Evaluation of friction of stainless steel and esthetic self-ligating brackets in various bracket-archwire combinations

This study measured and compared the level of frictional resistance generated between stainless steel self-ligating brackets (Damon SL II, SDS Ormco, Glendora, Calif), polycarbonate self-ligating brackets (Oyster, Gestenco International, Göthenburg, Sweden), and conventional stainless steel brackets (Victory Series, 3M Unitek, Monrovia, Calif), and 3 different orthodontic wire alloys: stainless steel (Stainless Steel, SDS Ormco), nickel-titanium (Ni-Ti, SDS Ormco), and beta-titanium (TMA, SDS Ormco). All brackets had a.022-in slot, whereas the orthodontic wire alloys were tested in 3 different sections:.016,.017 x.025, and.019 x 0.025 in. Each of the 27 bracket and archwire combinations was tested 10 times, and each test was performed with a new bracket-wire sample. Both static and kinetic friction were measured on a custom-designed apparatus. All data were statistically analyzed (Kruskal-Wallis and Mann Whitney U tests). Stainless steel self-ligating brackets generated significantly lower static and kinetic frictional forces than both conventional stainless steel and polycarbonate self-ligating brackets, which showed no significant differences between them. Beta-titanium archwires had higher frictional resistances than stainless steel and nickel-titanium archwires. No significant differences were found between stainless steel and nickel-titanium archwires. All brackets showed higher static and kinetic frictional forces as the wire size increased.

Probiotic Alternative to Chlorhexidine in Periodontal Therapy: Evaluation of Clinical and Microbiological Parameters

Periodontitis consists of a progressive destruction of tooth-supporting tissues. Considering that probiotics are being proposed as a support to the gold standard treatment Scaling-and-Root-Planing (SRP), this study aims to assess two new formulations (toothpaste and chewing-gum). 60 patients were randomly assigned to three domiciliary hygiene treatments: Group 1 (SRP + chlorhexidine-based toothpaste) (control), Group 2 (SRP + probiotics-based toothpaste) and Group 3 (SRP + probiotics-based toothpaste + probiotics-based chewing-gum). At baseline (T0) and after 3 and 6 months (T1-T2), periodontal clinical parameters were recorded, along with microbiological ones by means of a commercial kit. As to the former, no significant differences were shown at T1 or T2, neither in controls for any index, nor in the experimental groups for adherent gingiva and gingival recession. Conversely, some significant differences were found in Group 2 and 3 for the other clinical indexes tested. Considering microbiological parameters, no significant differences were detected compared to baseline values for any group, except in Group 2 and 3 at T2 only for the percentage of the orange complex pathogens and for the copies/microliter of Prevotella intermedia and Fusobacterium nucleatum. Accordingly, although colonization of probiotic bacteria has not been assessed in this study, the probiotics tested represent a valid support to SRP with a benefit on several clinical indexes and on specific periodontopathogens. Despite this promising action, the relationship between the use of probiotics and improvement in clinical parameters is still unclear and deserves to be further explored.

Effect of water and saliva contamination on shear bond strength of brackets bonded with conventional, hydrophilic, and self-etching primers

This study assessed the effect of water and saliva contamination on the shear bond strength and bond failure site of 3 different orthodontic primers (Transbond XT, Transbond Moisture Insensitive Primer, and Transbond Plus Self Etching Primer; 3M Unitek, Monrovia, Calif) used with a light-cured composite resin (Transbond XT). Bovine permanent mandibular incisors (315) were randomly divided into 21 groups (15 in each group). Each primer-adhesive combination was tested under 7 different enamel surface conditions: (1) dry, (2) water application before priming, (3) water application after priming, (4) water application before and after priming, (5) saliva application before priming, (6) saliva application after priming, and (7) saliva application before and after priming. Stainless steel brackets were bonded in each test group with composite resin. After bonding, all samples were stored in distilled water at room temperature for 24 hours and then tested for shear bond strength. Noncontaminated enamel surfaces had the highest bond strengths for conventional, hydrophilic, and self-etching primers, which produced the same strength values. In most contaminated conditions, the self-etching primer had higher strength values than either the hydrophilic or conventional primers. The self-etching primer was the least influenced by water and saliva contamination, except when moistening occurred after the recommended 3-second air burst. No significant differences in debond locations were found among the groups bonded with the self-etching primer under the various enamel conditions.

