Francesco Mangani

Bio: Francesco Mangani is an academic researcher from University of Rome Tor Vergata. The author has contributed to research in topics: Dental bonding & Inlay. The author has an hindex of 9, co-authored 13 publications receiving 222 citations.

Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study

Abstract: Consumption of acidic foods and drinks and other factors that cause enamel wear are responsible for the daily enamel loss and degradation. Use of some toothpastes that have been showed to possess different properties of remineralisation and/or repair of the enamel surface may help to protect tooth enamel. The aim of this study was to evaluate whether the use of toothpaste containing Zn-carbonate hydroxyapatite (CHA) nanostructured microcrystals may exert remineralization/repair effects of the enamel surface. Two groups of patients, aged between 18 and 75 years, used a Zn-CHA nanocrystals-based toothpaste (experimental group) and a potassium nitrate/sodium fluoride toothpaste (active control group) for 8 weeks. At the end of this period, extractions were performed in five subjects per study group. Negative controls consisted of two subjects treated with non-specified fluoride toothpaste. Teeth were processed for morphological and chemical-physic superficial characterizations by means of Scanning Electronic Microscopy with Elementary analysis, X-Ray Diffraction analysis and Infrared analysis. In this study, the use of a Zn-CHA nanocrystals toothpaste led to a remineralization/repair of the enamel surface, by deposition of a hydroxyapatite-rich coating. On the other hand, the use of both a nitrate potassium/sodium fluoride and non-specified fluoride toothpastes did not appreciably change the enamel surface. In conclusion, this study demonstrates that the toothpaste containing Zn-CHA nanostructured microcrystals, differently from nitrate potassium/sodium fluoride and non-specified fluoride toothpastes, may promote enamel superficial repair by means of the formation of a protective biomimetic CHA coating.

Clinical approach to anterior adhesive restorations using resin composite veneers.

Abstract: Scientific progress in adhesive dentistry has led to more conservative techniques, both direct and indirect, to solve esthetic problems in anterior teeth. This article will discuss only indirect techniques, which are clearly superior in complex cases in which it will be difficult to recreate harmonious tooth shape and color. After reviewing the literature and highlighting the properties of this technique, the indications and benefits compared to the direct technique will be assessed. This is followed by a step-by-step description of operative procedures, from treatment planning to relining and polishing of the cemented adhesive restoration. The long-term success of veneers depends mainly on the tooth preparation, which should be confined to enamel, involve proximal contact areas, maintain the cervical enamel margin, and incorporate the incisal edge to increase veneer resistance and enable correct placement. Although no clinical follow-up similar to that of ceramic materials is available, the latest-generation resin composites offer interesting features. They can withstand mechanical stress, have excellent esthetic properties, and, most importantly, can be repaired intraorally without impairing their physicochemical and mechanical properties.

Degree of conversion of dual-cure resins light-cured through glass-fiber posts.

Abstract: PURPOSE: To evaluate the degree of conversion (DC) of dual-curing materials used to lute glass-fiber posts in a simulated root canal polymerized by two different modalities. METHODS: Artificial root canals were used to simulate a clinical condition to lute 45 posts by three different dual curing luting cements (Calibra, Multilink Automix and Variolink II). Two light cure modalities were chosen for each luting cement: standard (S group) 400 mW/cm2 for 120 seconds and high-power (H group) 1200 mW/cm2 for 40 seconds. Raman spectra were collected at different positions in the post surface (1, 3, 5 and 7 mm from the coronal-most portion of the post covered in cement) and the percentage degree of conversion was computed. The data were analyzed using ANOVA and post-hoc Student-Neuman-Keuls t-test (P = 0.05). RESULTS: The DC of the tested luting composites decreased progressively while increasing the distance from the light tip. Regardless of the polymerization modality (H or S) applied. Conversely, the curing modality significantly influenced the DC of the tested materials, evidencing different responses to the same energy density: Calibra seemed to be less dependent on light-curing than the other tested materials, showing a constant behavior. Multilink Automix reached the highest DCs in the S group compared to the H mode. Variolink II showed an interesting drawback in DC at 7 mm when cured in the H model. Dual-cure materials show adequate monomer conversion but when the distance from the curing light increased, a variable, but significant lowering in conversion rate was observed. In addition, the time and power of curing appeared to be material-dependent and should be calibrated individually.

Effects of bonded composites vs. amalgam on resistance to cuspal deflection for endodontically-treated premolar teeth.

Abstract: Purpose To determine, by means of a non-destructive experimental procedure, the extent to which tooth cusps are weakened by endodontic procedures and the effectiveness of adhesive bonding restoration in reducing cuspal deflection as a function of different restorative procedures. Methods A mechanically controlled loading device induced cuspal deflection by axial force (range 98-294 N) on an occlusal surface while LTS laser twin sensors registered the amount of deflection. Cusp deflection values, in microns, were recorded for each tooth. Thirty sound maxillary premolars teeth were sequentially evaluated in the following conditions: A) intact tooth; B) completion of endodontic and restorative procedures. Teeth were randomly divided into five groups and restored respectively with: A) amalgam (Dispersalloy); B) Spectrum TPH; C) Surefil; D) Esthet-X; E) Esthet-X + Dyract Flow. Results The average loading force needed to induce 1 microm cusp deflection was evaluated, for all groups, in intact teeth (range 49.52-58.76 N/microm) and in restored teeth (range 8.56 - 47.05 N/microm). Statistical analysis (ANOVA for repeated measures) has been performed. Mean structural recovery values after restorative treatment were 17% with amalgam, 60% with Spectrum TPH, 59% with SureFil, 54% with Esthet-X, and 99% with Esthet-X/Dyract.

