Straight Handpiece Research Articles

A Randomized Controlled Study Comparing And Evaluating The Peri-Operative Outcomes Of Using Straight Versus Angled Handpieces During The Surgical Extraction Of Impacted Mandibular Third Molars

Introduction: The straight handpiece is one of the most commonly used instruments in third molar surgeries. However, its use has been suggested to carry a potential risk of soft tissue injury, possibly due to its design limitations leading to direct positioning and excessive heating, which could contribute to soft tissue damage. Direct positioning can sometimes cause excessive heating, leading to potential soft tissue damage. Additionall its design might limit accessibility in the confined surgical area, making it more difficult to maneuver effectively. This study aims to evaluate whether using an angled handpiece enhances accessibility and reduces the risk of soft tissue damage during surgical procedures. AIM: Comparison and evaluation of the use of straight and angled handpieces on perioperative outcomes in operative removal of obstructed lower third molars. Materials and Methods: This research included 30 healthy participants aged 18 to 40, all of whom were undergoing extraction of impacted lower third molars at the Department of Oral and Maxillofacial Surgery. Participants were randomly assigned to two groups.: Group A, where the extraction was carried out using an angled handpiece, and Group B, where a straight handpiece was employed. Results: No statistically significant differences were found in postoperative pain, edema, mouth opening, or surgical time between the angled and straight handpiece groups. Conclusion: The findings of our research indicate that there were no notable statistical differences observed between the two groups in relation to post-operative outcomes such as pain, edema, mouth opening, or surgical time. The lack of statistical significance may be attributed to the small sample size, emphasizing the importance of larger cohorts for a more accurate assessment of the clinical impact. However, operator comfort was reported to be better with angled handpieces in certain cases. Category: Dentistry, Pain Management, Patient Care

A Comparative Assessment of Right-Angle Screwdriver Versus Conventional Screwdriver for Orthognathic Surgeries.

Background Bilateral orthognathic surgery is one of the unique and challenging orthognathic surgeries that gained popularity after numerous modifications to the techniques. Using linear equipment inside the oral cavity might lead to malalignment or structural weakness due to incorrect placement, making the ramus osteotomy more difficult. By directly positioning the instrument perpendicularly over the mandibular ramus region, a right-angle drill can help promote a more ergonomic approach. Objectives The primary objective was to compare the efficacy of a right-angle screwdriver over a conventional screwdriver for orthognathic surgery using clinical parameters. The second objective was to assess the ease of fixation, the ease of osteotomy, and the time taken for the surgery in both groups. Methods This prospective observational study, comparing the effectiveness of conventional and right-angle screwdrivers for orthognathic surgery, was carried out on 12 patients. A split-mouth design was chosen. For the 12 patients, a right-angle screwdriver was used to secure the right mandibular plate and screw, while a traditional straight handpiece was used to fix the left plate and screw. Clinical parameters such as the ease of osteotomy, the ease of fixation, the time taken for fixation, and the postoperative angulation of the screw in relation to the bone with cone beam computed tomography were evaluated. The procedure was communicated to the patients, followed by obtaining written informed consent. Result Statistical analysis was done using descriptive and inferential statistics using an independent sample t-test and an unpaired t-test. IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA), was used. The level of significance was set at a p-value of <0.05. Compared to a conventional screwdriver, the right-angle screwdriver made osteotomies and fixations easier for 12 patients and also required less surgical time. Statistically, it was shown that ease of fixation had a statistically significant difference among right-angled and conventional screwdrivers (p-value < 0.001), whereas time taken had an insignificant difference (p-value 0.13). The angulation of screw fixation with the right angle showed a consistent result of fixation perpendicular to the bone when compared with conventional screwdrivers providing stable fixation, which was statistically significant (p-value < 0.001). Conclusion Compared to the conventional screwdriver used in orthognathic procedures, the right-angle screwdriver ensures solid fixation and eliminates the challenges encountered while drilling and screwing posteriorly positioned screws.

A comparative study on tensile strength of various thermoplastic polymers sheets following thermoforming on a pre-treatment and post-treatment maxillary model of a patient: an in vitro study.

