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[Marginal fit of porcelain-fused-to-metal crowns: a comparative study of metal and porcelain butt margin].

Marginal openings and shoulder fit of porcelain butt margins and metal butt margins of porcelain fused-to-metal crowns have been investigated. Crown restorations were constructed directly onto the prepared teeth with 1 mm. square shoulder. Marginal openings and shoulder fit of labial surface and the cross-section of shoulder area then observed using optical microscope. Marginal fit was found better in porcelain fused-to-metal crowns with porcelain butt margin and also practically invisible neutrally-coloured join between crown and prepared tooth, was achieved with shoulder porcelain.

Crowns↗

Shear bond strength of resin-mediated amalgam-dentin attachment after cyclic loading.

Several in vitro studies have suggested that a resin-mediated attachment mechanism can provide tooth reinforcement with silver amalgam restorations. This study investigated the ability of this attachment to withstand simulated occlusal function. Forty bovine incisors were divided into four groups. Prepared tooth surfaces were treated with a dentin bonding system (All-Bond 2) followed by amalgam (Tytin) condensation into a split mold. Samples were tested for shear bond strength after no cyclic loading or after 1000 and 5000 cycles with a weight of 700 grams (1.5 lb) at one strike per second. Mode of failure was assessed by microscopic investigation of fracture sites. The 24-hour shear bond strength (7.11 +/- 1.93 MPa) of Tytin spherical amalgam to dentin was progressively reduced after cyclic loading. Bond failure invariable occurred at the interface between the adhesive resin and amalgam. It was concluded that occlusal function may significantly reduce tooth reinforcement with bonded amalgam restorations.

Analysis of Variance↗

Crown cementation: put a handle on it.

During tooth preparation, the air and water from a dental handpiece occasionally cause painful stimulation of hypersensitive teeth. Use of mouthguards may be an alternative for management of patients with tooth hypersensitivity.

Cementation↗

Resin-bonded cast coverage for fractured posterior teeth.

Enamel-dentin fracture without pulpal involvement of intact posterior teeth demands restoration of form and function while preserving as much sound tooth material as possible. A partial-coverage restoration cast in nonprecious metal and air-abraded and bonded to the tooth by an adhesive resin is suggested. The strong bond of the adhesive resin to the enamel and dentin of the tooth and to the air-abraded metal allows for simple fabrication of a cast partial coverage that requires only minimal tooth preparation.

Adhesives↗

A bonded provisional fixed prosthesis to be worn after implant surgery.

The procedure described provides an esthetic means for inserting a provisional fixed restoration immediately after implant placement surgery. When this procedure is used, it is not necessary to prepare the abutment teeth adjacent to the surgical site for subsequent fixed restorations. This provisional restorative procedure may also be used immediately after extraction of teeth, when abutment tooth preparation is not desired or possible, or after stage II implant surgery when healing caps are inserted.

Acrylic Resins↗

Microleakage of temporary restorations in complex endodontic access preparations.

The microleakage allowed by three temporary restorative materials used for the sealing of teeth with both endodontic access and multisurface cavity preparations was measured and evaluated. Extracted human incisor, canine, and premolar teeth with extensive carious involvement were prepared and restored with either Cavit, IRM, or TERM. Microleakage was measured by a fluid filtration technique at various time intervals and after thermal stress. The results indicated that the TERM restorations provided excellent seals and were statistically superior to Cavit and IRM for restoring complex endodontic access preparations. The IRM restorations demonstrated significantly greater microleakage after thermal stress, while the Cavit restorations were deemed clinically unacceptable because of extensive cracks, expansion, and extrusion from the tooth preparations. These defects were not observed with the IRM and TERM restorations.

Calcium Sulfate↗

Applications of laser-based ultrasonics to the characterization of the internal structure of teeth.

