTabs) was highly accepted by the patients and seems to be a promising alternative to the solutions widely used.

Selective Laser Sintering versus Selective Laser Melting and Computer Aided Design - Computer Aided Manufacturing in Double Crowns Retention.

Purpose This in vitro study aimed at ascertaining the retention forces for telescopic crowns fabricated with Selective Laser Manufacturing (SLM) and Selective Laser Sintering (SLS) additive technologies, and Computer Aided Design - Computer Aided Manufacturing (CAD-CAM) subtractive technology, by using suitable materials for each.Materials and Methods Full-factorial design was employed for experimental testing, considering the following three factors: (a) inner crown material ‒ technology (zirconia ‒ CAD-CAM; metal-alloy ‒ SLS; metal-alloy ‒ SLM); (b) tooth type (canine or molar); (c) wet vs. dry conditions (i.e. either with or without artificial saliva). The roughness of the inner crowns was analyzed through atomic force microscopy. Three-way analysis of variance (ANOVA) was applied for statistical analysis, followed by Tukey's post-hoc comparisons between the crown types.Results The retention force mean values were between 3.8 N (dry, SLM) and 14.8 N (artificial saliva, SLS), with statistically significant (p<0.001) differences between the three types of inner crowns and interaction with the tooth type. No significant interaction was found between crown or tooth types and the wet vs. dry testing conditions. The zirconia crowns' retention force was significantly (p<0.001) higher compared to similar SLM crowns, with 95% CI (3.62; 5.55) N for the differences. Zirconia was significantly (p<0.001) less retentive compared to similar SLS crowns, with 95% CI (-5.99; -4.06) N for the differences. The roughness decrease and subsequent loss of retention force was the largest in zirconia.Conclusions The SLS inner crowns showed the best retention, followed by zirconia and SLM inner crows.