Thermoplastic polymers show alteration in their mechanical properties after thermoforming on a dental model. The purpose of this in-vitro study was to evaluate the tensile strength of different thermoplastic polymer sheets thermoformed on a pre-treatment (moderate crowding) and post-treatment (well-aligned) maxillary model of a patient. Forty maxillary models (Twenty Pre-treatment & twenty Post-treatment of uniform dimension) were made by duplicating them using alginate Hydrogum 5 (Zhermack). Samples were then divided into eight groups of 5 samples each. The thermoplastic sheets Imprelon® (Scheu-Dent), AVAC R® (Jaypee), Placa Crystal® (BioART), EZ-VAC® (3A Medes)-1.0mm thick were thermoformed on these models respectively. The sample was retrieved using ceramic bur mounted on a straight hand-piece and subjected for testing using TINIUS Olsen 10ST micro universal testing machine and recorded. There was no statistically significant difference (P > .05) in tensile strength of thermoformed thermoplastic polymer sheets between pre-treatment and post-treatment maxillary model. Tensile strength of EZ-VAC (3A Medes) showed higher variation between pre-treatment and post-treatment maxillary model though it was found to be statistically insignificant (P > .05). Significant difference (P < .05) was seen between groups when they were compared separately among pre-treatment and post-treatment models. Placa Crystal (BioART) among the pre-treatment group, EZ - VAC (3A Medes) among the post-treatment group, showed highest tensile strength. Results of the study highlights the necessity to test materials in conditions which stands in accordance with the clinical scenario to a considerable extent and also emphasizes the need for further study in aligner.

Evaluation of three physical mixing methods of nanoparticles to orthodontic primer

Background: Demineralization and white spot lesions are the most common complications in fixed orthodontic treatment. It is useful to enhance the remineralization properties of the orthodontic primer by the addition of remineralizing agents. Fluoride and calcium are regarded as the main component of enamel fluorohydroxyapatite crystals. This pilot study compared three mixing methods of calcium fluoride nanoparticles (nCaF2) with conventional orthodontic primer (Transbond XTTM) to develop a primer with enamel remineralization properties. Materials and methods: The nanoparticles were added to Transbond XTTM primer to form 20% (w/w) of the final solution. Three dark plastic bottles were prepared and stored until mixing. The first sample was mixed by a Vortex machine, the second was mixed with an electric agitator, and the third one was mixed with a customized plastic spatula adapted to a dental engine and a straight handpiece. Cured blocks of the developed primer were prepared and were examined for homogeneity, cracks, and agglomeration of the nanoparticles within the primer using Field Emission Scanning Electron Microscopy (FESM). Results: The third Sample showed a continuous distribution of nanoparticles with no apparent cracks or agglomeration of nanoparticles. In contrast, a higher agglomeration was seen in the first sample than in the other two. Conclusion: Mixing of nCaF2 with Transbond XTTM orthodontic primer was best achieved by the customized plastic spatula adapted to a dental engine compared to Vortex and electric agitator machines.

Effectiveness of piezoelectric versus straight hand piece at low speed within the surgical extraction of retained lower third molars

Determine the effectiveness of the piezoelectric handpiece vs. the straight handpiece at low speed in surgeries of impacted lower third molars, in relation to post-surgical effects (edema, pain and trismus) and the operative time of the osteotomy, in patients attending the Maxillofacial Surgery Service of the "Hospital de Especialidades Fuerzas Armadas N°1". It is an observational, analytical, longitudinal prospective cohort clinical study. A sample of 40 patients of both sexes aged between 18 and 25 years was taken, divided into two groups of 20 patients each, in group A extractions were performed with piezoelectric and in group B with straight rotary handpiece at low velocity. The results were analyzed on the third, fifth and eighth day, the edema was measured with the method of Amin and Laskin, for the pain the Visual Analogous Scale (VAS) was used, and for the presence of trismus with the instrument foot of king. In group A, edema (11.72 mm), pain (4.67) and mouth opening (39.49 mm) were lower than in group B edema (12.29 mm), pain (4.8) and mouth opening (35.83 mm) and osteotomy time was significantly longer with piezoelectric (6.54 ± 3.05 min) compared to the straight handpiece (1.55 ± 0.57 mm). min) and there was a difference in edema, pain and trismus under normal conditions in contrast to what was obtained at 3, 5, 8 days between the two instruments. the post-surgical effects of edema, pain and trismus of the extraction of retained lower third molars are less intense with the piezoelectric compared to the straight handpiece, the use of the piezoelectric being recommended.

