Medicine and Health Sciences Commons^™

Titanium Particles Within Mucosa During Non-Surgical Implant Debridement, Holvin Louie

Loma Linda University Electronic Theses, Dissertations & Projects

Titanium implants affected by peri-implantitis lesions are often treated non-surgically with various instruments, which may produce titanium particles that can become lodged within the peri-implant mucosa. Thus, a foreign body reaction may ensue. The aim is to assess the embedment of titanium particles into soft tissues from titanium implants via a stainless-steel ultrasonic scaler (SSU) versus a titanium hand scaler (TH). Sand-blasted, large grit, acid-etched surface-treated titanium implants were implanted into pig legs after creating peri-implantitis defects. Each implant was subjected to only one instrument type. Sequential strokes were conducted followed by thorough irrigation with sterile water. Soft tissue curettage …

A Study In Fresh Human Cadaver Heads Examining The Incidence Of Maxillary Sinus Membrane Perforation During Crestal Sinus Elevation Comparing Osteotomes To Osseodensification Drills., Thaer Alqadoumi

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Crestal sinus membrane elevation technique is a surgical procedure that helps gain vertical bone volume when there is a pneumatization of the maxillary sinus. Due to some visual limitations inherent to the procedure, the potential for maxillary sinus membrane perforations and subsequent complications exists. A crestal sinus lift using osseodensification drills has been used lately but there are not many studies to support the protocol. The primary aim of the study is to evaluate the incidence of sinus membrane perforation during Osseodensification compared to the incidence of bone added crestal sinus elevation using osteotomes (BAOSFE). The secondary aim …

A Comparison Of Heat Generated Between Carbide And Diamond Bur During Implantoplasty, Bryce Chun

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This study was conducted to evaluate heat generated during the implantoplasty procedure by comparing the heat generated using either a carbide or diamond round bur. Materials and Methods: Bovine ribs were selected as the osseous model for this study. Changes in temperature were measured using a digital thermometer (Extech SDL200 four channel thermometer, Extech instruments, Melrose MA). Ther k-thermocouples were positioned within the implant screw access, apex of the implant, and crestal bone adjacent to the implant and ambient air. 5 bovine rib bone blocks were prepared by place 5 cylindrical titanium grade 5 alloy large grit sand blasted …

Comparison Of Heat Generated During Twist Drilling Protocol By Guided And Non-Guided Implant Surgery, Joshua Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Guided implant surgery is becoming more prevalent among clinicians and is crucial for cases in which there are concerns about the proximity of the implant to vital anatomical structures, esthetic concerns, and the amount/quality of bone available. Surgical guides help with the angulation and positioning of the implant through the use of a CBCT scan and digital intraoral impression. However, there are some drawbacks with guided surgery. Heat that is generated during the osteotomy is one of the issues that has been of concern. The guide acts as a shield against the water irrigation from reaching the osteotomy …

Accuracy Of Intraoral Scanners With Different Total Occlusal Convergence Angles: An In-Vitro Study, Brittany M. Pang

Loma Linda University Electronic Theses, Dissertations & Projects

Digital intraoral imaging has become more utilized in contemporary dental practice. This is performed using an intraoral scanner and it can be used as an alternative to making conventional impressions when indicated. This technology has many advantages, such as decreasing the number of appointments by eliminating traditional techniques, along with a reduction of laboratory time and improved patient comfort. The accuracy of intraoral scanners is currently being assessed in various aspects. To our knowledge, no study has yet addressed the accuracy of intraoral scanners in regards to total occlusal convergence (TOC) of complete coverage of anterior and posterior preparations in …

Comparison Of Antimicrobial Agents Ozonated Olive Oil And Chlorhexidine Gluconate - An In Vitro Study, Amelia David

Loma Linda University Electronic Theses, Dissertations & Projects

Aim: This study was aimed to compare the antibacterial effect of a commercially available OzOO with CHX 0.12% oral rinse solution against periodontal pathogens F. alocis, Aa, S. mitis, and S. mutans using a disk diffusion method.

