The aim of this systematic review and meta-analysis was to state the efficacy of local administration of antibiotics in the treatment of peri-implantitis in terms of peri-implant probing depth (PPD) ...and bleeding on probing (BoP) reduction.
Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). Due to the encountered heterogeneity between the studies being combined, random-effects models were applied in order to analyze effect sizes. Twelve studies (365 patients and 463 implants) were included in the systematic review. After peri-implantitis treatment with local antibiotics, PPD was reduced 1.40 mm (95% confidence interval: 0.82-1.98). When local antibiotics were applied, a 0.30 mm higher reduction of PPD was obtained than in the control group (95% confidence interval: 0.07-0.53). BoP attained an odds ratio value of 1.82 (95% confidence interval: 1.09-3.04), indicating that the likehood of bleeding is almost two-fold when antibiotics are not locally administrated. Adverse effects were not found after applying local antibiotics.
The local antibiotic administration does reduce, without adverse effects, both peri-implant probing depths and bleeding on probing in patients affected by peri-implantitis, if compared to control groups without local antibiotic application.
Patients with dental implants frequently suffer from peri-implantitis. Clinical features of peri-implantitis lesions include the presence of bleeding on probing and increased peri-implant probing depths. Both BoP and PPD have become reduced after local administration of antibiotics.
Abstract Objectives To evaluate the effect of surface conditioning on the microtensile bond strength of zirconium-oxide ceramic to dual-cured resin cements. Methods Eighteen cylinder-shaped ...zirconium-oxide ceramic blocks (Cercon® Zirconia, Dentsply) were treated as follows: (1) Sandblasting with 125 μm aluminum-oxide (Al2 O3 ) particles; (2) tribochemical silica coating using 50 μm Al2 O3 particles modified by silica; (3) no treatment. Each ceramic cylinder was duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent) using a silicon mold. Composite cylinders were bonded to conditioned ceramics using: (1) Calibra (Densply Caulk); (2) Clearfil Esthetic Cement (Kuraray); (3) Rely × Unicem (3 M ESPE). After 24 h bonded specimens were cut into microtensile sticks that were loaded in tension until failure. Data were analyzed using two-way ANOVA and Student–Newman–Keuls test for multiple comparisons ( p < 0.05). Failure mode was recorded and the interfacial morphology of debonded specimens was observed using a scanning electron microscope (SEM). Surface topography and ceramic average surface roughness were analyzed under an atomic force microscope (AFM). Results Significant changes in zirconia surface roughness occurred after sandblasting ( p < 0.001). Bond strength of Clearfil cement to zirconia was significantly higher than that of Rely × Unicem and Calibra, regardless of the surface treatment ( p < 0.001). When using Calibra, premature failures occurred in non-treated and silica coated zirconia surfaces. Significance The phosphate monomer-containing luting system (Clearfil Esthetic Cement) is recommended to bond zirconia ceramics and surface treatments are not necessary.
Abstract Objective The objective of the study was to determine if zinc-doped etch-and-rinse dentin adhesive may induce therapeutic effects within the resin–dentin interface. Methods Human acid-etched ...dentin was infiltrated with Adper™ Single Bond Plus (SB, 3M ESPE, St. Paul, MN, USA), SB doped with 10 wt.% ZnO nanoparticles (ZnO-SB) or SB doped with 2 wt.% ZnCl2 (ZnCl2 -SB). AFM/nanoindentation analysis was performed on fully hydrated specimens to evaluate the nanomechanical properties ( Hi : hardness; Ei : modulus of elasticity) across the resin–dentin interface after different SBF storage periods (24 h, 1 m, 3 m). Confocal laser microscopy (CLSM) was used to evaluate the ultramorphology and micropermeability at 24 h and 3 m of SBF storage. Results SB control specimens exhibited a decrease in Hi in the hybrid layer (HL) and bottom of the hybrid layer (BHL) and a decrease in Ei in the HL after 3 m of SBF storage, indicating that severe degradation occurred in the control interface. ZnO-SB bonded specimens preserved the initial Hi and Ei at the HL and BHL subsequent SBF storage; ZnCl2 -SB bonded specimens showed a decrease in Ei , in the HL over time. CLSM analysis confirmed that both Zn-doped adhesives were able to preserve the integrity of the HL. Significance Specific formulation of Zn-doped etch-and-rinse adhesives may offer the possibility to maintain the nano-mechanical properties along the dentin-bonded interface by inhibiting dentin MMPs and by protective mineral crystals formation within the resin–dentin interface. Clinical advantages may be expected by preserving and improving the integrity of the hybrid layer when Zn-doped adhesives are employed.