Clinical and experimental Study to evaluate the effect of Biphasic calcium phosphate collagen composite (cpcc) on healing of bone defects after oral surgical procedures

Background: A recent discoveries used for reconstruction in maxillofacial surgery is the composite bone graft materials. The availability of collagen I matrix make our choice to use this material in surgery .It is biomaterials that its structure could be modified by simple techniques. Studies to find a new materials use for bone reconstruction is to overcome the disadvantages of autogenous bone and the synthetic resorbable bone substitutes.&#x0D; Objectives: This study was done to evaluate the effect of biphasic calcium phosphate collagen composite (ccpc) on healing of bone defects after oral surgical procedures.&#x0D; Type of the study: A cross sectional study.&#x0D; Method: It involved 60 patients, 35 male and 25 female, age (15-40) yearsand experimental animals study involved sixty rabbits.The study was done in Department of Maxillofacial surgery in Al anbarCollege of Dentistry (2015-2016).These patients were received tooth extraction, and other minor surgical procedures .Clinical and radiographical examination and patients consents are done before surgery. The surgery was done under local anesthesia.The resulting bone cavities are filled with composite bone graft material composed from combination of lyophilized hydrolysed collagen sponge (Hemospon),Brasil and Osteon II bone graft material,Korea .The area is closed with 3/0 block silk suture .Antibiotic cover (Ampicillin 500mg ×4) for 1 week was prescribed. The patients were followed up by careful clinical examination with radiograph 15-30 days after surgery. .Sixty New Zeleandi White rabbit were used in our study for histopathologicalexamination.Intraperitoneal injection of ketamine 10 mg with XYL-M2 solution 20 mg xylazine base used to anesthetize the animals. (5mm diameter) bone defects were made using straight surgical hand piece and bur in anterior mandibular region and filled with each material. The study design involve the following groups: group 1( involve 15 rabbit; the defect was made and filled with blood clot only (control group),group 2( involve 15 rabbit, the defect was made and filled with collagen sponge only),group 3(Involve 15 rabbit, the defect was made and filled with Osteon II bone graft only),group4( involve 15 rabbit, the defect was made and filled with Osteon II bone graft +collagen (Composite bone graft).The flap were closed 3/0 black silk suture. The rabbits were killed after 30 days. 10 cmexcisional biopsy specimen was taken from the paramandibular area and placed in 10%formalin then send histopathologicalexamination.&#x0D; Results: Clinically, the treated area show good healing with absence of infection .Radiographs during follow up period show radiopacity indicating new bone formation .The results of experimental animals (Rabbits) indicategrowth new bone . In group 1 and group2, the center of the defects was depressed by surrounding tissues Eung et al, While, in group 3&amp;group 4, the graft materials maintained the space and the center of the defect did not depress. Statistical analysis indicates that during 4 th week ,the highest healing % is (100%) in group 3 &amp;group4 in compared to control group (50%)..A significant difference in healing % was found among the treated groups.&#x0D; Conclusion:The result indicates that biphasic calcium phosphate collagen composite can be efficiently utilized clinically.

In vitro evaluation of bond strength of sealers after using various irrigants and Erbium-Yttrium-Aluminum-Garnet laser irradiation on radicular dentin surface: A SEM study