Materials and Methods:

The antimicrobial agents OzOO and 0.12% CHX were impregnated onto sterile discs and placed onto bacterial cultures of F.alocis, Aa, S.mutans, and S.mitis to evaluate their antimicrobial activity by the disk diffusion susceptibility method. The bacterial growth inhibition zone surrounding each disc was measured in millimeters of diameter with calipers to assess the antimicrobial activity of each agent. …

A Digitized Comparison Using Cone Beam Computed Tomography And Intraoral Scanning, Yvette Carrillo

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to evaluate the accuracy of digital workflow by evaluating the absolute technical differences in various scanning methods on jaw models with scanning bodies.

Material and Methods: Twenty identical 3-dimensionally printed mandibular quadrant jaw models with a single implant and scanning body replacing a missing tooth in area #19 were examined. Cone beam computed tomography .STL files were used as the first test group. Intraoral scans were used as the second test group. Desktop scans of each model and the .STL file was used as a control. The .STL files were then …

Comparison Of Antibacterial Activity Of Ozonated Olive Oil And Chlorhexidine Gluconate, Changmin Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Aim: The aim of this in vitro disk diffusion susceptibility test is to compare the antibacterial activity of ozonated olive oil (OzOO) with chlorhexidine gluconate (CHX) against periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter Actinomycetemcomitans. Materials and Methods: The antibacterial activity of two antiseptics, OzOO and CHX, and, two controls, olive oil and normal saline was assessed by disk diffusion susceptibility test. For disk diffusion susceptibility test, two periodontal pathogens, 20 petri dishes for P. gingivalis and 18 petri dishes for A. actinomycetemcomitans, were used. To assess the antibacterial activity, the diameters of the growth inhibition zone were measured with a …

Accuracy Of A Newly Developed Guided Dental Implant Delivery System, Fallon D. Livingston

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to evaluate the accuracy of a guided dental implant system with one operator comparing the treatment planned location to the actual location using a table top optical scanner. Materials and Methods: Twenty five patients were treated with a cone beam computed tomography (CBCT) scan. A stone cast was made of each patient and scanned using an optical table top scanner. The optical scan of the cast and the CBCT of the patient were superimposed and a single implant was placed virtually in the software program. A sterolithographic three dimensional (3D) surgical guide was …

Accuracy Of Implants Placed With Surgical Guides: Thermoplastic Vs. 3-D Printed, Caitlyn K. Bell

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to evaluate the accuracy of placed implants using two different guided implant surgery materials: thermoplastic vs. 3-D printed surgical guides. Materials and Methods:Twenty duplicate mandibular models, ten thermoplastic and ten 3-D printed surgical guides were used. Twenty implants were placed following the guided surgery protocol. Cone beam computed tomography scans of placed implants and the control implant were superimposed to measure deviations. Results: The thermoplastic group showed average deviations of 3.4 degrees, 1.3mm at the head, and 1.6mm at the apex of the implant compared to 2.36 degrees, 0.51mm, and …

Accuracy Of Volumetric Analysis Software Packages In Assessment Of Tooth Volume Using Cbct, Saylee Nimbalkar

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the accuracy of volumetric analysis software packages in assessment of tooth volume using cone beam computed tomography and compare them to the volume obtained using an optical digital scanner. Twenty-four single rooted teeth indicated for extraction were collected. Cone beam computed tomography scans of these teeth resting in a custom scan jig were taken. Three dimensional digital models were obtained from the DICOM image cone beam computed tomography files using segmentation software packages (Anatomage, Mimics, and Amira) and volumes were calculated for each of the segmented teeth. The teeth were then scanned …

Influence Of Low Temperature Degradation On Microstructural Integrity Of Zirconia Dental Implants, Mona Monzavi Rahimi

Loma Linda University Electronic Theses, Dissertations & Projects

Zirconia dental implants have become more popular in the field of implant dentistry. However, concerns have been raised regarding low temperature degradation and its influence on phase stability and micro-structural integrity in terms of increased micro-crack formation. In the case of dental implants, this could possibly result in delamination and interference with bone to implant contact and eventually lead to loss of integration and failure. Nevertheless, no study has reported the effects on commercially available Zirconia dental implants. The primary aims of this study was to determine if there is a correlation between ageing duration and 1) depth of tetragonal-monoclinic …

Novel Approach To Assess Periodontal Disease Severity Using Volumetric Analysis, Meera George Maveli

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate if the absolute change in linear measurements of bone loss on the facial plane of a maxillary central incisor at full and half root length along the vertical axis is directly proportional to volumetric change. The secondary aim was to evaluate if the variation of root volume is influenced by difference in root morphology.

