Objectives: Controlling oral biofilms by applying a metal nanoparticle coating is a very promising approach that relates to their potent antibacterial effect and superior impact on epithelial and connective tissue adhesion, leading to improved soft tissue regeneration. This study evaluated the antimicrobial effect and epithelial and fibroblast adhesion properties of silver nanoparticle-coated titanium surfaces, compared to untreated titanium and zirconia surfaces. Methods: To simulate abutment surfaces, disc-shaped samples were fabricated using zirconia, titanium, and titanium with a coating of nano-silver, deposited using splutter-coating technology. Three groups of samples were made and surface characterisation was carried out to assess surface morphology, thickness of the silver layer, and surface chemical content. To asses antimicrobial activity, samples in each group were placed in twelve- or twenty-four-well polystyrene culture plates and inoculated with bacterial cultures, and assessed for viable counts associated with the surface by obtaining total viable counts on TY/LB agar plates. Live and dead cells were quantified using a Backlight[tm] bacterial detection kit, and were imaged by confocal microscopy. To assess fibroblast adherence, oral fibroblasts were isolated from biopsy samples and grown in media (such as Dulbecco’s modified Eagle’s medium; DMEM) supplemented with serum and essential growth factors. Cells were added to achieve a density of 1 x105 cells/mL and placed in an incubator at 37° C and 5%carbon dioxide for 24 hours, to allow the cells to attach. Cell growth was assessed after 48 hours by MTT assay and compared to the control group. The amount of colour produced was directly proportional to the number of viable cells. All experiments were carried out in triplicates to negate any procedural error. Data were analysed by ANOVA with Duncan's multi-comparison procedure at a 5% confidence level. Results: Silver was deposited by sputtering silver ions on titanium surfaces, pretreated with emery paper and Piranha’s solution, to a final thickness of 6 mug/mm after 5 minutes. The silver ion release profile was studied over 28 days. The maximum cumulative silver concentration was 4 [mu]g/mL up to day 7 and thereafter underwent sustained release (with a similar rate to that of bioactive drugs from a matrix). Cytocompatibility assay showed time-dependant cell proliferation near the test samples that was inversely proportional to the amount of silver released. The silver-coated surfaces had a remarkable antibacterial effect against Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus mutans compared to untreated titanium and zirconia discs. The MTT assay revealed significantly higher fibroblast growth and proliferation in the presence of nanosilver-coated surfaces compared with untreated surfaces. Conclusion:Titanium surfaces can be modified by coating with silver nanoparticles using the sputtering technique. The modified surface show potent antibacterial action against a range of oral pathogens. Silver nanoparticle-coated surfaces may be used in regenerative therapy by virtue of their ability to promote increased adherence of gingival fibroblasts.

Before starting the full-mouth reconstruction, the oral-maxillary sinus fistula (oroantral fistula) has to be closed.

Gliederung: - Einleitung und Kontrolle der Lückenbreite und Farbauswahl - Oberflächenkonditionierung (Applikation der Matritze) - Lückenschluss, Finale Politur. Im vorliegenden Beitrag werden die Lücken an Zahn 22 durch eine direkte Adhäsivtechnik geschlossen. Der Lückenschluss wird in diesem Fall nach der kieferorthopädischen Behandlung eines zentralen Diastemas durchgeführt. Die Behandlung erfolgt mittels einer speziellen Matrizentechnik, welche eine perfekte Ausarbeitung der Aproximalflächen und Herstellung der approximalen Kontaktpunkte ermöglicht. Bei der Farbauswahl wird auf die genaue Auswahl der Dentin- und Schmelzfarben geachtet, so dass ein möglichst natürliches ästhetisches Ergebnis erzielt werden kann. Es werden unterschiedliche Komposite eingesetzt um dieses perfekte ästhetische Behandlungsergebnis zu erzielen.