Aim: The aim of this in vitro study was to evaluate and compare the push-out bond strength of Adseal and mineral trioxide aggregate (MTA) Fillapex sealer after using various irrigants and Erbium-Yttrium-Aluminum-Garnet (Er:YAG) laser irradiation on radicular dentin surface. Materials and Methods: A total of 80 freshly extracted human permanent maxillary anterior teeth were sectioned transversally below the cemento-enamel junction. The remaining root portion was sectioned to get 4-mm thick dentin disc from coronal end of the root, with straight handpiece, and diamond disc. Root canal of specimens was prepared with bur to create space for sealer placement. Specimens were divided into eight groups of 10 samples each, as per irrigants and sealer used. In Group 1, 3, 5, and 7 specimens irrigated with distilled water, NaOCl, Ethylenediaminetetraacetic acid (EDTA), and Er:YAG laser, respectively, and obturated with Adseal sealer. In Group 2, 4, 6, and 8 irrigated with distilled water, NaOCl, EDTA, and Er:YAG laser, respectively, and obturated with MTA Fillapex sealer. After sealer setting, the force used to remove the sealer was evaluated using universal testing machine. Recorded force used to calculate the push-out bond strength in Megapascals and scanning electron microscopy examination was done for specimens. Results: Adseal sealer had significantly higher bond strength than MTA Fillapex sealer, irrespective of irrigant used. The highest bond strength was seen in specimens irrigated with EDTA and obturated with Adseal sealer and least in specimens irrigated with distilled water and obturated with MTA Fillapex sealer. Conclusion: Adseal sealer had significantly higher bond strength than the MTA Fillapex sealer. EDTA irrigation showed better smear layer removal, followed by Er:YAG laser irradiation, then NaOCl, least by distilled water.

Tooth sectioning for coronectomy: how to perform?

The aim of this study was to determine the increase in heat production, preparation time, and cutting surface quality of conventional, high-speed rotating instruments and piezoelectric preparation for coronectomy procedures. One hundred intact extracted molars were sectioned horizontally, sub-totally, 1mm under the cemento-enamel line with five methods: (1) tungsten carbide torpedo (TcT), (2) round (TcR) drills using a conventional speed surgical straight handpiece (< 40,000min-1), (3) tungsten carbide fissure (TcF), (4) diamond torpedo (DT) drills using a surgical high-speed, contra-angle handpiece (~ 120,000min-1), or (5) a saw-like piezoelectric tip (PT). Temperatures, preparation times, and cutting surface irregularities were registered and the differences were analyzed with ANOVA, Tukey's HSD post hoc test (temperature, time) and with chi-square test (irregular surface). Rotating instruments produced a maximal temperature increase of less than 1°C. TcF produced the least heat (ΔT = - 3.92°C to the baseline), while PT produced significantly the highest temperature increases (ΔT = 12.38°C, p < 0.001). Tungsten carbide drills were the fastest for coronectomy (from 55.9 to 64.3s), while DT (169.7s) while PT (146.8s) were significantly slower. TcT and TcR drills produced an irregular root surface more frequently. During coronectomy, rotating instruments produced entirely acceptable heat, while PT produced unacceptable temperatures. Tungsten carbide drills performed coronectomies effectively, but the diamond torpedo and PT seemed clinically questionable. Considering heat, speed, and the cutting surface quality simultaneously, TcF in a surgical high-speed handpiece seems to be the best choice for coronectomy. The correct insert can significantly reduce excessive heat and operation time during coronectomy procedures.

Root anatomy and apical canal morphology of maxillary first premolars

Understanding the root anatomy and apical canal morphology of maxillary premolars is a key prerequisite for successful surgical and endodontic treatment. The aim of this study was to assess the root anatomy and apical canal morphology of maxillary first premolars. To achieve the set task, 30 maxillary first premolars were extracted. After thorough rinse visual assessment of root anatomy was made. Each root was transversally sectioned six millimeters from apex with a straight hand piece. The apical samples were decalcificated in 7.5% trichloroacetic acid, transversal sections were made, stored in 10% formalin then dyed in hematoxylin and eosin and numerated from I to VI. Apical canal morphology was evaluated with an optical microscope. Majority of maxillary first premolars had double roots (63.0%; n=19) that were mostly separated (50.0%; n=15) containing a single root canal. Minority had double roots that were fused (13.0%; n=4) with two root canals. Single root with almost equal occurrence of two, as well as variable root canal configuration were found in (30.0%; n=9). A very rare occurrence of maxillary first premolars with three roots (7.0%; n=2) was detected, two vestibular and one palatal, each containing a single canal configuration. Accessory lateral canals were detected in 20% of maxillary first premolars. Transversal communications were detected in maxillary premolars with one root and double fused roots (26.6%; n=8). A single apical foramen was detected in majority of maxillary first premolars (50.0%; n=15). Two apical foramina were detected in (33.4%; n=10), three in (10.0%; n=3) and four in (6.6%; n=2) maxillary premolars. Keywords: maxillary first premolar, root anatomy, apical canal morphology, decalcification, optical microscopy

