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PubMed1990

Diagnosis and treatment of dental emergencies in two Finnish cities.

According to the present clinical survey of dental emergencies treated by organised emergency services in two of the larger Finnish cities, the main causes (64 per cent) of the problems leading to these visits were caries and its consequences. In about 80 per cent of the 839 cases treated, the acute treatment was based on clinical examination only. Temporary fillings were provided for 19 per cent, permanent fillings for 8 per cent, endodontic treatment for 22 per cent and extractions for 14 per cent of the patients. Extractions were most often provided for patients who normally visited a dentist irregularly and these had a low mean number of teeth. Patients with pain lasting longer than a week were likely to receive endodontic treatment, whereas permanent fillings were provided for regular dental visitors who had their own dentists. About 90 per cent of the patients were considered to need other dental treatment in addition to the treatment of the acute condition.

Adult↗

PubMed1994

Shear bond strength of a composite resin after delayed bonding to a polymerised dentine bonding system.

Polymerised adhesive may serve as a temporary sealant on prepared dentine surfaces and may be used as a precursor to the final bonding of a resin restoration. This procedure may, however, have an adverse effect on the strength of the final bond. This study was undertaken on 40 extracted human molar teeth to assess the effect of delayed bonding on the shear bond strength of a composite resin luted with a luting resin to abraded dentine treated with the Scotchbond Multi-Purpose (SMP) Bonding System (3M). No significant difference (p = 0.969) could be demonstrated between shear bond strengths achieved after immediate and delayed bonding to the polymerised Scotchbond Multi-Purpose adhesive.

Analysis of Variance↗

PubMed1989

Bacteriostatic effect of tetracycline in a temporary cement.

Temporary crowns with subgingival margins can result in gingival inflammation. This inflammation is the result of plaque accumulating at the restoration-tooth interface and a change in the nature of that plaque to one associated with periodontitis. It was postulated that tetracycline incorporated in a slightly soluble cement would be released in the sulcus and decrease the amount, and improve the quality, of the subgingival microflora. The unknown was whether tetracycline is inactivated by any of the components of the temporary cement Temp Bond. To determine this concern, disks of Temp Bond cement with and without varying concentrations of tetracycline were anaerobically incubated in cultures of Bacteroides gingivalis. Results showed that tetracycline incorporated in Temp Bond at 10% by weight is highly bacteriostatic while retaining typical working properties of the cement.

Bacteriological Techniques↗

PubMedDate not supplied

A prospective clinical study evaluating the safety and effectiveness of narrow-diameter threaded implants in the anterior region of the maxilla.

The aim of the present study of single-tooth implants was to compare the success rate and marginal bone resorption of a narrow-diameter self-tapping implant placed in less available bone volume with the standard-diameter self-tapping implant placed in a well-dimensioned alveolar process. A new abutment technique and a different permanent abutment design were also evaluated. Fifty-five patients were included in the study; 27 patients received 28 standard-diameter (3.75-mm) implants, and 28 patients received 32 narrow-diameter (3.25-mm) implants replacing either a central or a lateral incisor in the maxilla. In an attempt to create an ideal emergence profile and to regenerate papillae, individual acrylic resin tooth-shaped temporary abutments were fabricated, based on impressions made immediately following implant placement, and connected to the implant after 6 months. A minimum of 2 months were then allowed before definitive restorative procedures were performed. Impressions were always made at the implant level. Follow-up examinations were performed at 6 months after loading and 1, 2, and 3 years after loading. Two narrow-diameter implants were lost after 6 months, but no other failures were subsequently observed in any of the groups after that. In both groups, marginal bone loss followed the same pattern and was recorded radiographically to be a mean of 0.4 mm from the first to the last examination.

Adolescent↗

PubMedDate not supplied

A comparison of wire- and Kevlar-reinforced provisional restorations.

Stainless steel wire 0.036 inch in diameter was compared with Kevlar 49 polyaramid fiber as a means of reinforcing a four-unit posterior provisional fixed restoration with 2 pontics. Three reinforcement patterns for wire and two for Kevlar 49 were evaluated and compared with the control, which was an unreinforced provisional restoration. A central tensile load was placed on the cemented provisional restoration and the variables were measured: (1) the initial stiffness; (2) the load at initial fracture; and (3) the unit toughness, or the energy stored in the beam at a point where the load had undergone a 1.0-mm deflection. Statistical analysis showed (1) the bent wire configuration had a significantly higher initial stiffness (P < or = .05), (2) there was no difference between designs for load at initial fracture, and (3) the bent wire had a significantly higher unit toughness value (P < or = .05).

