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PubMed2002

In vitro examination of the fracture strength of 3 different fiber-reinforced composite and 1 all-ceramic posterior inlay fixed partial denture systems.

PURPOSE: This in vitro study was carried out to examine the fracture strength of metal- free posterior inlay fixed partial dentures (IFPDs). The 3-unit IFPDs were made of either a polyethylene fiber-reinforced composite, 3 glass fiber-reinforced composites, or an all-ceramic material. MATERIALS AND METHODS: Eight IFPDs were fabricated of each material in accordance with the manufacturer's instructions and luted to extracted human molars with a dual-cure adhesive system. The molars were positioned in PMMA resin 10 mm apart mesiodistally. Inlay cavity preparations with enamel finishing lines were used. After thermal cycling and mechanical loading in an artificial oral environment, the cemented IFPDs were mechanically loaded until failure. Visual and radiologic examinations were done out to discern the different forms of fracture. Median and 25%/75% percentile values were calculated. Statistical analysis was performed using the Mann-Whitney U test and the Kruskal-Wallis test (p< or =0.05). RESULTS: With a median (and 25%/75% percentile) fracture strength of 368 N (234 N/424 N), the FibreKor/Conquest Sculpture showed significantly lower values than the Connect/BelleGlass [898 N (736 N/1033 N)], Vectris/Targis [723 N (692 N/806 N)], Everstick/Sinfony [634 N (532 N/673 N)], and Empress2 [520 N (385 N/706 N)]. CONCLUSIONS: Assuming maximum chewing forces of > or =500N in posterior areas, all systems showed sufficient fracture strength in most cases and warrant further investigation for potential clinical use.

Cementation↗
PubMed2001

Marginal adaptation of inlay-retained adhesive fixed partial dentures after mechanical and thermal stress: an in vitro study.

STATEMENT OF PROBLEM: There are no studies that analyze the long-term durability of minimally invasive fixed partial dentures (FPDs) by comparing different methods of adhesive bonding. PURPOSE: This in vitro study examined the influence of cavity design and operative technique on the marginal adaptation of resin-bonded composite FPDs. MATERIAL AND METHODS: Slot-inlay tooth preparations with cavity margins located in enamel were prepared in 18 maxillary canines and 18 maxillary first molars designated as abutments. The specimens were divided equally into 3 experimental groups. In all groups, butt joint tooth preparations were created in canines and molars. In group 2, canines were prepared additionally with a 1.5-mm wide palatal bevel in enamel. After pretests with modification spaces of 11 and 17 mm (length), 2 missing premolars were replaced by the ceromer Targis and reinforced with the glass-fiber material Vectris. The prostheses were inserted with Tetric Ceram with use of an ultrasonic-supported, high-viscosity technique. Restorations were selectively bonded to cavity finish lines in groups 1 and 2 ("selective bonding"). In group 3, restorations were bonded totally to the whole cavity surface ("total bonding"). The restorations were stressed in a computer-controlled masticator. Marginal quality was examined with an SEM at x 200. RESULTS: The percent area of optimal margins after thermomechanical loading between composite and enamel in each group was as follows: group 1, 86.2% +/- 12.3% for canines and 95.5% +/- 3.5% for molars; group 2, 95.3% +/- 2.1% for canines and 96.2% +/- 2.7% for molars; and group 3, 95% +/- 0.9% for canines and 86.4% +/- 3.2% for molars. The marginal quality for molars inserted with total bonding was significantly lower (P< or =.05). CONCLUSION: Within the limitations of this study, the selective bonding technique for slot inlay-retained fixed partial dentures resulted in a negligible loss of marginal quality after extensive mechanical and thermal stress. The selective bonding technique is recommended for box-shaped cavity preparations.

Acid Etching, Dental↗
PubMed2002

Onlay partial denture technique for assessment of adequate occlusal vertical dimension: a clinical report.

Clinical treatments that require restoration of occlusal vertical dimension pose a challenge to prosthodontists. This article describes the modification of existing removable partial dentures into onlay interim prostheses. This process allowed the patient's tolerance to the restored occlusal vertical dimension, esthetics, and phonetics to be evaluated before irreversible changes were made to the dentition.

Acrylic Resins↗
PubMed1987

Osseointegrated denture in a vascularized bone transfer: functional jaw reconstruction.

