Optimizing Class II composite resin esthetic restorations by the use of ceramic inserts.
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UNLABELLED: The application of multisurfaced tooth-colored restorations in the posterior dentition is an exercise in risk tolerance when dentin occupies the bulk of the tooth substrate. Part 1 of this article discussed the capricious nature of dentin bonding and acknowledged the prime tenet that clinical success involves more than esthetic realism in the posterior dentition. Success with indirect ceramic restorations is dependent on interfacial integrity, which is contingently related to operative competence. Innovative clinical techniques are described in this article, along with a discussion of the need for excellence in all phases of this demanding restorative sequence. CLINICAL SIGNIFICANCE: Restorative success in the posterior dentition is profoundly influenced by the variability of operative competence and diligence. Part 2 of this two-part article offers innovative solutions to the unique challenges of partial-coverage ceramic restorations.
UNLABELLED: Reproducing the form, function, and optical characteristics of natural dental structures with direct composites in large and moderately large proximoincisal (Class IV) restorations represents a great challenge for clinicians in general. Understanding color is fundamental to achieving success when restoring these defects, as was discussed in Part I of this two-part article (Volume, 16, Number 6). The proper restoration of the functional lingual contour is also a challenge that cannot be overcome without close attention to the restorative technique. In this second article, the composite application technique is discussed and presented in detail. Clinical photographs illustrate the proposed technique. CLINICAL SIGNIFICANCE: The proposed clinical protocol, including a try-in of the shades in a mock-up restoration to more accurately define color and shape, and a silicone guide to transfer the lingual and proximoincisal contour of the mock-up to the final restoration, is of great help to successfully restore proximoincisal defects.
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The information obtained from the metallographic procedure used in this paper, as compared with techniques of the past, indicates that certain subgroups such as pinhole porosity, microporosity and subsurface porosity require re-evaluation.
A technique using an optical comparator was employed to examine the dimensional changes resulting from cavity preparation, application of the matrix and packing with amalgam in three extracted molar teeth. The changes have been reported and the nature of the change discussed. A modification in the use of the matrix and amalgam packing technique is suggested.
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Here we report the complete genome sequence of Singapore grouper iridovirus (SGIV). Sequencing of the random shotgun and restriction endonuclease genomic libraries showed that the entire SGIV genome consists of 140,131 nucleotide bp. One hundred sixty-two open reading frames (ORFs) from the sense and antisense DNA strands, coding for lengths varying from 41 to 1,268 amino acids, were identified. Computer-assisted analyses of the deduced amino acid sequences revealed that 77 of the ORFs exhibited homologies to known virus genes, 23 of which matched functional iridovirus proteins. Forty-two putative conserved domains or signatures were detected in the National Center for Biotechnology Information CD-Search database and PROSITE database. An assortment of enzyme activities involved in DNA replication, transcription, nucleotide metabolism, cell signaling, etc., were identified. Viruses were cultured on a cell line derived from the embryonated egg of the grouper Epinephelus tauvina, isolated, and purified by sucrose gradient ultracentrifugation. The protein extract from the purified virions was analyzed by polyacrylamide gel electrophoresis followed by in-gel digestion of protein bands. Matrix-assisted laser desorption ionization-time of flight mass spectrometry and database searching led to identification of 26 proteins. Twenty of these represented novel or previously unidentified genes, which were further confirmed by reverse transcription-PCR (RT-PCR) and DNA sequencing of their respective RT-PCR products.
Microperoxidase (MP, a peptide tracer) was intravenously injected into rats after six days of tooth movement by the Waldo method. Bone resorption was seen along the distal bone surface of the inter-radicular septum of the upper first molar, and tooth root resorption occurred along the mesial and distal surfaces of the distal root of the same molar. Odontoclasts were smaller in size and numbers than osteoclasts, but had the same organelles [multiple nuclei, ruffled borders (RB), clear zones, vacuoles, mitochondria, and specific granules] as osteoclasts. MP was deposited on the resorbed area through the clear zone and was transported into the vacuoles along the channels of the RB. The uptake of MP by odontoclasts was small, compared with that by osteoclasts. Collagen fibrils were found in the channels of the RB but were not detected in the vacuoles. Instead, filament-like structures were seen in the vacuoles and were located very near the collagen fibrils in the channels. Fibroblasts outside the resorbed lacunae had endocytosed collagen. In contrast, some cells close to odontoclasts (osteoclasts) in the dentin (bone)-resorbed lacunae had not endocytosed any collagen fibrils. These findings suggest (1) that odontoclasts resorb the dentin or cementum just as osteoclasts do in bone resorption, (2) that the resorbed area connects with the extracellular spaces of the odontoclasts or osteoclasts, and (3) that the organic components (e.g., collagen fibrils) of dentin or cementum are endocytosed through the channels of the RB in the same manner as that for MP. However, the endocytotic ability of odontoclasts appears inferior to that of osteoclasts.
Successful restoration of posterior teeth with resin-based restorative materials requires the clinician to be aware of the factors influencing success. These include correct patient and cavity selection, correct choice of material, identifying a matrix system that will achieve a tight contact, and correct placement methods. A means of avoiding stress due to polymerization shrinkage should also be used.
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