Analysis of Variance↗

PubMed1994

A technique for developing a master cast with previously made dies.

This article describes a technique for preparing final working casts to be used in the laboratory phase of restorative treatment. The goal is to produce accurate working casts that have stable dies which are easily removed from the base and reliably replaced. Most casts with removable dies are made from a single master impression. However, individual dies are sometimes made previously from individual tooth (preparation) impressions. In such cases, transfer copings are required to relate the dies and produce the final working cast. Hollow plastic casting sprues are used as temporary dowels in this technique until a transfer coping pickup impression has been made. After the dies are seated and secured in the transfer coping pickup impression, the plastic casting sprues are replaced with conventional brass dowel pins. This technique ensures well-placed dowel pins that will facilitate easy and accurate withdrawal and replacement of the dies.

Dental Casting Technique↗

PubMed2005

Halitosis: a review.

Halitosis, or bad breath, is caused by mainly volatile sulfur compounds (VSC) as a result of bacterial breakdown of protein and can be quantitatively and qualitatively measured in the expired oral breath. In eight to ninety percent of cases, halitosis originates in the mouth due to inadequate plaque control, periodontal disease, dry mouth, faulty restorations, and in particular due to excessive bacterial growth on the posterior third of the dorsal surface of the tongue. In the remaining ten to twenty percent of cases, bad breath is caused by systemic disorders such as hepatic, pancreatic and nephritic insufficiencies, trimethylaminuria, upper and lower respiratory tract infection, medication and cases where gastric content may generate oral malodour. The methods of detecting or diagnosing halitosis are organoleptic or human sense of smell, sulfide monitoring and gas chromatography. All of these methods have limitations and disadvantages. A more accurate, analytical system which will be able to precisely detect the volatile compounds in the expired air and correlate the results to a specific cause is not yet available. Dental professionals require a good knowledge on the subject of bad breath in order to feel secure about counseling and managing patients suffering from this condition. The management of halitosis involves maintenance of plaque control, elimination of active periodontal disease and cleaning the tongue on a routine basis. Oral rinsing with a mouthwash could be indicated in some instances, as a temporary measure.

Bacteria, Anaerobic↗

PubMed1991

Effect of aging on temporary cement retention in vitro.

Retention of restorations cemented with temporary cement varies. Some cements are adhesive and others are weak in retention. In addition, cement retention may vary over time. This study determined (1) the retentive properties of four temporary cements, and (2) the effects of aging on temporary cement retention. Cylindrical amalgam cores and mated stainless steel retainers with a 0.05 mm cement space were used in the study. Cores were cemented into the retainers and stored in 100% humidity at 37 degrees C until tested. Retention was measured by applying a compressive force to the cores through a rod in an Instron machine. Half the samples were tested after 1 week and half were tested after 6 weeks. The results indicate a significant difference in retentive value among the four cements, including a significant decrease in retention for one cement over the 6-week aging period.

Cementation↗

PubMed1987

Influence of temporary filling materials on effect of dentin-bonding agents.

Dentin cavities, prepared in extracted human teeth, were filled with a dry mixture of zinc oxide-eugenol (ZOE) or a commercial temporary filling cement without eugenol (Cavit). The ZOE was removed 3 h later while the Cavit was removed after 7 days. The cavity wall and the surrounding dentin were then treated with a dentin-bonding agent before application of a restorative resin. The width and the extent of the marginal contraction gap were measured, using a light microscope, approximately 0.1 mm below the original free surface of the filling. It was found that the contraction gap was markedly increased in cavities previously filled with ZOE while the non-eugenol cement had no influence on the effect of the two dentin-bonding agents tested. The short-term test applied in the present study indicates that ZOE should not be used in cavities later to be restored with dentin-bonding agent and resin.

Adhesives↗

PubMed1989

A new method for generating ceramic restorations: a CAD-CAM system.

The CAD-CAM CEREC system is a small, complex unit developed for electronically designing and milling ceramic restorations. The system makes it possible to generate a restoration without taking impressions, developing temporary prostheses, and without laboratory assistance. The entire restorative procedure is performed in one appointment. Basic features include the following: the cavity preparation is scanned stereo-photogrammetrically, using a three-dimensional miniature video camera; the small microprocessor unit stores the three-dimensional pattern depicted on the screen; the video display serves as a format for the necessary manual construction via an electrical signal; the microprocessor develops the final three-dimensional restoration from the two-dimensional construction; the processing unit automatically deletes data beyond the margins of the preparation; the electronic information is transferred numerically to the miniature three-axis milling device; driven by a water turbine unit, the milling device generates a precision-fitting restoration from a standard ceramic block; the entire process of electronic designing and subsequent milling of a ceramic restoration requires approximately 10 to 15 minutes.

