The influence of cusped and cuspless teeth on patient satisfaction with complete dentures. A 2-year follow-up study.
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The literature relating to the determination of the bond strength of plastic denture teeth to acrylic resin denture material is reviewed. The papers are presented in chronological order with information on specimen preparation, batch sizes and methods of testing. The lack of uniformity in experimental techniques and the diverse range of products assessed makes recommendations for laboratory practice difficult to formulate. One consistent observation is that tooth surface contamination with wax decreases the bond strength between the teeth and the denture base material. A universal testing method needs to be formulated to replace the various techniques now employed.
INTRODUCTION: The purpose of this study was to investigate, in vitro, the short-term effect of a soft drink (Coca Cola, Coca Cola Company, Atlanta, Ga) with low pH on enamel surfaces at different levels of intake. Effects on labial and palatal surfaces were also compared. METHODS: Thirty human enamel blocks (labial and palatal enamel surfaces) were randomly divided into 5 groups-1 control and 4 experimental. For 7 days, the enamel surfaces in the experimental groups were immersed in Coca-Cola at different frequencies: 1, 2, or 3 times per day for 20 minutes each, with each immersion followed by 1 hour in artificial saliva. Specimens in the fourth group were immersed for 1 minute in the soft drink followed by 3 minutes in artificial saliva, and the cycle repeated for 20 minutes to better simulate drinking habits. Control specimens remained in physiological serum at room temperature. The measurements were made at baseline (T0), day 3 (T1), and day 7 (T2) with a Knoop hardness tester. Analysis of the variance was used to find differences between the groups. For the multiple comparisons, the Dunnett test was used. The statistical level was accepted at P < .05. RESULTS: The experimental groups showed significant reductions in microhardness values. Differences between the test groups were not statistically significant, nor were differences between the labial and the palatal surfaces. CONCLUSIONS: Soft drink intake, even of relatively short duration, can reduce enamel microhardness. The frequency of intake seems not to play a decisive role on enamel microhardness. Care should be taken to avoid soft drinks during orthodontic treatment with fixed appliances.
This case report describes the multidisciplinary management of an adolescent girl with traumatic loss of the maxillary right central lateral incisors, and a unilateral Class II crossbite malocclusion. A rapid palatal expansion appliance was used initially to correct the transverse deficiency and secondarily as an anchorage unit for unilateral molar distalization to correct the Class II molar relationship. Temporary incisors were extended from a Nance stabilizing appliance during premolar and canine retraction. A staged approach was used with bone grafting before the placement of 2 single-tooth implants. A favorable outcome was achieved through proper coordination among the orthodontist, the surgeon, and the restorative dentist.
Sialic acids and proteins bound to mucins are known to form complexes with calcium, and this mechanism may hamper the remineralization of calcium-containing mucin-based saliva substitutes. Thus, the aim of this investigation was to evaluate the effects of adding various concentrations of calcium phosphate to self-made mucin-containing solutions on demineralised bovine enamel in vitro. Bovine specimens were prepared, embedded in epoxy resin, and polished to 4000 grit. Subsequently, the surfaces of the specimens were partially covered with nail varnish, thus serving as a control of sound enamel, and demineralised (37 degrees C; pH 5.0) for 14 (19 groups; n=10) or 28 days (three groups; n=9). After demineralization, the specimens were exposed to mucin-based solutions (30 g/l) with various saturations with respect to apatites containing 0.1 mM NaF, CaCl(2) (0-20 mM) and KH(2)PO(4) (0-52 mM) at two different pH values (5.5 or 6.5). A fluoride-free solution and the commercially available saliva substitute Saliva Orthana (Orthana, Kastrup, Copenhagen Denmark) served as controls. The differences in mineral loss (DeltaDeltaZ) between the values prior to (DeltaZ(Demin)) and after storage (DeltaZ(Effect)) in the various solutions were evaluated from microradiographs of thin sections (100 microm). The general linear model revealed a significant dependency of DeltaDeltaZ for calcium (P=0.006), but not for phosphate (P=0.081) or pH (P=0.114). DeltaZ(Effect) was only significantly reduced compared with DeltaZ(Demin) in the group with the highest saturation with respect to hydroxyapatite (P<0.05; t-test). In conclusion, mucin-based saliva substitutes with an adequate composition are able to remineralize bovine enamel in vitro.
Lingualized articulation has been advocated by many practitioners over the past 60 years. It can be achieved using a variety of tooth molds arranged in a number of ways that seem to provide the least complicated approach to occlusal rehabilitation and to satisfy the needs of the edentulous patient. Clinical experience has supported its use during functional and nonfunctional activities [17, 18]. The different combinations of tooth molds available from one particular tooth manufacturer, and now specific molds designed for lingualized articulation by other manufacturers, allows the practitioner to improve the likelihood of maximal intercuspation, avoid deflective occlusal contacts, determine cusp height for selective occlusal reshaping, and achieve a natural and pleasing appearance. The articulation and arrangement of the posterior teeth in lingualized articulation assures a standardized arrangement.
