Frank Falkensammer

Color stability of different composite resin materials

STATEMENT OF PROBLEM Data are needed to better predict the color stability of current composite resin materials. PURPOSE The purpose of this study was to evaluate the impact of different storage solutions on the color stability of different composite resin materials. MATERIAL AND METHODS Different restorative and adhesive composite resin specimens (dual-polymerizing self-adhesive resin cement, autopolymerizing resin-based composite resin, dual-polymerizing resin-based composite resin, nanohybrid composite resin, and microhybrid composite resin) were fabricated and stored in red wine, black tea, chlorhexidine, sodium fluoride, tea tree oil, or distilled water for 4 weeks at 37°C. Color parameters were measured with a colorimeter before and after storage. Total color differences and specific coordinate differences were expressed as ΔE, ΔL, Δa, and Δb. A 2-way and 1-way analysis of variance (ANOVA) with Bonferroni adjustment for multiple comparisons were applied for statistical calculations (α=.05). RESULTS Red wine caused the most severe discoloration (ΔE >10), followed by black tea with perceptible (ΔE >2.6) to clinically unacceptable discoloration (ΔE >5.5). Colored mouth rinses discolored the materials to a lesser extent with clinically acceptable values. Dual-polymerizing resin adhesives showed a higher amount of discoloration. CONCLUSIONS Current restorative and adhesive composite resin materials discolor over time under the influence of different storage solutions. The composition related to the polymerizing mode seemed to be a causative factor.

Effect of nicotine and porphyromonas gingivalis lipopolysaccharide on endothelial cells in vitro.

Smoking is considered a significant risk factor for both periodontal disease and cardiovascular disease (CVD). Endothelial cells play an important role in the progression of both diseases. In the present study, we investigated in vitro the impact of nicotine on functional properties of human umbilical vein endothelial cells (HUVECs) stimulated with lipopolysaccharide (LPS) of periodontal pathogen Porphyromonas gingivalis. HUVECs were stimulated with different concentrations of nicotine (10 µM-10 mM) and/or P. gingivalis LPS. Expression levels of intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, monocyte chemoattractant protein 1, and interleukin-8 were measured on both gene and protein levels. Cell proliferation/viability, apoptosis, and migration were also investigated. Nicotine at a concentration of 10 mM significantly decreased P. gingivalis LPS-induced expression of all investigated proteins after 4 h stimulation, while lower nicotine concentrations had no significant effect on protein expression with or without P. gingivalis LPS. Proliferation/viability of HUVECs was also significantly inhibited by 10-mM nicotine but not by lower concentrations. Migration of HUVECs was significantly decreased by nicotine at concentrations of 1–10 mM. Nicotine at a concentration similar to that observed in the serum of smokers had no significant effect on the functional properties of HUVECs. However, high concentrations of nicotine, similar to that observed in the oral cavity of smokers, inhibited the inflammatory response of HUVECs. This effect of nicotine might be associated with decreased gingival bleeding indices in smoking periodontitis patients.