A Review of In-Office Dynamic Image Navigation for Extraction of Complex Mandibular Third Molars

We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS). A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47years (range, 27 to 72years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater. Each patient received custom intraoral splints to secure the tracking array and underwent cone beam computed tomography image acquisition. All surgical procedures were performed with a precalibrated tracking straight handpiece under dynamic navigation. All 25 cases were treated successfully with the use of the DINS. Twelve of these cases were associated with pathologic lesions. Three patients were noted to have inferior alveolar nerve paresthesia. One patient sustained a pathologic fracture at week 2. Postoperative infections were noted in 7 cases, 2 of which had a pre-existing infection. One patient reported temporary limitation of mouth opening. A coronectomy was performed in 1 case. We present results using a new technology, the DINS, for removal of complex mandibular third molars. Potential advantages are 1) improved visualization and localization of anatomic structures such as the inferior alveolar nerve, lingual cortical plate, and adjacent roots; 2) improved control during osteotomy; 3) decreased surgical access requirements and reduction in overall bone removal; 4) ability to perform complex procedures successfully in an in-office setting; 5) decreased surgical time resulting from improved visualization; and 6) potential use as a teaching tool. Possible limitations of the use of an in-office DINS include increased cost, increased time attributed to presurgical planning, initial learning curve, and optical array interference by the surgeon or assistants during surgery.

Comparative Evaluation of Anti Microbial effects of Triple Antibiotic Paste and Amox and its derivatives against E. Faecalis: An in vitro study.

BackgroundEnterococcus faecalis is a microorganism commonly detected in asymptomatic, persistent endodontic infections. Triple antibiotic paste has stood the test of time as a proven antibiotic combination against E. Faecalis. However, problems with this include staining of teeth and standardization of the preparation. Thus, the search for better alternatives and better preparation techniques is still on.AimTo observe the potential of combinations [(Amoxicillin+ Metronidazole, Amoxicillin Clavulanic Acid + Metronidazole; Amoxicillin and Cloxacillin + Metronidazole)] over Triple Antibiotic Paste.Material and MethodsFifty single rooted teeth free from dental caries were selected for the study. Teeth were cut at equal distance from root apex (13mm from apex) with sterile diamond disk and straight hand piece for standardization of root length. The opening of root canal was enlarged with engine driven pro-taper files. To remove the organic and inorganic debris, canal was cleaned with 17% EDTA followed by 2.5% NaOCl for 5min. Distilled water irrigation was done for 5 min to remove any traces of used chemical and then sterilized in autoclave at 1200c for 15 min. at 15 lbs pressure. Bacteria cultured on blood agar plate and at the same time fresh antibiotic combinations were made and placed in the root canals, then incubated in the incubator, under sterile conditions and observed at 24hrs, 48hr and 72hrs.ResultsThe largest inhibition zones were observed for the Triple Antibiotic Paste, followed by Amoxicillin and Clavulanic acid + Metronidazole group however, the clearest zones were achieved with Amoxicillin and Clavlunic acid + Metronidazole group and the smallest for Amoxicillin and Metronidazole group.ConclusionsThe results suggest that though Triple antibiotic showed the maximum inhibition, Amoxicillin and Clavulanic acid combination along with Metronidazole gave the most reliable results. Further studies using the different combinations and different concentrations along with different methods of increasing the shelf life of such medications can be undertaken. Key words:Enterococcus faecalis, Triple Antibiotic Paste, Amoxcillin, Clavulanic acid.