Three dimensional digital models of 70 random patients were obtained from

DICOM CBCT files using volumetric software, InVivoDental (Anatomage, San Jose,

CA). One central incisor of average root length was selected per patient and total length

(L1) and …

Factors Affecting Gingival Recession In The Esthetic Zone: A Human Cadaver Study, Christen Sather

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to assess the correlation of gingival recession to the following parameters in fresh cadavers: gingival thickness, buccal bone loss, buccal bone thickness, shape of bony dehiscence defect, and age. A secondary aim was to evaluate predictors for gingival recession.

Sixteen fresh cadavers were used in this study. Gingival recession, facial gingival thickness, alveolar bone loss, and buccal bone thickness were measured at teeth #6-#11 and #22-#27. Sites with a dehiscence (D) or fenestration (F) were presented, and resultant bony defect shape was noted. The correlation of gingival recession to gingival thickness, buccal bone loss, …

Identification Of The Mandibular Nerve With Cbct Using A Nerve Marking Tool Or Not, Myung Soo Choi

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: In the field of implant dentistry, cone beam computed tomography can give clinicians valuable information regarding anatomic structures, bone quantity and quality. If the mandibular nerve is encroached during surgery, severe morbidity of the patient and medico-legal issues may result. Thus the importance of accurate determination of the position of mandibular canal cannot be overemphasized. Purpose: The aim of this study is to evaluate the difference in the position of the mandibular nerve determined, and marked by a radiology technician utilizing nerve marking tool and compared to the same measurement by a clinician not utilizing a nerve marking tool. …

Factors Influencing Contrast Resolution Of Cone Beam Ct Using The Cb Mercuray, Roger M. Anderson

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Cone Beam Computed Tomography (CBCT) has an application in all dental specialties. CBCT is an aid in implant dentistry to evaluate anatomical landmarks in both quality and quantity. Hounsfield Unit (HU) values represent a grayscale that is standardized on CT machines relative to the density of water and air. It has been reported that the HU value represents an actual value of the bone density. However, recent studies at Loma Linda University have suggested that HU values retrieved using CBCT machines may be altered by various factors.

Purpose: The aim of this study is to evaluate the specific dosage …

Reproducibility Of Two Non-Consecutive Scans Using A Newtom 3g; In Vitro Model, Hyoung Jin Park

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The aim of this study was to evaluate the reproducibility of mineral density measurement expressed in Hounsfield Units (HU) using a phantom device with known mineral densities and the NewTom 3G Cone Beam Computerized Tomography (CBCT).

Materials and Methods: A phantom device made of 21 HA cylindrical disks with known densities was fabricated. The phantom was scanned in 6, 9, and 12 inch fields of view using a NewTom 3G CBCT. The scans were repeated at non-consecutive sessions. Volumetric data in each of the scans were formatted to DICOM images. HU values of the regions of interest were retrieved …

Influence Of Keratinized Mucosa, Bone Dimensions On Mucosal Recession And Bone Loss, Jeanette Keng Ling Chua

Loma Linda University Electronic Theses, Dissertations & Projects

Background: To accomplish successful esthetic outcome, it would be an advantage if some pre-implant placement conditions could be identified which would predict soft and hard tissue outcomes post-implant placement. This study was designed to evaluate the influence of 1) height of mid-buccal keratinized mucosa at implant surgery and 2) thickness of mid-buccal bone after osteotomy on the amounts of mid-buccal mucosal recession and bone loss during the first year after implant treatment. This report presents the initial 3-month follow-up.

