Effects of Aging Torque Controllers on Screw Tightening Force and Bacterial Micro-Leakage on the Implant-Abutment Complex

Aim: We assess the accuracy of torque controllers after several aging processes and the bacterial leakage on Implant-Abutment complexes (IAC).Methods: A total of 12 spring-type and 12 friction-type torque controllers and 48 IAC (24 conical and 24 hexagonal connections) were evaluated. Chemical, mechanical, temperature, and pressure-aging methods were applied individually to replicate clinical use. Torque controller accuracy was analyzed before and after aging using a calibrated gauge. To assess bacterial leakage, the IAC were suspended in a bacterial medium for 24 h. Direct Contact Test (DCT) and Polymerase Chain Reaction Test (RT-PCR) analyzed the infiltration of F. nucleatum and P. gingivalis into the IAC micro-gap. Results: A significant decrease in torque after 10 days of aging was found. The spring-type torque controller was affected the most, regardless of the aging method (P < 0.05). PCR results indicated that all groups exhibited significantly more bacterial leakage, regardless of the method used (P < 0.05). The conical IAC demonstrated more bacterial leakage of P. gingivalis compared with the hexagonal IAC (P = 0.07). DCT found bacterial growth in the IAC only before aging and was not identified after aging. Conclusion: Aging affects torque accuracy. A reduction in force was noticed after 10 days. The conical IAC exhibits more bacterial leakage, although this was not statistically significant.

Bacterial leakage assessment in root canals sealed with AH Plus sealer modified with silver nanoparticles

Background Successful endodontic therapy requires prevention of bacterial leakage between the root canal filing and root-canal walls. Sealing quality of a root canal filling depends strongly on the sealing ability of the sealer used. The present study aimed to evaluate the bacterial leakage resistance of AH Plus sealer modified with silver nanoparticles. Methods Forty sound teeth were obturated using lateral compaction technique except for five teeth as the negative controls. After considering five teeth as the positive controls (filled without sealer), the remaining teeth were assigned to two groups (n = 15) in terms of the sealer used (AH Plus sealer and silver nanoparticle-modified AH Plus). Bacterial leakage was evaluated in saliva using the two-chamber technique in every 24 h. When all the samples in the test groups were contaminated, the study was terminated. The data were analyzed with log-rank statistical test. Results All samples in both experimental groups were contaminated during the 3-months period of observation. There was no significant difference in contamination time between study groups (P > 0.05). Conclusions Silver nanoparticles used in tested concentration did not improve the bacterial leakage resistance of AH Plus sealer.

The Microbial Neck: A Biological Review of the Various Implant–Abutment Connections

Aim: This study reviews the importance of selecting implant systems with connection designs that ensure better long-term prognosis of the prosthesis, thus placed. Materials and Methods: An electronic search on the PubMed database was done using MeSH keywords (“dental implant OR abutment OR connection AND microleakage OR bone loss”) to review English language articles published since the year 2011, which compared the crestal bone levels and microleakage around various implant–abutment connection designs (external hex, internal hex, and Morse taper). The search screened for articles on human trials and in vitro studies to be included within the review. Results: Based on the inclusion and exclusion criteria applied to the preliminary search, a total of four articles were included in the review for evaluating the influence of connection type on peri-implant bone loss, while nine articles were included to study the influence on bacterial leakage across the implant–abutment interface. Conclusion: Based on the studies reviewed, the conical connection design proved to be the most biologically stable junctional geometry because of the better microbial seal and the lesser micromovement observed in these types of implants during functional loading. Moreover, this review even emphasizes the need for more longitudinal clinical trials to assess the microbial seal of these connection designs within the actual oral environment to evaluate long-term changes in the peri-implant tissues, and subsequently even factor the prognosis of the planned prosthetic intervention.

Bacterial translocation and microgap formation at a novel conical indexed implant abutment system for single crowns

Objectives A conometric concept was recently introduced in which conical implant abutments hold the matching crown copings by friction alone, eliminating the need for cement or screws. The aim of this in vitro study was to assess the presence of microgap formation and bacterial leakage at the Acuris conometric restorative interface of three different implant abutment systems. Material and methods A total of 75 Acuris samples of three implant-abutment systems (Ankylos, Astra Tech EV, Xive) were subjected to microbiological (n = 60) and scanning electron microscopic (SEM) investigation (n = 15). Bacterial migration into and out of the conical coupling system were analyzed in an anaerobic workstation for 48, 96, 144, and 192 h. Bacterial DNA quantification using qrt-PCR was performed at each time point. The precision of the conometric coupling and internal fit of cemented CAD/CAM crowns on corresponding Acuris TiN copings were determined by means of SEM. Results qrt-PCR results failed to demonstrate microbial leakage from or into the Acuris system. SEM analysis revealed minute punctate microgaps at the apical aspect of the conometric junction (2.04 to 2.64 µm), while mean cement gaps of 12 to 145 µm were observed at the crown-coping interface. Conclusions The prosthetic morse taper connection of all systems examined does not allow bacterial passage. Marginal integrity and internal luting gap between the ceramic crown and the coping remained within the clinically acceptable limits. Clinical relevance Conometrically seated single crowns provide sufficient sealing efficiency, relocating potential misfits from the crown-abutment interface to the crown-coping interface.

