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PubMed1985

Crown preparations for semiprecision attachment removable partial dentures.

The utilization of intracoronal or extracoronal removable partial denture attachments in conjunction with a fixed retainer applies additional stresses to the structural durability of the fixed retainer and its integrity with the underlying abutment. Therefore, the utilization of this attachment with a fixed retainer requires understanding and diligent application of the basic principles of fixed prosthodontics.The primary objective of prosthodontics must be the preservation and health of the remaining existing tissues and structures: teeth, periodontal tissues, temporomandibular joint, and oral facial muscles. This must be of primary importance as we achieve our goals of (1) eliminating existing pathology, (2) restoring morphology and function, and (3) improving esthetics and thereby heightening self-esteem and the psychological well-being of the individual. These objectives make us sensitive to the considerations we have discussed in preparation design and the tissue management required in the fabrication of fixed retainers.

Crowns↗
PubMedDate not supplied

Clinical outcome of glass-fiber-reinforced crowns and fixed partial dentures: a three-year retrospective study.

OBJECTIVE: Glass-fiber-reinforced resin composites for the fabrication of esthetic single crowns and fixed partial dentures have been developed recently. However, little data on the clinical outcome of such restorations have been published. The purpose of this retrospective study was to evaluate the clinical outcome of crowns and fixed partial dentures made from the glass-fiber-reinforced resin composite material Targis/Vectris. METHOD AND MATERIALS: Between 1995 and 1997, 39 patients were treated with 67 single crowns and 83 fixed partial dentures. Twenty-five crowns and 28 fixed partial dentures were cemented with temporary cement, while 42 crowns and 55 fixed partial dentures were cemented with either zinc-phosphate cement or glass-ionomer cement. RESULTS: In September 2001, 57 restorations in 17 patients were still in function. The three-year survival rate calculated according to the Kaplan-Meier method was 58.8% for all restorations. However, after this time, it was 37.5% for crowns and 59.9% for fixed partial dentures cemented with temporary cement, and 55.1% for crowns and 67.9% for fixed partial dentures cemented with zinc phosphate or glass ionomer. The differences between the restoration groups were not statistically significant. CONCLUSION: Glass-fiber-reinforced crowns and fixed partial dentures made with the glass-fiber-reinforced resin composite material Targis/Vectris showed a lower survival rate than that published for metal-ceramic crowns and fixed partial dentures. Therefore, the use of this material for the fabrication of single crowns or fixed partial dentures as permanent restorations cannot be recommended.

Adult↗
PubMedDate not supplied

Maintenance of the interdental papilla following anterior tooth removal.

Soft and hard tissue recession following the removal of an anterior tooth presents a unique restorative challenge for the treatment team. The dental literature has examined postextraction tissue loss and proposed multiple solutions for this aesthetic complication. The majority of these techniques have focused on the prevention of buccolingual recession of the residual ridge, while the maintenance of the interdental papilla following extraction has received less attention. The purpose of this article is to present a clinical technique for maintaining papillary height and form following single anterior tooth removal.

Cuspid↗
PubMed1995

Hard-copy provisional appliances in the rehabilitation of the edentulous patient.

A technique is described whereby a diagnostic appliance simulating an implant-supported fixed prosthesis for the edentulous patient can be made quickly and relatively inexpensively. Such an appliance gives the patient an understanding of the physical limitations of various modalities of prosthodontic restoration. It is a tool that permits both the patient and the dentist to assess functional, esthetic, and phonetic criteria in the realistic setting of everyday usage. Important decisions regarding future treatment can thus be finalized before a huge financial commitment is made. It is a highly cost-effective technique, both financially and emotionally.

Costs and Cost Analysis↗
PubMed2005

Success rate of root canal treatment in primary molars.

OBJECTIVES: The purpose of the present retrospective large-scale study is to evaluate rate of success of root canal treatments in primary infected molars using Endoflas F.S as a filling material. METHODS: The study material consisted of 382 records of root canal treated primary molars of which 174 teeth with high quality radiographs and sufficient data comprised the 'study group'. The technique for root canal treatment in one visit is described. Treatment was considered success if clinically the tooth was asymptomatic and radiographs showed decrease or no change in pre-existing pathologic radiolucent defects. RESULTS: In the total pulpectomy group there was a statistically significant difference between mandibular teeth presented with a periapical lesion prior to the treatment compared to maxillary teeth. This difference was not significant in the study group. Decrease in post treatment radicular radiographic defects was statistically significant more in the maxilla compared to the mandible. The success rate of teeth restored with a permanent restoration (stainless steel crown or amalgam filling) was statistically significant higher than those teeth left with a temporary filling. There was no statistically significant difference between success rate and the extent of root canal filling material. Rate of success was not statistically different depending on pre-existing radiolucent area prior to RCT. CONCLUSIONS: Endoflas F.S. can be used as an alternative root canal filling material for primary teeth. One condition for success is the prevention of microleakage. A permanent restoration should be placed as soon as possible after clinical signs and symptoms of inflammation are eliminated.