Dental health care and research workers require a means of imaging the structures within teeth in vivo. For example, there is a need to image the margins of a restoration for the detection of poor bonding or voids between the restorative material and the dentin. In addition, a high-resolution imaging modality is needed to detect tooth decay in its early stages. If decay can be detected early enough, the process can be monitored and interventional procedures, such as fluoride washes and controlled diet, can be initiated to help remineralize the tooth. Currently employed x-ray imaging is limited in its ability to visualize interfaces and incapable of detecting decay at a stage early enough to avoid invasive cavity preparation followed by a restoration. To this end, nondestructive and noncontact in vitro measurements on "as-is" extracted sections of human incisors and molars using laser-based ultrasonics are presented. Broadband ultrasonic waves are excited in the extracted sections by using a pulsed carbon-dioxide (CO2) laser operating in a region of high optical absorption in the dental hard tissues. Optical interferometric detection of the ultrasonic wave surface displacements is accomplished with a path-stabilized Michelson-type interferometer. Laser ultrasonics is found effective in characterizing the anisotropic and inhomogeneous nature of dentin. In addition, time-of-flight analysis of the measured bulk transmission waveforms allows for detection of dentino-enamel and carious dentin-dentin junctions. These results are compared to those obtained for specially prepared tooth phantoms that mimic the mechanical properties of dental hard tissues.

Anisotropy↗

Making a fixed restoration contour guide.

A silicone matrix of the diagnostic wax-up of the abutment teeth serves as a guide during tooth preparation and final contouring of the restoration. A cast with the castings on it with surrounding gingival tissues formed in silicone is made. This cast, along with the silicone matrix, provides the technician with definite guides for the axial contouring of the tooth-colored portion of the fixed restoration.

Dental Abutments↗

Periodontal considerations in operative dentistry.

Periodontal and preventive considerations, other marginal fit and occlusion, are discussed as they relate to the fabrication of restorations in operative dentistry. The development of buccal, lingual, proximal, and transitional line contours is presented as related to maintenance of healthy periodontal tissues. Proximal contacts and marginal ridge relationships are related to food retention and arch integrity. The gingival attachment is described, as it determines certain techniques of tooth preparation and impression making.

Alveolar Process↗

Tooth surface loss. 11. Surgical crown lengthening.

Restoration of worn teeth can be made easier by surgical crown lengthening. It improves appearance and facilitates tooth preparation. Anatomical features can limit the height that can be gained.

Crown Lengthening↗

Mandibular ceramic veneers: an examination of diverse cases integrating form, function, and aesthetics.

Mandibular anterior ceramic veneers, though used less frequently than maxillary anterior ceramic veneers, are highly useful for certain case conditions. The learning objective of this article is to explore the indications, tooth preparation design, provisionalization considerations, and placement procedures for these conservative aesthetic restorations. In addition, their functional utility, tissue biocompatibility, and variances from maxillary anterior ceramic veneers are discussed by means of several different case reports.

Aluminum Silicates↗

Comparison of the fracture strengths of metal-ceramic crowns and three ceromer crowns.

STATEMENT OF PROBLEM: The fracture strength of a number of new ceromer systems for the fabrication of anterior fixed partial dentures is unknown. PURPOSE: The purpose of this study was to compare the fracture strengths of metal-ceramic crowns and 3 types of ceromer crowns in a simulated anterior tooth preparation. MATERIAL AND METHODS: A resin maxillary central incisor analog was prepared with a 5-degree convergence angle and a 90-degree, 1-mm shoulder. The incisal edge was reduced by 2 mm, and the axiogingival and axioincisal line angles were rounded. A mold of this tooth was made with vinyl polysiloxane impression material. Ten wax patterns were made from the mold and cast in a nickel-chromium alloy for the fabrication of metal dies, from which 10 metal-ceramic crowns were fabricated. Ten crowns for each of 3 ceromer systems (Artglass, Sculpture, and Targis) were fabricated from the same metal die. Each crown group was prepared, polymerized, air-particle abraded, and finished in accordance with the specific manufacturer's instructions. All 4 types of finished crowns were luted to the dies and embedded in polymethyl methacrylate resin blocks. Their fracture resistance was tested in a universal testing machine. The load was directed at the incisolingual line angle, at 130 degrees to the long axis of each specimen, until catastrophic failure occurred. A 7-mm-diameter rod was used to load the artificial crowns, with the center of the rod in contact with the crown surfaces. Analysis of variance and Tukey's multiple comparisons test (P<.05) were applied to the data. RESULTS: Metal-ceramic crowns fractured at significantly higher values than ceromer crowns (1317 vs 602 N, respectively) (P<.05). No significant difference was found among the fracture values of Artglass, Sculpture, and Targis crowns. CONCLUSION: Within the limitations of this study, failure load values for the 3 ceromer crowns tested, although significantly lower than the values for metal-ceramic crowns, still exceeded normal occlusal forces.

