International Poster Journal of Dentistry and Oral Medicine, 03/2015

The way to a man's heart is through his stomach. An army marches on its feet. Many other such cliches center around one of life's necessities - eating. But for eating, teeth are mandatory. Thus it is essential to protect our teeth from the various chemical insults, which may lead to erosion.Dental erosion is irreversible loss of tooth structure due to chemical dissolution by acids, not of bacterial origin. Critical pH of the Mouth is 5.5. Indian cuisine consists of many spices which can lowers the pH of the mouth; dissolving the protective outer layer of the teeth. This study determines pH of the Indian spices like turmeric, red chillies, hing, dhaniya powder etc. The information could be considered useful when advising patients who eat Indian curries about causes of acid erosion of their teeth. Keywords: Spices, Dental Erosion

Objectives: To evaluate the disinfecting effect of sodium hypochlorite during partial caries excavation of deciduous teeth in vitro. Counts of microorganisms in dentin samples served as primary endpoint. Methods: 12 freshly extracted primary teeth from children with early childhood caries were sectioned in three parts and one of each part was treated as follows within two hours after extraction: 1. partial caries excavation (PE), 2. partial caries excavation with 1% NaOCl (PEC) and 3. complete caries excavation (CE) as a positive control. A round bur in a torque controlled handpiece was used for the excavation procedures under simulated clinical conditions at a room temperature of 37°C. Prior to collecting the dentinal debris, samples were rinsed with 65 ml ringer lactate. Vortexed dentin samples were anaerobically grown on blood agar for total viable counts and MSB and Rogosa agar for mutans streptococci and lactobacilli species respectively. Results: Compared to the CE group total viable counts were significantly higher in the PE and lower in the PEC group (p0.05). In the PEC group three samples showed no bacterial growth, lactobacilli were not identified in 11 samples and mutans streptococci were not found at all. In the CE group a relevant amount of cfu was detected on every culture media. Conclusions: Application of sodium hypochlorite during partial caries excavation will disinfect the remaining dentine more effectively than complete caries excavation and should be considered as a clinical standard like it is for root canal treatment. Keywords: excavation, Carious dentin, disinfection, Oral Pathogenic Bacteria, sodium hypochlorite

Idiopathic plasmacytosis (IP) is a rare benign inflammatory condition of gingiva of unknown etiology characterized by massive infiltration of plasma cells into the sub-epithelial gingival tissue. The classical presentation of IP includes painless, diffuse, erythematous and papillary lesion of the gingiva with a sharp demarcation along the mucogingival border. It mimics clinical presentation of mucous membrane pemphigoid, pemphigus, erosive lichen planus, squamous cell carcinoma or allergic gingivostomatitis. Thus, diagnosis of idiopathic plasmacytosis depends on clinical pathological correlation. A proper diagnosis and effective treatment strategy is must for successful management of IP. This presentation highlights a rare case of an 18 yrs. old male with chief complaints of painful gums and swollen lips since two years. Clinical and histopathological examination led to the diagnosis of IP. Scaling and root planing was performed and antihistaminic (cetrizine 10 mg daily for 15 days) was prescribed. Within a period of 8 months, patient reported just once with slight swelling in upper lip and poor oral hygiene. Again scaling and root planing was done and antihistaminic (for 15 days) was prescribed to the patient. Then patient reported after 2 years with poor oral hygiene, abundant plaque and painful bright red inflammed gingiva. Oral prophylaxis was performed and systemic corticosteroids were prescribed for 1 month followed by antihistaminics for 1 month. Patient was followed up to 2 yrs. without any recurrence. The objective of this presentation is to raise awareness of idiopathic plasmacytosis as a rare differential diagnosis for oral ulceration and its macroscopic similarity to malignancy. Keywords: Benign, Idiopathic, Plasma cells, Scaling, Antihistaminics, Corticosteroids

Objectives: Patient's satisfaction and adequate function of removable partial dentures [RPD] highly depend on the retention of the prosthesis. A telescopic overdenture is retained by secondary crowns that cover tooth-supported fixed copings. The retention of telescopic crowns [TC] depends on material, design and fit of the framework over the copings. The aim of this in-vitro-study is to compare different materials and designs of telescopic crowns. Methods: 3 groups each containing 5 specimens were tested (n=15): 1. Zirconia copings [ZC] with non-precious metal TC and gold friction-pins, 2. high-noble metal copings (0°) and TC [T] and 3. high-noble metal copings (6°) and TC [K]. A canine-supported mandibular overdenture was constructed. Each system was attached to the prosthesis and initial retention forces as well as after artificial aging (50,000 chewing cycles, 15,000 insertion-removal cycles) were measured. Statistical analysis was performed using SPSS 20.0 (Mann-Whitney-U-test, p0.05). Results: The initial mean retention forces [IF] for ZC (12.23N) were significantly higher than the IF of T and K. But the IF of T (9.62N) were significantly higher (p0.001) than the IF of K (6.03N). After artificial aging T and K showed a significant decrease of retention forces (T:69.75%, K:47.27%; p0.001), but were not significantly different from each other (p=0.800). Whereas, the retention forces of ZC were not affected by aging (p=0.857). Conclusion: The retention forces of high-noble metal TC decreased significantly after aging, but were still within clinically acceptable function. Therefore, the design had an effect on the wear. Within the limitations of an in-vitro-study the clinical use of zirconia telescopic crowns with gold-friction pins can be recommended based on the continuous retention forces. Keywords: telescopic crowns, overdenture, retention forces, wear, CAD/CAM, zirconia

