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PubMedDate not supplied

Indirect porcelain veneer technique for restoring intrinsically stained teeth.

Indirect porcelain veneers are often the ideal restoration for intrinsically stained teeth. This article details a step-by-step procedure for esthetically restoring discolored teeth. Porcelain laminate veneers are often indicated when teeth bleaching or direct composite bonding procedures cannot provide the desired esthetic result. Veneers are more appealing to many patients than full coverage crowns because of the more conservative tooth preparation required. If technique details are followed meticulously and cases are appropriately selected, porcelain veneers are not only durable but also promote marvelous gingival health and may be the most esthetic anterior dental restoration.

Adult↗
PubMed1993

[Application of porcelain veneers].

This paper introduces the technique of porcelain veneer restoration. The retention, cosmetic effect, gingival response, type of tooth preparation and stain of porcelain veneers were discussed. 12-20 months following clinical observation of 92 cases has been undertaken. It is concluded that porcelain veneers offer the advantages of aesthetics, stain resistance, wear resistance, colour stability and soft-tissue compatibility.

Adult↗
PubMed1997

[The value of horizontal discrepancy on the subgingival position of the tooth crown].

Marginal adaptation of the crown edge has been considered as primary and significant factor of prevention of secondary caries and periodontal disease on carryig tooth. There has been a clear dependence between hunting the periodontal tissue and the quality of edge closing of the crown. If we position subgingivaly the crown which clinically shows a good adoptiveness marginally and at the same time we position marginal crease in the ginguival sucus that should rush the accumulation of the plaque. The bacteries in the plaque would cause the inflammation of ginguive. The end of the crown edge in gingival sucus would cause chronic inflammation at ginguival tissue. The existence of transit zone that includes the crown edge, prepared tooth and dental cement became important if the crown edge has been positioned subgingivaly. If the crown edge ends in the ginguival sucus, the tooth meat is constantly being irritated that results with different degrees of inflammations. In many cases it causes ginguival dislocation. The possibility of clinical control of marginal positioning of subgingivaly positioned crown edge on demarcation line does not exist in terminal phase of cementing. The crown cement can be substratum of bacterial receptiveness and the plaque accumulation in the ginguival sucus. The procedure of cementing is an important cause of incomplete edge closing of the crown on the demarcation line. The form of demarcation line determine the form and the width of crown. They are favorising and degrading the level of marginal adaptations. The existing of horizontal discrepancy at the relation of based tooth--the crown edge is unavoidable. The question is if the amount of this discrepancy fits the assumed biological optimum.

Gingiva↗
PubMed1992

Functional alterations in pulpal microcirculation in response to various dental procedures and materials.

Using the quantitative 15 microns microsphere injection method, the effects of several restorative procedures on pulpal microcirculation in dog canine teeth were investigated. Pulpal blood flow (PBF) decreased steadily as the remaining dentin thickness (RD) became smaller with crown preparation without water spray. One hour after the preparation wit 1/3 RD (approximately 1 mm) PBF was reduced to 10% of the control, indicating that dry deep preparation has a deleterious effect on PBF. A careful preparation to an RD of 1 mm under copious water spray had a negligible effect on PBF. Dry preparation to an RD of more than 50%, on the other hand, caused a significant increase in blood flow through shunt vessels, AVAs and "U"-turn loops as determined with the 9 microns and 15 microns microspheres. These shunt vessel activities were especially prominent in the apical portion of the pulp, suggesting that the activation of the shunt vessels may be one of the compensatory mechanisms of the pulp in response to inflammation. In rat incisor teeth observed by intravital microscope, shunt vessels opened up as the incisor tips were drilled. Impression procedures after tooth preparation with water spray using the copper band with wax caused severe flow fluctuation as compared to rubber base material impression. In anesthetics, the use of epinephrine was found to be the single most important factor affecting pulp circulation. Whether it is by infiltration or mandibular block, the use of epinephrine containing anesthetic caused a severe reduction in PBF.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Impressions for prosthodontic restorations reproducing narrow spaces and severe undercuts.

