Evaluating the color stability of temporary crowns fabricated by 3-dimensional printing and manual methods.

This in vitro study aimed to compare the color stability of temporary crowns fabricated by 3-dimensional (3D) printing with that of crowns fabricated with 2 manual methods. An impression was made of a prepared central incisor, from which 90 dies were fabricated. The dies were randomly assigned to 3 groups (n = 30) based on crown fabrication method: 3D printing, automix bis-acryl resin, or powder-and-liquid polymethyl methacrylate. All specimens were immersed in a coffee, soft drink, or distilled water solution for 1 week (n = 10 per subgroup). Color change was measured using a spectrophotometer and the International Commission on Illumination's CIE L*a*b* method, and the values were converted to the National Bureau of Standards (NBS) index for assessment and comparison. When color change was assessed according to fabrication method, the highest (mean [SD]) ΔE* value was reported for the automix specimens (3.39 [2.86]), and the lowest was recorded for the powder-and-liquid specimens (2.05 [2.33]) (P < 0.05; Kruskal-Wallis test). The difference between ΔE* values of the 3D printing group (2.46 [1.75]) and the powder-and-liquid group was not statistically significant. When color change was assessed according to the immersion solution, the coffee solution showed a significantly higher (mean [SD]) ΔE* value (5.04 [2.67]) than the soft drink (1.43 [0.92]) and distilled water (3.41 [7.93]) solutions (P < 0.05; Kruskal-Wallis test). The color changes associated with the 3 methods were statistically equal in terms of the NBS index ranges, most frequently falling in the range of very minor to acceptable change. The powder-and-liquid method seems to be most suitable for fabricating temporary prostheses for long-term use.

Stress distribution pattern in all-on-four maxillary restorations supported by porous tantalum and solid titanium implants using three-dimensional finite element analysis.

Success/failure of dental implants depends on stress transfer and distribution at the bone-implant interface. This study aimed to assess the stress distribution pattern in all-on-four maxillary restorations supported by porous tantalum and solid titanium implants using three-dimensional (3D) finite element analysis (FEA). In this FEA, a geometric model of an edentulous maxilla, Zimmer screw-vent tantalum and solid titanium implants were modelled. Four models with the all-on-four concept were designed. The fifth model had 6 vertical implants (all-on-six). Two different implant types (porous tantalum and solid titanium) were modelled to yield a total of 10 models, and subjected to 200 N bilateral vertical load. Pattern of stress distribution and maximum von Mises stress values in cancellous and cortical bones around implants were analysed. In tantalum models, the effect of increasing the distal tilting of posterior implants was comparable to the effect of increasing the number of implants to 6 on von Mises stress values in cortical bone. However, in cancellous bone, the effect of increasing the tilting of posterior implants on stress was slightly greater than the effect of increasing the number of implants to 6. In solid titanium models, the effect of both of the abovementioned parameters was comparable on stress in cancellous bone; but in cortical bone, the effect of increasing the implant number was slightly greater on stress reduction. Despite similar pattern of stress distribution in bone around implants, higher maximum von Mises stress values around tantalum implants indicate higher stress transfer capacity of this type of implant to the adjacent bone, compared with solid titanium implants.

Compressive Strength of Temporary Crowns Made from Default design in Two Types of Software.