Objectives: Restorative-driven implant-placement requires a continuous diagnostic treatment-planning before the surgery. The implant design and position can be planned digitally using a CT-scan with a radio-opaque stent as well as special software. The aim is to make a surgical template for guided and therefore predictable implant-placement. This in-vitro-study compares the precision of different implant-planning software programs in combination with the corresponding surgical templates regarding to the implant position in the edentulous mandible. Methods: 30 radio-opaque resin-based mandibles with elastic mucosa (n=30) were used to test three different implant-planning software programs (SimPlant, Materialise Dental; coDiagnostiX, Straumann; SKYplanX, Bredent). The mandibles were standardized prepared for six reference pins (titanium) and scanned (CT, Multisclice Somatom Sensation, Siemens) with the system-specific radio-opaque stent. Each system was used to plan 4 implants (Standard plus, RN, Ø4,1mm, 10mm, Straumann) in the position of tooth #21, 23, 26, 28, manufacture the surgical stents and place the implants guided. A post-operative CT-scan was made and the measurements of both CT-scans were statistically analyzed (t-test, p0.05) Results: Measurements were made from the neck and the apex of each implant to each reference pin. The placed implants had the highest deviation at the neck and the apex for SimPlant (0.61mm, 0.71mm) and the lowest for SKYplanX (0.47mm, 0.38mm). There was no significant difference between pre- and post-operative measurements (SimPlant p=0.14; coDiagnostiX p=0.2; SKYplanX p=0.31) as well as between the three systems. Conclusion: The results of this in-vitro-study show low deviation for the three software programs between planned and actual implant position. Thus, the precision of guided implant placement in the edentulous mandible depends on the stability of the surgical stent. Keywords: implants, edentulous mandible, computer guided surgery, 3D navigation

Objective: Study the dimensional changes on gypsum casts poured with 2 addition silicones and a polyether, after the impressions were steam autoclave sterilized and stored. Material and Methods: 2 commercial brands of addition silicones and a polyether were used in an automatic mixing machine, Pentamix 2 (3M ESPETM): Aquasil Ultra DECATM Monophase (Dentsply); Normosil Adición Putty Fast (Normon©); ImpregumTM PentaTM Soft Polyether Impression Material (3M ESPETM). 10 samples of each impression material were obtained with a metallic matrix from ADA Specification n° 19 (1977) and ISO 4823:1989. The matrix was filled up with each impression material. They were didvided into 2 groups: A subjected to chemical disinfection with sodium hypochlorite 5.25% for 10 minutes; and B were submitted to autoclaving at 134°C for 25 minutes, in addition to the disinfection. The gypsum casts were made from each sample: after the procedure, 24 hours, at two weeks and at 6 months, and measured with a digital caliper. We measured three master lines in each cast, a), b) and c). Results: The Aquasil Ultra DECATM Monophase (Dentsply) casts had the most similar dimensions to the matrix. The Normosil Adición Putty Fast (Normon©) casts showed the most evident differences. Conclusion: The studied impression materials suffered dimensional changes. However, according to the ADA Specification n° 19 (1977) these changes aren't significant for they don't exceed 0,5%. There for we have come to the conclusion that these materials can be submitted to steam autoclave sterilization and stored for a long time. Keywords: Dimensional changes, Disinfection/sterilization, Gypsum products and Impression materials

Introduction: Due to a similar coefficient of thermal expansion of the dental materials titanium and zirconia the veneering porcelain Triceram is recommended to be used for both substrate materials. The aim of the study was to evaluate the influence of 3 different veneering thicknesses on the resulting biaxial bond strength to titanium and zirconia. Material & Methods: From each material 30 discs with a diameter of 12 mm and a thickness of 0.8 mm were veneered with a thickness of 1.0, 1.5 and 2.0 mm, respectively, using a special positioning device. With each specimen 5 firings (opaque 1 and 2, dentin 1 and 2, glaze; furnace: Dekema) were done according to the manufacturer's instructions. The biaxial bond strength test was performed on the basis of ISO 6872 using a universal testing machine (Zwick Z010, Ulm; software testexpert V12) with a crosshead speed of 1 mm/min. With all samples the veneered part was put on the balls and the biaxial bond strength for bilayered piston-on-three-ball discs was calculated [1] and, the Weibull modulus was determined. Results: The biaxial bond strength for 1.0, 1.5 and 2.0 mm veneering thickness was 193±43, 205±46 and 170±25 MPa for titanium/Triceram and, 187±46, 155±43 and 132±44 MPa for zirconia/Triceram. The Weibull modulus ranged from 5.5, 5.1 to 8.1 for titanium and, 5.0, 4.1 to 2.9 for zirconia. Conclusion: The veneering porcelain Triceram revealed higher bond strength characteristics with titanium compared to zirconia. Similar bond strength values could be found with 1.0 and 1.5 mm porcelain thickness, whereas 2.0 mm showed significantly lower values. Keywords: Titanium, Zirconia, Bilayer, Biaxial Bond strength