Biomimetic Effect of Nano-Hydroxyapatite in Demineralized Enamel before Orthodontic Bonding of Brackets and Attachments: Visual, Adhesion Strength, and Hardness in In Vitro Tests

Dietary habits with high consumption of acidic food can induce in orthodontic patients an increased risk of demineralization lesions around orthodontic brackets and bands. The purpose of the present laboratory study is to assess the in vitro visual efficacy of a biomimetic nano-hydroxyapatite remineralizing solution in a hypomineralized enamel surface and its effect on adhesion of fixed orthodontic appliances and on enamel microhardness. Intact teeth were demineralized, and subsequently the areas of demineralization were visually recorded using a 0-100 scale. Subsequently, a remineralizing solution (Biorepair® Repair Shock Treatment) was applied for ten minutes once a day/for one week per month for a total remineralizing treatment of 3 months. Visual effects were recorded. Moreover, bond strength was recorded and adhesive remnant index scores were measured for both orthodontic brackets and composite attachments both before demineralization and after demineralization and application of remineralizing solution. Also, Vickers microhardness was measured. All data were submitted to statistical analysis. The application of remineralizing solution induced a significant in vitro reduction of demineralized areas after the first week of application. No significant differences between untreated enamel surfaces and remineralized surfaces were detected after 2 months of remineralizing treatment. Bond strength values were significantly reduced for both brackets and attachments after remineralizing treatment. However, attachments showed higher adhesion values than brackets in both conditions tested. Remineralized enamel showed significantly higher microhardness values than demineralized enamel and lower values than intact enamel.

Paraprobiotics in Non-Surgical Periodontal Therapy: Clinical and Microbiological Aspects in a 6-Month Follow-Up Domiciliary Protocol for Oral Hygiene

Periodontal disease represents a progressive destruction of tooth-supporting tissues. Recently, paraprobiotics are regarded as an adjunctive therapy to the non-surgical Scaling-and-Root-Planing (SRP). The aim of this study is to evaluate the efficacy of two new formulations of paraprobiotics, a toothpaste and a mouthwash, respectively, for the domiciliary hygiene. A total of 40 patients were randomly assigned to the following domiciliary treatments: Group 1 (SRP + Curasept Intensive Treatment 0.2% chlorhexidine) (control) and Group 2 (SRP + Biorepair Peribioma toothpaste + Biorepair Peribioma Mousse mouthwash) (trial). At baseline (T0) and after 3 and 6 months (T1-T2), periodontal clinical (Bleeding on Probing, Probing Pocket Depth, Clinical Attachment Loss, Bleeding Score, Sulcus Bleeding Index, Plaque Index, Approximal Plaque Index, Adherent Gingiva, Gingival Recession, and Pathological Sites) and microbiological parameters (Pathological Bacteria, Saprophytic Bacteria, Enlarged Red Complex, Red Complex, Orange Complex, and counts of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensys, Treponema denticola, Prevotella intermedia, and Fusobacterium nucleatum). The use of the experimental products resulted in a significant reduction of most of the clinical indices assessed, which occurred at a major degree with respect to the conventional chlorhexidine considered as control. Additionally, after 6 months of use, the abovementioned products significantly decreased the percentage of pathological bacteria and the counts of those bacteria constituting the "Red Complex", more related to the periodontal disease. Accordingly, the paraprobiotics-based products tested in this study seem to represent a valid support to SRP with a benefit on both clinical indices and on specific periodontopathogens.