The objective was to state zinc contribution in the effectiveness of novel zinc-doped dentin cements to achieve dentin remineralization, throughout a literature or narrative exploratory review. ...Literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. Both zinc-doping silicate and hydroxyapatite-based cements provoked an increase of both bioactivity and intrafibrillar mineralization of dentin. Zinc-doped hydroxyapatite-based cements (oxipatite) also induced an increase in values of dentin nano-hardness, Young's modulus and dentin resistance to deformation. From Raman analyses, it was stated higher intensity of phosphate peaks and crystallinity as markers of dentin calcification, in the presence of zinc. Zinc-based salt formations produced low microleakage and permeability values with hermetically sealed tubules at radicular dentin. Dentin treated with oxipatite attained preferred crystal grain orientation with polycrystalline lattices. Thereby, oxipatite mechanically reinforced dentin structure, by remineralization. Dentin treated with oxipatite produced immature crystallites formations, accounting for high hydroxyapatite solubility, instability and enhanced remineralizing activity.
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•Zn-doped silicate cements facilitate functional remineralization of dentin.•Zn-loaded hydroxyapatite cements remineralize and seal root dentin.•Zn promotes amorphous and stoichiometric apatites formation at dentin.
Collagen matrices have become a great alternative to the use of connective tissue grafts for soft tissue augmentation procedures. One of the main problems with these matrices is their volume ...instability and rapid degradation. This study has been designed with the objective of examining the degradation of three matrices over time. For this purpose, pieces of 10 × 10 mm2 of Fibro-Gide, Mucograft and Mucoderm were submitted to three different degradation tests—(1) hydrolytic degradation in phosphate buffer solution (PBS); (2) enzyme resistance, using a 0.25% porcine trypsin solution; and (3) bacterial collagenase resistance (Clostridium histolyticum)—over different immersion periods of up to 50 days. Weight measurements were performed with an analytic microbalance. Thickness was measured with a digital caliper. A stereomicroscope was used to obtain the matrices’ images. ANOVA and Student–Newman–Keuls tests were used for mean comparisons (p < 0.05), except when analyzing differences between time-points within the same matrix and solution, where pair-wise comparisons were applied (p < 0.001). Fibro-Gide attained the highest resistance to all degradation challenges. The bacterial collagenase solution was shown to constitute the most aggressive test as all matrices presented 100% degradation before 14 days of storage.
Collagen membranes are currently the most widely used membranes for guided bone regeneration; however, their rapid degradation kinetics means that the barrier function may not remain for enough time ...to permit tissue regeneration to happen. The origin of collagen may have an important effect on the resistance to degradation. The aim of this study was to investigate the biodegradation pattern of five collagen membranes from different origins: Biocollagen, Heart, Evolution X-fine, CopiOs and Parasorb Resodont. Membranes samples were submitted to different degradation tests: (1) hydrolytic degradation in phosphate buffer saline solution, (2) bacterial collagenase from Clostridium histolyticum solution, and (3) enzyme resistance using a 0.25% porcine trypsin solution. Immersion periods from 1 up to 50 days were performed. At each time point, thickness and weight measurements were performed with a digital caliper and an analytic microbalance, respectively. ANOVA and Student–Newman–Keuls tests were used for comparisons (p < 0.05). Differences between time-points within the same membranes and solutions were assessed by pair-wise comparisons (p < 0.001). The Evolution X-fine collagen membrane from porcine pericardium attained the highest resistance to all of the degradation tests. Biocollagen and Parasorb Resodont, both from equine origin, experienced the greatest degradation when immersed in PBS, trypsin and C. histolyticum during challenge tests. The bacterial collagenase solution was shown to be the most aggressive testing method.