Materials and methods: Nine patients scheduled for surgical placement of a total of 11 single-staged implants, without adjacent teeth and planned …

Training Program To Improve Estimation Of Patients' Periodontal Pain Experience, Yoon Jeong Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The purpose of this study was to determine if periodontal residents could enhance their ability to appraise the pain levels experienced by their patients from probing, using Visual Analog Scale (VAS) to record pain. We hypothesized that with increasing experience by repeated comparisons of the patients' VAS pain ratings with independent ratings by the residents, they would improve their ability to appraise their patients' pain experiences.

Methods: For each of three periodontal residents, 40 consecutive periodontitis patients were asked to express the degree of pain they experienced during the probing. Independently, the residents rated the pain level they perceived …

Resonance Frequency Analysis As A Determinant Of Implant Initial Stability, Negar Tabandeh

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The clinicians' decision regarding immediate loading is largely determined by the assessment of initial stability of the dental implant. Computed tomographic assessment of recipient site bone quality, insertion resistance torque and post-insertion resonance frequency are currently the only objective methods of measurement establishing initial stability.

Purpose: A study was designed to measure resonance frequency of root form dental implants placed in cadaver jaws. The resonance frequency values were compared to previous subjective and objective data reported in prior studies in the series.

Materials and Methods: Resonance frequency measurements were secured using the Osstell ™ mentor unit on 4.0 X …

Comparison Of Different Methods Of Assessing Ridge Width Prior To Implant Placement, Lung-Cheng Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of this study was to compare the following 3 methods of assessing alveolar ridge dimensions prior to placement of dental implants: 1) ridge mapping measurement before surgical flap reflection using a caliper; 2) direct caliper measurement following surgical exposure of the bone, and 3) measurement using images from cone beam computerized tomography.

Sixteen subjects having 25 sites for planned implant placement or ridge augmentation were recruited. An acrylic stent was fabricated for each patient. The stent provided 3 buccal/lingual pairs of consistent measurement points for each implant site, located 4, 7 and 10 mm from the summit of …

Pain Experienced By Patients Using Thinner Vs. Thicker Probes During Probing, Mohamed A. Hassan

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of the present study, performed during periodontal recall visits, was to compare the levels of pain experienced by patients during periodontal probing using probes with tip diameters of either 0.40 mm or 0.63 mm.

Prior to the maintenance procedures, three groups of 20 adult patients were examined by 3 different therapists. Diagonal maxillary/mandibular quadrants were probed with a 0.40 mm and a 0.63 mm probe, respectively. At the completion of probing of each quadrant, the patients were asked to describe their pain using a Visual Analog Scale (VAS).

The results were as follows: Most patients showed low VAS …

Pain Experienced By Patients During Periodontal Examination, Mohammed A. Al-Ajmi

Loma Linda University Electronic Theses, Dissertations & Projects

The aims of the present study were to determine the level of pain experienced by patients from probing during periodontal examination, and to find out to what extent the examining periodontist and the dental assistant could estimate the degree of pain experienced by the patients.

For each of three periodontists, 20 patients referred for periodontal diagnosis and treatment were selected. The periodontist carried out his examination, which included probing at six sites per tooth. Following probing, the patients rated the pain using a Visual Analog Scale (VAS). The periodontist and the dental assistant who helped out during the examination independently …

Effect Of Anti-Tgfß1 And Pycnogenol® On Scar Formation In Rats, Pilseong Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Wound healing is a complex biologic process that involves chemotaxis and division of cells, neovascularization, synthesis of extracellular matrix proteins, and remodeling of the repaired tissues. Of equal importance is the restoration of normal tissue structure and function without scar formation. The aim of this study was to find out the clinical effects of anti-TGFß1 and Pycnogenol® on scarless wound healing on rat skin.