Adolescent↗
PubMed1977

Bacteria in experimentally infected cavity preparations.

The presence of bacteria on cavity walls was assessed histologically following experimental infection by inserting soft carious human dentin or guttapercha temporary filings in 40 monkey teeth. Eighty-five infected cavities which had been restored using zinc oxide-eugenol cement (34 teeth), Ca(OH)2 (39 teeth) or amalgam (12 teeth) were also evaluated. Bacteria could regularly be demonstrated in cavities where soft carious human dentin had remained in the cavities for 82 d, but not, or only very rarely, in any of the other series. It was concluded that vital dentin has considerable resistance against infection and that cavity sterilization appears to be of questionable value.

Animals↗
PubMed1989

Coronal microleakage of permanent lingual access restorations in endodontically treated anterior teeth.

Forty-six intact extracted human anterior teeth were treated endodontically with laterally condensed gutta-percha and sealer. The teeth were restored with a base of either zinc phosphate or temporary stopping and a permanent restoration of either acid etched composite resin with GLUMA as the dentin bonding agent or with Ketac-Fil glass ionomer. The teeth were thermocycled, coated with nail varnish (except for the access), immersed in silver nitrate, developed, and sectioned longitudinally. The linear dye penetration was measured. All restorations permitted leakage into the base. All groups had specimens which leaked into the gutta-percha. There was a tendency for the glass ionomer/zinc phosphate group to leak least, but there were no statistically significant differences among the groups.

Acid Etching, Dental↗
PubMed1989

Immediate esthetic treatment for anterior teeth: report of cases.

Prompt restoration of function and esthetic appearance of dentition can avoid psychological stress and functional problems. Surgical procedures that require long-term bone deposition and soft-tissue healing can accompany periodontal and orthodontic reinforcement, but other less invasive, immediate, intermediate, and final treatment plans can be initiated with good results.

Adult↗
PubMed2000

Clinical evaluation of allografts and homografts for restoration of missing tooth structure.

STATEMENT OF PROBLEM: The clinical performance of bonding human tooth fragments to either replace missing teeth or to restore defective teeth is unclear. Prospective studies can help to predict the success of such treatment options. PURPOSE: This study evaluated the feasibility of bonding tooth tissue homografts and allografts either to replace missing teeth or to restore defective teeth, and estimated the success rate of bonded allograft and homograft restorations 3 years after placement. METHOD AND MATERIAL: Twenty clinical cases were treated by bonding tooth fragments or crowns into 6 groups (Gp): Gp1, cervical erosion and abrasion lesions (6); Gp2, incisal edge fractures (4); Gp3, partially destroyed crowns (4); Gp4, teeth placed in a removable prosthesis (2); Gp5, missing tooth with no opposing tooth (2); and Gp6, temporary space maintenance (2). Restorations were examined using USPHS criteria every 2 months and whenever a patient called to report a failure. RESULTS: After a 3-year follow-up, the overall success rate was 80% for the 20 restorations. The 95% confidence interval was 63% to 94%. Four restorations failed by debonding (Gp2 [2]; Gp5 [1]; Gp6 [1]) during the first 4 months. The main cause of failure appeared to be excessive occlusal loading. CONCLUSION: Within the limitations of this clinical study, the results after a 3-year follow-up showed the success rate was not less than 63% for bonded allograft and homograft restorations.

Dental Bonding↗
PubMed2004

Four years of clinical experience with an adverse reaction unit for dental biomaterials.

OBJECTIVES: We describe the function of, and results from, the Norwegian National Dental Biomaterials Adverse Reaction Unit after 4 years of activity from 1993 to 1997. METHODS: During this period of time, 296 patients were examined at the unit, which is located at the Dental School, University of Bergen. The most prevalent age group was 40-49 years, and 70% were women. Dental amalgam was the primary reason for referral to the unit for nearly 85% of the patients, followed by metals in crowns and bridges (11%). Materials in removable dentures, resin-based filling materials and cements, endodontic materials, and others, including temporary materials, were also involved. Nearly all (96%) patients reported general subjective symptoms, such as muscle and joint pain, fatigue, and memory problems. Complaints involving the orofacial region (lips, face, temporomandibular joint) and intraoral subjective symptoms were also common. RESULTS: Of the patients who were patch tested with substances in dental materials, 23% were positive to gold, 28% to nickel, 14% to cobalt, 9% to palladium, 6% to mercury, and 8% to one or more components of resin-based materials. Mercury concentrations in blood and urine were statistically higher in the patients with amalgam fillings compared with those without. CONCLUSIONS: Generally, we could not establish a straightforward cause-and-effect relationship between the presence of dental biomaterials and general symptoms. Twenty patients were advised to replace restorative materials because of contact lesions. Another 20 patients were recommended replacement of materials because of allergy verified with positive patch tests. The complex nature of most of the reactions requires a multidisciplinary approach to the care taking of patients who are concerned about reactions from dental materials, particularly amalgam.

