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PubMed2004

What is minimally invasive dentistry?

Minimally Invasive Dentistry is the application of "a systematic respect for the original tissue." This implies that the dental profession recognizes that an artifact is of less biological value than the original healthy tissue. Minimally invasive dentistry is a concept that can embrace all aspects of the profession. The common delineator is tissue preservation, preferably by preventing disease from occurring and intercepting its progress, but also removing and replacing with as little tissue loss as possible. It does not suggest that we make small fillings to restore incipient lesions or surgically remove impacted third molars without symptoms as routine procedures. The introduction of predictable adhesive technologies has led to a giant leap in interest in minimally invasive dentistry. The concept bridges the traditional gap between prevention and surgical procedures, which is just what dentistry needs today. The evidence-base for survival of restorations clearly indicates that restoring teeth is a temporary palliative measure that is doomed to fail if the disease that caused the condition is not addressed properly. Today, the means, motives and opportunities for minimally invasive dentistry are at hand, but incentives are definitely lacking. Patients and third parties seem to be convinced that the only things that count are replacements. Namely, they are prepared to pay for a filling but not for a procedure that can help avoid having one.

Attitude to Health↗
PubMed2006

Effect of setting conditions on mineral trioxide aggregate flexural strength.

This study evaluated the effect of setting conditions (time and hydration) on mineral trioxide aggregate (MTA) flexural strength. MTA beam specimens were allowed to set for either 24 or 72 hours with specimens exposed to moisture on either one or two specimen surfaces. These moisture conditions were used to simulate MTA setting with only external tissue moisture (one-sided moisture) versus tissue moisture in combination with a moistened intracanal cotton pellet (two-sided moisture). Ten specimens were stored at 37 degrees C under each of the four experimental setting conditions (1) 24-hour/moist/2-sided; (2) 24-hour/moist/1-sided; (3) 72-hour/moist/2-sided; (4) 72-hour/moist/1-sided. After storage at respective setting conditions, MTA specimens were tested to failure with three-point bend test to measure flexural strength. Flexural strength of the 24h/moist/2-sided specimens, 14.27 +/- 1.96 MPa, was significantly higher (p < or = 0.05) than the flexural strength values associated with conditions two, three, and four, respectively, 10.77 +/- 1.44, 11.16 +/- 0.96, 11.18 +/- 0.99 MPa, which were not significantly different from each other (p > 0.05). Clinically, these results suggest that a moistened cotton pellet should be placed on the intracanal MTA surface under a temporary restoration; and if possible, to optimize flexural strength, the moistened pellet should only remain in place for 24 hours.

Aluminum Compounds↗
PubMed2005

Socket preservation followed by dental implant supported restorative treatment: a case report.

Implant-supported restorative treatment continues to revolutionize all aspects of dentistry. Any clinical procedure(s) with the potential to enhance and improve the success of implant-supported restorative treatment will gain favor with both practitioner and patient. Socket preservation following tooth extraction appears to offer several clinical advantages in preparing the ridge for future implant placement. A case report is presented describing treatment of a patient with evidence of root resorption of the maxillary central incisors, resulting in extraction and socket preservation followed by implant supported restorative treatment.

Adult↗
PubMed2001

Overlay removable partial dentures for a patient with ectodermal dysplasia: a clinical report.

The orofacial characteristics of ectodermal dysplasia include anodontia or hypodontia, hypoplastic conical teeth, underdevelopment of the alveolar ridges, frontal bossing, a depressed nasal bridge, protuberant lips, and hypotrichosis. Patients with this disease often need complex prosthetic treatment. The options for a definitive treatment plan may include fixed, removable, or implant-supported prostheses, singly or in combination. However, financial constraints and other priorities can prevent patients from choosing the most desirable treatment. This clinical report describes the diagnosis and treatment of ectodermal dysplasia in an 18-year-old man. The treatment included interim removable partial dentures fabricated to establish an acceptable therapeutic occlusal vertical dimension, followed by definitive overlay removable partial dentures and composite restorations.

Adolescent↗
PubMed1990

[Treatment planning for patients with periodontal disease].

The planning and execution of dental treatment in patients suffering from (severe) periodontal disease has to be carried out thoroughly and systematically. Based on a proper diagnosis and prognosis (problem analysis), a temporary treatment plan (problem solution) will be formulated. The initial (periodontal) treatment is concluded with a reevaluation. After this new diagnosis, and if necessary adjustment of the original goal of the treatment plan, a definite treatment plan can be effected. Also in this plan, the therapy must be carried out in separate phases with evaluations in between. Primarily, the periodontal therapy must be finalized, after which the definite restorative-prosthetic treatment can be carried out. A good cooperation between the dentist, dental hygienist and patient is of prime importance to achieve a permanent result. The principles of periodontal treatment planning are discussed in this contribution.

Humans↗
PubMed2001

Tissue preservation for single-tooth anterior esthetics.

Placing implants in the esthetic zone can be difficult because of the expectations of the patient. Inevitably, the hard and soft tissue architecture is lost after extraction in the traditional two-stage procedure, and additional surgical procedures are required to restore the tissue that has been lost. The authors describe techniques that can be applied to retain ideal soft tissue if it is present and predictably restore tissue that is less than ideal.

Adolescent↗
PubMed1997

An in vitro study of coronal microleakage in root-canal-treated teeth restored by the post and core technique.

