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New developments and advances in dental implantology.

Progress in laboratory investigation of the biologic basis of osseointegration coupled with an extensive world-wide clinical experience have created a better understanding of implant and tissue integration and has allowed expanded clinical applications. Techniques are now available to provide alloplastic tooth replacements that are biomechanically stable and predictable and provide adequate masticatory, phonetic, and esthetic function approximating that of the normal dentition. Computed tomography is now used to assist the surgeon in determining available recipient bone sites and to determine the exact three-dimensional positioning of endosseous implants in the jaw bone. Surgical management of bone volume deficiencies, utilizing grafting techniques with bone and bone substitutes and guided tissue regeneration with membrane barriers, have given previously rejected patients an opportunity to benefit from osseointegrated implants. Congenital and acquired bone defects may now be managed and reconstructed with techniques that include dental implant surgery. Osteoinductive and osteoconductive substances are now available to assist in accelerating healing and present great promise for future applications.

Alveolar Ridge Augmentation↗

Esthetic and biomechanical considerations in reconstructions using dental implants.

The single-tooth implant-supported restoration can provide an outstanding service to many patients. It requires an understanding of the biomechanical principles involved and attention to the many details involved with the diagnosis and treatment planning for these restorations. The clinician should realize that this restorative approach is contraindicated in many circumstances. As Peter K. Thomas said, "Spend more time planning than doing and doing becomes easier."

Dental Abutments↗

A new Brånemark single tooth abutment: handling and early clinical experiences.

A new prosthetic concept, today available under the name CeraOne, for single tooth replacement with the Brånemark system is described. This concept is characterized by a new design of the prefabricated components. A mechanical torque driver is used together with a gold screw and a special counter-torque device to ensure that the screw is tightened in an optimal manner to resist screw loosening and only transmit minor stress to the fixture interface. Another characteristic is the use of a prefabricated cap of sintered aluminum oxide as the basis for the ceramic crown. The crown is cemented to provide better esthetic possibilities even in situations of somewhat unfavorable fixture placement.

Adolescent↗

Effect of reinforcement methods on the retention of resin-bonded fixed partial dentures using a composite denture tooth as a pontic: in vitro evaluation.

PURPOSE: The incorporation of composite denture teeth as pontics in resin-bonded fixed partial dentures has been deemed to be short-lived. This study investigated whether pre- or posttreatments could improve the bonding of denture tooth pontics. MATERIALS AND METHODS: A model fixed partial denture was fabricated that included composite denture teeth (Endura) bonded with 1 of 2 resin systems (C&B-Metabond or Aeliteflo). The bonding surface of the pontic was pretreated with one of three methods (air-particle abrasion [AA], AA plus silanization, or cavity preparation plus AA). The bonding areas between pontic and abutments were posttreated with 1 of 2 methods (reinforcement with fiber or metal post). Five bonded specimens for each treatment group were subjected to 20,000 thermocycles (40 degrees C to 60 degrees C; dwell time 60 s) before retentive forces (N) were determined. All data were analyzed with two-way ANOVA and Bonferroni's test (p = 0.05). RESULTS: All specimens that underwent the pre- and posttreatment outperformed untreated specimens. For the specimens bonded with C&B-Metabond and posttreated with a polyethylene fiber (Ribbond) or a metal post (DC Post), the mean retentive forces were 316 N and 301 N for mandibular specimens, and 354 N and 380 N for maxillary specimens, respectively. These values were significantly higher than those obtained with other pretreatment methods (p < or = 0.0003). For mandibular specimens bonded with Aeliteflo, specimens posttreated with Ribbond exhibited significantly higher retentive forces (332 N) compared to other specimens (p < or = 0.0001). CONCLUSION: Within the limitations of this study, the bond strength of a resin-bonded fixed partial denture incorporating a composite denture tooth as the pontic was improved by reinforcement with either a polyethylene fiber or a metal post.

Analysis of Variance↗

Shear bond strength between composite resin and denture teeth: effect of tooth type and surface treatments.

PURPOSE: The purpose of this study was to investigate the strength of the composite resin-denture tooth bond as affected by different tooth surface treatments. MATERIALS AND METHODS: Spectrum TPH was condensed on 112 mandibular first molar acrylic resin and composite resin denture teeth, which received seven different treatments: Four groups were treated with Prime & Bond NT adhesive, and three groups were treated with One Step adhesive. Four groups (two of each adhesive category) were treated with Composite Activator and air abrasion. In one group, AeliteFlo was used just before the condensation of Spectrum TPH. Bond strength was evaluated with a shear test device on a Monsanto testing machine. The results were evaluated statistically with two-way ANOVA and the Scheffé method. RESULTS: There was a significant interaction between denture tooth type and surface treatments. Bond strength of composite resin was greater to composite than to acrylic resin teeth when the bond was mediated only with adhesives. One Step adhesive and AeliteFlo resulted in a higher bond of composite resin to both types of teeth. Wetting tooth surfaces with Composite Activator did not increase the bond. CONCLUSION: When repairing denture teeth with composite resin and adhesives, the bond strength was higher with composite than with acrylic resin teeth, and there were differences between the adhesives used.

