Giuseppe Varvara

Dimensional accuracy of resultant casts made by a monophase, one-step and two-step, and a novel two-step putty/light-body impression technique: An in vitro study

STATEMENT OF PROBLEMnDimensional accuracy when making impressions is crucial to the quality of fixed prosthodontic treatment, and the impression technique is a critical factor affecting this accuracy.nnnPURPOSEnThe purpose of this in vitro study was to compare the dimensional accuracy of a monophase, 1- and 2-step putty/light-body, and a novel 2-step injection impression technique.nnnMATERIAL AND METHODSnA stainless steel model with 2 abutment preparations was fabricated, and impressions were made 15 times with each technique. All impressions were made with an addition-reaction silicone impression material (Aquasil) and a stock perforated metal tray. The monophase impressions were made with regular body material. The 1-step putty/light-body impressions were made with simultaneous use of putty and light-body materials. The 2-step putty/light-body impressions were made with 2-mm-thick resin-prefabricated copings. The 2-step injection impressions were made with simultaneous use of putty and light-body materials. In this injection technique, after removing the preliminary impression, a hole was made through the polymerized material at each abutment edge, to coincide with holes present in the stock trays. Extra-light-body material was then added to the preliminary impression and further injected through the hole after reinsertion of the preliminary impression on the stainless steel model. The accuracy of the 4 different impression techniques was assessed by measuring 3 dimensions (intra- and interabutment) (5-mum accuracy) on stone casts poured from the impressions of the stainless steel model. The data were analyzed by 1-way ANOVA and Student-Newman-Keuls test (alpha=.05).nnnRESULTSnThe stone dies obtained with all the techniques had significantly larger dimensions as compared to those of the stainless steel model (P<.01). The order for highest to lowest deviation from the stainless steel model was: monophase, 1-step putty/light body, 2-step putty/light body, and 2-step injection. Significant differences among all of the groups for both absolute dimensions of the stone dies, and their percent deviations from the stainless steel model (P<.01), were noted.nnnCONCLUSIONSnThe 2-step putty/light-body and 2-step injection techniques were the most dimensionally accurate impression methods in terms of resultant casts.

In vitro evaluation of fracture resistance and failure mode of internally restored endodontically treated maxillary incisors with differing heights of residual dentin

STATEMENT OF PROBLEMnSome of the associated effects of different restorative systems placed in endodontically treated teeth with varying heights of residual dentin have yet to be examined in a comprehensive manner. There is a need for additional information regarding fracture resistance and mode of failure.nnnPURPOSEnThe purpose of this in vitro study was to evaluate the effect of 3 different restorative techniques with varying amounts of remaining dentin heights on the fracture resistance and failure mode of endodontically treated teeth.nnnMATERIAL AND METHODSnThree groups of 40 human maxillary incisors were subdivided into 4 subgroups (n=10) with respect to the uniform height of the residual coronal dentin, defined as 0-, 2-, 4-, or 5-mm from the cemento-enamel junction, and then restored internally using a composite resin (Z100 MP) (control group), a cobalt-chromium ceramic alloy custom-made cast post and core (IPS d.SIGN 30; CCPC group), or a carbon fiber post system (Tech Xop 2000; CFP group). All specimens were then restored with nonprecious cast crowns. Static loading tests were performed on each specimen until failure (crack without a complete fracture). The data were analyzed with 2-way ANOVA and Bonferroni-corrected t test for independent samples (alpha=.05). Failure was classified as either favorable (allowing repair) or catastrophic (not allowing repair).nnnRESULTSnThe fracture resistance values (N) for the 0-, 2-, 4-, and 5-mm residual dentin heights were: 88, 143, 154, and 202 for the control group, 230, 264, 364, and 383 for the CCPC group, and 153, 235, 346, and 357 for the CFP group, respectively. Generally, all the differences tested were statistically significant. The failure mode was catastrophic for no control specimens, for 36 CCPC specimens, and for 4 CFP specimens.nnnCONCLUSIONSnThe highest and lowest fracture resistances were recorded for the CCPC and control groups, respectively, at each residual dentin height. An increased height of residual dentin generally provided greater fracture resistance. The fracture resistance of the CCPC group was, however, similar or only slightly higher than that of the CFP group when 2, 4, or 5 mm of residual dentin height was present. In contrast, the failure mode was favorable for almost all of the CFP and control groups, while it was catastrophic in most of the CCPC group.

Use of Oral Chroma™ in the Assessment of Volatile Sulfur Compounds in Patients with Fixed Prostheses

Prosthetic rehabilitation improves the patients quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma™ in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p < 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.

ANTI-HEMORRHAGIC AGENTS IN ORAL AND DENTAL PRACTICE: AN UPDATE

Many oral surgeons in their daily practice have the problem of controlling postoperative bleeding. In surgical, oral and maxillofacial practice, standard anti-hemorrhagic protocols, especially in high risk patients, are obviously required and need to be continuously updated. The purpose of this review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs and medical devices such as lysine analogues and serine protease inhibitors, desmopressin, fibrin sealants, cyanoacrylates, gelatins, collagen and foams, protein concentrates, recombinant factors, complementary and alternative medicine and other compounds.

Evaluation of defects in surface detail for monophase, 2-phase, and 3-phase impression techniques: An in vitro study

STATEMENT OF THE PROBLEMnPolyvinyl siloxane materials of various consistencies have been tested to reduce defects commonly associated with different definitive impression techniques.nnnPURPOSEnThe purpose of this inxa0vitro study was to compare the number of visible defects within the surface of a new 3-phase, 2-step impression injection technique with the number found in the monophase and in the conventional 2-phase, 1-step and 2-phase, 2-step impression techniques.nnnMATERIAL AND METHODSnTwo complete crown abutment preparations were impressed 10 times for each of these 4 techniques, which gave 20 abutment impressions for each group. The 3-phase, 2-step impression--injection technique included extra-light--body impression material added for the impression and injected after reinsertion. After the removal of all of these impressions, an examiner counted the number of open voids and bubble-like enclosed voids visible to the naked eye at a working distance of approximately 150 mm. Only the defects in the area of the prepared abutments were included in the assessment.nnnRESULTSnThe frequency of defects ranged from 100% of the impressions in the monophase group to 5% with the new 3-phase, 2-step impression injection technique. No statistical differences were seen between the two 2-phase (1-step and 2-step) impression techniques, although there were numerically fewer impressions with defects with 2 steps (45%) than with 1 step (55%). The 3-phase, 2-step impression injection technique had the greatest accuracy, with fewer specimens with defects (5%) than with either of the 2-phase techniques, although these differences did not reach statistical significance.nnnCONCLUSIONSnThe 3-phase, 2-step impression injection technique provides improved defect-free reproduction of detail, showing fewer defects than other impression techniques.