Graphical abstract

Cytomorphometry is used in the sampling of biological materials and diagnostic procedures. The use of cytological studies in periodontal diseases is not well described in the literature. Our study aimed to quantitatively assess the inflammation dynamics using cytomorphometric analysis of the periodontium before and after the use of fixed dental prostheses. Following ethics approval, a total of 105 subjects were divided in 3 groups as gingivitis (n = 23), periodontitis (n = 58), and healthy periodontium (control) (n = 24). The fixed dental prostheses (crowns and fixed partial dentures) were fabricated from cobalt-chrome metal-ceramic prostheses using the conventional method (C/M-CoCr), cobalt-chrome metal-ceramic prostheses by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (C/C-CoCr), and zirconia-based ceramic prostheses by the CAD/CAM technique (C/C-Zr) among subjects with gingivitis and periodontitis. The gingival crevicular fluid (GCF) was obtained from subjects before and after the use of the prostheses. The total count of epithelial cells and the connective tissue cells or polymorphonuclear neutrophils (PMNs) in GCF were studied using cytomorphometric analysis. The Statistical Package Tor the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA) was used to analyze the results and the significance level was set at p = 0.05. The data for before and after the use of the prostheses were compared using independent t-Tests. Similarly, the results after the use of prostheses in gingivitis, periodontitis, and control in each type of prostheses were compared using One-way ANOVA with post hoc using Scheffe. The total epithelial cells and the PMNs were determined along with the epithelium/leukocyte index. Regardless of the prostheses type used, no significant change in the parameters was identified among patients with a healthy periodontium, before and after prosthetic treatment. In all study groups, a statistically increase (p value < 0.05) was observed in the oral epithelial cell counts and a statistically decrease (p < 0.05) in the PMNs count following the use of the fixed prostheses. Data on cytomorphometric analysis could enable the selection of the most appropriate prostheses for use in patients with periodontal pathologies. When choosing prostheses, changes in the composition of GCF could be considered as a useful criterion for their use.

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The effect of a restored machined hybrid dental ceramic crown–tooth complex is not well understood. This study was conducted to determine the effect of the stress state of the machined hybrid dental ceramic crown using three-dimensional finite element analysis. Human premolars were prepared to receive full coverage crowns and restored with machined hybrid dental ceramic crowns using the resin cement. Then, the teeth were digitized using micro-computed tomography and the teeth were scanned with an optical intraoral scanner using an intraoral scanner. Three-dimensional digital models were generated using an interactive image processing software for the restored tooth complex. The generated models were imported into a finite element analysis software with all degrees of freedom concentrated on the outer surface of the root of the crown–tooth complex. To simulate average occlusal load subjected on a premolar a total load of 300 N was applied, 150 N at a buccal incline of the palatal cusp, and palatal incline of the buccal cusp. The von Mises stresses were calculated for the crown–tooth complex under simulated load application was determined. Three-dimensional finite element analysis showed that the stress distribution was more in the dentine and least in the cement. For the cement layer, the stresses were more concentrated on the buccal cusp tip. In dentine, stress was more on the cusp tips and coronal 1/3 of the root surface. The conventional crown preparation is a suitable option for machined polymer crowns with less stress distribution within the crown–tooth complex and can be a good aesthetic replacement in the posterior region. Enamic crowns are a good viable option in the posterior region.

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