Gnathologic tooth preparation (I).
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The efficacy of conduction anesthesia with 2% solutions of novocain, celnovocain, trimecain, lidocain during the preparation of teeth for metal crowns was studied in experiments on 16 dogs by neurohistological and histochemical examination of the Gasserian and superior cervical ganglions, the nodose ganglion, teeth and pericoronal tissues. It was established that in terms of the degree of anesthesia efficacy increase, the test anesthetics can be arranged as follows: novocain, celnovocain, trimecain, lidocain.
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STATEMENT OF PROBLEM: The erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) hydrokinetic laser system has been successful in the ablation of dental tissues. It has been reported that this system is also useful for preparing tooth surfaces for adhesion, but results to date have been controversial. PURPOSE: This in vitro study evaluated the bond strengths of porcelain laminate veneers to tooth surfaces after etching with acid and Er,Cr:YSGG laser conditioning. Material and method Forty extracted caries- and restoration-free human maxillary central incisors were used. The teeth were sectioned 2 mm below the cementoenamel junction. The crowns were embedded in autopolymerizing acrylic resin with the labial surfaces facing up. The labial surfaces were prepared with.05 mm reduction to receive porcelain veneers. The teeth were divided into 4 groups of 10 specimens. Thirty specimens received 1 of the following surface treatments before the bonding of IPS Empress 2 laminate veneers: (1) laser radiation from an Er,Cr:YSGG laser unit; (2) 37% orthophosphoric acid; and (3) 10% maleic acid. Ten specimens received no surface treatment and served as the control group. The veneers were bonded with dual-polymerizing resin, Variolink II. One microtensile specimen from each of the cervical and incisal thirds measuring 1.2 x 1.2 mm was prepared with a slow-speed diamond saw sectioning machine with a diamond-rim blade. These specimens were attached to opposing arms of the microtensile testing device with cyanoacrylate adhesive and fractured under tension at a crosshead speed of 1 mm/min, and the maximum load at fracture (Kg) was recorded. The data were analyzed with a 2-way analysis of variance and Tukey HSD tests (alpha=.05). RESULTS: No statistically significant differences were found among the bond strengths of veneers bonded to tooth surfaces etched with Er,Cr:YSGG laser (12.1 +/- 4.4 MPa), 37% orthophosphoric acid (13 +/- 6.5 MPa), and 10% maleic acid (10.6 +/- 5.6 MPa). The control group demonstrated the lowest bond strength values in all test groups. Statistically significant differences were found between the bond strengths of cervical and incisal sections (P<.001). CONCLUSION: In vitro microtensile bond strengths of porcelain laminate veneers bonded to tooth surfaces that were laser-etched showed results similar to orthophosphoric acid or maleic acid etched tooth surfaces.
Debonding of resin-bonded fixed partial dentures has been partly resolved with modification of tooth preparations. Tooth preparations for resin-bonded retainers were completed on a maxillary central incisor, a lateral incisor, and a canine. Fifteen metal replicas were constructed (five of each tooth morphotype). The three tooth morphotypes were then modified with proximal grooves prepared parallel to the long axes, and another 15 metal replicas were prepared. Cast metal retainers were constructed and cemented to the replicas with a resin cement. Tensile shearing dislodging loads were applied at 20 degrees to the long axes of the teeth with a testing machine. The addition of proximal grooves made statistically significant differences in resistance to debonding forces for all three tooth morphotypes (p < 0.01). An increase of 76.7% was seen in dislodging forces for lateral incisors with proximal grooves compared with incisors without grooves.
Electrosurgery is a safe, effective modality for tissue management in conjunction with restorative dentistry. It can be used to remove redundant tissue to gain access for tooth preparation, develop a gingival trough around the margins of a prepared tooth for an accurate impression, control hemorrhage, remove opercula, and plane and reshape tissue of an edentulous area for the construction of a hygienic and esthetic pontic.
Both addition and condensation silicones produced stone dies that were larger in diameter and shorter in height than the tooth preparation. For both materials, there was little change in the distance between stone die preparations compared with the standard. The most significant difference between types of silicone was that condensation silicones produced significantly shorter dies (-0.24% to -0.37%) than addition silicones (-0.08%). Among addition silicones, Cinch produced more than twice as much vertical change (-0.16%) than the other three products (-0.06%). Since castings made from a short die will not seat completely on the prepared tooth, these results support the use of three of the four addition silicones tested. The same accuracy of impressions was achieved for all techniques (that is, putty/wash, single mix, and double mix) when addition silicones were used, whereas the putty/wash technique produced the most accurate dies for the condensation silicones. The custom tray produced dies that were much more accurate in vertical dimensions (-0.03%) than the stock trays (-0.15% to -0.21%). Thus the custom tray is the impression tray of choice, even for addition silicones, which produce relatively little polymerization shrinkage and are dimensionally stable.
Provisional restorations are fabricated to protect the prepared tooth structure during the period between tooth preparation and insertion of the definitive restoration. These restorations are also referred to in the literature as interim, temporary, or provisional restorations (prostheses). Such restorations should be uncomplicated and inexpensive to fabricate in a short period of time. Several laboratory and clinical techniques for the fabrication of provisional restorations have been described in the literature, such as the indirect technique, direct technique, and indirect-direct techniques for both single and multiple unit restorations. This article describes a step by step clinical technique for the fabrication of a direct provisional restoration to satisfy the issues of esthetics, patient comfort, speech and function, maintenance of periodontal health, and maxillomandibular relationships while wearing the restoration.