Evaluation of the Sealing Ability of Direct versus Direct-Indirect Veneer Techniques: An In Vitro Study

Backgrounds. Marginal discoloration, microleakage, wear, and marginal fractures are all prevalent problems with composite veneers, and this scenario leads the esthetic outcome to deteriorate with time, resulting in patient discontent. Aim of the Study. The study’s goal was to determine the marginal sealing ability of composite laminate veneers when employing two types of veneer techniques: direct and direct-indirect veneers, as well as two types of composite resin: nanohybrid and microfilled composite resin restorations, using dye penetration method. Materials and Methods. In this study, forty extracted human teeth were utilized. Following a standardized veneer preparation on the labial surface of the teeth, they were separated into two groups of 20 teeth each, using the following composite application techniques: group A: direct veneers and group B: direct-indirect veneers. Following that, each major group was separated into two subgroups of ten teeth each, based on the type of composite employed: subgroup 1 used nanohybrid composite resin, while subgroup 2 used microfilled composite resin. All of the samples were kept in distilled water, thermocycled, and soaked in 2% basic fuchsine dye. These specimens were sectioned and examined under a stereomicroscope for dye penetration at the gingival margin. The data was analyzed using independent T -tests using SPSS 22. Result. Using direct-indirect veneer technique with nanohybrid composite resin material resulted in the most negligible dye penetration at the gingival margin, while using direct veneer technique with microfilled composite resin material resulted in the maximum dye penetration. For both composite materials, gingival microleakage was lower when using the direct-indirect veneer technique than when using the direct technique, and the difference was statistically significant ( P < 0.05 ). In both techniques, gingival microleakage was lower with nanohybrid composite than with microfilled composite, and the difference was statistically highly significant ( P = 0.001 ). Conclusion. The sealing ability of the gingival margin of tooth/composite interface is better when applying direct-indirect veneer technique with nanohybrid composite resin than that of direct veneer technique with microfilled composite resin material.

Periodontal Pathogens Inhabit Root Caries Lesions Extending beyond the Gingival Margin: A Next-Generation Sequencing Analysis

We performed a comprehensive microbiome analysis of root caries lesions using 22 teeth extracted from patients with severe periodontitis. The carious lesions were mechanically collected and cryo-pulverized following tooth extraction. Differences in the microbiome were compared between independent lesions at the supragingival site (SG) and lesions extending beyond the gingival margin (GCB). DNA was extracted and the microbiome was characterized on the basis of the V3-V4 hypervariable region of the 16S rRNA gene using paired-end sequencing on an Illumina MiSeq device. The microbiota in root caries lesions showed compositionally distinct microbiota depending on the location. The most abundant OTUs in the SG group were Streptococcus (26.0%), Actinomyces (10.6%), and Prevotella (7.6%). GCB presented Prevotella (11.1%) as the most abundant genus, followed by Fusobacterium (9.6%) and Actinomyces (8.7%). The SG group showed a lack of uniformity in microbiota compared with the GCB group. The bacterial profiles of GCB varied considerably among patients, including periodontal pathogens such as Porphyromonas, Selenomonas, Filifactor, Peptococcus, and Tannerella. Periodontal pathogens inhabit root caries lesions that extend beyond the gingival margin. This study provides a new perspective for elucidating the microbial etiology of root caries.

Co-Relation of Gingival Biotype (Periodontal Phenotype) with Width of Keratinized Gingiva in Maxillary Anterior Teeth in Patients Reporting to a Local Tertiary Care Dental Hospital