Computer Simulation↗

PubMed2003

The Umgeni bridge, a resin bonded pontic using a preformed fibre post an aesthetic procedure of low biological and fiscal cost.

A missing anterior tooth or open embrasures destroys the aesthetics of a smile. The replacement of a missing anterior tooth is one of the most rewarding and challenging aspects of restorative dentistry. There are a number of techniques to do this, however, most involve the use of a technician, which means additional cost to the patient and multiple visits. In today's financial climate with practice expenses climbing and medical aid remuneration dwindling, one must seek methods to reduce costs and provide patients with more affordable dentistry. In addition, in crisis situations such as the traumatic loss of a tooth an immediate replacement technique albeit temporary is necessary. To replace a missing anterior tooth directly and immediately presents a rewarding challenge to the clinician. The Umgeni bridge named after the river that flows on the north side of Durban, is particularly useful in replacing congenitally missing laterals after completion of orthodontic treatment in the case of congenitally missing laterals and cleft palates.

Acid Etching, Dental↗

PubMed2006

[Rehabilitation of an abraded occlusion with Procera-ZrO2 all-ceramic crowns. A case report].

The rehabilitation of a patient with advanced tooth wear by means of Procera ZrO2 ceramic crowns is described. A healthy, 60 year old patient complained about front teeth esthetics and impaired function due to reduced tooth height. He was aware of bruxism and wished full mouth rehabilitation. The clinical examination showed that tooth wear was generalized, but most teeth could be maintained in both jaws. A staged procedure was planned, starting with a splint therapy and a provisional fixed prosthesis to reestablish correct vertical dimension of occlusion (VDO) and stable occlusal contacts. The new ZrO2 material with the Procera technique was chosen to restore all teeth in both jaws, except the mandible front teeth. In the second treatment phase, crown lengthening of the maxillary front teeth was performed and one implant placed to replace a maxillary premolar. After final tooth preparation, impression taking and bite registration the ZrO2 crown-copings were scanned, processed and completed by veneering. A flat occlusal scheme with stable front teeth guidance was established. The advantage of the presented treatment is the esthetic result in combination with a material of high mechanical and biological quality.

Bruxism↗

PubMed2001

Interdental wiring in jaw fractures: effects on teeth and surrounding tissues after a one-year follow-up.

Several authors have suggested that interdental wiring may have an adverse effect on the teeth and surrounding tissues. In the present study we examined 250 teeth that had been subjected to wiring and 142 adjacent teeth that had not been wired (controls). During the wiring period, and after a minimum of 1 year following treatment of the jaw fracture, the teeth and periodontal tissues were examined by periodontal probing, percussion sound test, mobility test, sensitivity test, and radiography. One tooth showed temporary increased mobility. Periodontal health was clinically and radiologically fully restored after a year in all teeth. Progressive caries was seen in 2 patients and was treated. Loss of sensitivity was seen in 3 teeth adjacent to the fracture site and in one tooth adjacent to a titanium cortical screw. However, these pulpal changes either recovered spontaneously or were treated endodontically. There were few late problems in the teeth and surrounding tissues. In 243 teeth (97%), completely healthy conditions were found in pulp and periodontium. There was no evidence of root resorption or dentoalveolar ankylosis. We conclude that late deleterious effects on the teeth and periodontal tissues from interdental wiring in the treatment of jaw fractures were uncommon 1 year after the removal of the interdental wiring.

Adolescent↗

PubMed2001

Salivary levels of mutans streptococci associated with restorations: a case-control study.

Our aim was to estimate whether restorative therapy with amalgam and composite resin could decrease salivary mutans streptococcal level, thus also decreasing the risk for other caries development. We selected a case group of 93 children with detectable salivary mutans levels (i.e., at least 1x10(4) cfu/ml), and a control group (n=93 subjects) with undetectable levels. Children had the same age (12 years), no extracted teeth, crowns, temporary fillings, and restorations other than amalgam and composite resin, and the two groups had similar gender distribution. We clinically examined children and recorded active caries, restorations and oral hygiene level by means of gingival bleeding on probing; we also investigated sucrose intake at breakfast. The case group had statistically significant higher prevalence of restorations (36.6% vs. 18.3%), active caries (44.1% vs. 12.9%), and bad oral hygiene (84.9% vs. 68.8%) than the control group. However, the logistic regression analysis showed that presence of active caries was the only significant variable associated with mutans streptococci (OR=4.0; p=0.0002), while the effects of sucrose intake and of restorations were marginally significant. This apparent contrast between statistical analyses was due to the concomitant presence, in children with detectable mutans streptococci level, of restorations and decayed teeth at the same time, and, on the basis of the multivariate analysis, presence of mutans streptococci in these children was explained by the presence of active caries, more than restorations.

