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PubMed2006

Composite partial crowns for injured anterior teeth.

Falls and collisions are the most commonly reported causes of dental injuries. These accidents involve principally the maxillary central incisors, causing uncomplicated crown fracture. Many materials and techniques can be used to restore injured anterior teeth. Adhesive dentistry allows reproduction of the original beauty of the teeth and preservation of almost all dental tissues. The aim of this paper is to propose the use of adhesive composite partial crowns as a conservative approach for restoring injured teeth.

Accidental Falls↗
PubMed2006

Endodontic techniques for scouting the apical thirds of root canals.

It might be said that there are as many endodontic instrumentation techniques as there are operators, although no two clinicians perform the procedure in exactly the same manner. Despite differences, there are basic principles (correct diagnosis, adequate access, adequate irrigation, removal of the entire pulp, instrumentation to the minor constriction of the apical foramen, three-dimensional obturation, etc.) whose observance are consistent with long-term endodontic success. As a subset of these time-honored principles, there are guidelines and techniques for apical third "scouting" and instrumentation, which can also be considered universal, irrespective of the particular instruments or technique used for canal preparation. The purpose of this paper is to describe a scouting technique that is designed to optimize the apical part of root canal preparation. The author first heard the word "scouting" used in the context described by Dr. Clifford J. Ruddle.

Dental Instruments↗
PubMedDate not supplied

Marginal adaptation of 1 fiber-reinforced composite and 2 all-ceramic inlay fixed partial denture systems.

PURPOSE: The aim of this in vitro study was to evaluate the marginal adaptation and retention of inlay fixed partial dentures (IFPDs) made with 1 fiber-reinforced composite and 2 different ceramic materials using quantitative scanning electron microscope analysis after thermal cycling and mechanical loading, which simulated approximately 5 years of oral service. MATERIALS AND METHODS: Eighteen IFPDs made with fiber-reinforced composite (SR Adoro/Vectris), zirconium oxide-TZP (Cercon), and magnesia partially stabilized zirconia (DC-Leolux) covered with silica-based ceramics were tested in this study. The specimens were mechanically loaded in the vestibular cusp of the pontic element in a computer-controlled masticator with 1,200,000 half-sinusoid mechanical cycles of maximum 49 N each at a frequency of 1.7 Hz. A total of 3,000 thermocycles at 5 degrees C and 55 degrees C, 2 minutes each, were performed simultaneously. The marginal adaptation was analyzed at the interface of the luting composite and the abutment inlay/onlay (CI) and at the interface of the tooth and the luting composite (TC). RESULTS: The percentages of continuous margin at the CI interface were 94.6 +/- 3.1 and 88 +/- 6.7 for Adoro/Vectris, 92.9 +/- 5 and 85.7 +/- 6.1 for Cercon, and 96.2 +/- 2.1 and 82.2 +/- 9.8 for DC-Leolux, respectively, before and after loading. The percentages of continuous margin at the TC interface were 86.7 +/- 6.7 and 62.5 +/- 16.4 for Adoro/Vectris, 93.3 +/- 3.4 and 83.2 +/- 5.9 for Cercon, and 96.1 +/- 2.4 and 75.3 +/- 7 for DC-Leolux. Statistically significant differences were found after loading between the fiber-reinforced composite and the 2 ceramic systems at the TC interface. CONCLUSION: Within the limitations of this experimental study with regard to the sample size and contacting vectors, the results showed that flexibility of the framework may play an important role in the marginal adaptation of the IFPDs. More rigid materials may transfer less stress to the margins, thus promoting a more stable adhesion to the dental tissues.

Acid Etching, Dental↗
PubMedDate not supplied

Comparing cutting efficiencies of diamond burs using a high-speed electric handpiece.

This study sought to compare the cutting efficiency of different diamond burs on initial use as well as during repeated use, alternating with sterilization. Long, round-end, tapered diamond burs with similar diameter, profile, and diamond coarseness (125-150 microm grit) were used. A high-torque, high-speed electric handpiece (set at 200,000 rpm) was utilized with a coolant flow rate of 25 mL/min. Burs were tested under a constant load of 170 g while cuts were made on a machinable ceramic substrate block. Each bur was subjected to five consecutive cuts for 30 seconds of continuous operation and the cutting depths were measured. All burs performed similarly on the first cut. Cutting efficiencies for three of the bur groups decreased significantly after the first cycle; however, by the fifth cycle, all bur groups performed similarly without any significant differences (p > 0.05). A scanning electron microscope revealed significant crystal loss after each use.

