Growth kinetics and characterization of human dental pulp stem cells: Comparison between third molar and first premolar teeth.

BACKGROUND: Dental pulp stem cells (DPSCs) play an important role in tissue regeneration. This study compares the growth kinetics and characterization of third molar and first premolar human DPSCs. MATERIAL AND METHODS: Dental pulp tissues were isolated from human first premolar and third molar teeth and were digested by treating them with collagenase type I. Single-cell suspensions from each dental pulp were seeded in T25 culture flasks and the media were replaced every 3 days until 70% confluence. The cells were enumerated to determine the population doubling time (PDT). Cells were characterized using flow cytometry, RT-PCR and osteogenic medium for differentiation of DPSCs. Karyotyping assay was also performed till passage 7th. RESULTS: The DPSCs had spindle-shaped morphology. There was an increase in PDT in third molar DPSCs when compared to first premolar teeth. Positive expression of CD44, CD73, and CD90 and negative expression of CD34 and CD45 were illustrated. A normal karyotype was visible for all seven passages. The Alizarin red staining was positive for osteogenic induction of DPSCs. CONCLUSIONS: When DPSCs are needed, third molar teeth can be a good and convenient candidate for cell transplantation, yielding high number of cells with mesenchymal characteristics. They can be a source for further investigations in vitro and work on tissue engineering protocols. Key words:Stem cells, dental pulp, growth kinetics, characterization.

A Comparison of the Marginal and Internal Fit of Cobalt- Chromium Copings Fabricated by Two Different CAD/CAM Systems (CAD/ Milling, CAD/ Ceramill Sintron).

STATEMENT OF THE PROBLEM: Marginal fitness is the most important criteria for evaluation of the clinical acceptability of a cast restoration. Marginal gap which is due to cement solubility and plaque retention is potentially detrimental to both tooth and periodontal tissues. PURPOSE: This in vitro study aimed to evaluate the marginal and internal fit of cobalt- chromium (Co-Cr) copings fabricated by two different CAD/CAM systems: (CAD/ milling and CAD/ Ceramill Sintron). MATERIALS AND METHOD: We prepared one machined standard stainless steel master model with following dimensions: 7 mm height, 5mm diameter, 90˚ shoulder marginal finish line with 1 mm width, 10˚ convergence angle and anti-rotational surface on the buccal aspect of the die. There were 10 copings produced from hard presintered Co-Cr blocks according to CAD/ Milling technique and ten copings from soft non- presintered Co-Cr blocks according to CAD/ Ceramill Sintron technique. Marginal and internal accuracies of copings were documented by the replica technique. Replicas were examined at ten reference points under a digital microscope (230X). The Student's t-test was used for statistical analysis. p< 0.001 was considered significant. RESULTS: Statistically significant differences existed between the groups (p< 0.001). The CAD/milling group (hard copings) had a mean marginal discrepancy (MD) of 104 µm, axial discrepancy (AD) of 23 µm and occlusal discrepancy of 130 µm. For CAD/ Ceramill Sintron group, these values were 195 µm (MD), 46 µm (AD), and 232 µm (OD). Internal total discrepancy (ITD) for the CAD/milling group was 77 µm, whereas for the CAD/Ceramill Sintron group was 143 µm. CONCLUSION: Hard presintered Co-Cr copings had significantly higher marginal and internal accuracies compared to the soft non-presintered copings.

Accuracy of different impression materials in parallel and nonparallel implants.

BACKGROUND: A precise impression is mandatory to obtain passive fit in implant-supported prostheses. The aim of this study was to compare the accuracy of three impression materials in both parallel and nonparallel implant positions. MATERIALS AND METHODS: In this experimental study, two partial dentate maxillary acrylic models with four implant analogues in canines and lateral incisors areas were used. One model was simulating the parallel condition and the other nonparallel one, in which implants were tilted 30° bucally and 20° in either mesial or distal directions. Thirty stone casts were made from each model using polyether (Impregum), additional silicone (Monopren) and vinyl siloxanether (Identium), with open tray technique. The distortion values in three-dimensions (X, Y and Z-axis) were measured by coordinate measuring machine. Two-way analysis of variance (ANOVA), one-way ANOVA and Tukey tests were used for data analysis (α = 0.05). RESULTS: Under parallel condition, all the materials showed comparable, accurate casts (P = 0.74). In the presence of angulated implants, while Monopren showed more accurate results compared to Impregum (P = 0.01), Identium yielded almost similar results to those produced by Impregum (P = 0.27) and Monopren (P = 0.26). CONCLUSION: Within the limitations of this study, in parallel conditions, the type of impression material cannot affect the accuracy of the implant impressions; however, in nonparallel conditions, polyvinyl siloxane is shown to be a better choice, followed by vinyl siloxanether and polyether respectively.