An acute incision wound model was used with 20 healthy rats. Four incisions were made on each rat's skin and 4 different variables were applied by local infiltration. The four variables were anti-TGFß1, Pycnogenol®, PBS, and …

Healing Following Placement Of A Subperiosteal Orthodontic Anchoring Device, Oliver Hoffmann

Loma Linda University Electronic Theses, Dissertations & Projects

Background: A method to accomplish orthodontic anchorage using a hydroxyapatite-coated disk that is placed below the periosteum in the mid-palatal area has been developed (OnPlant, Nobel Biocare, Yorba Linda, CA, USA). This report describes the early to 8-month healing events of the first 8 consecutive cases of placement of the OnPlant device at the Advanced Periodontics Clinic at Loma Linda University School of Dentistry. In addition, it presents the results of a questionnaire on how the patients experienced the various procedures. A radiographic analysis of the side of placement of the device was performed.

Methods: At 2 weeks and at …

Assessment Of Alveolar Bone Density Using Implant Insertion Resistance Torque, Scott Sangmoo Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Implant stability during healing is a pre-requisite for successful osseointegration. In the case of early or immediate implant loading, it is necessary to achieve high level of stabilization during surgical placement. Fixture stabilization can be measured by resonance frequency analysis or implant insertion resistance torque measurement. The aim of this study is to correlate pre-operative radiographic bone density to implant insertion resistance torque in human cadaver jaw bone.

Materials & Methods: Sixty-four implant osteotomy sites in human cadaver jaw bones were previously examined radiographically using quantitative computed tomography (QCT) and quantitative cone-beam computed tomography (QCBCT). Forty-two implant insertion sites …

The Effect Of Ultrasonics On Fibroblast Cells, Sheila A. Harris

Loma Linda University Electronic Theses, Dissertations & Projects

The field of dentistry uses the debriding properties of ultrasonic vibration. It is unknown if this property is detrimental to the periodontal ligament (PDL) of an avulsed tooth. This information is important when a clinician is faced with a debris-covered avulsed tooth following a traumatic event. The purpose of this study was to determine the effect that ultrasonic vibration has on those PDL cells most numerous and most vital to a successful tooth replantation, namely, the fibroblasts.

Several fibroblast cell sources were exposed to varying ultrasonic times. These included a commercially available cell line of human foreskin fibroblast (HFF), a …

Assessment Of Human Alveolar Bone Density By Using Volumetric Ct Machine, Prasit Aranyarachkul

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated bone density in designated implants sites using cone-beam computed tomography (CBCT) and compared the measurements to those of quantitative computed tomography (QCT) and subjective bone density evaluation. Sixty-two designated implant sites in 9 human cadavers jaws were used. Indicator rods, 2 mm in diameter, were placed in all sites. CT images representing 1 mm bucco-lingual slices immediately mesial and distal to the rods were selected for density evaluations. Bone density in Hounsfield units (HU) was assessed in a standardized implant area superimposed on the images, and also subjectively evaluated by 2 independent examiners using the Lekholm & …

Il-10 And Alveolar Bone Loss, Abdulaziz Saud Al-Rasheed

Loma Linda University Electronic Theses, Dissertations & Projects

Interleukin-10 (IL-10) is a cytokine with anti-inflammatory activities. IL-10 knockout (KO) mice exhibit severe intestinal inflammation in the presence of normal gut flora. We hypothesized that IL-10 KO mice would also be susceptible to inflammatory periodontal disease resulting in alveolar bone loss (ABL). The purpose of this study was to compare naturally occurring ABL in IL-10 KO and wild type (WT) mice. Twelve IL-10 KO and 12 WT mice, age-(7 months) and sex-(male) matched, were used. Half of the mice were on 129/SvEv and half on C57BL/6J background. Animal heads were defleshed and treated to remove all organic material. ABL …

Pain Experienced By Patients During Periodontal Recall Treatment, Thu-Diem Chung

Loma Linda University Electronic Theses, Dissertations & Projects

The aims of this study were to determine; 1) the degree of pain experienced by patients during probing and debridement; 2) if the treating hygienists could estimate the degree of pain experienced by the patients; and 3) if the patients' pain responses could be predicted by factors such as the patients' age, gender, number of residual periodontal lesions, and the patients' answers to a questionnaire on dental anxiety.

Prior to the maintenance procedures, 2 groups of 20 adult patients to be treated by 2 hygienists completed an anxiety questionnaire. Subsequently, measurements of probing depths were performed, followed by pain ratings …