No single occlusal morphology, scheme, or material will successfully treat all patients. Many patients have been treated, both successfully and unsuccessfully, using widely varying theories of occlusion, choices of posterior tooth form, and restorative materials. Therefore, experience has demonstrated that there is no one righ r way to restore the occlusion of all patients. Partially edentulous patients have many and varied needs. Clinicians must understand the healthy physiologic gnathostomatic system and properly diagnose what is or may become pathologic. Henderson [3] stated that the occlusion of the successfully treated patient allows the masticating mechanism to carry out its physiologic functions while the temporomandibular joints, the neuromuscular mechanism, the teeth and their supporting structures remain in a good state of health. Skills in diagnosis and treatment planning are of utmost importance in treating these patients, for whom the clinician's goals are not only an esthetic and functional restoration but also a lasting harmonious state. Perhaps this was best state by DeVan [55] more than 60 years ago in his often-quoted objective. "The patient's fundamental need is the continued meticulous restoration of what is missing, since what is lost is in a sense irretrievably lost." Because it is clear that there is no one method, no one occlusal scheme, or one material that guarantees success for all patients, recommendations for consideration when establishing or reestablishing occlusal schemes have been presented. These recommendations must be used in conjunction with other diagnostic and technical skills.
OBJECTIVES: The objective of this study was to examine the two-body wear resistance of nine different resin denture teeth and one experimental material. METHODS: The two-body wear test was performed in a chewing simulator with an antagonistic Al(2)O(3) ball under an axial load of 40 N for 100,000 cycles. In each test series, an enamel sample was included as a reference. The wear was determined with an optical 3D surface profilometer. For statistical evaluation, SPSS for Windows was used. RESULTS: The samples of Artiplus (18.7-SD 21.0) and e-Ha (21.2-SD 15.1) showed the lowest volumetric wear (in mm(3)x10(-3)) after 100,000 cycles. The difference from the other materials tested, except NC Veracia Posterior, was statistically significant (p=0.001-0.037). SR-Postaris-DCL (55.0-SD 6.8), SR-Orthosit-PE (61.1-SD 12.4) and Vitapan (72.1-SD 15.9) exhibited medium-sized wear values with low dispersion, whereas Orthognat (80.1-SD 31.6), Premium 8 (84.6-SD 31.4), NC Veracia Posterior (87.0-SD 52.7), SR-Orthotyp-PE (114.6-SD 28.0) and Trubyte Portrait (123.0-SD 45.6) showed high wear values with great variations. Statistically provable differences were found between SR-Orthotyp-PE and SR-Postaris-DCL (p=0.019) and also between SR-Orthotyp-PE and SR-Orthosit-PE (p=0.031). For enamel, a medium-sized wear value of 66.1-SD 76.8 was determined. SIGNIFICANCE: The denture teeth examined showed differences in two-body wear resistance. The wear values determined were in some cases higher and in others lower than those of natural enamel. A definite connection between the wear resistance and the chemical composition of the materials could not be found in this investigation.
OBJECTIVES: This in vitro study evaluated the fracture load of interim FPDs made with various materials and pontic heights. The hypothesis was that different materials and pontic heights result in different fracture resistance. METHODS: Groups of interim FPDs were fabricated with prosthodontic resin materials on two abutments with two different pontic heights (4.3 and 5.8 mm) and a pontic width of 4 units (19 mm) (n = 3). The following materials were tested: (1) a thermoplastic polymer (Promysan Star), (2) Promysan Star with a veneering composite (Vita Zeta), (3) a non-impregnated polyethylene fiber reinforced resin (Ribbond) with a veneering composite (Sinfony), (4) an impregnated fiber reinforced composite system (Targis/Vectris), and (5) a conventional poly methyl methacrylate (PMMA) (Biodent K+B, control group). After 5000 thermocycles, the FPDs were temporarily fixed with a provisional cement on the corresponding abutments and tested for fracture strength. One-way and two-way ANOVA and Bonferroni-Dunn's multiple comparison tests were performed for the statistical analysis (alpha = 0.05). RESULTS: The mean fracture strength ranged from 83.0 to 625.9 N for a pontic height of 4.3 mm and from 97.2 to 893.7 N for a pontic height of 5.8 mm. Vectris/Targis FPDs of both pontic heights exhibited significantly superior fracture resistance compared to the corresponding Promysan, Promysan/Vita Zeta, Ribbond/Sinfony and Biodent groups. Except Biodent FPDs, fracture resistance of FPDs with a pontic height of 4.3 mm showed no significant differences compared to a pontic height of 5.8 mm for each material. SIGNIFICANCE: Material type of the FPDs has a significant influence on the fracture strength, whereas pontic height has no significant effect (except control group).