A Sectioning Technique for Extraction of Impacted Third Molar by Using a Straight Handpiece and Carbide Bur: Case Report

Extraction of the lower third molar is one of the most common procedures performed in oral surgery. In general, impacted tooth extraction involves sectioning the tooth’s crown and roots. In order to divide the impacted tooth so that it can be extracted, high-speed air turbine drills are frequently used. However, complications related to air turbine drills may occur. In this report, we propose an alternative tooth sectioning method that obviates the need for air turbine drill use by using a low-speed straight handpiece and carbide bur. A 21-year-old female patient presented to the institute’s dental hospital complaining of symptoms localized to the left lower third molar tooth that were suggestive of impaction. After physical examination, tooth extraction of the impacted left lower third molar was proposed and the patient consented to the procedure. The crown was divided using a conventional straight low-speed handpiece and carbide bur. This carbide bur can easily cut through the enamel of crown. On post-operative day number five, suture was removed and the wound was extremely clear. This technique could minimise intra-operative time and reduce the morbidity associated with air turbine drill assisted lower third molar extraction.

The Effect of McInnes Solution on Enamel and the Effect of GC Tooth Mousse on Bleached Enamel: AnIn VitroStudy

The aim is to evaluate the effect of McInnes bleaching agent on the microhardness of enamel before and after bleaching and to evaluate the effect of G C Tooth Mousse on the bleached enamel surface for its microhardness. The materials and methods used are McInnes bleaching solution, Casein phosphopeptide-amorphous calcium phosphate CCP-ACP (G C Tooth mousse) artificial saliva (Dept. of Oral Pathology, GDC Bellary), deionized water, Vickers’ Micro Hardness tester (Zwick/ZHV, Germany), freshly extracted teeth, cold cure acrylic, Diamond disc (Horico–PFINGST New Jersey, USA, KAVO-Germany), straight handpiece (kavopecareta) and plastic moulds (6.5 × 2 mm2). The purpose of this study was to evaluate and compare microhardness of the sound enamel surface by Vickers’ Hardness Number (VHN) before and after bleaching with McInnes solution, and to evaluate the effect of casein phosphopeptide amorphous calcium phosphate (G C Tooth Mousse) on the bleached enamel surface for its microhardness. The data obtained from the test were subjected for statistical analysis and are presented as range, mean and standard deviation. P value of 0.05 or less was considered for statistical significance. The changes in microhardness at different times of assessment were analyzed using the paired ‘t’ test. The results of all the samples showed decrease in the microhardness after two cycles of bleaching, though immediately after bleaching the decrease in the microhardness was not significant (P = 0.34). However, after the second cycles, it showed a significant decrease (P<0.01) in the microhardness. After application of remineralization solution (GC Tooth mousse), the samples showed a marginal increase in the microhardness (P<0.05) after seven days and a marked increase after fourteen days (P<0.001).McInnes bleaching agent does decrease the microhardness of enamel by causing enamel demineralization and GC Tooth mousse used in the study causes an increase in the microhardness of bleached enamel by maintaining a high gradient of calcium and phosphate ions at the enamel subsurface.

An evaluation of apical microleakage in roots filled withthermoplastic synthetic polymer based root canal fillingmaterial (RealSeal 1 bonded obturation)

Background: This study aimed to evaluate and compare the apical microleakage of roots canal filled with cold lateral condensation of gutta-percha, cold lateral condensation of Resilon, Thermafil and RealSeal1 bonded obturation. Materials and methods: Sixty freshly extracted maxillary first molars with straight palatal roots .Using diamond disc bur with straight hand piece and water coolant the palatal roots of teeth were sectioned perpendicular to the long axis at the furcation area. All roots were prepared with crown-down technique using hand ProTaper system (Sx-F4).The prepared roots randomly divided into 4 groups of fifteen roots each; the groups obturated with different obturation technique. In Group 1 roots obturated with( lateral condensation of gutta-percha), Group 2 was obturated with(lateral condensation of Resilon),group3 was obturated with (Thermafil) while in group4 obturated with( RealSeal 1 bonded obturation).All the samples sealed coronally and stored in normal saline at 37°C for one week ,then all the roots submerged Indian ink for one week. The roots were cleared and the degree of linear dye penetration was measured in millimeter by stereomicroscope under 40X magnification with calibrated scale ocular grid. Results: The results showed that the RealSeal1 bonded obturation leaked apically significantly higher than other test groups, while the group of lateral condensation of gutta-percha exhibited the least value of apical microleakage. Conclusion: The complete hermetic apical seal cannot be created neither with gutta-percha nor with Real Seal 1bonded obturation.