The effect of various veneering techniques on the marginal fit of zirconia copings.

PURPOSE: This study aimed to evaluate the fit of zirconia ceramics before and after veneering, using 3 different veneering processes (layering, press-over, and CAD-on techniques). MATERIALS AND METHODS: Thirty standardized zirconia CAD/CAM frameworks were constructed and divided into three groups of 10 each. The first group was veneered using the traditional layering technique. Press-over and CAD-on techniques were used to veneer second and third groups. The marginal gap of specimens was measured before and after veneering process at 18 sites on the master die using a digital microscope. Paired t-test was used to evaluate mean marginal gap changes. One-way ANOVA and post hoc tests were also employed for comparison among 3 groups (α=.05). RESULTS: Marginal gap of 3 groups was increased after porcelain veneering. The mean marginal gap values after veneering in the layering group (63.06 µm) was higher than press-over (50.64 µm) and CAD-on (51.50 µm) veneered groups (P<.001). CONCLUSION: Three veneering methods altered the marginal fit of zirconia copings. Conventional layering technique increased the marginal gap of zirconia framework more than pressing and CAD-on techniques. All ceramic crowns made through three different veneering methods revealed clinically acceptable marginal fit.

Evaluation of the Effect of Axial Wall Modification and Coping Design on the Retention of Cement-retained Implant-supported Crowns.

Background and aims. Because of compromised angulations of implants, the abutments are sometimes prepared. The purpose of this study was to investigate the effect of removing one wall of the implant abutment on the retention of cement-retained crowns. Materials and methods. Four prefabricated abutments were attached to analogues and embedded in acrylic resin blocks. The first abutment was left intact. Axial walls were partially removed from the remaining abutments to produce abutments with three walls. The screw access channel for the first and second abutments were completely filled with composite resin. For the third and fourth abutments, only partial filling was done. Wax-up models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The copings of fourth abutment had an extension into the screw access channel. Copings were cemented with Temp Bond. The castings were removed from the abutment using an Instron machine, and the peak removal force was recorded. A one-way ANOVA was used to test for a significant difference followed by the pairwise comparisons. Results. The abutments with opened screw access channel had a significantly higher retention than the two other abutments. The abutment with removed wall and no engagement into the hole by the castings exhibited the highest retention. Conclusion. Preserving the opening of screw access channel significantly increases the retention where one of the axial walls of implant abutments for cement-retained restorations is removed during preparation.

Rapid Prototyping Technologies and their Applications in Prosthodontics, a Review of Literature.

The early computer-aided design/computer-aided manufacturing (CAD/CAM) systems were relied exclusively on subtractive methods. In recent years, additive methods by employing rapid prototyping (RP) have progressed rapidly in various fields of dentistry as they have the potential to overcome known drawbacks of subtractive techniques such as fit problems. RP techniques have been exploited to build complex 3D models in medicine since the 1990s. RP has recently proposed successful applications in various dental fields, such as fabrication of implant surgical guides, frameworks for fixed and removable partial dentures, wax patterns for the dental prosthesis, zirconia prosthesis and molds for metal castings, and maxillofacial prosthesis and finally, complete dentures. This paper aimed to offer a comprehensive literature review of various RP methods, particularly in dentistry, that are expected to bring many improvements to the field. A search was made through MEDLINE database and Google scholar search engine. The keywords; 'rapid prototyping' and 'dentistry' were searched in title/abstract of publications; limited to 2003 to 2013, concerning past decade. The inclusion criterion was the technical researches that predominately included laboratory procedures. The exclusion criterion was meticulous clinical and excessive technical procedures. A total of 106 articles were retrieved, recited by authors and only 50 met the specified inclusion criteria for this review. Selected articles had used rapid prototyping techniques in various fields in dentistry through different techniques. This review depicted the different laboratory procedures employed in this method and confirmed that RP technique have been substantially feasible in dentistry. With advancement in various RP systems, it is possible to benefit from this technique in different dental practices, particularly in implementing dental prostheses for different applications.