OBJECTIVE: To determine the differences, if any, between hardness measured with traditional Vickers and Martens hardness test methods on denture teeth under 2, 10 and 50 N loads. METHOD: Hardness of acrylic resin (VIV), composite resin (ORT) and porcelain (POR) denture tooth materials was measured using a traditional Vickers hardness (HV) method and Martens hardness (HM) method at 2, 10 and 50N test loads. Vickers hardness was also calculated from the force-indentation depth curves (HVfid) that were recorded during Martens hardness. Indentation creep of the three test materials was also determined during Martens hardness testing. RESULTS: HM values were the same irrespective of the test force used. However, HV values were different for the three test forces. ANOVA using Tukey's test of the HM data showed that the hardness of POR was significantly higher than VIV or ORT (P<0.001). Moreover, ORT had a significantly higher hardness than VIV (P<0.001). The statistical analysis of HVfid data showed similar results. ANOVA of the HV data showed the hardness of VIV to be significantly higher than ORT (P<0.001) under 2, 10 and 50 N test load. The HV values for POR under 2 and 10 N test load could not be calculated because of inability to measure the indentation diagonals. Under the 50 N load, the hardness of POR was significantly higher than VIV and ORT. POR had a significantly lower creep value than any other material tested while VIV showed a statistically significantly higher creep than ORT. SIGNIFICANCE: This study confirms that the visco-elastic recovery of the materials has a very significant effect on the outcome of the hardness tests of denture teeth and the Martens hardness test method has obvious advantages when testing dental materials.
OBJECTIVES: Polymers used in saliva substitutes might inhibit remineralization. The present study evaluated the effects of various calcium, phosphate, and fluoride concentrations of linseed based solutions on the mineral loss of predemineralized bovine dentin in vitro. METHODS: Dentin specimens were prepared, embedded and polished. The specimens were demineralized (pH 5.6; 6 d; 37 degrees C) and half of each sample was covered with nail varnish. Subsequently, the specimens (n=10) were exposed to 14 linseed based solutions (calcium 0-1.1 mM; phosphate 0-7.7 mM, fluoride 0-0.03 mM) at pH 5.5 and 6.5 as well as to Salinum for 14 days (37 degrees C). The differences in mineral loss (DeltaDeltaZ) between the values prior to and after storage in the solutions were evaluated from microradiographs of thin sections. RESULTS: After the exposure to the various solutions decreased mineral contents compared to those after demineralization could be observed (p<0.05; paired t-test) whereas for the specimens stored in solution with the highest calcium and phosphate concentration no significant change in mineral loss could be evaluated (p>0.05). Salinum induced a significantly greater mineral loss compared to the equivalent saturated solution (p<0.05; ANOVA, Bonferroni). The general linear model revealed a significant dependency for DeltaDeltaZ on 'phosphate' (p=0.000) and 'fluoride' (p=0.001), but not on 'calcium' (p=0.397) and 'pH' (p=0.368). CONCLUSIONS: The addition of calcium, phosphates, and fluorides seems to have a positive effect on the remineralizing qualities of linseed based saliva substitutes.
The purpose of this study was to determine if electronic apex locators (EAL) or electric pulp testers (EPT) interfere with the function of implanted cardiac pacemakers (ICP) or cardioverter/defibrillators (ICD). Twenty-seven patients with ICPs or ICDs had continuous electrocardiogram monitoring and device interrogation to detect interferences during the use of two types of EALs and one EPT. No interferences were detected by any ICP or ICD. In six patients, with intermittent pacing, a significant increase in pacing was observed during EAL/EPT stimulation (p < 0.05). Examination of RR intervals (a measure of intrinsic heart rate) demonstrated significantly longer RR intervals (slower intrinsic heart rate) during EAL/EPT stimulation (p < 0.05). Evaluation of the electrocardiograms for each patient failed to show any abnormalities in pacing during testing. These findings led us to conclude that the increased pacing frequency observed was related to a slower intrinsic heart rate and not electrical interference with the cardiac devices. In conclusion, the two EALs and one EPT used in this study did not interfere with the functioning of any of the cardiac devices tested.
Dentures were fabricated for a 73-year-old woman using porcelain 20-degree maxillary posterior teeth and acrylic resin flat planes in the mandibular posterior region. A digital gothic arch tracing device was used to observe the horizontal mandibular positions before insertion and to evaluate the therapeutic effect of the diagnostic dentures at 1 and 3 months after insertion.
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An interim obturator prosthesis is required for the restoration of speech, deglutition, and improvement of esthetics after maxillectomy. This article describes a simple method for fabricating the interim obturator prosthesis by duplicating the patient's teeth and palate. The interim obturator prosthesis fabricated by duplication of the presurgical appearance and contour may be more acceptable to the patient.
Numerous methods for replacing missing removable partial denture abutments have been introduced, however, most of them are time consuming and require several visits to complete the procedure. Since magnetic attachments can provide support and bracing as well as retention for overdenture abutments, the remaining tooth root structure can be used to support the coping with the keeper. Through the use of composite resin and adhesive material, improved retention of the keeper to the root may be achieved, along with improved esthetics. This article describes a method for replacing the missing abutment of a removable partial denture with a magnetic attachment, and a composite resin coping with a keeper.