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PubMed1981

Significance of occlusion in the etiology and treatment of early, moderate, and advanced periodontitis.

Elimination of lesions diagnostic of trauma from occlusion is an essential part of complete periodontal therapy and restoration of health in the masticatory system for such patients. This can be achieved by orthodontic treatment, temporary splinting, bite-planes, occlusal adjustment and permanent splinting of teeth. Occlusal therapy may be required during periodontal treatment for trauma from occlusion and to enhance occlusal stability at any stage of periodontitis, but is most often needed in advanced periodontitis. Splinting of hypermobility of self-limiting trauma from occlusion is not indicated. Splinting may be required in addition to occlusal adjustment in moderate to severe periodontitis when trauma from occlusion is progressive.

Animals↗
PubMed2005

A prospective 3-year study of fixed bridges linking Astra Tech ST implants to natural teeth.

BACKGROUND: Connecting teeth and osseointegrated implants in fixed reconstructions is not generally recommended because of differences in their response to loading. AIM: The aim of the present study was to assess the clinical and radiographic performance of the teeth and implants used to support three unit fixed bridges subjected to normal functional loads. SUBJECTS AND METHODS: Nineteen subjects (10 males, nine females, age range 27-65 years) with an edentulous posterior free end saddle in either maxilla or mandible (Kennedy Class 2), and opposing natural teeth or a tooth-supported fixed bridge were treated and completed the 3-year trial. An Astra Tech ST implant (length: 9 mm (n=2), 11 mm (n=9) or 13 mm (n=8); diameter: 4.5 mm) was placed immediately distal to the last tooth or leaving a single premolar sized space. The distal tooth received a gold coping and the implant was restored with a customised Prepable abutment (Astra Tech Profile BiAbutment: diameter 5.5 or 7 mm). A fixed bridge was placed linking the gold coping and implant abutment either with the pontic as a distal cantilever (n=6, length 7-8 mm) or as a fixed-fixed design (n=13, length 6-12 mm). Standardised radiographs and clinical records were taken at delivery of the prosthesis (baseline BL) and annually. RESULTS: Plaque scores at implant sites increased between BL and subsequent years (P<0.02). Statistically significant increases in probing depth were observed at both abutment teeth and implants between baseline and subsequent years (P<0.001). Marginal bone levels (mm) at the implant and tooth were stable between BL, 1-, 2- and 3-year examinations (implant: BL 0.65+/-0.42, 1 year 0.63+/-0.47, 2 years 0.88+/-0.55, 3 years 0.78+/-0.64; tooth: BL 2.29+/-0.82, 1 year 2.41+/-0.8, 2 years 2.38+/-1.02, 3 years 2.68+/-0.86). No signs of the intrusion of the abutment teeth were detected. One case of abutment screw loosening occurred. Eight bridges required re-cementation with a permanent cement in place of the temporary cement. There were eight subjects presenting with fractures/chips to the composite component of the bridges. CONCLUSION: The 3-year results demonstrate fully functional successful restorations with no evidence of tooth intrusion and with stable bone levels at both teeth and implants.

Adult↗
PubMed2006

Reattachment and orthodontic extrusion in the management of an incisor crown-root fracture: a case report.

This article describes the management of a case of oblique crown root fracture of a central incisor where the fractured fragment was used as a temporary replacement crown in order to maintain esthetics during the period of orthodontic extrusion of the remaining root. Placement of the final restoration after orthodontic extrusion resulted in good esthetics and periodontal health postoperatively. The merits and demerits of this treatment modality are discussed.

Adolescent↗
PubMed2002

Prosthetic rehabilitation of extremely worn dentitions: case reports.

The stomatognathic system is a complicated structure, and patients usually adapt to their existing vertical dimension of occlusion. Therefore, prosthetic rehabilitation of decreased vertical dimension of occlusion should be considered only when dictated by esthetic or functional requirements. If the loss of vertical dimension is significant, provisional prostheses should be used before the final prosthesis to prevent tension or pain in the temporomandibular joints and the muscles as the patient adapts to the new dimensions. Acrylic resin provisional prostheses were used for three patients before the final prosthesis was fabricated with the restored vertical dimension of occlusion. The period of use varied, depending on the patient's individual adaptive ability. The important aspect is to find the most comfortable position for the patient.

Adaptation, Physiological↗
PubMed1992

Initiating restorative procedures at the first-stage implant surgery with a positional index: a case report.