Objective: To find out the correlation of gingival biotype with width of keratinized gingiva in maxillary anterior teeth in patients at tertiary care dental hospital presenting for routine periodontal care. Materials And Methods: In this crossectional study, a total of 87 patients were observed in department of Periodontology, Fatima Memorial Hospital College of Medicine and Dentistry Lahore. The gingival biotype (gingival thickness) were determined by using the transparency of the periodontal probe through gingival sulcus. The width of the keratinized gingiva was measured by measuring the distance between the most coronal point of the gingival margin and the mucogingival junction measured at the midpoint of the vestibular face of the teeth using a Michigan O periodontal probe with William’s markings. Results: In this study mean age was 38 years with SD ± 10.88. Forty six percent patients were male and 54% patients were female. Mean width of keratinized gingiva was 4.22mm ± 1.10 while mean gingival biotype was 1.5 mm ± 0.65. The correlation coefficient r=0.277 shows a positive correlation of width of keratinized gingiva with gingival biotype Conclusion: The study concluded that there is a positive correlation of gingival biotype with width of keratinized gingiva in maxillary anterior teeth. Keywords: gingival biotype, width of keratinized gingival, maxillary anterior teeth

SOME ASPECTS OF RETRACTION THE GINGIVAL SULCUS

In order to achieve an optimal fit between the crown and the margin formed below the gingival margin, a good mapping of the space behind the margin is required. This can be accomplished in a variety of ways. At various stages, general dentists and prosthodontists apply gum retraction across the board on a daily basis. Gum retraction was first described in 1941 by Thompson. Today, a large assortment of retraction cords is presented on the material market. One of the main requirements forhigh-precision impressions is a clear display of the gingival sulcus around the abutment teeth. To obtain high-quality impressions, it is necessary to ensure the unimpeded position of the impression material in this area, which is ensured by retraction. With the generalized form of increased abrasion of the hard tissues of the teeth, all teeth or most of them are subject to restoration of the anatomical shape, therefore it is important to choose a retraction method that would not only allow obtaining ahigh-quality impression, but also minimize its negative effect. Since 1975, PubMed and Google Scholar have searched for studies on gingival tissue management prior to impression creation on fixed dentures. The conclusions were extracted and summarized by us. Gingival retraction methods are divided intomechanical, chemical or surgical types. This article discusses the various methods of gingival retraction for subsequent double-layer impressions.

Evaluation of the Marginal Location and Periodontal Health in Crowns and Bridges – A Patient Preference Based Study

OBJECTIVE: The objective of this paper was to evaluate the marginal location preference and periodontal health in extra coronal restoration of anterior and posterior teeth. METHODOLOGY: In this prospective case control study, a total of 652 patients who had crown and bridge for not less than six months were included. The gingival margin location preference and reasons behind choosing a particular gingival margin was asked from the patients. Additionally, the teeth with and without restoration were also examined for periodontal health. Split mouth technique was used as unrestored, healthy contra lateral teeth in the same individual served as controls. Descriptive statistics and Chi square test were used for analysis to formulate the results. RESULTS: Ironically, 92% patients were not given a chance by their dentist to give input about margin location preference. The majority of patients preferred equi gingival margin for their anterior crowns 495 (75.92%) and supra gingival margin 586 (89.87%) for their posterior teeth, with esthetics 547 (83.89%) and hygiene 599 (91.87%) respectively being the most common reasons for selecting the particular margin location. The clinical examination revealed that supra gingival and equi gingival margins demonstrated superior gingival health indices as compared to subgingival margins CONCLUSION: This study concluded that the supra gingival and equi gingival margins demonstrated superior gingival health indices as compared to subgingival margin and in order to achieve optimal periodontal health and patient satisfaction the health professionals should wisely consider the margin location and involve the patient in treatment decisions wherever possible. KEY WORDS: Crown and Bridge, Margin location, Patient preference, Periodontal Health.

Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study

Objectives. The aim of this study was to analyze the behavior of the periodontal tissues around teeth in the anterior region when restored with zirconia single crowns, using a biologically oriented preparation technique (BOPT), over a 6-year follow-up. Methods. The study investigated tooth-supported single crowns in the anterior region that were fabricated with a zirconia core and feldspathic ceramic covering, in 34 patients. Follow-up analysis took place annually for 6 years, assessing periodontal responses by evaluating the following variables: plaque index (PI); probing depth (PD); gingival index (GI); gingival thickness adjacent to the restoration; and stability of the gingival margin (MS). Any (biological and mechanical) complications were also recorded, as well as the patients’ satisfaction with the treatment. Results. After 6 years’ follow-up, a low mean plaque index was obtained, probing depth was stable, and gingival thickness and margin stability had increased. Complications (biological and mechanical) did not present a statistically significant incidence and a crown survival rate of 97.2% was achieved. Patients’ satisfaction obtained a mean VAS score of 9.04 under 10. Conclusion. Teeth that are prepared with BOPT in the anterior region present good periodontal behavior around the restored teeth, particularly in terms of the stability of the gingival margin and increased gingival thickness. Single crowns prepared with BOPT obtain an excellent clinical survival rate, as well as a high score in patients’ satisfaction after 6 years.

Prevalência de perda de inserção periodontal em adolescentes de 12 a 16 anos em uma escola pública de Porto Alegre

The aim of this study was to verify prevalence of loss of attachment in 12-16 years old adolescents of a public school in Porto Alegre. The prevalence of loss of attachment was determined by means of periodontal probing a mesial, distal, buccal and lingual surfaces of incisors and first permanent molars. A trainer examiner performed the examination with Williams periodontal probe, odontoscope are standard illumination. The level of attachmet was defined as thc distance in millimeters from the cementum-enamel junction to the most apically probable portion, close to thc bottom of the sulcus/pocket. For cach site, two measurements were performed, the distance from the gingival margin to the cementure enamel junction, and the distance from the gingival margin to the bottom of the sulcus pocket. The level of attachment for a site was calculated subtracting the first and the second or, in case of gingival recession, adding both. Loss of attachment was considered when this measure exceeded 2 mm in buccal-lingual surfaces and 3 mm in proximal surfaces. 3048 sites were examined, showing a prevalence of 4.82% of loss of attachment. From these, 36.77% bled on probing and 61.22% did not. The buccal surface was the one with the highest prevalence of loss of attachment.

Occupational conditionality of diseases of chronic generalized periodontitis and bruxism in limestone quarry workers

Aim. To identify the occupational risk of developing chronic generalized periodontitis and bruxism in limestone quarry workers.Materials and methods. We examined 214 workers of the limestone quarry, of which 66 patients were diagnosed with chronic generalized periodontitis, aggravated by bruxism, these patients were taken for treatment. Investigated the indices of hygiene, bleeding, periodontal, measured the depth of periodontal pockets. Electromyography of the temporal and masticatory muscles, microcirculation of periodontal blood flow, and radiography were performed. Established professional conditioning. The patented treatment we proposed: a children's phytogel for teeth and gums Karmolis was introduced into the pathological pockets and along the gingival margin, after which lasertophoresis was carried out according to the labile technique on the upper and lower jaws segmental. Fluctuorization, mouthguards, remedial gymnastics, self-massage – all these are the therapeutic measures offered by us.Results. After the treatment we carried out, the index of the indices improved, the speed and volume of blood flow in the periodontium increased, the temporal and masticatory muscles became less tense, all this indicates a favorable course of the therapy.Conclusions. Moderate CGP, aggravated by bruxism, are occupational diseases in limestone mining workers.

EFFECTS OF GINGIVAL MARGIN ASYMMETRIES ON THE SMILE ESTHETIC PERCEPTION OF DENTAL PROFESSIONALS AND LAYPEOPLE IN KHAMMAM

OBJECTIVE: This study aimed to determine the smile esthetic perception of dental professionals and laypeople in Khammam on gingival margin asymmetries. MATERIALS AND METHODS: A frontal close-up smile photograph of a female volunteer was captured and digitally altered in four stages of 0.5mm increments and nal images were assessed by dentists and laypeople. A questionnaire was carried out to evaluate the attractiveness of images by using a visual analog scale. Collected data were analyzed using Mann – Whitney U test. RESULTS: Smiles with 2mm gingival asymmetries were found to be less esthetic. Dentist's scores were signicantly lower than patient scores. CONCLUSION: As the amount of gingival display increased, esthetic scores decreased in both groups.