A clinical comparative study of Cadiax Compact II and intraoral records using wax and addition silicone.

Evaluation of mandibular movements is necessary to form the occlusal anatomical contour, analyze the temporomandibular joint status, and evaluate the patient's occlusion. This clinical study was conducted to compare the mandibular recording device Cadiax Compact II with routine intraoral records for measuring condylar inclinations. The results showed that the differences between Cadiax and intraoral records were statistically significant for all measurements. Cadiax measurements had a stronger correlation with silicone records. The quantities of recorded Bennett angles were lower and the values of sagittal condylar inclination were higher with Cadiax than with routine intraoral records.

Evaluation of the effect of a home-bleaching agent on the surface characteristics of indirect esthetic restorative materials: part I--roughness.

BACKGROUND: Pressing esthetic demands of good looking make people undergo bleaching procedures. However, the effect of bleaching agents on esthetic restorative materials with different surface preparations has been poorly studied. AIM: The aim of this study was to examine the effect of a homebleaching agent (carbamide peroxide: CP 38%) on the surface roughness of the polished fiber reinforced composite (FRC), overglazed, autoglazed, or polished ceramic samples. MATERIALS AND METHODS: Twenty standardized cylindrical specimens were made of each of the following groups: over-glazed, autoglazed, polished porcelain and also FRC. The test specimens exposed to the CP 38%, 15 minutes, twice a day for 2 weeks according to the manufacturer's recommendation. Six samples from each group were selected randomly to form negative controls. Surface roughness measurements (Ra, micrometer) for baseline, test and control specimens were performed by use of a profilometer. Paired t-test, Mann-Whitney test, and Kruskal-Wallis test were used for statistical analyses. RESULTS: The data showed that bleaching with CP 38% significantly increased the surface roughness of all the test samples (p < 0.05). The type of surface preparation caused significant differences between the susceptibility of porcelain subgroups to bleaching (p < 0.05). The polished porcelain specimens showed the highest changes after bleaching. CONCLUSION: CP 38% significantly increases the surface roughness of the porcelains and FRC. The type of surface condition affects the amenability of the porcelain surface to the bleaching agent. Glazed porcelains were more resistant to roughness than the polished porcelains and also the composite. CLINICAL SIGNIFICANCE: Roughening of porcelain and FRC occur following bleaching procedure. No special surface preparation of indirect esthetic restorative materials can completely preserve these materials from adverse effects of bleaching agents.

Evaluation of the effect of a home bleaching agent on surface characteristics of indirect esthetic restorative materials--part II microhardness.

BACKGROUND: The exponential usage of esthetic restorative materials is beholden to society needs and desires. Interaction between the bleaching agents and the esthetic restorative materials is of critical importance. AIM: This in vitro study has been conducted to evaluate the effect of a home bleaching agent, carbamide peroxide (CP) 38%, on the microhardness of the fiber reinforced composite (FRC), overglazed, autoglazed, or polished porcelain specimens. MATERIALS AND METHODS: For overglazed, autoglazed, polished ceramics and also FRC cylindrical specimens (n = 20 per group) were prepared. The specimens were stored in distilled water at 37°C for 48 hours prior to testing. Six samples from each group were selected randomly as negative controls which were stored in distilled water at 37°C that was changed daily. CP 38% was applied on the test specimens for 15 minutes, twice a day for 14 days. By using Knoop-microhardness tester microhardness testing for baseline, control and test specimens was conducted. Data were statistically analyzed using paired t-test, Mann-Whitney test, and Kruskal-Wallis test. RESULTS: Home bleaching significantly decreased the surface microhardness of all the test samples (p < 0.05), whereas the control groups did not show statistically significant changes after 2 weeks. The polished porcelain and polished composite specimens showed the most significant change in microhard-ness after bleaching process (p < 0.05). CONCLUSION: Although the type of surface preparation affects the susceptibility of the porcelain surface to the bleaching agent, no special preparation can preclude such adverse effects. CLINICAL SIGNIFICANCE: The contact of home bleaching agents with esthetic restorative materials is unavoidable. Therefore protecting these restorations from bleaching agents and reglazing or at least polishing the restorations after bleaching is recommended.