Distortion of an impression material may occur in special clinical situations in which the material's elastic limit is exceeded. Impressions were made of a master model designed to test such situations. Three different hydrocolloids and an addition silicone were used in the experiment. An extended setting time had to be used for one material, to prevent it from tearing. When this extended time was used, this material was the dimensionally most accurate material in the test. All materials were accurate in reproducing normally positioned abutments, while some of the impressions failed to reproduce adjacent abutments with particularly narrow interspaces; narrow passages may therefore require further tooth preparation. In the most severely undercut area differences existed among the materials, and sometimes tears occurred. When the papilla is missing, the undercut area should be blocked out to prevent plastic deformation of the impression material, causing inaccurate restorations.

Agar↗
PubMed1996

Conservative restoration of function and aesthetics in a bulimic patient: a case report.

Traditionally, the treatment of acid erosion lesions of the maxillary and mandibular dentition has been invasive, often utilizing full-coverage crown restorations. Intentional endodontic and post-and-core treatments have been used in the past to gain crown length for retention of cemented cast restorations. The learning objective of this article is to discuss the primary cause of acid erosion-bulimia nervosa-and present an alternative dental treatment modality. The alternative treatment uses conservative tooth preparation, dentin bonding technology, and pressed ceramic restorations, achieving aesthetic results. The indications and advantages are discussed, and a case report illustrates the clinical procedure. The importance of achieving the cessation of the purging habit as a prerequisite to dental treatment is emphasized.

Adult↗
PubMed1994

Prevention of tooth hypersensitivity caused by the hydrodynamic action of zinc phosphate and composite resin luting cements (SEM) study.

This study was done to determine the role of cement liner as a reducing factor to the fluid movement in order to prevent tooth hypersensitivity according to the hydrodynamic theory during cementation of crowns. A total of fourty freshly extracted intact lower molar were selected for this study. After conventional tooth preparation the teeth were sub-divided into four equal groups to identify the role of cement liner in preventing the penetration of used cement into the dentinal tubules. Scanning electron microscopic study proved the efficiency of glass ionomer liner on preventing cement penetration into the dentinal tubules.

Composite Resins↗
PubMedDate not supplied

Two-year clinical performance of a polyacid-modified resin composite and a resin-modified glass-ionomer restorative material.

This study compared the clinical performance of a polyacid-modified resin composite and a resin-modified glass-ionomer restorative material over two years. Thirty-four pairs of restorations of Compoglass and Fuji II LC were placed in caries-free cervical erosion/abfraction lesions without tooth preparation. Restorations were clinically evaluated at baseline, 6, 12, 18 and 24 months using modified Ryge/USPHS criteria. A significantly higher incidence of failed restorations was found with the polyacid-modified resin composite (p < 0.05).

Adult↗
PubMedDate not supplied

Aesthetic solution for large maxillary anterior diastema and frenum attachment.

Resin-bonded porcelain veneer restorations can be used to correct unaesthetic diastemata caused by tooth position or discrepancies in the tooth size/arch development. The size of the diastema, size and proportion of the clinical crowns, tooth preparation, and dental occlusion require special attention; an excessive frenum attachment requires additional care and coordination of the treatment. This article describes the placement of six resin-bonded porcelain veneer restorations in a patient with a large diastema between the maxillary central incisors and associated frenum and soft tissue involvement. The learning objective of this article is to demonstrate the importance of pretreatment planning and problem solving in achieving predictable final restorations.

Adult↗
PubMed1997

The use of adhesive metal-ceramic restorations as an alternative to conventional crown and bridge materials.

A compromise is often necessary when choosing the most appropriate material in the construction of crowns and bridges. The most commonly used material is porcelain fused to metal since it is aesthetic and has acceptable physical characteristics to be used in the restoration of both anterior and posterior teeth. Unfortunately, to achieve a predictable and durable result extensive tooth preparation is invariably necessary. More conservative alternatives such as dentine-bonded crowns may have inferior physical characteristics and allow less predictable control over the occlusal contour. This paper describes the construction of fixed restorations which use both lost wax and refractory die techniques in their construction. This results in a restoration which has the combined advantages of both traditional porcelain fused to metal and dentine-bonded crowns and bridges.