Vickers Micro-Hardness of New Restorative CAD/CAM Dental Materials: Evaluation and Comparison after Exposure to Acidic Drink

CAD/CAM (computer-aided design/computer-aided manufacturing) for indirect restorative materials has been recently introduced in dentistry. The purpose of this study was to evaluate the change of the surface micro-hardness of different restorative CAD/CAM materials after exposure to a carbonated acidic drink (Coca-Cola, Coca-Cola Company, Milan, Italy). One hundred and eighty specimens of identical size (2 mm thickness) were obtained by sectioning each tested CAD/CAM block of four materials: a hybrid ceramic (CERASMART™, GC Corporation, Tokyo, Japan), a resin nano ceramic (Lava™ Ultimate, 3M, Monrovia, CA, USA), a nanohybrid composite (Grandio blocs, VOCO GmbH, Cuxhaven, Germany), and a zirconia-reinforced lithium silicate glass ceramic (VITA SUPRINITY® PC; VITA Zahnfabrik, Bad Sackingen, Germany). Forty-five specimens of each material were tested. Micro-hardness was measured at baseline, after 7 days and after 28 days. The data were analyzed. The micro-hardness of each material varied significantly after immersion in Coca-Cola. The nanohybrid composite had a high initial micro-hardness and the greatest percentage loss after acid exposure. The hybrid ceramic and the resin nano ceramic had similar percentage losses of micro-hardness values even if the second material had higher initial values. The zirconia-reinforced lithium silicate glass ceramic had the highest baseline values and the lowest percentage loss of micro-hardness. The different CAD/CAM materials presented different micro-hardness values before and after acid exposure.

Home Oral Care of Periodontal Patients Using Antimicrobial Gel with Postbiotics, Lactoferrin, and Aloe Barbadensis Leaf Juice Powder vs. Conventional Chlorhexidine Gel: A Split-Mouth Randomized Clinical Trial

Periodontitis is a progressive destruction of both soft and hard tooth-supporting tissues. In the last years, probiotics have been proposed as a support to the gold standard treatment scaling and root planing (SRP), but no extensive literature is present as regards the effect of the more recent postbiotics. Thirty patients subjected to SRP were randomly assigned to two domiciliary hygiene treatments based on the following oral gels: the postbiotics-based Biorepair Parodontgel Intensive (Group 1) and the chlorhexidine-based Curasept Periodontal Gel (Group 2). At baseline (T0) and after 3 and 6 months (T1-T2), the following periodontal clinical parameters were recorded: Probing Pocket Depth (PPD), recession, dental mobility, Bleeding on Probing (BoP), and Plaque Control Record (PCR). A significant intragroup reduction was assessed in both groups for PPD, BoP, and PCR; conversely, recession significantly increased in both groups, whereas dental mobility did not vary. As regards intergroup comparisons, no statistically significant differences were assessed. Both gels, respectively, containing antioxidant natural ingredients and chlorhexidine, are effective for the domiciliary treatment of periodontitis. Further studies are required to evaluate the singular chemical compounds of the gels expected to exert the beneficial action assessed in this preliminary study.

Computerized Casts for Orthodontic Purpose Using Powder-Free Intraoral Scanners: Accuracy, Execution Time, and Patient Feedback

INTRODUCTION

Intraoral scanners allow direct images of oral situation, with fewer steps than conventional impressions. The purpose of this study was to compare the accuracy of digital impressions, traditional impressions, and digitalization of full-arch gypsum models, to evaluate timing of different methods and finally to study perception of patients about conventional and digital impression techniques.

METHODS

Dental arches of fourteen patients were evaluated by alginate impression, titanium dioxide powder-free intraoral scanning (Trios, 3Shape), and digitalization obtained from gypsum models using the same scanner. Conventional and digital techniques were evaluated through measurements (lower and upper arch anteroposterior length, lower and upper intercanine distance, and lower and upper intermolar distance) with a caliber for analogic models and using a computer software for digital models (Ortho Analyzer, Great Lakes Orthodontics). In addition, chairside and processing times were recorded. Finally, each patient completed a VAS questionnaire to evaluate comfort. Statistical analyses were performed with ANOVA and Tukey tests for accuracy measurements and paired t-test for times and VAS scores. Significance was predetermined at P < 0.05.

RESULTS

The measurements obtained with intraoral scanning, gypsum models after conventional impression, and digitalized gypsum models were not significantly different. Both chairside and processing times of digital scanning were shorter than the traditional method. VAS reporting patients comfort were significantly higher when evaluating digital impression.

CONCLUSIONS

Intraoral scanners used for orthodontic applications provide useful data in clinical practice, comparable to conventional impression. This technology is more time efficient than traditional impression and comfortable for patients. Further evolution with more accurate and faster scanners could in future replace traditional impression methods.

Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations

Dental caries is one of the most common diseases-both in adults and children-that occurs due to the demineralization of enamel and dentine by the organic acids formed from bacteria present in dental plaques through anaerobic metabolism of dietary sugars. The aim of this article is to provide a guideline to assess the risk of caries by looking for the main factors involved. Literature research was performed for studies that analyzed the factors most involved in the development of child caries, such as poor oral hygiene, bad eating habits (or food disorders), and an alteration of the oral bacterial flora-with an increase of Streptococci spp., Lactobacilli spp., Candida albicans, Cryptococcus neoformans, and Candida sake. It is therefore essential to assess the risk of caries in children, based on the assessment of risk factors, in order to be able to establish preventive and/or therapeutic approaches that will reduce or stop the development of dental caries. The use of fluoride products, products made from casein phosphopeptide-amorphous calcium phosphate, substituted zinc biomimetic hydroxyapatite products, or products containing self-assembling oligopeptide SAP-P11-4 are useful. In terms of the clinical approach, a communicative approach should be added to learn about the eating habits and the oral hygiene habits of the child and parents; in addition, the use of a simple method to frame the factors involved, and subsequently establish the risk of carious lesions in the child, allows the reduction of the DMFT (Decayed Missing Filled Teeth) or ICDAS (International Caries Detection and Assessment System) index on large scales.

Evaluation of friction of conventional and metal-insert ceramic brackets in various bracket-archwire combinations

The purpose of the study was to measure and compare the level of frictional resistance generated between conventional ceramic brackets (Transcend Series 6000, 3M Unitek, Monrovia, Calif), ceramic brackets with stainless steel slot (Clarity, 3M Unitek), conventional stainless steel brackets (Victory Series, 3M Unitek), and 3 different orthodontic wire alloys: stainless steel (stainless steel, SDS Ormco, Glendora, Calif), nickel-titanium (Ni-Ti, SDS Ormco), and beta-titanium (TMA, SDS Ormco). All brackets had a 0.022-in slot, and orthodontic wire alloys were tested in 3 different sections: 0.016 in, 0.017 x 0.025 in, and 0.019 x 0.025 in. Each of the 27 bracket-archwire combinations was tested 10 times, and each test was performed with a new bracket-wire sample. Static and kinetic friction were measured on a specially designed apparatus. All data were statistically analyzed (analysis of variance and Scheffé for the bracket effect, Kruskal-Wallis and Mann Whitney for the alloy and section effects). Metal-insert ceramic brackets generated significantly lower frictional forces than did conventional ceramic brackets, but higher values than stainless steel brackets, in agreement with the findings of the few previous reports. Beta-titanium archwires had higher frictional resistances than did stainless steel and nickel-titanium archwires. No significant differences were found between stainless steel and nickel-titanium archwires. All the brackets showed higher static and kinetic frictional forces as the wire size increased. Metal-insert ceramic brackets are not only visually pleasing, but also a valuable alternative to conventional stainless steel brackets in patients with esthetic demands.

SEM/EDS Evaluation of the Mineral Deposition on a Polymeric Composite Resin of a Toothpaste Containing Biomimetic Zn-Carbonate Hydroxyapatite (microRepair®) in Oral Environment: A Randomized Clinical Trial

Toothpastes containing biomimetic hydroxyapatite have been investigated in recent years; the behavior of this material in the oral environment has been evaluated directly on dental enamel showing a marked remineralizing activity. To propose microRepair®-based toothpastes (Zn-carbonate hydroxyapatite) for the domiciliary oral hygiene in patients with dental composite restorations, the aim of this study was to evaluate the deposition of Zn-carbonate hydroxyapatite on a polymeric composite resin with Scanning Electron Microscopy/Energy-Dispersive X-ray Spectrometry (SEM/EDS) analysis. Twenty healthy volunteers underwent the bonding of 3 orthodontic buttons on the vestibular surfaces of upper right premolars and first molar. On the surface of the buttons, a ball-shaped mass of composite resin was applied and light-cured. Then, the volunteers were randomly divided into two groups according to the toothpaste used for domiciliary oral hygiene: the Control toothpaste containing stannous fluoride and the Trial toothpaste containing microRepair®. The buttons were debonded after 7 days (T1-first premolar), after 15 days (T2-second premolar), and after 30 days (T3-first molar) to undergo the SEM/EDS analysis. The deposition of calcium, phosphorus, and silicon was assessed through EDS analysis and data were submitted to statistical analysis (p < 0.05). SEM morphologic evaluation showed a marked deposition of the two toothpastes on the surfaces of the buttons. EDS quantitative analysis showed an increase of calcium, phosphorus, and silicon in both the groups, with a statistically significant difference of calcium deposition at T3 for the Trial group. Therefore, the use of toothpaste containing Zn-carbonate hydroxyapatite could be proposed as a device for domiciliary oral hygiene because the deposition of hydroxyapatite on polymeric composite resin could prevent secondary caries on the margins of restorations.

Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial

Peri-implant mucositis represents an inflammatory lesion of the mucosa surrounding an endosseous implant, without the loss of the supporting peri-implant bone. Considering its reversible nature, every effort should be made to contrast it, thus avoiding the eventual progression towards peri-implantitis. The aim of the present randomized clinical trial is to evaluate the efficacy of the ozonized water against peri-implant mucositis. A total of 26 patients diagnosed for this latter clinical condition were randomly divided according to the professional oral hygiene protocol performed on the pathological sites at baseline, at T1 (1 month), and T2 (2 months). Group 1 underwent an ozonized water administration (experimental treatment), whereas Group 2 underwent a pure water one (control treatment). Both administrations were performed with the same professional irrigator (Aquolab® professional water jet, Aquolab s.r.l. EB2C S.r.l., Milano, Italy) with no differences in color or taste between the two substances delivered. At each appointment, the following indexes were assessed: the Probing Pocket Depth (PPD), Plaque Index (PI), Bleeding on Probing (BoP), and Bleeding Score (BS). As regards intragroup differences, in Group 1 ozonized water significantly and progressively reduced all the clinical indexes tested, except for PI in the period T1–T2, whereas no significant differences occurred within the control group. Despite this, no significant intergroup differences were generally detected between the two treatments. Accordingly, the role of ozone for the management of peri-implant mucositis deserves to be further investigated.

New Resin-Based Bulk-Fill Composites: in vitro Evaluation of Micro-Hardness and Depth of Cure as Infection Risk Indexes

The current in vitro study evaluated the Vickers hardness number (VHN) and hardness ratio of four bulk-fill composites (VisCalor bulk; Admira Fusion x-tra; x-tra fil; and GrandioSO x-tra-Voco, Cuxhaven, Germany) to assess the risk of bacterial colonization in comparison with standard composite materials. Thirty samples were prepared for each group. The VHN of both the external (top) and internal surface (bottom) was determined with a micro-hardness tester (200 g load for 15 s), and the hardness ratio was also calculated for each sample. Subsequently, storage in an acidic soft drink (Coca-Cola, Coca-Cola Company, Milano, Italy) was performed; for each group, 10 samples were stored for 1 day, while another 10 were stored for 7 days and the remaining 10 were kept in water as controls. A significant reduction in VHN was shown for all the groups when comparing the external versus internal side (P < 0.05), although the hardness ratio was greater than 0.80, resulting in an adequate polymerization. Regarding the acid storage, all the groups showed a significant decrease of VHN when compared with the controls, both after 1 day (P < 0.05) and after 7 days (P < 0.001). All the products showed adequate depth of cure without further risk of bacterial colonization. However, acid exposure negatively affected micro-hardness values, which might promote subsequent colonization.

