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Comparison of nickel-titanium and stainless-steel spreader penetration and accessory cone fit in curved canals.

The purpose of this study was to compare nickel-titanium and stainless-steel spreader penetration in curved canals. Twenty prepared plastic blocks with a 30 degrees curvature were used for each part of the study. In part 1, the force required to insert each spreader to within 1 mm of working length in an empty canal was measured. In part 2, the force required to insert each spreader to within 3 mm of working length was measured in a canal containing a master cone. In part 3, the depth of penetration of each spreader with a master cone in place using a 1.5 kg force was measured. Additionally, in part 3, the depth of penetration of the first accessory cone was measured. The results from part 1 showed that a nickel-titanium spreader required significantly less force than a stainless-steel spreader (0.30 kg vs. 0.59 kg). In part 2, a nickel-titanium spreader required significantly less force than a stainless-steel spreader (1.56 kg vs. 2.42 kg). In part 3, a nickel-titanium spreader penetrated significantly deeper than a stainless-steel spreader (15.0 mm vs. 14.0 mm). There was no significant difference in the depth of penetration of the first accessory cone used after either spreader (0.8 mm vs. 0.7 mm). Therefore, the potential for vertical root fracture in curved canals during lateral condensation may be minimized by using nickel-titanium spreaders.

Dental Instruments↗

The endodontic cube: a system designed for evaluation of root canal anatomy and canal preparation.

An extensively redesigned muffle system is presented incorporating improved design features, such as rigid external fixation and machined internal indexing to enable a more accurate, clinically relevant, and reproducible evaluation of root canal anatomy before and after preparation. Given the ability to directly observe and quantify changes in the root canal system, the information obtained using this design is comprehensive. In each tooth pretreatment evaluation provides the ideal control, reinforcing the suitability of this technique.

Dental Pulp Cavity↗

Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments.

We evaluated the influence of manual preflaring and torque on the failure rate of rotary nickel-titanium ProTaper instruments Shaping 1 (S1), Shaping 2 (S2), Finishing 1 (F1), and Finishing 2 (F2). These factors were evaluated using an in vitro method by calculating the mean number of Endo-Training-Blocks shaped before file breakage under different conditions. Group A (S1 on simulators with no preflaring) shaped 10 blocks before failure, group B (S1 on manually preflared simulators) shaped 59 blocks (p<0.01 versus group A), group C (S2 with low torque) shaped 28 blocks, group D (S2 with high torque) shaped 48 blocks (p<0.01 versus group C), group E (F1 with low torque) shaped eight blocks, group F (F1 with high torque) shaped 23 blocks (p<0.01 versus group E), group G (F2 with low torque) shaped four blocks, and group H (F2 with high torque) shaped 11 blocks (p<0.01 versus group G). Manual preflaring creates a glide path for the instrument tip and is a major determinant in reducing the failure rate of these rotary nickel-titanium files. All instruments worked better at high torque.

Dental Alloys↗

The surgical template: a prescription for implant success.

The surgical template is utilized in the planning and execution of a successful implant rehabilitation. A method of template fabrication is presented which is useful for cases requiring precise root form fixture placement. Stents are fabricated using a duplicate denture or acrylic base and orthodontic wire, which is contoured to create the acceptable perimetric limits of fixture placement. This approach provides good visual access, operator flexibility, and template stability. The technique can be utilized for the edentulous and the partially edentulous arch.

Acrylic Resins↗

Angulation assessment of anterior single tooth root form implants: technical note.

A technique is presented to evaluate the angulation and position of an anterior single tooth root form implant by means of a surgical template, a pilot osteotomy, and an abutment guide. The space available for the restorative materials can be assessed and the angulation modified, if necessary, to improve the esthetic potential. If the angulation is satisfactory and sufficient room is available for the prosthesis, the surgeon can continue with implant placement at the initial site.

Cuspid↗

SwissPlus Implant System, Part 1: Surgical aspects and intersystem comparisons.

Implant survival in poor-quality bone continues to pose a significant clinical challenge to dentists. The SwissPlus System comprises one-piece, straight and tapered implant designs with self-tapping, apical threads, and a microtextured surface on the intraosseous portion of the implant bodies. Although both designs are indicated for all ranges of bone density, Tapered SwissPlus features double-lead threads and a soft-bone surgical protocol designed to enhance initial mechanical stability at the time of placement. This paper presents an overview of the SwissPlus System with emphasis on the surgical aspects. Presented test data also illustrate intersystem compatibility and differences between the straight SwissPlus and ITI synOcta implants.

Bone Density↗

The shaping effects of three nickel-titanium rotary instruments in simulated S-shaped canals.