Statement of the Problem: Various default values in each software can eventually lead to different crown thicknesses and affect their compressive strength. Purpose: This study aimed to compare the compressive strength of temporary crowns made with the milling machine, designed in Exocad and 3Shape Dental System software. Materials and Method: In this in vitro study, 90 temporary crowns were made and evaluated based on each software settings. For this purpose, a sound premolar was first scanned as a pre-operative model by 3Shape laboratory scanner. The standard tooth preparation and scanning were performed, and then the temporary crown files (designed by each software) were transferred to the Imesicore 350i milling machine. A total of 90 temporary crowns (45 based on the file of each software) were made using poly methyl methacrylate (PMMA) vita cad-temp block. The value of compressive force displayed on the monitor was recorded at the first crack and the ultimate failure of the crown. Results: The first crack and the ultimate strength of crowns designed with the Exocad software was 903.5±96N and 1490±139.3N and for crowns designed with 3Shape Dental System software was 1060.4±160.2N and 1691.1±73.9N, respectively. The amount of compressive strength of temporary crowns made with 3Shape Dental System was significantly higher than those made with Exocad software and this difference was statistically significant(p= 0.000). Conclusion: The compressive strength of temporary dental crowns made by both softwares is in a clinically acceptable range, but considering that the average compressive strength in the 3Shape Dental System group was slightly higher than of the other group, it is preferable to design and fabricate with 3Shape Dental System software to increase the compressive strength of these crowns.

The Comparison of Color Stability of Aloe Vera Gel and Chlorhexidine Solution on Acrylic Teeth.

Background: There is insufficient knowledge about aloe vera color change property on acrylic teeth compared to other denture cleaners, especially chlorhexidine solution (CHX). Objective: The present study aimed to compare the color change property of the aloe vera and chlorhexidine solution on denture acrylic teeth. Methods: This study was experimental in vitro study design conducted in the dental laboratory of Tabriz University of Medical Sciences, Iran, 2021. The sample size in each group was 21 acrylic teeth which were randomly divided into aloe vera gel 100% and chlorhexidine solution 2% groups. Tooth colors were measured by a spectrophotometer (Spectro Shade Micro, MHT S.P.A., Milan, Italy). The immersion time in both groups was 36 hours. Data analyzed using an independent t-test was used at a 95% of confidence level. Results: The comparison of the total color differences (ΔE) between the two groups was not statistically significant after 36 hours of immersion (P=0.440). In the chlorhexidine group, the brightness of teeth was lower than that in the aloe vera group (P=0.002). Conclusions: Clinicians should be aware that aloe vera gel does not change the color of denture acrylic teeth after 36 hours of immersion similar to the chlorhexidine solution. For patients who cannot use chlorhexidine, aloe vera gel is a good cleaner for denture acrylic teeth without worrying about the color change of the denture. It can be considered an acceptable cleaner for denture acrylic teeth.

Comparison of the maximum hand-generated torque by professors and postgraduate dental students for tightening the abutment screws of dental implants.

Background. Dental implants are utilized with an ever-increasing rate. One of the causes of abutment screw loosening has been identified as inadequate preload. The objective behind this study was to compare the maximum hand-generated torque for tightening abutment screws by professors and postgraduate dental students using a digital torquemeter with 0.1 N/cm precision. Methods. In a laboratory study conducted in Dental Implant Department of Faculty of Dentistry, Tabriz University of Medical Sciences, the maximum hand-generated torque for tightening abutment screws by professors and postgraduate dental students was investigated, using a digital torquemeter with 0.1 N/cm precision. Results. The participants consisted of 36 (41.9%) females and 50 (58.1%) males, totaling 86 participants, of whom 45 (46.87%) and 41 (53.13%) were university professors and postgraduate dental students, respectively. The mean age of the participants was 33.4±10.2 years with an age range of 25‒60 years; 50 (58.1%) participants were in the 25‒34-year, 23 (26.7%) in the 35‒47-year, and 13 (15.1%) in the 48‒60-year age range. The mean age of professors and postgraduate dental students was 41±8.3 and 25.1±3.3 years, respectively. The means of maximum torques generated by female and male professors were 14.3±3 and 20.8±4.2, respectively. The means of maximum torques generated by female and male postgraduate dental students were 14.7±3.4 and 18.7±4.3, respectively. Statistical analyses showed no significant differences between the mean maximum torques generated by professors and postgraduate dental students (P=0.051). Conclusion. In the present study, the mean maximum torque generated by professors was higher than that generated by postgraduate dental students. However, the difference was not statistically significant. The mean maximum torque generated by male subjects was significantly higher. No interaction was seen between the studied groups and sex. However, there was a statistically significant difference between the mean maximum torques generated in different age ranges; i.e., the maximum torque generated in the 25‒34-year age range was lower than that in the other two age groups. Finally, the effect of age range on the mean maximum torque was similar in both groups.