Evaluation of the Antibacterial Effect of AH Plus Sealer Modified with Silver Nanoparticles

Background: The present study aimed to evaluate the antibacterial activity of AH Plus sealer modified with silver nanoparticles. Methods: Forty sound teeth were obturated using lateral compaction technique except for five teeth as the negative controls. After considering five teeth as the positive controls, the remaining teeth were assigned to two groups (n=15) in terms of the sealer used (AH Plus sealer and silver nanoparticle-modified AH Plus). Bacterial leakage was evaluated in saliva using the two-wall technique in every 24 hours. When all the samples in the test groups were contaminated, the study was terminated. The data were analyzed with log-rank statistical test.Results: The samples became contaminated with bacteria until the end of the third month in both groups. There was no significant difference in microleakage time between study groups (P>0.05).Conclusions: The incorporation of silver nanoparticles at concentrations tested into the AH Plus sealer did not prevent bacterial leakage.

Efficacy of MTA Modified by Nanosilver for the Prevention of Coronal Leakage

Background: Numerous materials have been introduced as coronal barriers, however, they have shown various degrees of microleakage. Therefore, attempts are undertaken to introduce more reliable materials with the potential to provide a long-term coronal seal. Introduction: This in vitro study aimed to assess the efficacy of gray ProRoot Mineral Trioxide Aggregate (MTA) modified by a suspension of silver nanoparticles (AgNPs) as an orifice plug using a bacterial leakage method. Methods: 40 extracted human teeth were prepared and filled (except for the negative control group) using the lateral compaction technique. The coronal 2 mm of the root filling was removed in the experimental groups. The teeth were randomly divided into two experimental (n = 15) and two control (n = 5) groups. In the experimental group 1 (MTA group) and the experimental group 2 (Ag-MTA group), MTA modified by a suspension of AgNPs was used as an orifice plug. In the negative control group, the entire root surfaces were covered with two layers of nail varnish. In the positive control group, the root canals were filled with a single gutta-percha cone without a sealer and no orifice plug. Bacterial leakage was assessed using a two-chamber system. The teeth were incubated at 37°C and 100% humidity for 120 days, and human saliva was added to the samples every 3 days. Bacterial microleakage was assessed by daily monitoring and observating the turbidity of the Brain Heart Infusion (BHI) broth. The data were analyzed using the log-rank test. Results: All positive controls showed contamination after 5 days. None of the negative controls were contaminated during the experiment. The Ag-MTA group demonstrated a significantly better coronal seal than the MTA group (p = 0.031). Conclusion: Gray ProRoot MTA modified by AgNPs has the potential for being used as an orifice plug in endodontically treated teeth.

In Vitro Bacterial Leakage at the Implant-Abutment Connection of Two Dental Implant Systems with Internal Connection

Objectives: Bacterial leakage at the implant-abutment interface is one of the main causes of peri-implant inflammation. One of the factors that influences bacterial leakage is the structural design of the interface. Considering the limited studies that have examined slip-joint connections, a comparative study of bacterial leakage was performed on two different systems namely Zimmer (Tapered Screw-Vent, Zimmer Dental) with slip-joint connection and Argon (Konus K3pro, Argon Implants) with conical connection. Materials and Methods: Twenty-two implants were selected in 2 groups (11 Zimmer with slip-joint connection, and 11 Argon with conical connection) with similar platforms. Escherichia coli (E. coli) suspension (2 μL) was pipetted into the internal lumen of implants. The abutments were screwed onto the implants with a closing torque of 30 Ncm. The assemblies were placed in culture broth for 6, 24, 48 and 72 h, and 7 and 14 days. The colonies were counted and analyzed by the Mann-Whitney test (a=0.05). Results: Microleakage was observed in 20% of the samples of conical connection group after 6 h to 2 days, and in 50% of the samples in slip-joint connection group after 3 to 7 days. There was a significant difference in bacterial leakage rate between the two implant groups (P<0.001) but no significant difference was seen in bacterial leakage over time (P>0.05). Conclusion: Type of connection had a significant effect on bacterial leakage, but the rate of bacterial leakage did not significantly change over time.