Treatment of Persistent Idiopathic Facial Pain (PIFP) with a Low-Level Energy Diode Laser

The purpose of this study was to test the therapeutic efficacy of low- level energy diode laser on persistent idiopathic facial pain (PIFP). PIFP has presented a diagnosis and management challenge to clinicians. Many patients were misdiagnosed, which resulted in unnecessary dental procedures. Low-level energy diode laser therapy has been applied to different chronic and acute pain disorders, including neck, back, and myofacial pain; degenerative osteoarthritis; and headache, and it may be an effective alternative treatment for PIFP. A total of 16 patients, who were diagnosed with PIFP, were treated with an 800-nm wavelength diode laser. A straight handpiece having an end size of 0.8 cm in diameter, or an angled handpiece with an end size of 0.5 cm in diameter was used. When laser was applied, the handpiece directly contacted the involved symptomatic region with an energy density of 105 J/cm(2). Overall pain and discomfort was analyzed with a 10-cm visual analogue scale (VAS) before and after treatment. All patients received diode laser therapy between 1 and 10 times. The average pain score was 7.4 before the treatment (ranging from 2.9 to 9.8), and 4.1 after the treatment. An average pain reduction of 43.87% (ranging from 9.3% to 91.8%) was achieved. The pain remained unchanged at a lower level for up to 12 months. Low-level energy diode laser may be an effective treatment for PIFP.

Treatment of Burning Mouth Syndrome with a Low-Level Energy Diode Laser

To test the therapeutic efficacy of low-level energy diode laser on burning mouth syndrome. Burning mouth syndrome is characterized by burning and painful sensations in the mouth, especially the tongue, in the absence of significant mucosal abnormalities. Although burning mouth syndrome is relatively common, little is known regarding its etiology and pathophysiology. As a result, no treatment is effective in all patients. Low-level energy diode laser therapy has been used in a variety of chronic and acute pain conditions, including neck, back and myofascial pain, degenerative osteoarthritis, and headache. A total of 17 patients who had been diagnosed with burning mouth syndrome were treated with an 800-nm wavelength diode laser. A straight handpiece was used with an end of 1-cm diameter with the fiber end standing 4 cm away from the end of handpiece. When the laser was applied, the handpiece directly contacted or was immediately above the symptomatic lingual surface. The output used was 3 W, 50 msec intermittent pulsing, and a frequency of 10 Hz, which was equivalent to an average power of 1.5 W/cm(2) (3 W × 0.05 msec × 10 Hz = 1.5 W/cm(2)). Depending on the involved area, laser was applied to a 1-cm(2) area for 70 sec until all involved area was covered. Overall pain and discomfort were analyzed with a 10-cm visual analogue scale. All patients received diode laser therapy between one and seven times. The average pain score before the treatment was 6.7 (ranging from 2.9 to 9.8). The results showed an average reduction in pain of 47.6% (ranging from 9.3% to 91.8%). The burning sensation remained unchanged for up to 12 months. Low-level energy diode laser may be an effective treatment for burning mouth syndrome.

Influence of grinding procedures on the flexural strength of zirconia ceramics

The surface of zirconia may be damaged during grinding, influencing the mechanical properties of the material. The purpose of this study was to compare the flexural strength of zirconia after different grinding procedures. Twenty bar-type zirconia specimens (21 x 5 x 2 mm) were divided into 4 groups and ground using a high-speed handpiece or a low-speed straight handpiece until the bars were reduced 1 mm using two different grinding times: continuous grinding and short-time grinding (n=5). Control specimens (n=5) were analyzed without grinding. The flexural strengths of the bars were determined by using 3-point bending test in a universal testing machine at a crosshead speed of 0.5 mm/min. The fracture load (N) was recorded, and the data were analyzed statistically by the Kruskal Wallis test at a significance level of 0.05. In the test groups, high-speed handpiece grinding for a short time had produced the highest mean flexural strength (878.5 ± 194.8 MPa), while micromotor continuous grinding produced the lowest mean flexural strength (733.8 ± 94.2 MPa). The control group was the strongest group (928.4 ± 186.5 MPa). However, there was no statistically significant differences among the groups (p>0.05). Within the limitations of the study, there was no difference in flexural strength of zirconia specimens ground with different procedures.