With the use of a positional index, the restorative dentist and laboratory technician can be provided with an accurate record of implant fixture location after first-stage surgery. Thus it is possible to fabricate a master cast with implant analogs and initiate laboratory procedures immediately after first-stage surgery, and a provisional restoration can be processed and delivered at the time of second-stage surgery. A case report is presented to illustrate the technique.

Dental Casting Technique↗
PubMed1995

Guided soft tissue healing in implant dentistry.

Frustrations with creating subgingival implant restorations that are aesthetic and maintainable can be alleviated by using surgical indexing; provisionals as implant copings; or corresponding healing abutments and impression copings. Advantages and disadvantages of each are presented.

Dental Abutments↗
PubMed2001

Potential risk of serious oral infections in the diabetic patient: a clinical report.

Diabetes has many manifestations, including increased vulnerability to bacterial and fungal infections, that may be of concern to the dental profession. Oral candidosis and other opportunistic fungal infections may be early, nonspecific signs of uncontrolled diabetes. Rhinocerebral involvement often extends to the paranasal sinuses, pharynx, palate, orbit, and brain, causing severe tissue destruction and necrosis. This clinical report describes a young woman with diabetes who developed mucormycosis of the maxilla. Tissue destruction resulted in loss of the entire premaxilla, the anterior half of the hard palate, and all maxillary teeth except for the right and left second molars. An interim clear acrylic resin prosthesis was fabricated to restore facial contours and speech and to allow mastication. This prosthesis subsequently was duplicated, and teeth were added for improved lip support, esthetics, and mastication.

Acrylic Resins↗
PubMed2006

Treatment of a unilateral Class II crossbite malocclusion with traumatic loss of a maxillary central incisor and a lateral incisor.

This case report describes the multidisciplinary management of an adolescent girl with traumatic loss of the maxillary right central lateral incisors, and a unilateral Class II crossbite malocclusion. A rapid palatal expansion appliance was used initially to correct the transverse deficiency and secondarily as an anchorage unit for unilateral molar distalization to correct the Class II molar relationship. Temporary incisors were extended from a Nance stabilizing appliance during premolar and canine retraction. A staged approach was used with bone grafting before the placement of 2 single-tooth implants. A favorable outcome was achieved through proper coordination among the orthodontist, the surgeon, and the restorative dentist.

Adolescent↗
PubMed2004

In vitro assessment of dentinal permeability after the use of ultrasonic-activated irrigants in the pulp chamber before internal dental bleaching.

This in vitro study aimed to assess dentin permeability quantitatively after the use of different irrigants into the pulp chamber, with or without ultrasonic activation, before the application of an internal bleaching agent. Thirty maxillary anterior teeth, treated endodontically, were randomly assigned to six groups, according to the irrigant used: group I, distilled water; group II, 17% EDTA; group III, 1% sodium hypochlorite; for groups IV, V, and VI, respectively, the same solutions were used, but were ultrasonicated. In groups I, II, and III, the irrigant that filled the pulp chamber was left undisturbed for 15 s and was then aspirated; in groups IV, V, and IV, the irrigants were placed into the pulp chamber, ultrasonic-activated for 15 s, and were then aspirated. This sequence was repeated three times for all groups. Afterwards, for all groups, the pulp chamber was dried, filled with a bleaching agent, and sealed with glass ionomer cement. At each change of the whitening agent, these procedures were repeated. Then, the temporary restorations were removed, access cavities were cleaned, and teeth were immersed in a 10% copper sulfate aqueous solution, submitted to vacuum and immersed in a 1% rubianic acid alcohol solution. Copper ion penetration was revealed by the rubianic acid. After staining, roots were removed at the cemento-enamel junction (CEJ) and sectioned in a mesiodistal direction starting from the cervical plug level. The sections were thinned, observed under an optical microscope, the images were digitized, and copper ion penetration was measured in each section using a specific software. Means and SD were: group I, 2.41 (+/-1.45); group II, 5.22 (+/-1.79); group III, 8.32 (+/-2.55); group IV, 3.73 (+/-0.89); group V, 14.83 (+/-4.99); and group VI, 10.51 (+/-2.65). Statistical analysis using two-way anova and Tukey test showed that, regardless of the irrigant, ultrasonication increased dentinal permeability (P < 0.01). Comparing the overall effectiveness of the tested solutions, EDTA yielded the greatest increase in dentinal permeability (P < 0.01). Based on these results, it may be concluded that use of ultrasonic-activated irrigants in the pulp chamber, before the accomplishment of internal dental bleaching procedures, may result in a remarkable increase of dentin permeability, which may enhance the efficiency of the whitening agent.