Acid Etching, Dental↗

Maintenance requirements of implant-supported fixed prostheses opposed by implant-supported fixed prostheses, natural teeth, or complete dentures: a 5-year retrospective study.

PURPOSE: The purpose of this study was to compare the maintenance requirements of implant-supported fixed prostheses with cantilever arms in edentulous jaws when opposed by fixed prostheses of similar design, by natural teeth, or by complete dentures. MATERIALS AND METHODS: The maintenance requirements for the 5-year follow-up period were obtained by examining the dental records of 37 people. Six were provided with fixed prostheses in both arches, 22 with a fixed prosthesis in the mandible opposed by a complete denture, and 9 with a fixed prosthesis opposed by natural teeth. Everyone was treated with Nobel Biocare implants using standard implant and prosthetic protocols. RESULTS: The denture teeth and acrylic resin were repaired on 44 occasions in the group with implants in both jaws, on 14 occasions in the group with implants opposed by natural teeth, and twice in the group in which the implants were opposed by a complete denture. The group with implants in both jaws was more likely to fracture the gold-alloy framework, which occurred on six occasions. The group with implants in both jaws was significantly different from the other two groups in relation to higher incidence of fracture of the teeth and gold-alloy framework. CONCLUSION: The maintenance requirements of implant-supported fixed prostheses with cantilever arms opposed by fixed prostheses of similar design were much greater than when opposed by natural teeth or complete dentures.

Acrylic Resins↗

The role of complete denture principles in implant prosthodontics.

During the past 30 years, there has been a growth of implant courses in dental schools at the predoctoral level to meet a burgeoning demand. At the same time, there has been a concomitant reduction in curriculum time devoted to clinical and technical aspects of complete denture construction. There will be a sizable cohort of patients with limited natural dental landmarks seeking implant reconstructions that may be difficult for the general practitioner to restore. This article reviews basic prosthodontic principles and procedures that are important to understand when designing an implant prosthesis.

Dental Occlusion, Centric↗

[The abrasion resistance of plastic teeth--an in-vitro study].

Resistance against abrasion of premolar plastic teeth on their chewing surfaces was determined using an in vitro test method which approximately simulated oral conditions, as well as contact between antagonists, chewing pressure, biting pressure and chewing motion. The humpy surface of commercially manufactured teeth was levelled by grinding, using the abrasion test machine itself, which resulted in two little plain surfaces. After measuring the size of these surfaces, wear due to abrasion was determined by loss of weight. The commercial products showed different resistances against abrasion, the teeth of Dens-Nobilis and Vitapan, which contain amorphous silica, appeared to be more resistant against abrasion than IPN (Artiplus) and PMMA (Keracryl-7, Planustar, SR-Orthotyp-PE) teeth. Unexpectedly, IPN teeth did not show a higher resistance against abrasion than the PMMA teeth, which were tested in this investigation. Only SR-Orthotyp-PE were significantly worse. Under the prevailing test conditions SR-Orthosit-PE teeth are very little resistant against abrasion, although they contain amorphous silica. Investigations with a raster electron microscope revealed that they are too brittle.

Bite Force↗

The copy denture technique.

The copy denture technique facilitates the replication of the good feature of existing dentures. Assessment of the existing dentures provides essential information for diagnosis and treatment planning. Copy templates are made which exhibit those features of the existing dentures which are satisfactory and are to be reproduced in the new dentures, while facilitating controlled and predictable modification of undesirable features. All impressions and occlusal registrations are obtained with the aid of the templates which then provide stable trial bases. The patient may adapt to the new dentures quicker because of the reproduction of familiar features.

Dental Articulators↗

Various clinical situations and their influence on linear occlusion in treating combination syndrome: a discussion of treatment options.

Eliminating anterior tooth contact is paramount when treating combination syndrome. It is possible to do so through the use of linear occlusion with a non-interceptive arrangement and the bilateral fulcrum of protrusive stability. The presence of mandibular anterior teeth often complicates this procedure. When establishing the horizontal plane of occlusion, clinical circumstances often necessitate modifications; nevertheless, certain principles must be incorporated into the design of the prostheses. Clinical circumstances may dictate altering the approach but these principles must be maintained to eliminate anterior hyperfunction.

Crowns↗