Influence of surface conditioning on ceramic microstructure and bracket adhesion

The objective of this study was to investigate the influence of different conditioning procedures on various ceramic microstructures and bracket adhesion. Ceramic specimens (feldspathic, leucite, leucite-free, and fluorapatite) were mechanically conditioned (n = 20 per ceramic type) with conventional hydrofluoric acid (5 per cent HF; 60/30 seconds), buffered hydrofluoric acid (9.6 per cent BHF; 60/30 seconds), or sandblasting (Al(2)O(3)/SiO(2) particles). Silane coupling agents were added for chemical conditioning before bracket bonding. Bracket adhesion was calculated with a shear test in a universal testing machine. The bracket-composite-ceramic interface was further evaluated using the adhesive remnant index (ARI). One specimen of each ceramic/conditioning combination was subjected to qualitative electron microscopy investigation. One-way analysis of variance followed by Tukeys honestly significant difference test were applied for inferential statistics. Conditioning with conventional 5 per cent HF or sandblasting resulted in significantly (P < 0.001) higher bond strengths (mean values: 34.11 and 32.86 MPa, respectively) than with 9.6 per cent BHF (mean value: 12.49 MPa). Etching time or sandblasting particles had no statistical (P > 0.001) influence on bond strength. Higher ARI scores were found in the conventional 5 per cent HF and sandblasted groups, when compared with the 9.6 per cent BHF group. Microscopic examination of the conditioned ceramic surfaces showed that leucite and leucite-free ceramics differed most with respect to their surface roughness, though without an influence on shear bond strength (SBS; P < 0.001). Bracket adhesion was mostly influenced by the conditioning procedure itself. Sandblasted ceramic surfaces showed sufficient conditioning and bracket adhesion; however, the increased bracket adhesion was associated with a risk of ceramic surface damage.

Influence of different conditioning methods on immediate and delayed dentin sealing

STATEMENT OF PROBLEM Data are needed to evaluate the effect of various conditioning methods on immediate and delayed dentin sealing. PURPOSE The purpose of this study was to test bond strength and surface configuration of immediate and delayed dentin sealing surfaces after applying different surface conditioning methods. MATERIAL AND METHODS A total of 96 premolars were allocated to the immediate and delayed groups. The groups differed in the timing of dentin sealing. The immediate-group specimens were sealed with a self-etching adhesive immediately after preparation. The delayed-group specimens were sealed before the final ceramic restoration bonding. Provisional restorations were cemented on immediate-group and delayed-group specimens for 1 week. Four conditioning methods were used: polishing with fluoride-free pumice paste, airborne-particle abrasion with silicoated aluminum oxide, glycin, or calcium carbonate. After 24-hour storage, the shear bond strength was tested. The fractured specimens were optically inspected with a stereomicroscope. An optical 3-dimensional surface analysis was performed for quantitative and qualitative evaluation. A 2-way ANOVA with post hoc Tukey honestly significant difference tests for significant effects was performed to investigate effects of the 2 factors, sealing and conditioning, and their interaction (α=.05). RESULTS Two-way ANOVA found significant differences between the sealing and conditioning groups. The immediate group had significantly lower bond strengths than the delayed group. In all groups, surface polishing produced the highest bond strengths, and airborne-particle abrasion with calcium carbonate produced the lowest. Fracture analysis found more failures in the adhesive layers in the immediate groups and a prevalence of mixed failures in the delayed groups. The surface analysis found significant abrasion and roughness when airborne-particle abrasion with silicoated aluminum oxide was used for immediate and delayed dentin sealing surfaces. CONCLUSIONS Polishing and airborne-particle abrasion with silicoated aluminum oxide or glycin are efficient methods in conditioning immediate and delayed dentin sealing surfaces. Airborne-particle abrasion with silicoated aluminum oxide leaves significant surface alterations on both types of surfaces.

Rebonding performance of different ceramic brackets conditioned with a new silane coupling agent

The objective of this study was to investigate the rebonding effect of a new silane coupling agent on various ceramic brackets bonded to ceramic specimen. Different ceramic brackets (Fascination 2, Clarity SL, and In-OvationC) were assigned to three groups: rebonding with new silane coupling agent, rebonding with conventional silane coupling agent, or regular bonding as control (n = 16). Bracket adhesion was calculated with a shear test in a universal testing machine. The bracket-composite-ceramic interface was evaluated using the adhesive remnant index score. One-way analysis of variance was applied for inferential statistics. Rebonding with the new silane coupling agent resulted in high shear bond strengths (SBSs; mean values: 37.44-41.24 MPa) and ceramic specimen fractures. Rebonding with the conventional silane coupling agent resulted in significantly (P < 0.001) lower clinically adequate SBS (mean values: 20.20-29.92 MPa) with the least ceramic specimen fractures. Regularly bonded ceramic brackets resulted in clinically adequate to high SBS (mean values: 17.06-41.56 MPa) depending on their bracket base design. Rebonded ceramic brackets showed sufficient SBS to ceramic specimen surfaces. However, increased bracket adhesion was associated with a risk of ceramic specimen surface damage. Therefore, ceramic brackets rebonded with the new silane coupling should be debonded cautiously using alternative debonding methods.