Adhesiveness↗
PubMedDate not supplied

The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children.

Mandibular infiltration has been routinely avoided in treating mandibular molars because of its questionable adequacy. The purpose of our investigation was to determine the effectiveness of mandibular infiltration compared with mandibular block in treating primary molars in children, and to relate the effectiveness to age and type of treatment performed. The study population consisted of 89 cooperative children, 3 to 9 years old, requiring the same type of treatment on contralateral mandibular molars. The half-mouth study design was used. Dental procedures included class I and II amalgam restorations, stainless steel crowns, formocresol pulpotomies, and extractions. Evaluations of pain and behavior for each anesthesia technique and type of treatment were made using sounds, motor, and ocular changes indicating pain and the Frankl Behavior Rating Scale. Evaluations were made upon probing, rubber dam placement, and during tooth preparation and extraction. No statistically significant differences was found between the two anesthetic techniques for either behavior or pain when performing amalgam or stainless steel crown restorations (P = 0.05). Mandibular infiltration was less effective than mandibular block for pulpotomy and extraction (P = 0.05). No significant relationship to age as determined by primary or mixed dentition, for effectiveness was noticed.

Anesthesia, Dental↗
PubMed1997

The clinical evolution of the 'Dahl Principle'.

The restorative management of patients with localised tooth wear is a major challenge to the dental profession. There is rarely adequate interocclusal space available to place restorations without the need for extensive tooth preparation or the involvement of many unaffected teeth. In 1975, a method was described which created interocclusal space by the use of a partial coverage appliance made of cobalt chromium alloy. The technique reduced the need for more invasive palatal reduction. This paper, with the aid of clinical case examples, highlights the development and evolution of the original removable appliance. However, there remains a need for further clinical studies to evaluate fully these techniques.

Adolescent↗
PubMed2006

Clinical evaluation of 2 flowable composites.

OBJECTIVE: This study evaluated the clinical efficacy of 2 flowable resin composites used to restore occlusal carious lesions. Tetric Flow (Vivadent) and Esthet-X Flow (Dentsply/Caulk) are resin composites with decreased filler loading and lower viscosity compared to conventional resin composites. METHOD AND MATERIALS: Sixty occlusal restorations (30 of each material) were placed. After tooth preparation and caries removal, each material was inserted with rubber dam isolation. Prime & Bond NT (Dentsply/Caulk) was used to bond both flowable composites, which were incrementally placed and light-cured for 20 seconds. Each restoration was evaluated at baseline (1 week after restoration placement), 3 months, 6 months, and 1 year for marginal discoloration, secondary caries, anatomic form, retention, polishability, marginal adaptation, and color match. Groups were compared at 1 year and the data analyzed statistically with a .05 level of significance. RESULTS: A marginally significant difference in color match was observed at 1 year (favoring Esthet-X Flow). No other differences were observed between materials. Marginal discoloration significantly worsened for all restorations at 6 months and 1 year, and marginal adaptation significantly worsened at 1 year for all restorations. A positive association between preparation size and sensitivity was detected at 3 months; no association was found at 6 months and 1 year. At 1 year, restoration size was positively associated with marginal adaptation. Despite some changes from baseline, all restorations were clinically acceptable at 1 year. CONCLUSION: Although flowable resin composites are advocated for occlusal restorations, it is recommended that they be limited to small and moderate-sized restorations.

Composite Resins↗
PubMedDate not supplied

One-year clinical performance of a self-etching adhesive in class V resin composites cured by two methods.

This study evaluated the clinical performance of a self-etching adhesive for resin composites over one year. Thirty pairs of restorations of Pertac II, using the adhesive Prompt L-Pop, were placed in caries-free cervical erosion/abfraction lesions without tooth preparation. One of each pair was cured using "soft-start" polymerization, while the other was polymerized with high-intensity halogen light. Restorations were clinically evaluated at baseline, six and 12 months using modified Ryge/USPHS criteria. Although no significant difference (p>0.05) was observed between the curing methods, adhesive performance was poor, with a 35% loss of restorations overall.