Effect of denture cleansing agents on tensile and shear bond strengths of soft liners to acrylic denture base.

Background. The aim of the present study was to evaluate the effect of Corega and 2.5% sodium hypochlorite cleansing agents on the shear and tensile bond strengths of GC soft liner to denture base. Methods. A total of 144 samples (72 samples for tensile and 72 for shear bond strength evaluations) were prepared. The samples in each group were subdivided into three subgroups in terms of the cleansing agent used (2.5% sodium hypochlorite, Corega and distilled water [control group]). All the samples were stored in distilled water, during which each sample was immersed for 15 minutes daily in sodium hypochlorite or Corega solutions. After 20 days the tensile and shear bond strengths were determined using a universal testing machine. In addition, a stereomicroscope was used to evaluate fracture modes. Data were analyzed with one-way ANOVA, using SPSS 16. Results. The results of post hoc Tukey tests showed significant differences in the mean tensile and shear bond strength values between the sodium hypochlorite group with Corega and control groups (P=0.001 for comparison of tensile bond strengths between the sodium hypochlorite and control groups, and P<0.001 for the comparison of tensile bond strengths between the sodium hypochlorite and Corega groups and the shear bond strengths between the sodium hypochlorite and Corega groups, and sodium hypochlorite and control groups).The majority of failures were cohesive in the control and Corega groups and cohesive/adhesive in the sodium hypochlorite group. Conclusion. Immersion of soft liners in Corega will result in longevity of soft liners compared to immersion in sodium hypochlorite solution and sodium hypochlorite solution significantly decreased the tensile and shear bond strengths compared to the control and Corega groups.

Determining the distance from the lingual frenum anterior attachment to the lower incisors' incisal edges.

Background. Occlusal rims are used to determine the jaw relationships in the transverse and vertical dimensions and estimate the inter-occlusal distance in edentulous patients. It is important to find ways to determine the height and shape of the occlusal rims correctly. This study was undertaken to determine the exact distance from the oral cavity floor to the incisal edges of mandibular incisors to serve as a guide for adjusting the height of the mandibular occlusal rim. Methods. Forty patients were selected and special trays were fabricated to prepare accurate stone casts on which the measurements were made at 0.01-mm accuracy. Two marks were placed on the casts at the incisal edges of mandibular incisors and at anterior attachment of lingual frenum. Then the distance between these two marks was determined on the vertical spindle of a surveyor using a digital Vernier measuring tool and recorded. Results. The results showed that the mean and standard deviation of the distances between the oral cavity floor and the incisal edges of lower incisors were 14.35 ± 1.68 mm, with a range of 10.2‒17.02 mm. The mean distances in males and females were 15.42 ± 0.97 and 13.28 ± 1.57 mm, respectively. T-test showed significant differences in this distance between males and females, with greater distances in males. Conclusion. The distance between the oral cavity floor and the incisal edges of mandibular incisors at anterior attachment of lingual frenum might be a proper criterion for the initial adjustment of occlusal rims.

The effect of occlusal surface relief of dies on marginal adaptation of metal-ceramic casting copings.