Effects of Shock Waves on Expression of IL-6, IL-8, MCP-1, and TNF-α Expression by Human Periodontal Ligament Fibroblasts: An In Vitro Study

Background Extracorporeal shock wave therapy (ESWT) can modulate cell behavior through mechanical information transduction. Human periodontal ligament fibroblasts (hPDLF) are sensible to mechanical stimulus and can express pro-inflammatory molecules in response. The aim of this study was to evaluate the impacts of shock waves on interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemotactic protein 1 (MCP-1), and tumor necrosis factor-alpha (TNF-α) expression by hPDLF. Material/Methods After being treated by shock waves with different parameters (100–500 times, 0.05–0.19 mJ/mm2), cell viability was tested using CCK-8. IL-6, IL-8, MCP-1, and TNF-α gene expression was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) and IL-6 and IL-8 protein was measured by enzyme-linked immunosorbent assay (ELISA) at different time points. Results Shock waves with the parameters used in this study had no significant effects on the viability of hPDLF. A statistical inhibition of IL-6, IL-8, MCP-1, and TNF-α expression during the first few hours was observed (P<0.05). Expression of IL-8 was significantly elevated in the group receiving the most pulses of shock wave (500 times) after 4 h (P<0.05). At 8 h and 24 h, all treated groups demonstrated significantly enhanced IL-6 expression (P<0.05). TNF-α expression in the groups receiving more shock pulses (300, 500 times) or the highest energy shock treatment (0.19 mJ/mm2) was statistically decreased (P<0.05) at 24 h. Conclusions Under the condition of this study, a shock wave with energy density no higher than 0.19 mJ/mm2 and pulses no more than 500 times elicited no negative effects on cell viability of hPDLF. After a uniform initial inhibition impact on expression of inflammatory mediators, a shock wave could cause dose-related up-regulation of IL-6 and IL-8 and down-regulation of TNF-α.

Impact of extracorporeal shockwave therapy on tooth mobility in adult orthodontic patients: a randomized single‐center placebo‐controlled clinical trial

AIM This RCT investigated the effect of non-invasive extracorporeal shockwaves on tooth mobility in orthodontic patients after active treatment. MATERIALS AND METHODS Seventy-two adult patients were included in the study. Immediately after active orthodontic treatment, patients were assigned to a treatment or a placebo group based on block randomization. The orthodontic patients were required to be otherwise healthy. The region of interest was the anterior portion of the mandible. The treatment group received a single shockwave treatment with 1000 impulses while the placebo group was treated with an acoustic sham. Tooth mobility was evaluated over a period of 6 months using a Periotest and manual testing. Pocket probing depths, bleeding on probing and the irregularity index were also assessed. RESULTS Tooth mobility reduced significantly over 6 months in both groups, but shockwaves achieved significantly more rapid reduction on manual testing. Probing depth was significantly reduced while the irregularity index remained stable. Bleeding on probing was significantly reduced in the treatment group. No anti-inflammatory effect could be derived due to possible initial group differences. CONCLUSIONS The mobility of teeth aligned by orthodontic treatment reduces over time. Shockwave treatment appeared to reduce tooth mobility more rapidly.