Effect of abutment modification and cement type on retention of cement-retained implant supported crowns.

OBJECTIVE: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. MATERIALS AND METHOD: Two prefabricated abutments were attached to their corresponding analogs and embedded in an acrylic resin block. The first abutment (control group) was left intact without any modifications. The screw access channel for the first abutment was completely filled with composite resin. In the second abutment, (test group) the axial wall was partially removed to form an abutment with 3 walls. Wax models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The prepared copings were cemented on the abutments by Temp Bond luting agent under standardized conditions (n=20). The assemblies were stored in 100% humidity for one day at 37°C prior to testing. The cast crown was removed from the abutment using an Instron machine, and the peak removal force was recorded. Coping/abutment specimens were cleaned after testing, and the testing procedure was repeated for Dycal luting agent (n=20). Data were analyzed with two- way ANOVA (α=0.05). RESULTS: There was no significant difference in the mean transformed retention (Ln-R) between intact abutments (4.90±0.37) and the abutments with 3 walls (4.83±0.25) using Dycal luting agent. However, in TempBond group, the mean transformed retention (Ln-R) was significantly lower in the intact abutment (3.9±0.23) compared to the abutment with 3 walls (4.13±0.33, P=0.027). CONCLUSION: The retention of cement-retained implant restoration can be improved by the type of temporary cement used. The retention of cast crowns cemented to implant abutments with TempBond is influenced by the wall removal.

Evaluation of the Cadiax Compact® II accuracy in recording preadjusted condylar inclinations on fully adjustable articulator.

BACKGROUND: Mandibular movement analysis is a critical step in making the functional occlusal morphology and improving the diagnosis and treatment of temporomandibular joint disorders (TMDs). Cadiax Compact® is an electronic condylograph that claims to record the horizontal condylar inclination (HCI), Bennett angle (BA) and relative shape of the articular eminence. This study aims at assessing the accuracy of Cadiax Compact® II in its claimed abilities. MATERIALS AND METHODS: The electronic condylograph (Cadiax Compact®II) was fitted on the fully adjustable articulator (gamma dental reference-SL). After setting of HCI and BA on the arbitrary degrees, eccentric movements were produced manually on the articulator. The Cadiax recorded these preadjusted angles and the accuracy of its recordings was assessed by comparison of the results with the preadjusted HCI, BA and color inserts as references. RESULTS: The majority of the comparisons showed statistically significant differences between articulator settings and Cadiax recordings. However, the maximum difference was about 2.50 which seems acceptable for clinical practice. CONCLUSION: The obtained results showed that Cadiax Compact is an accurate and reliable instrument for diagnostic purposes, yielding reproducible measurements. Despite this, Cadiax is a technically sensitive device that can preclude its routine usage.

Prosthodontic rehabilitation of a shotgun injury: a patient report.

This report describes the prosthodontic rehabilitation of a shotgun patient traumatized in the maxillary, mandibular, and nasal areas resulting in severe problems in her esthetics, phonetics, and mastication. The patient was treated with removable partial prostheses using tooth, soft tissue, and implant support.

Fracture resistance of endodontically treated teeth restored by different FRC posts: an in vitro study.

BACKGROUND: Posts and cores are often required for restoration of pulpless teeth and to provide retention and resistance for a complete crown, but conventional posts may increase the root fracture. OBJECTIVE: This study was performed to compare the root fracture resistance of extracted teeth treated with different fibers reinforced with composite posts and treated teeth with conventional post and core systems. MATERIALS AND METHODS: Root canal therapy was performed for 50 mandibular first premolars. The coronal portion of each tooth was amputated, and five post and core systems (cast, polyethylene woven, glass, carbon, and quartz fiber posts) were compared. Acrylic resin blocks were used for mounting, using a layer of elastomeric impression material covering the roots. The load was applied axially and measured with a universal testing machine. RESULTS AND CONCLUSION: Significantly, cast posts and cores had a higher failure threshold including teeth fracture; whereas, fiber posts failure was due to core fracture, with or without fractures in coronal portion of posts. Difference in FRC posts did not provide any significant difference in the load failure and the mode of fracture.