[Use of dowel inserts and stump crowns for restoring tooth form and function].
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Three procedures to ensure the correct location of components in the orifice of a hydroxyapatite-coated implant cylinder are presented. These facilitate recording of an accurate impression and the correct location of a customized abutment supporting a single-tooth crown. A technique is offered for obtaining the reproducible, comparable radiographs necessary for monitoring horizontal bone levels.
A 13-year-old boy had fractured his maxillary right central incisor. The fracture line involved 2/3rd of the crown, compromising the pulp and extended subgingivally on the palatal aspect invading the biologic width. The procedure used to manage this case included endodontic treatment of residual tooth orthodontic extrusion to move the fracture line above the alveolar bone. Finally the tooth was restored prosthodontically.
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Gingival overgrowth is a common health problem caused by genetic and environmental risk factors. Animal models for quantitative histological studies are needed to uncover genetic predisposition and dose-response data that might put individuals at increased risk for gingival disease. Gingival height, thickness, inflammation, and the degree of encroachment of gingiva over the tooth, are clinical measures of overgrowth; most of these parameters can be measured histologically, but in order to quantify gingival coverage of the tooth, the image of the crown must be present. Tooth and bone typically require decalcification for histology; thus, the tooth crown, a critical landmark, is lost. We describe a method for imaging the crown histologically, using impression materials applied to dissected mouse mandibles. Four dental alginates, three polyvinyl siloxanes, and one polyether and gelatin were used. The impression-material/mandibular tissue blocks were processed routinely. Polyvinyl siloxanes were incompatible with embedding resin; alginates, polyether and gelatin could be fixed, decalcified, embedded, and sectioned. Alginates and gelatin could be stained. Success in imaging the tooth crown varied with the preparation, but the alginates, polyether, and gelatin permitted a useful degree of measurement of exposed crown and enamel thickness, along with other morphometric parameters such as thickness of the dentin, lateral mandibular ramus, rete pegs, height of the gingiva, and volume density of vessels and inflammatory cells in the lamina propria. In conclusion, this new application for impression materials allows gingival coverage of tooth crown, as well as numerous other parameters to be measured for comparison with clinical data.
The purpose of this study was to compare shear bond strength values obtained in human enamel and dentin with the values obtained in bovine teeth using two adhesive systems with different actions. Forty human tooth half-crowns and forty bovine tooth crowns were flattened to a minimum plain area of 5 mm in diameter. The samples were divided in four groups of 20 specimens each: 1) human enamel; 2) bovine enamel; 3) human dentin; 4) bovine dentin. The samples of each group were divided in 2 subgroups of 10 samples each, according to the adhesive system used: 1) Scotchbond Multi-Purpose (SBMP); and 2) Clearfil Liner Bond 2V (CLB2V) applied according to the manufacturer's recommendations. Afterwards, restorations of Z100 composite with cylindrical shape (4 mm diameter x 5 mm height) were made using a metallic mold to submit the samples to shear bond testing on an Instron universal testing machine, at a crosshead speed of 0.5 mm/min. The data were submitted to ANOVA and Tukey's test (5%). In enamel, there was no statistical difference between bovine and human teeth for SBMP (7.36 MPa, human; 8.24 MPa, bovine), nor for CLB2V (10.01 MPa, human; 7.95, bovine). In dentin, SBMP showed a statistically lower mean on human dentin (7.01 MPa) than on bovine dentin (11.74 MPa). For CLB2V, there was no statistical difference between human (7.43 MPa) and bovine (9.27 MPa) substrates.
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Due to extensive loss of tooth substance the restoration of endodontically treated tooth requires intracanal dowels to give an efficient strength for the crown. The aim of our study was to investigate whether the previous type of restoration of the tooth, i.e. composite restoration with screw post versus one-piece dowel crown, has an effect on the prognosis of crowns with dowels. The material consisted of 111 single crowns and as a previous restoration there were 83 composite restorations with screw posts and 28 one-piece dowel crowns. The mean follow-up time was 78 months (range 6--163 months). The cumulative survival was 87% for one-piece dowel crowns and 84% for composite resins with screw posts. There were six root fractures, four losses of cement retention and one tooth extraction due to caries in crowns with previous composite resin with screw posts. In one-piece dowel crowns as a previous restoration there were two root fractures and one tooth extraction for periodontal reasons. In conclusion, it seems that the previous restoration has no marked effect on the prognosis of crowns with dowels when studying a composite resin restoration with screw post and a one-piece dowel crown.
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This study was done to evaluate the retention of complete cast crowns in teeth with adequate and inadequate crown height and to evaluate the effects of auxiliary retentive features on retention from of complete cast crowns. Thirty-six extracted human maxillary first premolars were obtained. In one group teeth were prepared to a constant height of 3.5 mm and in the second group teeth were prepared to a constant height of 2.5 mm. Each group was further subgrouped into three. In the first subgroup teeth were prepared conventionally, second subgroup proximal grooves were incorporated and in the third subgroup proximal boxes were incorporated. Tensional forces required to dislodge each cemented casting from its preparation was used for comparison of retention quality. These results were then subjected to an analysis of variance (ANOVA). The retention of crown in tooth with adequate crown height were statistically highly significant (P < 0001), compared to inadequate crown height and in boxes compared to grooves and conventional preparation.
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