Effect of different enamel matrix derivative proteins on behavior and differentiation of endothelial cells

OBJECTIVES Enamel matrix derivative (EMD) is an effective biomaterial for periodontal tissue regeneration and might stimulate angiogenesis. In order to clarify mechanisms underlying its biological activity, we separated two EMD fractions with different molecular weight protein components and investigated their effects on human umbilical vein endothelial cells (HUVECs) in vitro. METHODS Fraction Low-Molecular Weight (LMW) included proteins with a molecular weight (M.W.)<8kDa. Fraction LMW-depleted included proteins with M.W.>8kDa and lower than approximately 55kDa. The effect of EMD fractions on proliferation/viability, apoptosis, migration and expression of angiopoetin-2 (ang-2), von Willebrand factor (vWF), E-selectin, intracellular adhesion molecules 1 (ICAM-1), vascular endothelial growth factor (VEGF) receptors Flt-1 and KDR was investigated. RESULTS The proliferation/viability of HUVECs was inhibited by both LMW and LMW-depleted at concentrations 100μg/ml, whereas EMD slightly increased cell proliferation/viability. The expression of all investigated proteins was up-regulated by EMD. However, differences in the effect of EMD fractions on the protein expression were observed. The effect of LMW-depleted on the expression of ICAM-1 and E-selectin was markedly higher compared to LMW. In contrast, the expression of vWF and VEGF receptors Flt-1 and KDR was primarily affected LMW than by LMW depleted. The expression of ang-2 was not influenced by LMW and LMW-depleted. HUVECs migration was stimulated more strongly by LMW than by EMD and LMW-depleted. CONCLUSION Our in vitro study shows that the proteins composing EMD have different and specific biological activities and consequently have the ability to cover different aspects of EMDs biological and clinical effects.

The Impact of Education on the Perception of Facial Profile Aesthetics and Treatment Need

BackgroundThe purpose of this study was to evaluate the influence of education on the perception of various male and female Caucasian profiles with respect to attractiveness and treatment need.MethodsFour hundred questionnaires were distributed among six groups of raters (nonacademic laymen, academic laymen, preclinical students, clinical students, orthodontists, and maxillofacial surgeons). Male and female profile images were altered digitally in the sagittal and vertical dimensions resulting in nine different male and female profiles. The raters had to assess the images according to attractiveness and treatment needs.ResultsThree hundred four questionnaires were completed in this study. Age and gender of the rater had no significant influence on the perception of profile attractiveness. The different groups of raters perceived the Class I normodivergent profiles as most attractive. Significant differences in the perception of attractiveness were seen between laymen, orthodontists, and maxillofacial surgeons. The orthodontists and maxillofacial surgeons reported treatment needs the most. The orthodontists were most sensitive in discerning profiles.ConclusionAttractive male and female profiles are recognizable by any rater. Education seemed to have a significant influence on facial profile perception and recommendation for treatment need of unattractive profiles. Professionals should be aware of their judgment discrepancy to laymen.Level of Evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Effect of double conical abutment screw on implant preload.

OBJECTIVE This study compared the loosening torque of experimental double conical abutment screws to that of conventional conical abutment screws and flat-head screws in implants with internal connections before and after mechanical loading. MATERIAL AND METHODS Eighty implant-screw-abutment assemblies were divided into four groups: flat-head screw (Xive S), conical screw (Straumann), conical screw (Nobel Biocare), and double conical screw (RTB). Abutments were tightened to a torque of 30 Ncm. After 10 min, they were retightened and loosening torque was measured. The same abutments were then retightened with new screws to a torque of 30 Ncm and, again, retightened after 10 min. They were then mechanically loaded for 3 000 000 cycles, and loosening torque was again measured. Data were collected, and an exploratory analysis was performed. RESULTS Comparisons before mechanical cycling showed significant differences between groups. After mechanical cycling, only the comparisons of Straumann and Nobel Biocare showed no significant differences. Considering the same group before and after mechanical cycling, all comparisons showed significant differences. CONCLUSION The shape of the abutment screw head significantly influenced loosening torque: Double conical-head screws showed significantly higher loosening torque values than conical-head screws. Conical-head screws showed higher loosening torque values than conventional flat-head screws before and after loading.