Research of an apparatus and method for the distraction and supporting of tissues, that requires two degrees of freedom, which operates in a programmable and autonomous fashion. The programmable and autonomous distractor comprises the anchoring rods and the body of distraction, which includes the external structure, the electric motors, the control unit that allows progressive and automatic distraction, the communication unit that allows a customizable programming of the device and the power supply required for the operation. The distractor may be implantable and in the case of the mandible is applied intra-oral and its anchoring is done directly on the teeth, preferably, between the first molar and the first premolar. Protection of the invention by submitting a patent (20121000038753) Keywords: distraction osteogenesis, mandibular distractor

Introduction: The presented poster reports the analysis of a b-TCP-based paste-like bone substitute material for socket preservation and sinus augmentation procedures. Preliminary histological and histomorphometrical results from a multi-centre study are presented. Materials and Methods: Sockets of teeth not worth preserving were augmented according to a standardised study protocol with a b-TCP-based paste-like bone substitute material (Cerasorb Paste, Curasan, Kleinostheim, Germany) and covered with a xenogenic collagen membrane. Further, in cases of reduced dentition and atrophy of the alveolar crest in the upper molar region, sinus floor augmentation was performed to enlarge the amount of local bone previous to insertion of dental implants. After an integration period of three months, implants were inserted in the augmented region simultaneously with bone biopsy extraction for histological and histomorphometrical analysis. Additionally, the inserted implants were investigated with a focus on implant stability and achieved red-white aesthetics. Results: The bone substitute material investigated showed favourable handling and easy application in the sockets of extracted teeth and sinus cavities. A complete and marginal filling of both sockets and sinus cavities could be achieved due to the adhesion and "flow-ability" of the material. Histologic and histomorphometrical results from a preclinical in vivo study in rats showed a biphasic arrangement of the bone substitute material with an inner core and an outer ring, which prevents early ingrowth of connective tissue in the implantation bed. Further, outspreading vessels and no signs of a foreign body reaction to the bone substitute material were obvious. Conclusion: Preliminary clinically results from a multi-centre study investigation of a paste-like b-TCP-based bone substitute material for socket preservation and sinus augmentation showed favourable handling and suitability for augmentation procedures. Further, histological and histomorphometrical in vivo analysis showed good integration of the bone substitute material in the peri-implant tissue, a high rate of vascularisation and no signs of a foreign body reaction. Keywords: b-TCP, bone substitute material, socket preservation, sinus floor augmentation, foreign body reaction

Introduction: The aim of the presented research was to analyse and compare the tissue reaction to different xenogeneic bone substitute materials (Bio-Oss®, BO and BEGO Oss®, BGO) of different processing techniques and material-specific characteristics in vivo. Materials and Methods: Two bone substitute materials were implanted subcutaneously in CD-1 mice for up to 60 days. Tissue formation, implant bed vascularisation and the formation of multinucleated giant cells were investigated histologically and histomorphometrically. Results: Both bone substitute materials showed good integration within the peri-implant tissue and no signs of adverse effects. Both groups presented an increasing vascularisation over the whole study period. Within the implantation bed of the bone substitute of low sintering temperature (BO), few multinucleated giant were obvious on the surface of small sized bone substitute granules in the early integration period, while the tissue reaction to the bigger granules at later stages consisted mainly of mononuclear cells. In contrast, the tissue reaction to the bone substitute material of high sintering temperature (BGO) consisted of a biomaterial surface associated multinucleated giant cells. Discussion: The tissue reactions to the low and high sintering temperature bone substitute materials investigated showed distinct differences, mainly in the formation and migration of multinucleated giant cells. As both biomaterials have the same origin, the observed differences seem to be related to the different processing techniques and the resulting different physico-chemical structures. Keywords: bone substitute materials, xenogenic, foreign body cell reaction, multinucleated giant cells

Peripheral ossifying fibroma is a solitary growth on the gingiva considered to originate from the periodontal ligament. It is non-neoplastic inflammatory response of connective tissue to minimal amount of local factors. Though clinically similar to Pyogenic Granuloma, it is important to differentiate the lesions. Clinical and radiographic examination followed by histopathogical examination is crucial for its final diagnosis. Presenting a case report of 28 yr old female patient, reported to the department of periodontics and oral implantology with chief complaint of painless swelling in lower front region which recurred after 7 months. This pedunculated, fibrous growth was excised in toto with meticulous root planning and curettage. Specimen was sent for histopathological examination which revealed the diagnosis of peripheral ossifying fibroma Keywords: peripheral ossifying fibroma, non-inflammatory, curette, scaling, root planing, surgical excision, recurrence