Purpose: The hazards of aerosols generated during dental treatments are poorly understood. This study aimed to establish visualization methods, discover conditions for droplets/aerosols generated in simulating dental treatments and identify the conditions for effective suction methods.
Methods: The spreading area was evaluated via image analysis of the droplets/aerosols generated by a dental air turbine on a mannequin using a light emitting diode (LED) light source and high-speed camera. The effects of different bur types and treatment sites, reduction effect of intra-oral suction (IOS) and extra-oral suction (EOS) devices, and effect of EOS installation conditions were evaluated.
Results: Regarding the bur types, a bud-shaped bur on the air turbine generated the most droplets/aerosols compared with round-shaped, round end-tapered, or needle-tapered burs. Regarding the treatment site, the area of droplets/aerosols produced by an air turbine from the palatal plane of the anterior maxillary teeth was significantly higher. The generated droplet/aerosol area was reduced by 92.1% by using IOS alone and 97.8% by combining IOS and EOS. EOS most effectively aspirated droplets/aerosols when placed close (10 cm) to the mouth in the vertical direction (0°).
Conclusions: The droplets/aerosols generated by an air turbine could be visualized using an LED light and a high-speed camera in simulating dental treatments. The bur shape and position of the dental air turbine considerably influenced droplet/aerosol diffusion. The combined use of IOS and EOS at a proper position (close and perpendicular to the mouth) facilitated effective diffusion prevention to protect the dental-care environment.
Using a dental air turbine and a mannequin, the authors recreated the droplets and aerosols that occur during dental procedures. The key is the high-sensitivity camera and high-intensity LED light source, which allowed for high-quality images of the droplet spreading during the simulated procedure. Using these techniques, the authors demonstrated efficient reduction of droplet and aerosol spread by using oral suction devices. Understanding the spread and diffusion of such particles in the air is a key step in successfully protecting individuals from potentially harmful diseases that can be spread through airborne droplets.
Purpose: The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)?
Study selection: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed.
Results: Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI95%= 1.54-2.49, P< 0.00001).
Conclusions: Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.
There is a debate among clinicians regarding severe endodontically treated teeth (ETT) in terms of residual tooth substance—whether to extract the tooth or perform partial ferrule. This work conducts the first meta-analysis study that introduces clear evidence-based guidance for clinicians regarding partial ferrule so that they can take appropriate clinical decisions and adequately plan restorative dental treatments of ETT.
Purpose: The aim of this study was to review the literature on current surface modification strategies used to improve the binding efficiency of an emerging biological material, polyetheretherketone (PEEK), with bone and soft tissues.
Study selection: This review was based on articles retrieved from PubMed, Google Scholar, Web of Science, and ScienceDirect databases. The main keywords used during the search were “polyetheretherketone (PEEK),” “implant,” “surface modification,” “biomaterials,” “bone,” “osseointegration,” and “soft tissue.”
Results: The suitability of PEEK surface modification strategies has been critically analyzed and summarized here. Many cell and in vivo experiments in small animals have shown that the use of advanced modification technologies with appropriate surface modification strategies can effectively improve the surface inertness of PEEK, thereby improving its binding efficiency with bone and soft tissues.
Conclusions: Surface modifications of PEEK have revealed new possibilities for implant treatment; however, most results are based on in vitro or short-term in vivo evaluations in small animals. To achieve a broad application of PEEK in the field of oral implantology, more in vivo experiments and long-term clinical evaluations are needed to investigate the effects of various surface modifications on the tissue integration ability of PEEK to develop an ideal implant material.
The widespread use of Polyetheretherketone (PEEK) as an oral implant material is an ongoing topic of investigation. This review article summarizes the current surface modification strategies used to improve the binding efficiency of the emerging biomaterial PEEK with bone and soft tissues. Although many studies have shown that various surface modifications can successfully improve the biological activity of PEEK, further in-vivo experiments and long-term clinical evaluations are required to investigate the effects of various surface modifications on the tissue integration ability of PEEK implants.