Management of Gingival Bleeding in Periodontal Patients with Domiciliary Use of Toothpastes Containing Hyaluronic Acid, Lactoferrin, or Paraprobiotics: A Randomized Controlled Clinical Trial

Periodontitis is an irreversible oral disease causing the destruction of tooth-supporting tissues. In addition to scaling and root planing (SRP) procedures, patients should achieve a correct domiciliary oral hygiene in order to maintain a healthy status. The aim of the present study was to evaluate the efficacy of different toothpastes in reducing gingival bleeding in periodontal patients. In addition to a professional treatment of SRP, 80 patients were randomly divided into four groups according to the toothpaste assigned for the daily domiciliary use using an electric toothbrush: Group 1 (Biorepair Gum Protection), Group 2 (Biorepair Plus Parodontgel), Group 3 (Biorepair Peribioma PRO), and Group 4 (Meridol Gum Protection) (control group). After baseline (T0), patients were visited after 15 days (T1), 3 months (T2), and 6 months (T3). At each appointment, the following periodontal indexes were assessed: bleeding on probing (BoP), full-mouth bleeding score (FMBS), and modified sulcus bleeding index (mSBI). All the experimental toothpastes caused an immediate significant modification of the three clinical indexes measured, except for the control product. Biorepair Peribioma PRO, with its paraprobiotic content, was also the only toothpaste causing a prolonged effect, reducing BoP even at T3. Accordingly, both hyaluronic acid and lactoferrin appear as reliable supports for the domiciliary management of periodontal disease. In spite of this, paraprobiotics are likely to show the most important benefit thanks to their immunomodulating mechanism of action.

Oral Microbiota in Patients with Peri-Implant Disease: A Narrative Review

Peri-implant infections are the most common complications related to the placement of dental implants. There are many microbial similarities between peri-implantitis and periodontitis but due to current laboratory techniques there are just as many differences. This review was performed to assess changes in the oral microbiota at sites with peri-implant disease, according to the state of the art. The peri-implant microbiota presents a lower microbial quality than the periodontal microbiota, becoming increasingly complex as it progresses from peri-implant mucositis to peri-implantitis. The microbial difference detected between the peri-implant and periodontal microbiota is primarily related to whole bacterial populations, rather than specific bacterial taxa. The use of probiotics could support the reduction of peri-implant pockets, in association with mechanical debridement, due to their mechanism of action of competitive inhibition for adhesion sites. The peri-implant microbiota represents a qualitatively inferior but quantitatively superior bacterial ecosystem for some bacterial genera compared to the periodontal microbiota, showing that a progression from healthy state to peri-implantitis causes changes in microbiota composition in the absence of specific disease-causing bacteria. Transcriptomics could provide useful information for the prevention, diagnosis, and therapy of peri-implant pathology through knowledge of bacterial virulence factors.

Copper-Alloy Surfaces and Cleaning Regimens against the Spread of SARS-CoV-2 in Dentistry and Orthopedics. From Fomites to Anti-Infective Nanocoatings

The latest diffusion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease (COVID-19), has involved the whole world population. Even if huge efforts to control the pandemic have been done, the viral spread is still continuing. COVID-19 is reported as a zoonosis jumped from bats and pangolins to humans. After infection in humans, SARS-CoV-2 is found in the nasopharyngeal and salivary secretions. The virus has also been detected in the blood plasma of infected patients. The viral spread occurs through droplets exhaled from the nose and mouth of the infected people when they breath or talk, or through droplets propelled as a dense cloud by chough or sneeze. The virus can also be delivered as an aerosol from blood plasma, through surgical procedures. Following these ways, the virus can disperse in the air, then reaching and settling on the exposed surfaces. How long the virus will survive on a surface depends on the material the surface is made from. Infection via high-touch surfaces should be prevented. Copper alloy coatings, combined with efficient hygienic/disinfectant procedures and careful surgical practice, could be helpful to health protection in dental practice and can also be adopted in orthopedic traumatology.

Failure load and stress analysis of orthodontic miniscrews with different transmucosal collar diameter