Total functional reconstruction of the lower jaw often falls short of ideal goals. While reconstructive techniques are available to close large defects with both hard and soft tissue, the insertion of a prosthetic dental appliance and the return to normal masticatory function are often technically impossible or not even attempted. Presented here is a case report of a patient successfully rehabilitated with a fixed dental appliance supported by jaw fixtures osseointegrated into a vascularized iliac crest mandibular reconstruction. At present, 6 additional patients have had mandibular reconstructions and are in various phases of functional dental rehabilitation. When these data are complete, a series report will be presented for publication.

Adult↗
PubMed1976

Stress distribution within circumferential clasp arms.

An analysis of stress distributions within circumferential clasp arms with various tapers, was undertaken in an effort to (1) determine the area of maximum stress concentration in both tapered and non-tapered clasps, and (2) to compare this point of maximum stress concentration with the area of frequent clasp breakage. The non-tapered clasp showed better distribution of stresses than the tapered clasps. The less favourable stress concentrations could result in eventual failure of the clasp when coupled with other factors such as porosities. The maximum shear stresses in the non-tapered clasp also were lower than those in the tapered clasps. As the taper of the clasp became more accentuated, the magnitude of the stresses increased and shifted towards the tip of the clasp. The maximum tensile stress calculated in a replica of a chromium-cobalt-nickel clasp was in the order of 34 MN/m2 which is well below the ultimate tensile strength of the alloy. This observation leads to the proposal that failure of clasps is a function not only of design but also of other variables, such as porosities, surface irregularities, and fatigue.

Dental Stress Analysis↗
PubMed1980

Proximal plaque accumulation with two minor connector designs.

The relationship of plaque accumulation to two different designs of a proximal minor connector, was studied in twenty-seven removable partial denture wearers. On thirty proximal surfaces adjacent to a closed space design, and on thirty-two surfaces adjacent to an open space design, plaque formation was recorded using a plaque scoring system. Mean plaque scores were calculated separately for the two types of design, and no difference was found between the two sets of scores.

Adult↗
PubMed1986

Clinical and radiographic observations after 6 years on bridge abutment teeth carrying pinledge retainers.

A group consisting of 108 bridge recipients (71 female, 37 male) with a total of 114 bridges retained solely (n = 40) by pinledges or retained by a combination (n = 74) of pinledges and complete crowns was examined clinically and radiographically 6 years after completion. The study was to review evidence of any displacement of bridges as well as the incidence of periapical changes and carious lesions of those abutment teeth fitted with pinledges (n = 210). The results showed that bridges retained solely by pinledges had become displaced more frequently than bridges retained by a combination of crowns. The failure rates (%/year) for bridges retained solely by pinledges was 2.5% and for bridges with a combination of retainers 0.25%. Three teeth (1.4%) experienced pulp exposure during the preparatory work and 6 teeth (2.8%) had been or had to be rootfilled after 6 years. Carious lesions had developed in 6 abutments (1.9%).

Dental Abutments↗
PubMed1987

Patient satisfaction after insertion of an osseointegrated implant bridge.

The general and specific satisfaction of patients treated with a jawbone-anchored bridge was compared with their pretreatment satisfaction with dentures (condition 1, n = 31). Patients who asked for information on the osseointegration method but did not apply for treatment (condition 2, n = 32), and a group of patients that did not ask for information (condition 3, n = 10) were also questioned on their satisfaction with dentures. The results indicated that condition 1 subjects were both socially and physically substantially more satisfied with their bridge than with their earlier dentures. On all satisfaction measures condition 3 subjects indicated more satisfaction with dentures than either condition 1 or condition 2 subjects. There were no significant differences between the three groups on several personality characteristics (neuroticism, test-taking attitudes, internal/external control). Condition 3 subjects were less extrovert (socially oriented) than the other subjects. Condition 1 subjects made several suggestions towards improvement of the pre- and post-operation phase, concerning the amount of pain involved and the cleaning of the bridge, etc.

Consumer Behavior↗
PubMed1987

Edentulousness--an oral handicap. Patient reactions to treatment with jawbone-anchored prostheses.

A questionnaire was sent to all 189 edentulous patients with denture adaptation problems who were treated with fixed prostheses on osseointegrated oral implants during the period 1965-1978. One hundred and fifty-two patients (80%) responded. Practically all had adapted well to the prostheses and were most satisfied with the rehabilitated oral function, including chewing ability. Four out of five patients regarded the bridge as part of their own body instead of a foreign object, and 90% would not hesitate to have the treatment performed again, if necessary. Parallel with the improved oral function the patients reported a definite reduction of psychosocial problems associated with their previous oral invalidity, and increased security and self-esteem.