Abstract Objectives To evaluate the hydrolytic stability of different dual-cure resin cements when luted to zirconia ceramic. Methods Eighteen cylinder-shaped zirconia blocks (Cercon Zirconia, ...Dentsply) were conditioned with: Group 1, no treatment; Group 2, sandblasting (125 μm alumina–Al2 O3 -particles); Group 3, tribochemical silica coating (50 μm silica-modified Al2 O3 particles). Ceramic blocks were duplicated in composite resin (Tetric Evo Ceram, Ivoclar-Vivadent). Composite disks were luted to pre-treated ceramic surfaces using: (1) Clearfil Esthetic Cement (CEC; Kuraray); (2) Rely X Unicem (RXU; 3M ESPE); (3) Calibra (CAL; Dentsply Caulk). After 24 h, bonded samples were cut into microtensile sticks (1 mm2 ). Half of the sticks were loaded in tension until failure (cross-head speed of 0.5 mm/min). The remaining half was tested after 6 months of water storage at 37 °C. Data was analyzed with three-way ANOVA and Tukey’s test ( P <0.05). Fractographic analysis was performed by SEM. Results After 24 h, bond strength of CEC to zirconia was significantly higher than that of RXU and CAL, independently from the ceramic pre-treatment ( P <0.001). Using CAL, all samples failed prematurely except when luting to sandblasted surfaces. After 6 months of water aging, bond strength of CEC significantly decreased. RXU did not significantly alter bond strengths. Adhesion of sandblasted specimens luted with CAL fell over time. Micromorphological alterations were evident after water storage. Significance Resin–ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments. CEC and RXU were both suitable for luting zirconia. Water aging played an important role in the durability of zirconia-to-composite chemical bonds.
Barrier membranes are employed in guided bone regeneration (GBR) to facilitate bone in-growth. A bioactive and biomimetic Zn-doped membrane with the ability to participate in bone healing and ...regeneration is necessary. The aim of the present study is to state the effect of doping the membranes for GBR with zinc compounds in the improvement of bone regeneration. A literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. A narrative exploratory review was undertaken, focusing on the antibacterial effects, physicochemical and biological properties of Zn-loaded membranes. Bioactivity, bone formation and cytotoxicity were analyzed. Microstructure and mechanical properties of these membranes were also determined. Zn-doped membranes have inhibited in vivo and in vitro bacterial colonization. Zn-alloy and Zn-doped membranes attained good biocompatibility and were found to be non-toxic to cells. The Zn-doped matrices showed feasible mechanical properties, such as flexibility, strength, complex modulus and tan delta. Zn incorporation in polymeric membranes provided the highest regenerative efficiency for bone healing in experimental animals, potentiating osteogenesis, angiogenesis, biological activity and a balanced remodeling. Zn-loaded membranes doped with SiO2 nanoparticles have performed as bioactive modulators provoking an M2 macrophage increase and are a potential biomaterial for promoting bone repair. Zn-doped membranes have promoted pro-healing phenotypes.
Oral soft tissue thickening or grafting procedures are often necessary to cover tooth recession, re-establish an adequate width of keratinized tissue, correct mucogingival deformities improving ...esthetics, prepare a site for an implant or prosthetics, for ridge preservation procedures, and soft tissue contouring around dental implants. Gingival recession and root or implant exposure are commonly associated and have led to mucogingival deficiencies that have traditionally been treated with free gingival grafts and autogenous soft tissue grafts. The latter represents the gold standard in acquiring a functionally adequate zone of keratinized attached gingiva. However, soft tissue substitutes are more usually employed because they lessen morbidity and abbreviate surgical time. This review is aimed at assessing oral soft tissue augmentation techniques and biomaterials used from existing literature, principally concerning scaffolds from both human and animal-based tissue derivatives matrices. In order to avoid the use of human donor tissue, the xenogenic collagen matrices are proposed for soft tissue augmentation. In general, all of them have provided the remodeling processes and enhanced the formation of new connective tissue within the matrix body.
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