Acid Etching, Dental↗
PubMedDate not supplied

One-year clinical performance of a resin-modified glass ionomer and a resin composite restorative material in unprepared Class V restorations.

This study evaluated the clinical performance and appearance of a resin-modified glass ionomer and a resin composite over one year. Thirty-seven pairs of restorations of Fuji II LC and Z250/Single Bond were placed in caries-free cervical erosion/abfraction lesions without tooth preparation. Restorations were clinically evaluated at baseline and 6 and 12 months, using modified Ryge/USPHS criteria. No significant difference (p>0.05) was observed in performance of both materials, although retention of the Z250 restorations was below the minimum specified in the ADA Acceptance Program for Dentin and Enamel Adhesives. Little difference in the restorations' appearance was observed.

Adult↗
PubMedDate not supplied

Two-year clinical performance of a resin-modified glass-ionomer restorative material.

This study was a 2-year clinical evaluation of a conventional and a resin-modified glass-ionomer restorative material. Thirty-four restorations each of Ketac-Fil and Photac-Fil were placed without tooth preparation in cervical abrasion/abfraction lesions, primarily in premolar teeth. Patients ranged in age from 30 to 73 years, with a median age of 45 years. Isolation for the restorations was accomplished with cotton rolls. Restorations of both materials were retained at the rate of 93%, and both were comparable in appearance, receiving Alfa ratings for more than 85% of the restorations. One occurrence of secondary caries was observed for each material. No significant difference between the materials was observed for any evaluation category (exact binomial test, P > 0.05).

Adult↗
PubMed2005

Clinical performance of Rochette bridges used as immediate provisional restorations for single unit implants in general practice.

A retrospective clinical audit of the role and survival of 69 Rochette bridges used as immediate provisional restorations for single tooth, implant-retained crowns was carried out over the period between February 1991 and May 2001. In each case the extracted tooth was immediately temporised using a Rochette bridge with a single wing and pontic and cemented to the abutment tooth without any tooth preparation (Phase I). This bridge was removed at the time of implant placement and recemented (Phase II). At the implant exposure stage the bridge was removed and discarded. In Phase I, 15.9% of the bridges required recementation and 27.5% of the bridges required recementations in phase 2; 7.2% of the bridges required recementations in both phases. An 80% probability of survival was noted after an interval of 200 days for phase I and a 78% probability of survival over the same time interval was observed for Phase II. A significant debond rate was observed when the retainer was a canine in comparison to the other bridges in Phase I. In Phase I the spring cantilever debond rate was significantly higher than that observed on the other bridges. More debondings were observed in males (25.8%) compared with females (7.9%) in Phase I. More debondings were noted in the maxilla than in the mandible in Phase II. The performance characteristics of the metal acrylic Rochette bridge observed in this report supports the conclusion that this type of restoration is an effective means of immediate temporisation for patients undergoing single tooth implant retained restorations.

Adult↗
PubMed1996

Longevity of glass-ionomer restorative materials: results of a 10-year evaluation.

Three restorative materials used for cervical erosion /abrasion lesions were evaluated clinically after 10 years. Thirty adult patients with at least four cervical lesions received one restoration of each of Ketac-Fil, finished immediately, Ketac-Fil, finished after a delay, Chelon-FIl (all glass-ionomer cements), and Cervident (a resin composite). Restorations were placed without any tooth preparations. Eighteen patients returned for their 10-year examinations. Two experienced examiners provided the periodic evaluations. Complete retention at 10 years was 83% for Ketac-Fil, finished immediately; 78% for Ketac-Fil, finished after a delay; 67% for Chelon-Fil; and 17% for Cervident. All three glass-ionomer restorative materials exhibited statistically significantly greater retention that did Cervident. When a noninvasive procedure is desired, glass-ionomer materials are the restorative material of choice for abrasion/erosion lesions because of their long-term retention values.

Adult↗