Adult↗
PubMed1991

Periodontal aspects of osseointegrated fixtures supporting an overdenture. A 4-year retrospective study.

196 Brånemark implants in 86 consecutive patients rehabilitated by means of overdentures (6 upper jaws, 80 lower jaws) were observed longitudinally. In each jaw, only 2 implants were used to anchor the overdenture. 2 implants in the lower jaw showed some mobility at the abutment installation and were removed immediately. During the loading period (mean loading time 19.1 months ranging from 4 to 48 months), none of the implants showed any signs of non-integration. The marginal tissue reaction and plaque accumulation were monitored using conventional indices. Clinical methods and standardized radiographs were used to evaluate the bone level and density. The numbers of approximal surfaces without plaque (40%) or with gingival inflammation (55%) were almost constant throughout the study. The probing pocket depths remained within the range of 2.7 to 3.2 mm during the observation time, whereas the distance of the gingival margin from the top of the abutment clearly increased (from 1.8 to 2.9 mm). For loaded lower jaw implants connected to each other with a straight bar, a radiographic bone loss of 0.8 mm was observed during the first postsurgical year followed by a mean annual bone loss of less than 0.1 mm. For the "sleeping" fixtures, 50% less bone loss was recorded. For loaded but not interconnected implants in the upper jaw, the bone loss during the first 6 months reached 2.0 mm. The loss in marginal bone height did not clearly correlate with parameters such as the plaque index, the gingivitis index, the presence or absence of gingiva around the abutment, or the implant length. The present data, with an observation time up to 4 years, showed that the failure rate for Brånemark implants supporting overdentures in the lower jaw can be limited to 1%. However, the use of 2 unconnected fixtures in the upper jaw cannot presently be advocated since considerable bone loss was observed.

Adult↗
PubMed1995

Characteristics of 5410 edentulous implant candidates and the treatment they receive.

Since 1989 implant dentistry in the Netherlands is a National Dental Insurance (NDI) benefit, thus reducing out-of-pocket expenditures for implant candidates considerably. A nationwide investigation was set up in order to evaluate quantitative, qualitative and financial effects of this new provision. The patient and treatment characteristics of 5410 edentulous implant candidates are discussed. Intensive monitoring of the usage of these new regulations facilitates health care policy making, including future planning. Over a 3 1/2 yr period, two out of every thousand totally edentulous NDI patients were treated in combination with dental implants. This number is being considered small, bearing in mind the number of edentulous patients in the Netherlands and the proportion of dissatisfied denture wearers. Demographic data, prosthetic and pre-prosthetic surgical history reveal that these patients, mostly female and middle-aged, experience severe denture-related problems. In the majority of cases the implants are placed by an oral surgeon and the suprastructure is made by a general dentist or at a centre for special dental care. The treatment itself mostly consists of an implant retained overdenture on two or four permucosal implants and a bar-construction.

Adolescent↗
PubMed2001

Esthetic considerations in removable prosthodontics.

UNLABELLED: Patients requiring extensive replacement of teeth with removable prostheses are indeed esthetic orphans in many contemporary dental practices. Although the advent of successful osseointegration has dramatically reduced the need for removable prostheses, there are still many patients who for health, anatomic, psychological, or financial reasons are not candidates for implants. These patients deserve the same level of esthetic restorative dentistry as those who are restored with fixed prostheses. Clearly, the restorative dentist has the greatest flexibility from an esthetic standpoint with complete dentures. Soft and hard tissues can be replaced with contemporary characterized denture-base materials, and a truly infinite variety of tooth forms, shades, and arrangements can be used to meet the expectations of the most demanding patient. For partially edentulous patients, the major problem is designing a removable partial denture that avoids the unsightly display associated with conventional clasp assemblies. There are strategies available to accomplish this effectively while establishing an environment for optimal periodontal health, and to minimize destructive stresses on the abutment teeth. CLINICAL SIGNIFICANCE: This article discusses the procedures essential for providing an upscale, quality esthetic service with removable prostheses. Effective strategies to eliminate unsightly clasp assemblies with removable partial dentures are described.

Dental Abutments↗
PubMed1978

Magnetodontics. The use of magnetic forces in dentistry.

A recently discovered alloy of cobalt and samarium (CO5Sm) has exceptional magnetic properties. A laboratory evaluation was made of the grip force of samples of this alloy of a size suitable for dental use. A review of both dental and general literature points to the need for establishing, prior to widespread usage, that magnetic fields are harmless to surrounding tissues.

Biophysical Phenomena↗