Chelating Agents↗
PubMed1991

The implant-supported, heat-processed provisional fixed partial denture.

When fabricating an implant-supported fixed partial denture a provisional prosthesis is commonly required for function and esthetics. A laboratory-fabricated, heat-polymerized provisional restoration will provide excellent fit, function, esthetics, and durability while saving chair time. This article describes the clinical and laboratory procedures for the fabrication of the implant-supported, heat-processed provisional fixed partial denture.

Dental Implants↗
PubMedDate not supplied

A custom titanium implant-retained single-tooth restoration: a clinical report.

Titanium is an inexpensive metal that can be used to create custom cast restorations. Although special investment and casting equipment is needed to make titanium castings, the potential benefit of inexpensive, biocompatible, and custom restorations is significant. Porcelain can easily be applied to titanium with excellent bond strength and esthetics. Problems associated with casting roughness and fit can be corrected using electrical discharge machining. A method of diagnosis and treatment planning that evaluates the restorative space prior to implant placement and eliminates the use of machined components is presented.

Biocompatible Materials↗
PubMed2000

Retrospective study of the clinical performance of fiber posts.

PURPOSE: To evaluate the clinical performance of C-Posts, AEstheti Posts and AEstheti Plus Posts after a period of clinical service ranging from 1-6 yrs. MATERIALS AND METHODS: 1,304 posts were included in the study: 840 Composiposts, 215 AEstheti posts and 249 AEstheti Plus posts were placed into endodontically treated teeth. Four combinations of bonding/luting materials were used. The patients were recalled every 6 months and clinical and radiographic examinations were completed. Endodontic and prosthodontic results were recorded. Actuarial Life Table statistical analysis and Mantel-Haenszel comparison of survival curve have been performed at 95% level of confidence. RESULTS: The 3.2% failure rate was due to two reasons: 25 posts debonded during removal of temporary restorations, and 16 teeth showed periapical lesions at the radiographic examination. No statistical significant differences were found among the four groups. The results of this retrospective study indicate that fiber posts in combination with bonding/luting materials can be routinely used.

Adult↗
PubMed1989

A provisional restoration technique for laminate veneer preparations.

A direct construction technique for laminate veneer provisional restorations uses autocuring acrylic resin and other available armamentarium to facilitate construction. Only a slight preparation modification of the tooth to be treated is necessary to retain the provisional prosthesis.

Dental Impression Technique↗
PubMed1996

Treatment of crown fractures with pulp exposure.

Thirty permanent incisors with vital pulps and complicated crown fractures were treated by a partial pulpotomy (Cvek technique). This consisted of amputation of 1 to 2 mm of the exposed pulp, placement of calcium hydroxide powder, and a temporary restoration. Clinical and radiographic assessment of the hard tissue barrier was done after 3 months and again after 1 to 8 years. The treatment was successful in all incisors. No differences were found in stage of root development, size of exposure, and length of time exposed. In conclusion, the partial pulpotomy technique is a successful and permanent treatment for crown fractures with pulp exposure regardless of the size of exposure, the maturity of the root, or the interval between accident and dental treatment.

Adolescent↗
PubMed1994

Transferring provisional restorations to final master casts.

Many principles guide preparation and fitting of provisional restorations. Their importance as a diagnostic tool is considered. Aesthetic, phonetic, functional, parafunctional and dysfunctional factors after evaluation in the provisional restorations have to be transferred to the master cast to incorporate them into the final restoration. A method for transferring morphology of provisional restorations to the master cast through preparation of a wax analogue fixed partial denture is presented. This method is precise, practical, suitable for most rehabilitation cases, and not clinically time-consuming since most stages are carried out in the dental laboratory.

Dental Casting Technique↗
PubMed1990

Implant prosthodontics contribute to restorative dentistry.

This paper is directed toward dental practitioners who accomplish the prosthodontic procedures for dental implants. It includes a discussion of most of the major steps in current implant dentistry. Several implant systems are compared with a look at the future of implant prosthodontics.

Dental Implantation, Endosseous↗
PubMed1996

Provisionalization of a combination implant/natural abutment restoration.

This article describes a technique the dental technician can use to fabricate a long-term combination implant and natural tooth provisional prosthesis that will be used to evaluate esthetics and function. This provisional will act as an interim prosthesis while additional implants are healing.

Dental Abutments↗