The aims of this study were to compare coronal microleakage around cast and prefabricated post and cores and to examine the coronal seal achieved by temporary post crowns. Thirty extracted, single-rooted, human teeth were prepared chemomechanically, root filled with gutta-percha and sealer and prepared for a standard post. Three groups, each of 10 teeth, were restored with either: (i) cast post and cores cemented with zinc phosphate cement; (ii) prefabricated posts and composite cores cemented with a composite luting cement; or (iii) temporary post crowns cemented with a temporary zinc oxide-eugenol cement. The teeth were thermocycled and placed in Indian ink for 1 week, then demineralized and rendered transparent. Linear coronal dye penetration around the posts was measured and recorded. Results indicated that while cast post and cores and prefabricated posts and composite cores produced a good seal, leakage was significantly greater with temporary post crowns (P < 0.05). It is concluded that to prevent re-infection of the root canal system, it may be preferable to restore the tooth immediately with a prefabricated post and composite system rather than place a temporary post crown and subsequently a cast post and core.

Analysis of Variance↗
PubMed1985

Periodontal aspects of porcelain restorations.

At present, no man-made restorative can match the biologic acceptance of a hygienic natural tooth surface. Ideally, no restorative material would approach the gingival apparatus. However, as case demands often dictate violating this ideal, careful adherence to the principles discussed will minimize the damage to the periodontium. Ultimately, the response of the periodontal tissue will give the final approval or disapproval of any restorative procedure. The principles discussed must be considered at all phases of any restorative procedure. They must always be of primary concern.

Animals↗
PubMed1992

A vinyl polysiloxane die used to make interim restorations.

A die made of vinyl polysiloxane is a great aid for making interim restorations and for establishing correct gingival contours for finer restorations. This article describes the rationale and procedures for such a procedure.

Acrylic Resins↗
PubMed1989

Provisional removable partial and complete prostheses.

The incorporation of the use of provisional removable complete and partial prostheses is an extremely valuable diagnostic and therapeutic modality in the comprehensive rehabilitation of the partially and fully edentulous patient. There is no question that the use of this restoration addresses many of the chief complaints of patients in a timely fashion and, in so doing, builds a high degree of confidence in the dentist by the patient. The evaluation of the provisional restorations and their subsequent refinement results in a higher quality, more predictable definitive restoration. Experience has demonstrated that postinsertion problems are reduced with the definitive prosthesis following successful therapy with the provisional restoration. The provisional prosthesis is also valuable as a "spare" denture after insertion of the definitive prosthesis. The role of the provisional removable prosthesis is readily understood and accepted by most patients, and the appropriate use of these restorations in prosthetic dentistry is an indication of a high-quality, highly individualized, and service-oriented dental practice.

Denture Design↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adult↗
PubMed2003

Selecting treatment options and sequencing treatment in the replacement of 2 maxillary central incisors with implants: a case report.

This article describes treatment provided to replace 2 maxillary central incisors with implant-supported restorations. The site of a missing maxillary central incisor was treated utilizing a bone expansion technique to augment the labial hard and soft-tissue profiles at the time of implant placement. The adjacent central incisor tooth, although destined to be extracted, was retained to serve as an abutment for a fixed provisional restoration until the first implant was deemed to have successfully integrated. At the appointment to uncover this implant, the fractured tooth was extracted and an implant was immediately placed into the socket. The first implant was then used to support the provisional restoration during the healing phase of the second implant. The techniques utilized resulted in optimum soft-tissue contours, allowed the patient to have a comfortable and esthetic provisional restoration, and minimized the number of surgical procedures.

Adult↗
PubMed2006

Restoration of maxillary incisors with a zirconia all-ceramic system: a case report.

The increase in patient demands for enhanced esthetics has prompted the development of several all-ceramic restorative systems. Despite their esthetic advantage, unsatisfactory mechanical properties have restricted the clinical indications of all-ceramic restorations. Recently, densely sintered zirconia-based restorations have become available. This material appears to have adequate strength and toughness to allow for the fabrication of anterior and posterior crowns and fixed partial dentures. This clinical report describes the procedures used for the restoration of maxillary incisors with the zirconia-based Lava system.

Adult↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthdontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adolescent↗
PubMed2002

In vitro strain gauge analysis of axial and off-axial loading on implant supported fixed partial dentures.

The purpose of this study was to compare the in vitro strains on dental implants supporting cement-retained fixed partial dentures under axial and off-axial loading conditions. Ten implants incorporating strain gauges were placed in a certain configuration to simulate different clinical situations and were embedded in an experimental model. Two implant supported three-unit fixed partial dentures were fabricated on four groups of implants, and each group consisted of seven restorations. The prostheses were cemented with a temporary cement. Fifty N vertical load was applied on predetermined axial and off-axial loading locations on the prostheses. Strain indicator readings were recorded at a standardized time following each loading sequence. The point of load transfer affected strains on implants. For all prosthetic designs, off-axial loading generated more strain than axial loading on implants (P < 0.05). In comparison with axial loading, off-axial loading causes bending of the implants that may affect bone loss around the implant collar. Axial loading of implants should be provided by using wide diameter implants, narrow occlusal tables, and proper occlusal contacts on implant restorations.

Analysis of Variance↗