PURPOSE: The purpose of this study was to evaluate the impact of occlusal relief of dies on internal adaptation of metal-ceramic casting copings. MATERIALS AND METHODS: Standardized preparations were made on 80 extracted third molar teeth. Impressions were made with poly(vinyl siloxane), and stone dies were prepared. Dies were covered with four layers of die spacer, covering the entire preparation together with the occlusal surface excluding the apical 0.5 mm of the preparation in group 1 (40 specimens), and covering the same area excluding the occlusal surface in group 2 (40 specimens). Copings were cast using nickel-chromium-based metal ceramic alloy and cemented using zinc phosphate cement. The specimens were sectioned along the long axis. Internal discrepancies were recorded with a 0.001-mm resolution stereoscope at 6 points: the middle of the occlusal surface (MO), middle of the lingual wall (ML), middle of the buccal wall (MB), middle of the buccal shoulder finish line (MSH), middle of the lingual chamfer finish line (MCH), and middle of the buccal bevel finish line (MBL). Student's t-test was used for statistical analysis. Significance level was set at p < 0.05. RESULTS: The marginal discrepancies of group 1 were higher than those of group 2. Significant differences in discrepancies were found on MO (p < 0.0001), MSH (p = 0.012), and MBL (p = 0.035). The bevel margin showed the least marginal discrepancy following occlusal surface of the die with no relief. CONCLUSION: Leaving the occlusal part of the die uncovered with the die spacer improved the crown seating considerably in the occlusal surface as well as shoulder and bevel margins.

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report.

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.

Characteristics of anatomical landmarks in the mandibular interforaminal region: a cone-beam computed tomography study.

OBJECTIVES: This study was conducted to assess appearance, visibility, location and course of anatomical landmarks in mandibular interforaminal region using cone-beam computed tomography (CBCT). STUDY DESIGN: A total of 96 CBCT examinations was re-evaluated to exploit anatomical landmarks. The examinations used the Promax 3D CBCT unit. A sole examiner carried out all the measurements. Visibilities of the anatomical landmarks were scored using a four-point rating scale. RESULTS: The mandibular foramen, anterior loop, incisive canal and lingual foramen were observed in 100, 84, 83, 49% of the images, respectively. The mean size, diameter and width of anterior loop, incisive canal and lingual foramen were obtained 3.54 ± 1.41, 1.47 ± 0.50 and 0.8 ± 0.09 mm, respectively. CONCLUSION: It is not safe to recommend any definite distance mesially from the mental foramen. The diameter of the canals and foramens should be determined on a case-by-case basis to exploit the appropriate location for each individual.

A simple method for prosthodontic rehabilitation of edentulous patient with epidermolysis bullosa: a clinical case report.

An abnormally small oral orifice is defined as microstomia. Microstomia may result from epidermolysis bullosa (EB), which consists of a group of disorders characterized by the presence of mechanical fragility of the skin with recurrent de-velopment of blisters and vesicles, resulting from minor mechanical friction or trauma. Since such patients have a small oral aperture, it may be impossible to take impression and fabricate dentures using conventional methods. In this article, a simple method for taking preliminary impressions from upper and lower edentulous ridges in one patient with limited mouth opening and then preparing the complete denture with custom denture teeth in a single unit was described.

Tomographic volume evaluation of submandibular fossa in patients requiring dental implants.

OBJECTIVE: The aim of this study was to evaluate submandibular fossa volume from multislice CT scans of patients requiring endosseous implants. STUDY DESIGN: One hundred spiral computed tomographic (CT) preoperative examinations of patients requiring assessment the lower jaw before implant placement were retrospectively evaluated to determine anatomical variations in bone morphology in the submandibular fossa region. Reformatted cross-sectional images tangential to the mandibular dental arch and distal to the mental foramen border were selected. The deepest area of submandibular fossa or concavity depth was measured on all of the images. To measure the concavity depth, a tangent line was first derived to the lingual surface of the fossa and the deepest point was then selected by moving a perpendicular line across the tangent line. RESULTS: Within our sample we could classify the depth of the submandibular gland fossa as a function of the lingual concavity depth over a range up to a maximum value of 6.6 mm. Mandibular lingual concavity depth could be divided into 3 groups. A lingual concavity (depth > or =2 mm) was observed in 80% of the jaws. In 20% of the cases, there were flat depressions less than 2 mm in depth (Type I) and in 52% of the cases the concavities were 2 to 3 mm deep (Type II). About 28% of the examined regions showed significant concavities of more than 3 mm (Type III). The obtained distribution as a function of the depth did not reveal any dependence on age and gender of patients examined by this study (P > .05). CONCLUSION: Mandibles with any lingual concavity pose a potential increased risk of lingual cortical perforation during surgery, particularly endosseous implant placement. Cross-sectional imaging provides excellent delineation of mandibular anatomy and important information on the depth of the submandibular gland fossa in the preoperative assessment of the posterior mandible for dental implant fixture placement and other surgical procedures.