A method of removing a splint material from a cast with minimal damage

Londono and Marafie Givan and AuClair Thin vacuum-formed materials are used for a variety of purposes in dentistry, including: as a matrix for provisional restorations, for vertical and horizontal space assessment, or as surgical guides for implant placement, crown lengthening, and other preprosthetic surgical procedures. A clinician may desire a set of unaltered casts for presentation purposes, and most methods to remove a vacuumformed matrix will result in scratching or otherwise marring the cast. A simple procedure to remove a matrix while minimizing damage to casts is presented. In this method, a mounted bristle brush or similar short-bristle rotary brush is used with light pressure and rapid rotation in a straight handpiece or laboratory motor to efficiently cut the splint material. Alternative methA method of removing a splint material from a cast with minimal damage

A device to hold implant abutments for extraoral preparations

Londono and Marafie Givan and AuClair Thin vacuum-formed materials are used for a variety of purposes in dentistry, including: as a matrix for provisional restorations, for vertical and horizontal space assessment, or as surgical guides for implant placement, crown lengthening, and other preprosthetic surgical procedures. A clinician may desire a set of unaltered casts for presentation purposes, and most methods to remove a vacuumformed matrix will result in scratching or otherwise marring the cast. A simple procedure to remove a matrix while minimizing damage to casts is presented. In this method, a mounted bristle brush or similar short-bristle rotary brush is used with light pressure and rapid rotation in a straight handpiece or laboratory motor to efficiently cut the splint material. Alternative methA method of removing a splint material from a cast with minimal damage

The effect of McInnes solution on enamel and the effect of Tooth mousse on bleached enamel: An in vitro study.

Aims:To evaluate the effect of McInnes bleaching agent on the micro hardness of enamel before and after bleaching and to evaluate the effect of G C Tooth Mousse on the bleached enamel surface for its microhardness.Materials and Methods:McInnes bleaching solution, Casein phosphopeptide-amorphous calcium phosphate CCP-ACP (G C Tooth mousse) artificial saliva (Dept of Oral Pathology, College of Dental Sciences, Davengere), deionized water, Vickers Micro Hardness tester (Zwick/ZHV, Germany), freshly extracted teeth, cold cure acrylic, Diamond disc (Horico - PFINGST New jersey USA, KAVO- Germany), straight handpiece (kavo peca reta) and plastic moulds (6.5 × 2 mm). The purpose of this study was to evaluate and compare microhardness of the sound enamel surface by Vickers Hardness Number before and after bleaching with McInnes solution, and to evaluate the effect of casein phosphopeptide amorphous calcium phosphate (G C Tooth Mousse) on the bleached enamel surface for its microhardness.Statistical analysis:The data obtained from the test were subjected for statistical analysis and are presented as range, mean and standard deviation. P value of 0.05 or less was considered for statistical significance. The changes in microhardness at different times of assessment were analyzed using the paired ‘t’ testResults:All the samples showed decrease in the microhardness after two cycles of bleaching, though immediately after bleaching the decrease in the microhardness was not significant (P = 0.34). However, after the second cycles, it showed a significant decrease (P<0.01) in the microhardness. After application of remineralization solution (GC Tooth mousse), the samples showed a marginal increase in the microhardness (P<0.05) after seven days and a marked increase after fourteen days (P<0.001).Conclusion:McInnes bleaching agent does decrease the microhardness of enamel by causing enamel demineralization and GC Tooth mousse used in the study causes an increase in the microhardness of bleached enamel by maintaining a high gradient of calcium and phosphate ions at the enamel subsurface.