The purpose of this study was to compare the shaping effects of three nickel-titanium rotary instruments, ProTaper, K3, and RaCe, with emphasis on canal transportation. Simulated canals with an S-shaped curvature in clear resin blocks were prepared with a torque-control, low-speed engine. Canals were prepared using the crown-down technique to the size of #30. Canal aberrations were assessed by comparing the pre- and postinstrumentation images under a stereomicroscope. ProTaper instruments caused greater widening of canals compared to K3 or RaCe. Furthermore, ProTaper files showed a tendency to ledge or zip formation at the end-point of preparation. These canal aberrations may be caused by ProTaper finishing files, which appear to be less flexible than other files of the same tip-size, because of their greater taper-size. These results suggest that nickel-titanium file systems including less tapered, more flexible instruments, like K3 and RaCe should be used in the apical preparation of canals with a complicated curvature.

Dental Alloys↗

The accuracy of six impression techniques for osseointegrated implants.

PURPOSE: Six impression techniques were evaluated using tapered and square impression copings. MATERIALS AND METHODS: The absolute distortion was measured using a cast metal impression tray with fiduciary reference points external to the impression material. Measurements of the x, y, z coordinates on the master cast and the impressions were directly made with a travelling digitizing microscope. The difference between the coordinates of each of six sites in the impression and the corresponding reference site were compared. RESULTS: There was no significant difference between the techniques for the square copings but that there was a significant loss of accuracy in the z-axis with the tapered copings. CONCLUSIONS: No significant differences were noted.

Analysis of Variance↗

The use of light-cured composite resin on altered diagnostic casts.

Light-cured composite resin as an alternative to wax for altered diagnostic casts is demonstrated. The value of altered diagnostic casts as a diagnostic tool is addressed. The benefits in the use of composite resin versus the traditional use of wax are emphasized.

Acrylic Resins↗

Use of a surgical template for autologous bone grafting of alveolar defects.

This article describes the fabrication of a surgical template for planning and performing the harvest and placement of autologous bone grafts for the reconstruction of alveolar defects before implant placement. A diagnostic cast is altered to replicate the anticipated bone anatomy. The ideal bony contours for implant placement are then created on the cast to form the template. This template may then be used for treatment-planning donor sites for the harvest of corticocancellous bone grafts. The template is sterilized and used by the surgeon in procuring and placing the bone graft. This template allows communication of the prosthetic requirements of the ridge augmentation, as well as ensuring adequate volume and proper positioning of the block graft for eventual implant placement.

Alveolar Bone Loss↗

Die-spacing technique by diffusion precipitation.

The present study has shown that it is possible by utilizing the principle of diffusion to precipitate on stone dies an adequate resin spacer of uniform and desirable thickness. Details and variables of the technique are described. The precipitation technique is simple and requires a minimum of time and equipment. This spacer technique opens up gateways for a new and improved casting technique cleared of most of the variables affecting the precision of the methods employed up till now. A new gypsum bonded investment for the new casting technique is being developed.

Acetone↗

A review of modern impression materials.

A number of new elastic impression materials have been developed over the past few years. The working time, setting time, elasticity at set, permanent deformation, dimensional change on setting and long-term stability were determined for several of these impression materials. The new addition type silicone impression materials proved superior to the other materials tested, but all materials were capable of giving good clinical results.

Dental Impression Materials↗

The effects of die-spacing on post-cementation crown elevation and retention.

This paper reviews the relevant dental literature concerning the effect of die-spacing on crown elevation and pre- and post-cementation crown retention. Techniques of providing die-spacing and measurement of the thickness of die-spacer are discussed. A review of the role of the provision of a cement space in reducing post-cementation crown elevation is presented. Factors which may affect crown retention prior to and following cementation are also reviewed. The influence of variables in techniques and experimental design on the results of the studies reviewed is discussed.

Cementation↗

Individualized catenary curves: their relationship to arch form and perimeter.

Study casts of the lower arches of 35 children in whom arch alignment was considered acceptable, were examined using a reflex microscope. Arch perimeter was calculated mathematically from a method which required measurement of the mesio-distal widths of the teeth only. This was described as the 'overlap' method. Arch perimeter was also calculated using individualized catenary curves for each subject. Two calculations were made, recording arch width either at the distal contact points of the first permanent molars or between their mesio-buccal cusps. Arch perimeter measured from the length of the catenary curves was consistently shorter than that calculated by the overlap method. The variation ranged from 0.02 to 4.58 mm. The catenary constructed using the distal molar contacts gave a better representation of the actual arch form: the mean discrepancy was 2.36 mm, compared with 2.86 mm with the second method where arch width was measured between mesio-buccal cusps. Both techniques for calculation of arch perimeter were highly reproducible. The catenary curve only approximated arch form well when the arch was relatively narrow across the inter canine region. For square arches this method was unsatisfactory. It is suggested that alternative techniques would be more reliable and the overlap method described here is considered satisfactory.

Cephalometry↗