Proportions of maxillary anterior teeth relative to each other and to golden standard in tabriz dental faculty students.

BACKGROUND AND AIMS: Various methods are used to measure the size and form of the teeth, including the golden pro-portion, and the width-to-length ratio of central teeth, referred to as the golden standard. The aim of this study was to eval-uate the occurrence of golden standard values and golden proportion in the anterior teeth. MATERIALS AND METHODS: Photographs of 100 dentistry students (50 males and 50 females) were taken under standard conditions. The visible widths and lengths of maxillary right and left incisors were calculated and the ratios were compared with golden standard. Data was analyzed using SPSS 14 software. RESULTS: Review of the results of the means showed statistically significant differences between the width ratio of right lateral teeth to the central teeth width with golden proportion (P<0.001). Likewise, the difference was significant for the left side, too (P<0.001). Test results of mean differences showed that the mean difference between proportion of right laterals to centrals with golden proportion was significant (P<0.001). The difference was significant for the left side, too (P<0.001). As a result, there is no golden proportion among maxillary incisors. The review of results of mean differences for single samples showed that the mean differences between the proportion of width-to-length of left and right central teeth was statistically significant by golden standard (P<0.001). Therefore, considering the width-to-length proportion of maxillary central teeth, no golden standard exists. CONCLUSION: In the evaluation of the width-to-width and width-to-length proportions of maxillary incisors no golden proportions and standards were detected, respectively.

Prosthodontic rehabilitation of a bruxer patient with severely worn dentition: a clinical case report.

The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This article describes the full mouth rehabilitation of a 54-year-old bruxer woman with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account.

Effect of Different Disinfectants on Staphylococcus aureus and Candida albicans Transferred to Alginate and Polyvinylsiloxane Impression Materials.

BACKGROUND AND AIMS: Several products have been marketed for disinfecting impression materials. The present study evaluated the effect of Deconex, Micro 10, Alprocid and Unisepta Plus sprays on Staphylococcus aureus and Candida albicans transferred to alginate and polyvinylsiloxane impression materials. MATERIALS AND METHODS: A total of 180 impressions of a maxillary model (90 alginate and 90 polyvinylsiloxane im-pressions) were taken for the purpose of this in vitro study. Half of the impressions were infected with Staphylococcus au-reus and the other half were infected with Candida albicans. Then the microorganisms were cultured and their counts were determined. Subsequently, the impressions were divided into groups of 15 impressions each. Each group was disinfected with Deconex, Micro10, Alprocid and Unisepta Plus according to manufacturers' instructions except for the control group. The culturing procedure was repeated after disinfection and microbial counts were determined again. Data was analyzed by ANOVA and paired-sample t-test. RESULTS: There were statistically significant differences in the means of S. aureus and C. albicans counts before and after the use of disinfectants (P < 0.05). The use of the four disinfectants reduced S. aureus counts to zero in 80% of the cases. There were no statistically significant differences in S. aureus count reductions between the four disinfectants evaluated (P = 0.31). Micro 10 was more effective on alginate; Deconex was more efficient for polyvinylsiloxane and Alprocid had a better efficacy in both impression materials in eliminating C. albicans (P < 0.05). CONCLUSION: All the disinfectants evaluated have high disinfecting postentials.