[The relationship between bucco-lingual shape of the tooth crown and its gingival shape. 3. The difference between the natural crown and the artificial crown (author's transl)].
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The enamel knot (EK), located in the center of cap-stage tooth germs, is a transitory cluster of non-dividing epithelial cells, eventually linked to the outer dental epithelium by the enamel septum (ES). It might act as a signaling center providing positional information for tooth morphogenesis and could regulate the growth of tooth cusps through the induction of secondary signaling EKs. The EK undergoes apoptosis, which could constitute a mechanism whereby the signaling functions of this structure are terminated. Recently, we demonstrated the segregation of 5-bromo-2'-deoxyuridine (BrdU) negative inner dental epithelial (IDE) cells of the EK into as many individual groups of cells as cusps will form and suggested a morphogenetic role for these particular IDE cells. Using Z-VAD-fmk, a specific caspase inhibitor, apoptosis in the primary EK of first mouse lower cap-staged molars and lower incisors cultured in vitro was abrogated. No obvious histological alterations were observed in the incisors, whereas a prominent EK and an ES connecting the outer dental epithelium (ODE) and the BrdU negative IDE cells capping cusp L2 were observed in the molars. EK specific transcription (Shh, Msx-2, Bmp-2, Bmp-4) was down-regulated in the body of these structures with the exception of the associated IDE cells. In these experimental conditions, segregation of non-dividing transcriptionally active IDE cells occurred and a normal cusp pattern was expressed.
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AIM: To evaluate the success and maintenance requirements of cylindrical, hydroxyapatite coated implants used as single-tooth implants. DESIGN: A five-year prospective trial. METHOD: Twenty patients, attending the Department of Prosthetic Dentistry at GKT Dental Institute, London, were provided with 23 Calcitek, Integral Omniloc single tooth implants. Annual reviews were undertaken for five years. Assessment criteria included implant survival; abutment or crown looseness; radiographic evidence of bone loss; evidence of plaque and inflammation of the mucosal cuff; the patient's perception of the restoration. RESULTS: All implants integrated. Two subjects, with three crowns, dropped out giving a known cumulative survival rate of 87%. Twelve implants exhibited no measurable bone loss and six demonstrated funnel formation up to 2mm in depth which, at five years, appeared to be stable; three implants exhibited continuing bone loss and their inclusion as failures gives a known success rate of 74%. The abutments came loose on four occasions; the crowns decemented on 12 occasions; two crowns were repaired and one remade. The appearance was judged to be good or very good. CONCLUSION: The prospective study indicated that hydroxyapatite coated implants can be successful as single tooth implants, over a five-year period.
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Optimizing aesthetics in the anterior maxilla can be a challenge because of tissue contouring problems. Dental implants allow for restoration of edentulous areas, thus improving function. Some compromises may result as a result of the necessity of predicting the stability of the replacement restorations. The Frialit-2 dental implant system with the internal hex design provides excellent stability for single-tooth restorations. Aesthetics are maximized using Procera Allceram crowns. This case study describes in detail the following: diagnosing and treatment planning for a challenging trauma case; surgical preparation and placement of two Frialit-2 dental implants in the maxillary left central and lateral incisor areas; primary impression techniques and fabrication of a temporary prosthesis over ProTect abutments; second-phase opening; final impressions; and fabrication of two single crowns.
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