The success of indirect restorations in posterior teeth: a systematic review of the literature.

Abstract: Aim Aim of the study was to evaluate the long-term reliability and effectiveness of inlays and onlays in ceramic and composite material, examining scientific studies published from 2004 to 2013. The results of this review were analyzed and compared with the important literature review proposed by Manhart in 2004. Methods With this review it was possible to analyze a total sample of 5858 Class I and II restorations, made in the posterior region: 5295 ceramic and 563 composite restorations in 2377 patients. Works were evaluated using USPHS, modified USPHS and CDA criteria after a mean observation period of 5.4 years (5.9 years for ceramic restorations, 2.6 for composite restorations). Results The arithmetic average of success was 94%, higher in ceramic restorations (94.9%) than composite materials (91.1%). The weighted average success rate was 95.3%, 92.8% for composite restorations and 96.3% for ceramic ones. The highest rates of success were found in ceramic restorations notwithstanding the longer observation period. Conclusion Indirect restorations have a low failure rate and they prove to be an excellent choice in the treatment of both class I and II lesions. During the last 6 years, the parameters related to these restorations have improved, with a 4% increase of success.

Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars. Part I: fracture resistance and fracture mode

Abstract: Statement of problem Unresolved controversy exists concerning the preferred cavity design and restorative technique used to restore endodontically treated maxillary premolars to improve their resistance to fracture under occlusal load. Purpose The purpose of this study was to evaluate the fracture resistance, stress distribution, and cusp deformation of endodontically treated human maxillary premolars restored with different materials. The study is divided into 2 parts. In Part I, fracture resistance and fracture mode were determined. Material and methods Seventy noncarious human maxillary premolars were selected and divided into 7 groups (n=10). The control group, ST, consisted of sound unprepared teeth. Teeth in the other 6 groups were endodontically treated and each received 1 of 2 cavity preparation designs: MODd, direct mesio-occlusal-distal preparation; MODi, indirect mesio-occlusal-distal preparation. Teeth were restored with 4 types of material: AM, MODd restored with amalgam; CR, MODd restored with composite resin; LPR, MODi restored with laboratory-processed composite resin; and LGC, MODi restored with leucite-reinforced glass ceramic. The fracture resistance (N) was assessed under compressive load in a universal testing machine. The data were analyzed by 1-way ANOVA and the Tukey HSD test (α =.05). Fracture modes were recorded based on the degree of tooth structure involvement and restoration damage. Results Statistical analysis showed that the ST group presented the highest fracture resistance values. The restored groups showed significantly higher fracture resistance values compared to the nonrestored groups. The groups restored with adhesive techniques (LPR, CR, and LGC) presented significantly higher fracture resistance values than the group restored with the nonadhesive technique (AM) ( P Conclusions Teeth with the greatest amount of remaining tooth structure and those restored using adhesive technology showed higher fracture resistance values. There was great variation in the type of fracture among groups.

Hydroxyapatite and Fluorapatite in Conservative Dentistry and Oral Implantology-A Review.

Abstract: Calcium phosphate, due to its similarity to the inorganic fraction of mineralized tissues, has played a key role in many areas of medicine, in particular, regenerative medicine and orthopedics. It has also found application in conservative dentistry and dental surgery, in particular, as components of toothpaste and mouth rinse, coatings of dental implants, cements, and bone substitute materials for the restoration of cavities in maxillofacial surgery. In dental applications, the most important role is played by hydroxyapatite and fluorapatite, i.e., calcium phosphates characterized by the highest chemical stability and very low solubility. This paper presents the role of both apatites in dentistry and a review of recent achievements in the field of the application of these materials.

Clinical evaluation on porcelain laminate veneers bonded with light-cured composite: results up to 7 years

Abstract: The purpose of this study was to evaluate the clinical performance of laminate porcelain veneers bonded with a light-cured composite. Thirty patients were restored with 119 porcelain laminate veneers. The veneers were studied for an observation time of 7 years. Marginal adaptation, marginal discoloration, secondary caries, color match, and anatomic form were clinically examined following modified United States Public Health Service (USPHS) criteria. Each restoration was also examined for cracks, fractures, and debonding. Pulp vitality was verified. In addition, plaque and gingival indexes and increase in gingival recession were recorded. Survival rate evaluating absolute failures and success rate describing relative failures were statistically determined, using both restoration and patient-related analyses. On the basis of the criteria used, most of the veneers rated Alfa. After 7 years, the results of the clinical investigation regarding marginal adaptation and marginal discoloration revealed only 2.5% and 4.2% Bravo ratings, respectively, among the 119 initially placed veneers. Using the restoration as the statistical unit, the survival rate was 97.5%, with a high estimated success probability of 0.843 after 7 years. Using the patient as the statistical unit, the survival rate was 90.0% and the estimated success probability after 7 years was 0.824. Gingival response to the veneers was all in the satisfactory range. Porcelain laminate veneers offer a predictable and successful treatment modality giving a maximum preservation of sound tooth. The preparation, cementation, and finishing procedures adopted are considered key factors for the long-term success and aesthetical result of the veneer restorations.