Single appointment crown and bridge. An innovative technique.
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A promising method of fabricating porcelain esthetic resin-bonded pontics is proposed. CAD-CAM crown software in the CEREC system is edited and modified to mill the replacement for a missing lower incisor out of a block of porcelain.
Congenital labiomaxillary clefts result from the absence or incomplete fusion of the maxillary and medial nasal processes with resultant hard and soft tissue defects. Comprehensive treatment of these defects requires the collaborative efforts of surgeons, orthodontists, restorative clinicians, and laboratory technicians. Precise periodontal and orthodontic treatments must be carefully coordinated with the restorative plan to ensure sufficient space and tissue architecture for the definitive restorations. This article describes the multidisciplinary treatment of a cleft lip/palate patient using conservative fixed and removable restorative options to provide aesthetic restoration.
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Restoring a tooth with an inadequate contact point and root proximity is a challenge to the practitioner. Ignoring such situations or making compromises in the treatment plan may hinder a successful treatment outcome. Treatment options include strategic extractions, sectional orthodontics, and minor orthodontic movements. The purpose of this article is to discuss the clinical problems and difficulties arising from this situation and to present a modified treatment modality through two case reports. Elastic separating rings, which open an interdental space for placing orthodontic appliances, can be modified to serve as a preprosthetic means for solving mesiodistal crowding of teeth in daily practice. The classic method is modified by the use of elastic rings in sequentially increased thickness, so that the space gained with one ring is followed and increased with a thicker one. An orthodontic background and special instruments are not necessary.
PURPOSE: To clinically evaluate conservative fiber-reinforced composite inlay fixed partial dentures (IFPDs) bonded to inlay abutments. MATERIALS AND METHODS: Forty fiber-reinforced composite IFPDs were made for 29 patients. Restorations were manufactured with the composite Targis reinforced by Vectris prefabricated glass-fiber elements and were inserted with a high viscosity insertion technique. Forty bonded IFPDs were examined clinically after 1 year, and 25 after 2 years, using modified USPHS criteria. Twenty-five abutment inlays and 12 pontics were analyzed quantitatively by scanning electron microscopy SEM. Results were tested for statistical significance with ANOVA. RESULTS: Although most clinical criteria were rated "alpha", four IFPDs had to be replaced: two retainers debonded and two presented total delamination of veneering material from fiber framework. Two partial delaminations were repaired intraorally. No fractures of framework were observed. SEM marginal analysis of tooth-composite interface exhibited 96.5 +/- 3.0% continuous margin at baseline, 91.0 +/- 5.7% at the 1-year and 89.6 +/- 5.2% at the 2-year recall. Decrease of marginal quality was statistically significant between baseline and 1 year (P= 0.001), but not between 1- and 2-year recalls.
This article represents a clinical report from daily experience with the C-POST system, a carbon-fiber post for core build-up. The C-POST was invented in France in 1988 and introduced in Sweden in 1992. When I first started using the system, little literature about it had been published. Because the C-POST fits well in the modern bonding concept, it has become my therapy of choice. In my practice, more than 900 treated teeth have been registered in a computer so that treatment progress can be followed. Every treated tooth was registered according to the type of primer, cement, core material, number of posts, and type of prostheses used. The prosthetics included large composite fillings, porcelain crowns, and/or metal crowns or bridges from 3 to 12 units. Of the 900 treated teeth, 173 of them are between 3 and 4 years old, 2 contain fractured roots, and 1 had a post fracture. This article describes how to fabricate a C-POST core build-up and contains clinical hints and advice. Other applications for the post, such as splinting, bridges, and repair of fixed prosthodontics and vital teeth, are discussed.
Inherent differences have been identified between multidisciplinary and interdisciplinary treatment approaches. This article demonstrates the restorative techniques used for the treatment of a patient with congenitally missing lateral incisors according to the interdisciplinary concept outlined in Part I. The restorative design and material selection were based on the size and shape of the existing ridge, occlusion, evaluation of previous treatment, the ability of the restoration to mimic the natural dentition and the supporting gingival tissues, and the patient's expectations and finances.
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All-ceramic systems have been utilized for fixed partial dentures (FPDs) to replace a missing tooth since the early 1990s. Clinical studies that assess the long-term outcome of both anterior and posterior three-unit all-ceramic FPDs are required to determine whether they can serve as a viable treatment option for functional and aesthetic tooth replacement. This article discusses the evolution and development of all-ceramic systems for FPDs as well as the clinical and laboratory considerations for treating patients using these restorations.
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The purpose of the study was to compare the segmental measurement tool from the Shick Technologies CDR digital system with the conventional film radiography measurement technique to determine preoperative working length. Natural extracted human teeth with varying degrees of root curvature were used. All teeth were imaged using the Shick Technologies CDR direct digital system and conventional E-speed film. Measurements from digital radiography and conventional film were compared with measurements made directly from the endodontic files. The Wilks' Lambda multivariate test was used. The mean measurement of each modality was compared with the other and with the gold standard. The test showed statistically significant differences between the two modalities at p<0.05. The mean measurements for both modalities were not significantly different from the gold standard. The modality most closely approaching the gold standard was the conventional film.
Root perforations are significant complications of endodontic treatment. However, when teeth are of strategic value, perforation repair is clearly indicated. The successful utilization and placement of a subgingival resin-ionomer restoration to repair an endodontic root perforation is demonstrated. Sustained tissue health and minimal probing depths at the surgical site demonstrate clinical success.
Tooth wear leads to alterations in both static and functional occlusal contacts and may contribute to temporomandibular joint disorders and dysfunction. Treatment of tooth wear may be time consuming, expensive and destructive of remaining tooth tissues. Bruxism has been associated with the recording of abnormally high clenching forces. This paper describes a technique for the provision of the canine riser restoration, which deliberately alters the cuspal incline in canine teeth to provide a canine guided occlusion. These restorations may help to control excessive loading of teeth, limit further tooth wear and assist in the management of temporomandibular disorders and dysfunction.