Miniscrews have been introduced in orthodontics as temporary anchorage devices (TADs), in order to move the correct teeth and avoid other elements to slide toward a wrong direction. Moreover the ease of use of TADs encouraged clinicians to use miniscrews also for non-conventional purposes, as fixation in mandibular fracture, mini-implant supported temporary pontics, miniscrew-assisted rapid palatal expanders and distalizers. These applications develop higher forces, so TAD fracture can be an unwanted complication. Some authors analyzed torsional loads but no studies measured forces required to bend the screws and ultimate flexural strength. Accordingly, in the present report, Ti-6Al-4V TADs were mechanically evaluated. Seven different diameters of screws were tested: 1.3 mm (Aarhus Screw, Medicon), 1.5 mm (Spider Screw, HDC), 1.6 mm (Aarhus Screw, Medicon), 1.7 mm (Ortho Easy, Forestadent), 1.8 mm (Ortho Implant, 3 M), 1.9 mm (Spider Screw, HDC) and 2.0 mm (Storm, Kristal). The forces to bend the titanium TADs were measured at 0.1 mm, 0.2 mm magnitude of deflections and at maximum load (as peak before screw fracture) in air with a universal testing machine. Statistical analyses were performed. Both at 0.1 mm and at 0.2 mm deflections and at maximum load, the significantly highest forces were reported with 1.7, 1.8, 1.9, and 2.0 mm TADs. The lowest values were reported with 1.6, 1.5, and 1.3 mm mini-implants. No significant differences were reported between 1.6 mm and 1.7 mm screws. It was found that load values in N versus stress in MPa were not fully comparable when screws with small and larger diameter were compared. Therefore, when placing a miniscrew for applications that need maximum shear bending resistance, these results would be considered in order to reduce risk of unwanted fracture.

Domiciliary Use of Chlorhexidine vs. Postbiotic Gels in Patients with Peri-Implant Mucositis: A Split-Mouth Randomized Clinical Trial

Peri-implant mucositis is a pathological condition characterized by an inflammatory process in the peri-implant soft tissues. Progression to peri-implantitis takes place in case of peri-implant bone resorption. Recently, an aid for non-surgical treatment by mechanical debridement (SRP) has been identified in probiotics. As there are no recent studies regarding their use for peri-implant mucositis, the aim of this study was to test a new postbiotic gel for this clinical condition. A split-mouth randomized clinical trial was performed. Twenty patients undergoing SRP were randomly assigned to two treatments based on the following oral gels: chlorhexidine-based Curasept Periodontal Gel (Group 1) and postbiotic-based Biorepair Parodontgel Intensive (Group 2). At baseline (T0) and after three (T1) and six (T2) months, the following peri-implant mucositis indexes were recorded: Probing Pocket Depth (PPD), Plaque Index (PI), Gingival Bleeding Index (GBI), Bleeding Score (BS), Marginal Mucosal Condition (MMC). A significant decrease is reported for both postbiotic and chlorhexidine for all peri-implant mucositis indices studied. Quite the opposite, no significant variation was present in intergroup comparisons. Greater improvements for BS, GBI and MMC inflammatory indices of the postbiotic gel compared to chlorhexidine suggest the importance of further studies to investigate the relevance of the product alone.

Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial

OBJECTIVE

To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients.

MATERIALS AND METHODS

30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM).

RESULTS

For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM.

CONCLUSION

Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.

Evaluation of Adjuvant Systems in Non-Surgical Peri-Implant Treatment: A Literature Review

Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.

Home Oral Care with Biomimetic Hydroxyapatite vs. Conventional Fluoridated Toothpaste for the Remineralization and Desensitizing of White Spot Lesions: Randomized Clinical Trial

Introduction: Biomimetic hydroxyapatite-based toothpastes have been investigated in recent years for their remineralizing activity on dental surfaces. The aim of the present study was to evaluate the efficacy of toothpaste containing biomimetic hydroxyapatite versus a 1450 pppm fluoride one in promoting the remineralization and desensitization of white spot lesions. Methods: 40 patients were randomly assigned to two different domiciliary oral hygiene treatments: toothpaste containing 1450 ppm of fluoride (control group) and toothpaste containing biomimetic hydroxyapatite (experimental group). Dental sensitivity/pain and dental erosion were assessed at baseline and after 15, 30, and 90 days using the following indexes: Schiff Air Index (SAI), Visual Analogue Scale (VAS), and Basic Erosive Wear Examination (BEWE). Results: Data were submitted for statistical analysis. SAI significantly decreased after 3 months (T3) of treatment only in the Trial group (p < 0.05). VAS values significantly decreased at T2 in the trial group (p < 0.05) with a further significant reduction at T3 (p < 0.05). BEWE scores did not significantly vary during the follow up neither in the trial nor in the control group. Conclusions: The hydroxyapatite-based toothpaste tested caused a reduction of hypersensitivity/pain values higher than conventional fluoride toothpaste.

