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Hard and soft tissue management for the restoration of traumatized anterior teeth.

The restoration of coronally fractured anterior teeth without surgical invasion is contingent upon several factors. Specifically, the biologic width of the tooth should not be violated by the apical extent of the fracture, and the residual root structure must possess an adequate ferrule. In patients with these conditions, it is possible to prosthetically restore the tooth following orthodontic extrusion. This article describes a technique in which orthodontic extrusion is utilized to provide adequate tooth structure for the prosthetic restoration of patients who presented with fractured anterior teeth.

Adolescent↗

Aesthetic posts and cores for metal-free restoration of endodontically treated teeth.

Utilization of contemporary post and core systems has facilitated the aesthetic restoration of endodontically treated teeth. Light transmission and biocompatibility have been enhanced by the introduction of metal-free post systems. The periodontal and endodontic status, root length, and histological structure of the devitalized teeth must be considered in order to achieve successful restoration following endodontic treatment. This article presents various restorative criteria for the aesthetic placement and buildup of post and core materials, as well as the preservation of maximum coronal and root structure.

Biocompatible Materials↗

Root reshaping: an integral component of periodontal surgery.

It is the aim of this article to present a surgical option to the traditional method of returning lost biologic width where invasion of the junctional and/or connective tissue attachment associated with a tooth has occurred. The alternative to conventional osseous resection involves reshaping the existing tooth surface in combination with conservative removal of the supporting alveolar bone to create the width needed for the restoration to be biologically acceptable. This procedure accomplishes several goals: (1) minimum supporting bone is removed; (2) deleterious root surface anatomy, such as grooves, concavities, and cementoenamel projections, is diminished; (3) a smooth root surface that is more biologically acceptable to soft tissue is created; (4) Class I and II furcation lesions may be decreased or eliminated; and (5) improved gingival contours and space for restorative materials can be created in situations in which close root proximity is present. This article will present a step-by-step approach to using root reshaping as an alternative to traditional crown lengthening.

Alveolectomy↗

Preformed posterior stainless steel crowns: an update.

For almost 50 years, dentists have used stainless steel crowns for primary and permanent posterior teeth. No other type of restoration offers the convenience, low cost, durability, and reliability of such crowns when interim full-coronal coverage is required. Preformed stainless steel crowns have improved over the years. Better luting cements have been developed and different methods of crown manipulation have evolved. This article reviews stainless steel crown procedures for primary and permanent posterior teeth. Step-by-step placement of a primary molar stainless steel crown is documented and permanent molar stainless steel crown restoration is described. A method for repairing a worn-through crown also is reviewed.

Bicuspid↗

Bonded resin composite strip crowns for primary incisors: clinical tips for a successful outcome.

The bonded resin composite strip crown is perhaps the most esthetic of all the restorations available to the clinician for the treatment of severely decayed primary incisors. However, strip crowns are also the most technique-sensitive and may be difficult to place. The purpose of this step-by-step technique article is to present some simple clinical tips to assist the clinician in achieving an esthetic and superior outcome.

Color↗

An up to 15-year longitudinal study of 515 metal-ceramic FPDs: Part 1. Outcome.

PURPOSE: This study reports on the outcome of 515 metal-ceramic fixed partial dentures (FPD) involving 1,209 abutments and 885 pontics placed by one operator in a specialist prosthodontic practice between January 1984 and December 1997. MATERIALS AND METHODS: Clinical and laboratory protocol was kept constant as much as was practical. Each FPD and abutment was given a subjective prognostic rating at the time of cementation. Patients were recalled in 1993 (review 1) and 1998 (review 2). Clinical examination by the author covered 85% of 342 FPDs at review 1 and 82% of 515 FPDs at review 2. At review 2, 37% had been in clinical service for 5 to 10 years (group b), and 34% had been in service for 10 to 15 years (group c). An objective classification protocol was used to assess outcome. RESULTS: At review 2, the FPDs had failure rates of 2%, 7%, and 11% in groups a, b, and c, respectively. There was a significant increase in the failure rate of group c at review 2 (11%) compared with review 1 (5%). Cumulative survival analysis indicated that FPDs have an expected survival rate of 96%, 87%, and 85% at 5, 10, and 15 years, respectively. The applied prognostic rating proved more accurate as clinical service time increased. Outcome was not related to number of units. Cantilevered FPDs, nonvital abutments, and anterior abutments had significantly greater failure rates. Of initially vital abutments, 2% were subsequently endodontically treated. CONCLUSION: Tooth-supported FPDs have an expected survival rate of 85% at 15 years when the described clinical and laboratory protocol is applied.

Adult↗

Accidents happen.

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Cementation↗

Preformed metal crowns for primary and permanent molar teeth: review of the literature.

The aim of this study was to carry out a review of the use and efficiency of preformed metal crowns (PMCs) for primary and permanent molar teeth. A literature search of English language journals was carried out using MEDLINE. Papers that addressed areas related to the use of PMCs regarding indications for use, placement techniques, risks, longevity, cost effectiveness and utilization were included in the review. Eighty-three papers were traced which fulfilled the above criteria, the majority addressing PMCs in primary molar teeth. Over half the papers were concerned with placement techniques and indications for use, with fewer papers reporting on clinical studies. The clinical data on PMCs spanned a considerable number of years and involved heterogeneous populations of patients, different makes and designs of crown, and differences among the operators and evaluators who were involved in the studies. The results, however, were in agreement that PMCs are superior to amalgam restorations for multisurface cavities in primary molar teeth.

Cementation↗

[Clinical value of cast post-core porcelain fused to metal crown in restorating residual root and crown of molars].

OBJECTIVE: To investigate the effect of cast post-core porcelain fused to metal crown on the restoration of residual root and crown of molars. METHODS: One hundred and sixty-four residual roots and crowns of molars were treated with root canal therapy and restored by cast core porcelain fused to metal crown. The restoration effect was assessed at the 3rd, 6th, 12th and 24th month. RESULTS: The strength of dental prosthesis retention, marginal fitness, and strength of crowns were satisfactory. The effective rate reached 95.12% during the 2 year follow-up. CONCLUSION: The cast post-core porcelain fused to metal crown is a better method in treating the residual root and crown of molars.

Adult↗

New telescopic crown protocol for partially edentulous patients: report of 32 cases.

In some periodontal cases, biomechanical, esthetic, medical, or economic concerns make it difficult for clinicians to employ either traditional therapy or restoration with an implant-supported prosthesis. To avoid any compromise and ensure a good result in such cases, we chose a removable telescopic prosthesis on natural teeth. In this paper we present a new clinical and technical method for the telescopic prosthesis, and we show that this is a predictable, reliable solution that is easy to realize, inexpensive, and comfortable for patients.

Adult↗

Preformed resin-veneered stainless steel crowns for restoration of primary incisors.

Stainless steel crown forms with bonded resin veneers for primary incisors are commercially available to dentists. This type of preveneered crown was developed to serve as a convenient, durable, reliable, and esthetic solution to the difficult challenge of restoring severely carious primary incisors. This article describes preveneered crowns, reviews their advantages and disadvantages, and details a technique for placement of such restorations.

Child↗