Analysis of Variance↗

Composite matrix for large, non-wedgeable Class III or Class IV preparations with gingival or subgingival margins.

Dentists sometimes are required to place a matrix to restore large Class III or Class IV preparations that have gingival or subgingival margins or are prepared in rotated or malposed teeth. In these situations, dentists sometimes cannot place a wedge between the prepared tooth and a neighboring tooth because the wedge cannot engage enough interproximal tooth structure to firmly anchor both itself and a matrix strip. This article presents a technique for placing a matrix around such large, non-wedgeable Class III or Class IV preparations.

Composite Resins↗

Influence of different metal restorations bonded with resin on fracture resistance of endodontically treated maxillary premolars.

STATEMENT OF PROBLEM: Fracture of endodontically treated teeth has been of great interest because it is a common clinical occurrence. PURPOSE OF STUDY: This research evaluated the fracture resistance of endodontically treated first maxillary premolars restored with different metal restorations and bonded with Panavia Ex resin. MATERIAL AND METHODS: Fifty teeth were randomly divided into five groups with MOD tooth preparation: (1) inlay with an isthmus width of one third the intercuspal distance for a silver amalgam restoration (negative control), (2) inlay with an isthmus width equal to that in group 1, (3) inlay with an isthmus width of half the intercuspal distance, (4) equal to group 3 with lingual and proximal preparation, and (5) onlay (positive control). The cast restorations of groups 2, 3, and 4 were bonded with Panavia Ex resin and those from group 5 cemented with zinc phosphate cement. Samples were restored and subjected to thermocycling, and the teeth were submitted to an axial compressive force. RESULTS: The cast inlay restorations that bonded with Panavia Ex resin significantly elevated the fracture resistance of endodontically treated maxillary premolars compared with the silver amalgam restorations. However, teeth restored with cast onlay restorations cemented with zinc phosphate cements recorded the best results. CONCLUSION: The increase of fracture resistance by MOD inlay cast restoration bonded with Panavia Ex resin suggested valid clinical application within the conditions of this study.

Analysis of Variance↗

[Gingivo-dental sparing strategy of orthodontic treatment (fitting with permanent dentures)].

Development of inflammatory process in the marginal part of the mucosa is caused not only by epithelial injury during tooth preparation and dental plaque accumulation, but by irregular contour and position of the artificial crown edge as well. Clinical, x-ray, and cytoenzymological studies showed that orthodontic treatment with cermet and polyceramic dentures with fixation of the supporting elements at the level of the gingival edge in tissues adjacent to the tooth causes the slightest pathological changes. The compensatory adaptive processes in this area of the buccal mucosa are the most pronounced if preparation of hard dental tissues is combined with closed currettage of periodontal pouches, which was confirmed by remote clinical results and laboratory findings in patients with slight and medium-severe periodontitis.

Adaptation, Physiological↗

Fitting accuracy of indirect restorations: a review of methods of assessment.

The current interest in indirectly manufactured, tooth-coloured restorations has highlighted a need to identify factors pertinent to the success of both these and other indirect restorations. Although restoration longevity is limited by the degree of adaptation to the prepared tooth, there exists no standard method for either the assessment of marginal adaptation or the overall accuracy of fit. This review examines methods of assessment of both of these important parameters, and considers the problems associated with existing in vivo and in vitro techniques.

Crowns↗

Scanning electron microscope study of the junction between restorations and gingival cavosurface margins.

This study demonstrates a definite interfacial void between the cervical margins of the tooth preparation and gold inlay, composite resin, and amalgam restorations. In addition, these marginal defects permit plaque formation within them. Furthermore, microleakage may be a complicating factor in this lack of fit. Restorations which may be "clinically acceptable" may not, in fact, be ideal because of the properties of the restorative materials. It would seem desirable, therefore, to encourage the development of new restorative materials that will bond to the tooth surface.

Composite Resins↗