Case-Control Studies↗

PubMed1998

Applications of computer modelling for the design of orthopaedic, dental and cardiovascular biomaterials.

Biomaterials do not escape from the general trend present in all contemporary science and technology towards increasing use of computers and information technology. In this paper the use of computer modelling for the design of biomaterials is discussed. The word 'biomaterials' is interpreted in its broadest sense, i.e. referring to any foreign object brought into the body for temporary or permanent use. Computer modelling will first be discussed as a tool to model biological structures (bones, arteries) or to investigate and simulate biological interactions at implant-host interfaces. It will then be illustrated how computer modelling, using insights gained from the modelling of the biological structures themselves, is used in the design process of dental, orthopaedic and cardiovascular prostheses. The area of computer modelling for biomaterials applications has become so vast that an exhaustive overview is impossible in the framework of one paper. Rather, some illustrative case studies will be discussed which are, in the opinion of the authors, representative of general trends in this challenging domain of science on the boundary between engineering and medicine.

Cardiovascular Diseases↗

PubMedDate not supplied

Predictable peri-implant gingival aesthetics: surgical and prosthodontic rationales.

Bone resorption following maxillary anterior tooth extraction is common and often compromises gingival tissue levels for the implant restoration. The creation of predictable peri-implant aesthetics requires proper understanding and preservation of the osseous and gingival tissue surrounding the failing tooth. This article addresses the various factors that affect the predictability of peri-implant gingival aesthetics in anterior single-tooth replacement. The surgical and prosthodontic procedures for maintenance of peri-implant aesthetics are also presented using an ovate pontic tooth on a removable partial denture following immediate extraction and implant placement.

Adult↗

PubMedDate not supplied

Alveolar distraction osteogenesis: a case report involving ankylosed maxillary central incisors.

Restorative dentistry, for the optimal esthetic and functional result, at times requires innovation, exacting techniques, and employment of various treatment modalities. A case has been presented here involving a large esthetic defect in the maxillary anterior. Traditional methods of restoration may have been successful but alveolar distraction osteogenesis was determined to be the treatment of choice due to time, predictability, lack of invasiveness, and cost. It is a relatively new surgical procedure that has many applications to restore esthetic defects, ridge augmentation, and large craniofacial abnormalities. Movement of osseous sections can be made in a vertical, labial, or lingual direction. When treatment planning restorative dentistry with vertical hard and soft tissue deficiencies, alveolar distraction osteogenesis can be considered to achieve optimal esthetics and a more ideal crown-to-root ratio. Further information can be obtained from any oral surgeon, orthodontist, or from the Internet. Dr. Martin Chin, a maxillofacial surgeon from San Francisco, has done much of the clinical work regarding distraction procedures on humans and continues to be an innovator in craniofacial distraction osteogenesis. His work can be found on the Internet at www.distraction.net; other interesting Web sites include www.klsmartin.com/distract.dir/indexdistract.html and www.seattle-implants.com/articles/distost.htm.

Adolescent↗

PubMed2001

[Treatment of Baume class IV pulp diseases with calcium hydroxide: a clinical experimental study in Dakar].

The calcium hydroxide used as intracanalar temporary medication in modern endodontics, is the aim of this clinical and radiographic appraisal of endodontic treatment during two sessions (HESS J. C. and all. 1990); on 22 mature permanent teeth with peri apical lesion. In this second Dakar serial study, the mediate disinfection during 6 weeks in average, was followed by a root canal filling for: 11 mono-radicular teeth by compactage of gutta percha, adjusted monocone for 11 pluri-radicular teeth; and so by definitive coronal restoration. The direct magistral preparations used in this study are not expensive, but simple and efficient; our endodontic processing (pre-treatment and treatment) end up at clinical silence and radiographic apical healing in 90.91% of cases after 9 months for 66.67% of root canal filling located at the safety apical limit.

Adolescent↗