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The physical properties of a machinable resin composite for esthetic restorations.

To investigate the pre-clinical relevancy of a machinable composite, its physical properties were evaluated and compared with a machinable ceramic and two indirect composites. A machinable resin composite (GN-I composite, CO), a machinable ceramic (GN-I ceramic, CE), and two resin composites (Artglass dentin, AG; Estenia dentin, ET) were used. Compressive strength, diametral tensile strength, flexural strength, elastic modulus, and fracture load of standardized, premolar crown-shaped specimens were determined. In terms of compressive strength, diametral tensile strength, and flexural strength, AG showed significantly lower values than the other three materials. In terms of fracture load, specimens with 1.5 mm thick wall showed a higher value than those with 1.0 mm thick wall, and the value decreased in the order of ET, CE, CO, and AG. Marginal tipping was also observed in ET and CE. Within the limits of the current study, CO showed physical properties favorable for constructing esthetic restorations.

Analysis of Variance↗

The esthetics of hair transplantation.

There are many potential candidates, and greater attention to esthetic considerations has accelerated the interest in the hair transplantation field. Although discriminatory selection is essential, there are few interested patients who could not benefit from this procedure. Successful hair transplantation and patient satisfaction depend on the physician's skillful sustained concentration on the frontal hairline, tenacious motivation of the patient to seek a sufficient number of transplants, and the choice of a pleasing hair style with utilization of recommended grooming aids.

Alopecia↗

[Experience in the use of midazolam in esthetic surgery].

Anesthesias with midazolam are described. The drug has a favorable effect on the course of anesthesia and consciousness recovery. The authors claim that midazolam can virtually supersede other benzodiazepines in anesthesia for esthetic surgery.

Adolescent↗

[Obesity and women: esthetic preoccupation or medical problem?].

Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if obesity with gynoid adipose tissue distribution is less deleterious than android obesity from a metabolic point of view, severe obesity is frequently associated with cardiovascular risk factors which may hinder the prognosis of these female patients. Other complications are common in obese women, such as oestrogen-related cancers, osteoarticular problems and psychological disturbances. Various therapeutic approaches are available which permit an encouraging weight loss and a rapid improvement of risk factors. Unfortunately, long-term results are often disappointing, essentially because of the difficulty to follow on the long term a strict diet regimen and practice physical exercise and because of the usual unrealistic expectations of the obese women who consult medical doctors.

Adult↗

Surface roughness and weight loss of esthetic restorative materials related to fluoride release and uptake.

The objective of this study was to assess the surface roughness of eight esthetic restorative materials and the relationship with weight changes during fluoride release and uptake. Five specimens each of ChemFil Superior, Fuji IX Dyract, Fuji II LC, Vitremer, Photac-Fil, Ketac-Silver, and Z100 (control) were prepared and immersed in 2 ml of artificial saliva at 37 degrees C. The changes in specimen weight and fluoride release were monitored for 12 weeks. This protocol was repeated after recharging the specimens with 1.23% APF gel for 12 more weeks. The immersed and fresh specimens for each material were then examined with SEM and surface profilometry. There was a significant weight loss for all glass ionomer cements following APF gel application (P < 0.01), which correlated with fluoride release (r = 0.89-0.98). Mean roughness (Ra) measurements and SEM showed that roughness increased from the resin composite to the conventional glass ionomer cements. The marked erosive effect of APF gel on glass ionomer restorations could increase surface colonization by plaque micro-organisms, and reduce the longevity of the restorations.

Acidulated Phosphate Fluoride↗

Prosthodontic considerations in complicated restorative and esthetic dental problems.

An axiom of prosthetic dentistry has always been that the restoration of esthetics, speech and function requires the successful arrangement of teeth in space. The road to this success often requires the restorative dentist be a visionary who can coordinate multidisciplined planning in the presence of such obstacles as deficient alveolar bone and gingival tissues, poor occlusal plane, and jaw malrelations. Dr. Cook would like to thank the many Albuquerque generalists and specialists whose experienced hands contributed to the successful treatment of these patients.

Adult↗

Polymerization color changes of esthetic restoratives.

The color changes of three different types of tooth-colored restoratives during polymerization were investigated using colorimetry. L*, a*, b* color parameters of five different shades of Z100 (a mini-filled composite resin), Fuji II LC (a resin-modified glass-ionomer cement), and Dyract (a polyacid-modified composite resin) were taken precure and postcure. The results showed that the restoratives evaluated all underwent color changes during polymerization. The polymerization changes in color parameters were shade and not material dependent. Changes in L* parameter or lightness during polymerization were significant for all material and shade combinations and had the greatest influence on the overall polymerization color change. As the color change was perceivable by the human eye for most shades of materials, the clinical practice of polymerizing some material on, or adjacent to, the undried tooth to confirm shades of esthetic restoratives before restorative procedures is prudent.

Colorimetry↗

Esthetic gingival recontouring--a plea for honesty.

There continues to be a tremendous amount of confusion in the dental literature and among practitioners regarding the diagnosis and treatment of gingival discontinuities. The purpose of this article is to present a rationale for gingival recontouring, illustrated by a case report. A patient requested gingival recontouring. Because the preoperative evaluation was inadequate, a simple gingivectomy procedure was performed. After healing, the tissue had rebounded to its preoperative levels. The patient was then evaluated more comprehensively, and gingival recontouring was accomplished with a mucoperiosteal flap and osseous recontouring. The tissue subsequently healed at the correct position and remained stable. To reliably perform gingival recontouring procedures, the dentist must have a clear understanding of the biologic width. By using diagnostic bone sounding, the practitioner can determine the appropriate surgical procedure that will ensure an esthetic and stable postoperative result.

