Prosthodontic rehabilitation of malpositioned implants after ameloblastoma followed by mandibulectomy and costal bone graft: a clinical report.

This clinical report describes the rehabilitation with costal bone graft reconstruction and 3 implants of a patient with a partial mandibular defect as a result of a partial mandibulectomy due to ameloblastoma of the left mandible. Due to the altered shape of the graft bone, the implants were malpositioned in the buccolingual plane. The prosthodontic rehabilitation was successfully completed by using an implant-supported milled bar combined with telescopic crown-retained dentures. This tooth implant-supported prosthesis successfully restored function and esthetics. Aspects that deal with the repair of the buccal soft tissues are discussed.

[Effect of different irrigants on radicular dentin cleansing and resin tag formation after post space preparation].

OBJECTIVE: To evaluate the effect of different root canal irrigants on smear layer removal and dentinal tubule opening of root canal surfaces after post space preparation. METHODS: Thirty maxillary anteriors were endodontically treated. After post space preparation, the teeth were assigned to three groups with ten teeth each: group A, B, C. 3% H2O2, 15% ethylenediamine tetraacetic acid(EDTA), 15% EDTA and 3% NaClO were used as irrigant of group A, B, C. After post space irrigation, eight teeth of each group were examined under scanning electron microscope (SEM) for smear layer removal and dentinal tubule opening. The left two specimens were restored with fiber posts and prepared for evaluation of resin tag formation. RESULTS: The cleansing effectiveness of group A, B and C was respectively 3.89 +/- 0.36, 1.77 +/- 0.30, 1.25 +/- 0.21. The dentinal tubule opening of group A, B and C was respectively (2.53 +/- 0.19), (3 11 +/- 023) (3.83 +/- 0.52) microm. The cleansing effectiveness and dentinal tubule opening of root canal surfaces were significantly affected by different root canal irrigants (P < 0.05). Excessive erosion of the dentin was observed in group C. Resin tag formation differed between the three irrigant groups, and group B showed excellent resin tag formation. CONCLUSION: Irrigation with 15% EDTA after post space preparation can excellently remove the smear layer and improve dentinal tubule opening, permitting well penetration of resin adhesive into the dentinal tubules and collagen fibrillar structure.

Does endodontic post space irrigation affect smear layer removal and bonding effectiveness?

The effect of different post space irrigants on smear layer removal and dentin bond strength was evaluated. Sixty-six extracted sound maxillary central incisors were endodontically treated. After post space preparation, the teeth were assigned to three groups of 22 teeth each. The teeth of these three groups were irrigated for 1 min with 17% ethylenediaminetetracetic acid (EDTA) (group 1), 5.25% sodium hypochlorite (NaOCl) (group 2), or 0.9% sodium chloride (NaCl) (group 3). In each group, eight specimens were split longitudinally for smear layer evaluation, and the other fourteen specimens were filled with a self-etching adhesive system (Panavia F). Four of 14 specimens of each group were prepared for evaluation of the resin-dentin interdiffusion zone (RDIZ) and resin tags, and the other 10 specimens were serially sectioned for push-out test analysis. Smear layer removal and bond strength were affected by different post space irrigants. EDTA removed the smear layer extremely effectively and, as a result, improved the bond strength at each region (apical, middle, and coronal) of the roots. Resin tag formation and the RDIZ were also affected by different irrigants and in accordance with bond strength. Therefore, removal of the smear layer use a self-etching luting system plays an important role in bonding effectiveness.

Effect of different irrigation on smear layer removal after post space preparation.

The purpose of this study was to evaluate the effect of different irrigating solutions on smear layer removal and dentinal tubule opening on root canal surfaces after post space preparation and to study whether additional ultrasonic irrigation has any effect on smear layer removal. Forty-eight anterior teeth were treated endodontically. After post space preparation, they were assigned to six groups: group 1, EDTA; group 2, EDTA with ultrasonic activation; group 3, sodium hypochlorite (NaOCl); group 4, NaOCl with ultrasonic activation; group 5, sodium chloride (NaCl); and group 6, NaCl with ultrasonic activation. Specimens were examined under a field-emission scanning electron microscope and scored for debris removal and dentinal tubule opening at the coronal, middle, and apical thirds of the root canal. The results showed that EDTA performed significantly better than NaCl and NaOCl in smear layer removal and dentinal tubule opening. Additional ultrasonic irrigation did not improve smear layer removal significantly.