Purpose: To determine postoperative periodontal and radiographic factors that predict the survival rates of abutments of removable partial dentures (RPDs).
Methods: Patients who wore RPDs for > 10 years and received supportive periodontal therapy were included. Periodontal examinations and radiographic assessments were conducted on 83 abutment teeth in 35 patients at baseline, and five years after RPD insertion. In addition to conventional factors, such as tooth mobility at 5 years, radiographic factors, such as the crown–root ratio (ΔCR ratio) and gray-level changes reflecting changes in alveolar bone density (ΔABD), were evaluated. The impact of the covariables on the 10-year survival of abutment teeth was estimated using a multivariate Cox regression model, considering multicollinearity.
Results: Patients were classified as having A2–B2 (45.7%) and B3–C2 (54.3%) tooth loss, according to the Eichner classification. A probing depth ≥ 4 mm, tooth mobility ≥ grade 1, and CR ratio ≥ 1 were found in 30.1%, 33.7%, and 51.8% of abutment teeth, respectively. The 10-year survival rate of abutment teeth was 86.7%. Multivariate analysis showed that the 10-year survival of abutment teeth was significantly associated with root canal treatment (p = 0.045, hazard ratio [HR] = 1.23), the 5-year ΔCR ratio (p = 0.022, HR = 3.20), and ΔABD on the edentulous side of the abutment teeth (p = 0.047, HR = 1.08).
Conclusions: In addition to root canal treatment, changes in the CR ratio and radiographic alveolar bone density at five years predicted the long-term survival rate of RPD abutments.
To predict the success of prosthodontic treatments and plan effective maintenance care strategies, it is essential to precisely evaluate the risk factors. This retrospective study reports the 5- and 10-year survival of the abutment teeth of removable partial dentures. In addition to the presence of root-canal treatment at the baseline, postoperative radiographic changes in crown-root ratio and alveolar bone density on the denture side were significantly associated with abutment tooth loss.
Purpose: This study aimed to evaluate the influence of subcrestal implant placement depth on bone remodeling using time-dependent finite element analysis (FEA) with a bone-remodeling algorithm over 12 months.
Methods: Seven models of different subcrestal implant placement depths (0, 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm) were analyzed using FEA to evaluate the biomechanical responses in the bone and implant, including von Mises equivalent stress, strain energy density (SED), and overloading elements. SED was used as a mechanical stimulus to simulate cortical and cancellous bone remodeling over the first 12 months after final prosthesis delivery.
Results: The highest increase in cortical bone density was observed at Depth 1.5, whereas the lowest increase was observed at Depth 3.0. In contrast, the highest increase in bone density was observed at Depth 3.0 in the cancellous bone, whereas the lowest increase was observed at Depth 0. The highest peak von Mises stress in the cortical bone occurred at Depth 2.5 (107.24 MPa), while that in the cancellous bone was at Depth 2.5 (34.55 MPa). Notably, the maximum von Mises stress values in the cancellous bone exceeded the natural limit of the bony material, as indicated by the overloading elements observed at the depths of 2.0, 2.5, and 3.0 mm.
Conclusion: Greater bone density apposition is observed with deeper implant placement. An implant depth of more than 1.5 mm exhibited a higher maximum von Mises stress and greater overloading elements.
In silico finite element analysis (FEA) has been widely used to evaluate stress/strain distribution in bone and implants under standardized conditions. The authors adopted a time-dependent FEA to evaluate the influence of subcrestal implant placement depth on bone remodeling. The time-dependent FEA demonstrated that an implant depth of more than 1.5 mm exhibited a high stress concentration and great overloading elements, particularly in cancellous bone. The established in silico approach will possibly become a useful tool to uncover the optimal implant placement depth that provides an appropriate bone response.
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Released on J-STAGE: January 11, 2022 | Volume 66 Issue 1 Pages 53-67
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