Adult↗

The resin retained natural tooth pontic: a transitional esthetic solution.

This case report presents an alternative treatment option for the premature loss of a maxillary anterior tooth due to severe periodontitis. A natural tooth pontic acid-etch prosthesis was fabricated using the patient's clinical crown from the extracted tooth. This measure proved to be a very adequate, esthetic treatment solution before a permanent restorative plan could be developed for the patient's long term dental needs.

Adult↗

The direct posterior esthetic restoration using state-of-the-art composite resin technology.

As a result of the evolution of both materials and techniques, the direct posterior composite restoration has become a common procedure in today's dental practice. Advances in the adhesive protocol have allowed for the conservative preparation of the dentition by using the micromechanical potential of the sound tooth structure. Improvements of composite resin materials have further enabled the practitioner to re-create the natural esthetic beauty of the dentition while at the same time restoring the functional morphology. This article describes the technical protocol and materials necessary to perform the direct posterior composite restoration in the posterior dentition.

Bicuspid↗

Esthetic soft-tissue augmentation adjacent to dental implants.

Patients and clinicians are becoming increasingly aware of the need to improve dental esthetics. After tooth extraction or trauma, there may be residual hard- or soft-tissue defects. These may be related to deficits in the bone or soft tissue. The evaluation of preoperative study casts, radiographs, and photographic documentation can aid the clinician in determining which types of augmentation are necessary. If adequate bone volume is present, the implants are placed according to protocol. Soft-tissue defects can be significantly reduced by implanting various biomaterials between the inner borders of the flap and surrounding bone. This case series describes patients who were successfully treated for soft-tissue defects with either demineralized freeze-dried bone or bovine bone.

Adult↗

The sandwich technique and strip crowns: an esthetic restoration for primary incisors.

The restoration of carious, fractured, or discolored primary incisors is rewarding to dentists because it gives them the satisfaction of knowing they have restored the smile and self-confidence of a growing child. However, restoring primary teeth can be a strenuous task because of the difficulty in keeping these patients' teeth dry and the uncooperative behavior of the child that sometimes occurs. Dentists are always seeking procedures that are esthetic, easy to use, and relatively quick to complete. This article describes a relatively easy technique that produces a beautiful outcome in a comparatively short time. The author has used this procedure on hundreds of children for more than 20 years, modifying the approach as appropriate when new methods and materials become available.

Acid Etching, Dental↗

Effect of intracrevicular restoration margins on peri-implant health: clinical, biochemical, and microbiologic findings around esthetic implants up to 9 years.

PURPOSE: The aim of the present study was to evaluate longitudinally the stability of a cohort of esthetic implants that had been in function for at least 1 year prior to the baseline examination. MATERIALS AND METHODS: Sixty-one maxillary anterior ITI implants in 45 systemically healthy patients, supporting single crown restorations, were randomly selected and examined. Clinical, microbiologic, and biochemical parameters were recorded at baseline and again after 3 years. Clinical examination included Plaque Index, Gingival Index, bleeding on probing, probing pocket depth (PPD), distance between implant shoulder and mucosal margin (DIM), and mobility. Dark-field microscopy and immunofluorescence were used to evaluate the bacteria morphotypes and the presence of 5 specific pathogenic bacteria, respectively. Peri-implant crevicular fluid (PICF) was collected at the mesial and distal sites of each implant, and total amounts of 3 biochemical markers were assessed: alkaline phosphatase was measured by using p-nitrophenyl-phosphate as substrate, elastase activity was measured by the use of a low-molecular-weight fluorogenic substrate, and the inhibitor alpha2-macroglobulin (alpha2M) was measured by enzyme-linked immunosorbent assay. RESULTS: The only statistically significant differences between baseline and follow-up examination concerned PPD and DIM measurements, which increased slightly. The remainder of the clinical measurements and almost all of the microbiologic and biochemical parameters did not change significantly. Furthermore, no associations were observed between the above results and the number of years that implants had been in function. DISCUSSION AND CONCLUSIONS: Based on an observation period of 4 to 9 years (mean 6.8 years at the time of the follow-up examination), it can be concluded that in patients with appropriate oral hygiene, the intracrevicular position of the restoration margin does not appear to adversely affect peri-implant health and stability.

Adult↗

Achieving ideal esthetics in osseointegrated prostheses. Part II. The single unit.

There are several advantages to the CeraOne single-tooth abutment. It seats directly onto the fixture, forming a nonrotating joint. A new type of gold alloy screw that can be tightened to 32 N/cm is used. In addition, the restoration is constructed on a prefabricated ceramic cap onto which porcelain is directly baked. A case report illustrates the technique and the highly esthetic results of such single-tooth replacement.

Adolescent↗

Indirect composite resin crowns as an esthetic approach to treating ectodermal dysplasia: a case report.

This article presents a case report describing the indirect fabrication of composite resin crowns for the restoration of primary anterior teeth. A 3-year-old with a confirmed diagnosis of hypohidrotic ectodermal dysplasia was provided with composite resin crowns that were both esthetic and functional. The indirect method decreases clinical time, provides a durable restoration, and allows treatment of patients who lack the cooperative ability to endure prolonged direct bonding appointments. The indirect technique may be feasible for the restoration of carious teeth as well as the presented case.

Acrylic Resins↗

Computerized design and manufacturing of esthetic dental restorations.

The "high-tech race" in restorative and esthetic dentistry is underway. The Cerec System, which currently leads the race, is reviewed. Other systems, which soon will be available, are discussed briefly. New and innovative technologies are sure to become a significant part of dentistry, both today and in the future. Many traditional methodologies and materials will be replaced by these new developments.

Ceramics↗