Adult↗
PubMedDate not supplied

Success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth.

PURPOSE: This study was performed to retrospectively evaluate treatment of deep caries in primary molars with formocresol pulpotomy (FP) and indirect pulp therapy (IPT). METHODS: 133 primary molars with deep caries approaching the pulp were treated with FP (N = 78) or IPT (N = 55) and followed 2-7 years. All IPTs received immediate stainless steel crowns (SSCs); 61 FPs got an immediate SSC, 13 an intermediate restorative material (IRM), and 4 amalgam. Thirteen IPTs and 25 FPs had pre-operative pain compatible with a diagnosis of reversible pulpitis. Treatment notes and radiographs were independently assessed. RESULTS: Overall IPT success was 93% (51/55) versus 74% (58/78) for FP. Molars with pain compatible with a diagnosis of reversible pulpitis were successfully treated by IPT 85% (11/13) versus 76% (19/25) for FP. FP-treated molars exhibited earlier exfoliation 38% (30/78), while all IPT molars exhibited normal exfoliation. FPs receiving immediate SSCs had 50/61 (82%) succeed; FPs restored with an IRM temporary succeeded 5/13 (39%), amalgam 3/4 (75%). CONCLUSIONS: IPT success was significantly higher than FP (P = 0.01) in the treatment of deep caries. Both IPT and FP were successful in treating teeth with pain compatible with the diagnosis of reversible pulpitis. FP significantly hastened the exfoliation of pulpotomized primary molars (P = 0.001). IPT in primary teeth can be successfully used in a one step procedure. SSCs placed immediately after FP significantly increased FP success vs. FP followed by IRM temporary (P = 0.01).

Chi-Square Distribution↗
PubMedDate not supplied

Computerized milled solid implant abutments utilized at second stage surgery.

Single tooth restoration with implants traditionally has been complicated due to the difficulty in achieving ideal emergence profile and crown form. The Atlantis milled abutment overcomes these difficulties, utilizing CAD/CAM technology to develop a customized milled abutment with ideal emergence profile and shape to simplify crown fabrication.

Adult↗
PubMed2005

Observations on pulpal response to carbon dioxide laser drilling of dentine in healthy human third molars.

Preservation of pulpal health is the primary prerequisite for successful application of laser systems in the hard tissue management of vital teeth. The purpose of this study was to investigate the short and long-term pulpal effects to cavity preparations in healthy human teeth using carbon dioxide (CO2) laser. A total of seven, healthy, third molars that were scheduled to be removed due to space problems were used. After the laser drilling, the occlusal cavities were closed temporarily, and the teeth were extracted 7 days (n=5) and 3 months (n=2) after the operation. The specimens were fixed, decalcified, subdivided and processed for light and transmission electron microscopy. Seven days postoperatively all the five teeth that had been irradiated with the CO2 laser did not reveal any pathological changes in the pulpo-dentine complex. Three months postoperatively the two teeth that were prepared with the laser showed subtle but distinct apposition of tertiary dentine that was lined with intact odontoblasts. One of the specimens at 3 months revealed the presence of a mild, but very circumscribed, pulpal infiltration of chronic inflammatory cells subjacent to the cavity preparation. The latter is unlikely to be due to a direct effect of the laser irradiation but a possible consequence of microleakage of oral antigens and/or other tissue-irritating molecules through the temporary restoration and the remaining dentine thickness (RDT). Although these preliminary histological results suggest that the CO2 laser under investigation induced only minimal response of the dentine-pulp complex when used as a hard-tissue drilling tool, with specific energy settings, pulse duration within thermal relaxation time and emitting radiations at 9.6 microm of wavelength, larger clinical trials involving various types of teeth are necessary to reach definite conclusions for large-scale clinical application of the laser device.

Carbon Dioxide↗
PubMed2005

The failure rate of adhesively retained composite core build-ups in comparison with metal-added glass ionomer core build-ups.