Sella turcica bridging and dental anomalies: is there an association?

BACKGROUND

Sella turcica bridging (STB), or calcification of the interclinoid ligament of sella turcica, has been reported to be associated with some dental anomalies (palatal canine impaction and transposition).

HYPOTHESIS OR AIM

The aim of the study was to find any association between canine impaction, hyperdontia or hypodontia and sellar dimensions or bridging.

DESIGN

Lateral cephalometric radiographs from 78 patients with impacted canines, 68 with dental agenesis and 17 with hyperdontia were collected. Linear dimensions of sella turcica were calculated and compared to those of a control group (47 individuals). A standardize scoring scale was used to quantify the extent of STB from each radiographs.

RESULTS

The frequency of partial and complete calcifications of sella in patients with dental anomalies is increased when compared to controls. STB can influence the interclinoid distance but does not affect other linear dimensions of sella. No statistically significant difference has been found in sellar dimensions and STB expression when evaluating radiographs at different ages.

CONCLUSIONS

STB is frequently found in patients with dental abnormalities.

Flexural Properties and Elastic Modulus of Different Esthetic Restorative Materials: Evaluation after Exposure to Acidic Drink

BACKGROUND

Acidic beverages, such as soft drinks, can produce erosion of resin composites. The purpose of the present study was to investigate mechanical properties of different esthetic restorative materials after exposure to acidic drink.

METHODS

Nine different composites were tested: nanofilled (Filtek Supreme XTE, 3M ESPE), microfilled hybrid (G-ænial, GC Corporation), nanohybrid Ormocer (Admira Fusion, Voco), microfilled (Gradia Direct, GC Corporation), microfilled hybrid (Essentia, GC Corporation), nanoceramic (Ceram.X Universal, Dentsply De Trey), supranano spherical hybrid (Estelite Asteria, Tokuyama Dental Corporation), flowable microfilled hybrid (Gradia Direct Flo, GC Corporation), and bulk fill flowable (SureFil SDR flow, Dentsply De Trey). Thirty specimens of each esthetic restorative material were divided into 3 subgroups (n=10): specimens of subgroup 1 were used as control, specimens of subgroup 2 were immersed in 50 ml of Coca Cola for 1 week, and specimens of subgroup 3 were immersed in 50 ml of Coca Cola for 1 month. Flexural strength and elastic modulus were measured for each material with an Instron Universal Testing Machine. Data were submitted to statistical analysis.

RESULTS

After distilled water immersion, nanofilled composite showed the highest value of both flexural strength and elastic modulus, but its flexural values decreased after acidic drink immersion. No significant differences were reported between distilled water and acidic drink immersion for all other materials tested both for flexural and for elastic modulus values.

CONCLUSIONS

Even if nanofilled composite showed highest results, acidic drink immersion significantly reduced flexural values.

Biomimetic hydroxyapatite paste for molar-incisor hypomineralization: A randomized clinical trial

OBJECTIVES

The aim of this randomized clinical trial was to evaluate the desensitizing and remineralizing effect of a new zinc-hydroxyapatite-based paste in sites affected by molar-incisor hypomineralization (MIH), by assessing dental sensitivity, tooth wear, and periodontal indexes.

MATERIALS AND METHODS

Twenty-five patients with presence of 1 enamel demineralization of permanent molars and incisors in two different quadrants were recruited. After professional dental hygiene, a domiciliary hydroxyapatite-based paste was assigned and recommended to be applied on 2 MIH teeth in one random quadrant (test group), while the 2 contralateral MIH teeth did not undergo paste application (control group). The following primary outcomes were assessed: Plaque Control Record (PCR), Bleeding Index (BI), MIH Treatment Need Index (MIH-TNI), and Schiff Air Index (SAI).

RESULTS

No significant inter- and intragroup differences were found for PI and BI, except for both intragroup T0-T1. For MIH-TNI, significant intergroup differences were detectable in the test group after 9 months of treatment. For SAI values, no significant differences were found in the control group, while in the test group, significant lower values were found after 1 and 3 months since baseline, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Biomimetic zinc-hydroxyapatite showed a desensitizing effect when used to treat MIH.