Prefabricating Implant-supported Interim Prosthesis from CBCT Scans: a Case Report of Digital Immediate Implant Restoration.

This clinical report describes the immediate implant placement and restoration for a 47-yearold woman with a protruded and loose maxillary right central incisor. The treatment included minimally invasive extraction, flapless immediate implant placement using a fully guided surgical template, and immediate implant-supported provisionalisation. The interim anatomical prosthesis was fabricated in advance based on preoperative CBCT scans, and the digital technique made it possible to integrate data precisely from different sources. After 6 months of provisionalisation, satisfactory gingival aesthetic and functional improvements were achieved, followed by a definitive screw-retained zirconia restoration. Thus, application of a complete digital workflow could reduce chairside time and create an optimal emergence profile that matches the residual bone architecture of the extraction sites with minimal interference.

[Bile-resistant Gram-negative bacteria effect of different kinds of root decoction pieces].

To investigate the microbial contamination in Chinese herbal decoction pieces with different functional types by studying the total aerobic microbial count (TAMC), and total yeast and mould count (TYMC) in 40 samples of 8 types of root decoction pieces; further evaluate the contamination load of bile-resistant Gram-negative bacteria, and identify the Gram-negative bacteria by using biochemical identification system for Gram-negative bacteria. Our results showed that the TAMC value was more than 1 000 CFU•g⁻¹ in 85% (34/40) samples, and was more than 100 CFU•g⁻¹ in 30% (12/40) samples; the contamination of bile-resistant Gram-negative bacteria was detected in 45% (18/40) of the samples. The bile-resistant Gram-negative bacteria load of seven batches of samples was N>1 000 MPN•g⁻¹. Sixteen bacterium strains including Serratia plymouthensis, Cedecea neteri, Escherichia vulneris, Klebsiella oxytoca, Enterobacter amnigenus, E. cloacae, E. sakazakii, Proteus penneri and E. gergoviae were obtained and identified. E. cloacae was the predominant bacterium that was isolated from Salviae Miltiorrhizae Radix et Rhizoma, while E. amnigenus, Yersinia pseudotuberculosis was the typical bacterium of Ophiopogonis Radix and Codonopsis Radix, respectively. All these suggested that the contamination of bile-resistant Gram-negative bacteria was severe for the root decoction pieces in Wuhan city. Microbial species have certain selection specificity for medicinal ingredients, so the type and limit of control bacteria for detection should be formulated according to the pollution type and quantity of bile-resistant Gram-negative bacteria.

[Effect of a desensitizing polishing paste on bonding strength of two self-etching adhesives to dentin].

OBJECTIVE: To evaluate the effect of an 8% arginine-CaCO3 containing desensitizing polishing paste on bonding strength of two self-etching adhesives to dentin. METHODS: Thirty-six intact human premolars extracted for orthodontic reasons were collected within 1 month after extraction and randomly assigned into three groups using a table of random numbers (n = 12): specimens without any treatment served as control. In the polishing powder group specimens were polished with a slurry of pumice, and in the desensitizing polishing paste group dentin surfaces of the sample teeth were treated with 8% arginine-CaCO3 containing desensitizing polishing paste. Then each group was divided into two sub-groups using a table of random numbers in order to evaluate the bonding strength of two self-etching adhesive agents (G-Bond, GC; Fl-Bond II, Shofu). Microtensile bond strength test was conducted immediately and after 5000 thermocycling (n = 15). Scanning electron microscope (SEM) was used to evaluate the occluding effect of the desensitizing polishing paste. RESULTS: In the pre-thermocycling stage, there were no significant differences in Fl-Bond II bonding strength among the three groups [control: (30.34 ± 5.42) MPa, polishing powder group: (29.72 ± 5.16) MPa, desensitizing polishing paste group: (31.53 ± 4.86) MPa] (P > 0.05). However there were significant differences among the three groups in G-Bond bonding strength [control: (38.19 ± 4.42) MPa, polishing powder group: (36.47 ± 4.72) MPa, desensitizing polishing paste group: (46.88 ± 7.83) MPa] (P < 0.05). After thermocycling process, there were no significant differences in bonding strength among the three groups in both G-Bond groups and Fl-Bond II groups. SEM observation showed that the desensitizing polishing paste could occlude open dentinal tubules effectively, and the application of self-etching adhesives could re-open the dentinal tubular orifices. An even layer can be seen on the dentin surface treated with self-etching adhesive containing functional monomers. CONCLUSIONS: The 8% arginine-CaCO3 containing desensitizing polishing paste could effectively occlude dentinal tubules, thus may have potential benefits in preventing post-operative sensitivity. Additionally, it had no adverse effect on bonding strength of self-etching adhesives to dentin.

[Study on the micropermeability of resin-dentin bonding interfaces with ethanol-wet bonding technique].

OBJECTIVE: To evaluate the micropermeability on bonding hydrophobic adhesive to dentin with ethanol-wet bonding under simulated pulp pressure. METHODS: Twenty-four intact human third molars were used in the study. After the enamel of occlusal surfaces was removed, the molars were randomly divided into six groups. Adper Scotchbond Multi-Purpose was used in the control group; in the experimental groups, the dentin surfaces were saturated with ethanol for 20 s (group 1), 1 min (group 2), 2 min (group 3), 3 min (group 4) or with a series of increasing ethanol concentrations before application of hydrophobic adhesive (group 5). All the bonding procedures were done under simulated pulp pressure. After 24 hours, micro-tensile bond strength test were performed on the specimens. Bonding interfaces were observed under laser scanning confocal microscope (LSCM) after the pulp chamber were filled with a water-soluble fluoroprobe rhodamine B for 3 hours. RESULTS: Compared with the control group [(38.14 ± 4.97) MPa], bond strengths in group 1 [(21.02 ± 7.23) MPa] and group 2 [(29.64 ± 3.81) MPa] were statistically lower (P > 0.05), while bond strength in group 3 [(38.40 ± 5.03) MPa], group 4 [(37.26 ± 4.68) MPa] and group 5 [(40.12 ± 5.95) MPa] were similar to the control group (P < 0.05). The images taken by LSCM showed that with extension of ethanol-wet time, the deposition of fluorescent dye in hybrid layer and along the dentinal tubules decreased gradually. Especially in group 5, only spare fluorescent dye deposition could be detected in the hybrid layer. CONCLUSIONS: Dentin saturated with ethanol for more than 2 min before bonding hydrophobic adhesive to dentin could provide favorable bond strength and decreased the micropermeability of bonding interfaces under simulated pulp pressure.