OBJECTIVES: The purpose of this study was to evaluate the clinical performance of two adhesively retained composite core materials and compare them with a metal-added glass ionomer. The main objective evaluated was total or partial loss of build-ups during the treatment prior to crown cementation. METHODS: In 187 patients, 315 vital and non-vital teeth were built up after randomisation with either Rebilda D (RD), Rebilda SC (RSC) or Ketac Silver Aplicap (KSA). The composites were applied in the total-etch-technique with the corresponding dentin bonding agent. The metal-added glass ionomer was used with a conditioner. One group of patients was treated by experienced dentists, the other by dental students, in order to evaluate the effects of different levels of experience. Data were analysed using Mann-Whitney-U-Test and binomial logistic regression. RESULTS: The early failure rate (partial or total loss) of core build-ups before crown cementation was significantly higher for KSA (28.8%), as compared to RSC (15.3%, p=0.037) and RD (15%, p=0.025). Most failures were observed during the removal of the temporary crowns. The rate of replacements was between 3.0 (RD/dentists) and 20.4% (KSA/students). Furthermore, we found that build-ups made by students had a significantly higher risk of loss than those made by dentists (p=0.028). CONCLUSIONS: Adhesively retained self-curing composites show a better clinical short-term performance and can be recommended as core build-up materials.

Adhesives↗
PubMed1991

Human saliva coronal microleakage in obturated root canals: an in vitro study.

This study assessed salivary penetration through obturated root canals as related to time by using two methods of analysis--histological examination and dye penetrations. A total of 160 human maxillary anterior teeth were instrumented to size 60 Hedstrom file. Ten of the teeth were not obturated; 150 teeth were obturated by lateral condensation of gutta-percha and Roth's root canal sealer. Fifty of these teeth received intermediate restorative material temporaries to a thickness of approximately 3 mm. All teeth were immersed in 50 ml of whole human saliva and kept at 37 degrees C and 100% humidity. The saliva was changed daily. At 2, 7, 14, 28, and 90 days, 32 teeth were removed from the saliva. Of these, two were unobturated and were examined for bacterial penetration by culturing of the apical one-third. Ten teeth without temporaries were immersed in Pelikan ink for 2 days to demonstrate the extent of salivary penetration. These teeth were decalcified and cleared to allow direct measurement of dye penetration. Decalcified serial 7-microns-thick sections were prepared from the remaining 20 teeth, 10 with and 10 without intermediate restorative material temporaries. The sections were stained with hematoxylin and eosin stain and Brown and Hopps stain. Saliva penetration assessed in histological sections was significantly less than was visualized with dye analysis. Salivary penetration at 3 months was significantly greater than at the four earlier study periods. This amount of salivary penetration was considered to be clinically significant. The results strongly suggest retreatment of obturated root canals that have been exposed to the oral cavity for at least 3 months.

Analysis of Variance↗
PubMed1980

Provisional restorations for traumatically injured teeth requiring endodontic treatment.

The acid-etch-composite resin technique is used to retain a provisional restoration during the course of endodontic treatment. As described, the use of a gutta percha cone during the buildup and bonding to adjacent teeth provides the following: (1) good esthetics during endodontic treatment, (2) good support for rubber dam placement, (3) good entry to the canal, (4) good coronal seal for medication within the canal, and (5) good function as required by the provisional crown.

Acid Etching, Dental↗
PubMed1982

Technique for making a template for temporary restorations.

A fast, accurate, and simple technique for fabricating custom templates used to construct customized acrylic resin temporary crowns and fixed partial dentures has been presented. Acrylic resins are used directly on the diagnostic cast to restore single tooth contours, secure pontics to the cast, and to contour edentulous areas. Duplicate casts and impressions are not needed. Acrylic resins prove superior to wax and other materials for constructing custom templates because they will not distort or melt under the heat and pressure of the thermal vacuum machine. Thus, the template is accurate and free of melted residue on the inner template surface.

Acrylic Resins↗
PubMed1999

Restoring the gingival contour by means of provisional resin crowns after single-implant treatment.

A consecutive group of 55 patients was treated with 63 single-implant restorations. The soft tissue was allowed to heal to either provisional resin crowns (n = 25) that were placed at the time of second-stage surgery, or to healing abutments (n = 38) before final crown insertion. An index that assessed the size of the interproximal mucosa adjacent to the single-implant restorations was used to evaluate the volume of the papillae 2 years after crown insertion. The results indicated that the use of provisional crowns may restore soft tissue contour faster than healing abutments alone, but the papillae adjacent to single-implant restorations presented similar volume in both groups after 2 years in function. Furthermore, the mean marginal bone loss at the implants was 0.9 mm after 1 year, and no differences were observed between the 2 groups. The present data focus on the need for more scientific data to evaluate different clinical procedures for optimizing esthetic results in implant dentistry.

Adolescent↗