Ceramics↗
PubMed2006

Permanent diagnostic provisional restorations for predictable results when redesigning the smile.

In order to determine the optimal method of patient care, the patient's existing clinical condition must be accurately diagnosed and treatment objectives (eg, biocompatibility, aesthetics, long-term function) established accordingly. Once analysis of the condition is complete, the correct restorative procedure can be selected and the complications presented by the patient can be addressed. Comprehensive radiographic and clinical examinations are integral in determining the preoperative status of the patient and, consequently, in evaluating the possibility of actually achieving a successful rehabilitation.

Composite Resins↗
PubMed2006

[Three-dimensional finite analysis of the application of attachment for restoration of unilateral maxillary defect].

PURPOSE: To study the stress of the application of attachment for restoration of unilateral maxillary defect. METHODS: Using the 3-D FE model of the unilateral maxillary defect, two different 3-D FE models of the application of attachment framework for restoration of different unilateral maxillary defects (attachment on the mesial side of the central incisor or canine) were designed and established. RESULTS: The area of stress concentration of the two prostheses were on the palatal base near the position of the anterior teeth. The stress was on the posterior teeth of the healthy side. When the attachment was on the mesial side of the central incisor, the stress of the mesial surface of the central incisor was 1.306MPa, and the stress concentration was at the junction of the attachment and the lingual guide plane. When the attachment was on the mesial of the canine, the stress of the mesial surface of the canine was 0.797MPa, and stress concentration was at the corner of the front and bottom of the lingual guide plane. CONCLUSIONS: The application of attachment for restoration of unilateral maxillary defect meets the biomechanical demands without increasing the stress load on the abutment. And further study of the design of the attachment framework should be done.

Dental Abutments↗
PubMed2006

[Problems with working length determination during endodontic therapy].

Accurate working length (WL) determination is a crucial part of successful root canal therapy. Working length is the distance from the coronal reference plane to the apical constriction. The apical constriction, also referred to as cementodentinal junction, represents the transition between the pulpal and the periodontal tissues. It is widely accepted that canal preparation and filling should be terminated at that point. However, the location and form of the apical constriction are variable and not always detectable. Moreover, the available clinical methods used for WL measurements are also inaccurate. At present two methods are recommended in dental practice for determination of WL: radiographic technique, and by the means of electronic apex locators. Advantages and disadvantages of the two methods are discussed in this paper.

Electronics, Medical↗
PubMed2006

Alternative oral rehabilitation of children with hypodontia and conical tooth shape: a clinical report.

This case report outlines an alternative oral rehabilitation treatment of a 4-year-old boy with hypodontia and conical tooth shape, which along with other characteristics led to a suspicious ectodermal dysplasia diagnosis. Diagnostic waxup and a silicone matrix formed the basis to the successful reconstruction of the anterior teeth with resin composite. Additionally, removable partial dentures were fabricated to improve esthetics and chewing ability. Positive psychologic influence of this alternative treatment on this patient is also discussed.

Anodontia↗
PubMedDate not supplied

Surgical management of iatrogenic root perforation following endodontic therapy.

Endodontic mishaps still occur despite technological advancements in the field of dental instrumentation and materials. Iatrogenic root perforations during access preparation, canal instrumentation or preparation of post space are not uncommon, and instrument fractures during filing or reaming, as well as root fractures during condensation, are also encountered. Many of these mishaps are hard to avoid because of the extreme variability in root canal anatomy, canal calcification, abnormal root shapes and curvatures. They occur most often during access preparation, root cleaning, shaping and preparation of post space, or when attempting to bypass fractured instruments. Procedural errors impede endodontic therapy, thus increasing the risk of treatment failure, especially in teeth with necrotic pulps and periradicular lesions. Clinicians often have difficulty diagnosing and treating root perforations and the treatment of such mishaps is very difficult, especially in posterior teeth and in the area of the mandibular furcation. We report on a case of root perforation in a mandibular first molar that was successfully treated by surgery without the use of additional biomaterials.

Adult↗
PubMed2005

Validating the roles of apex locators and sonic instrumentation in root canal therapy.

Paramount to the success of endodontic therapy is determining the working length of the canal and, subsequently, effectively cleaning and irrigating the canal. Electronic apex locators and sonic instrumentation can help overcome some of the clinical and practical challenges inherent in endodontic treatment. This article reviews literature findings regarding the applications of apex locators and sonic instrumentation to more accurately determine working length and enhance canal preparation and irrigation. A clinical technique is presented for completing canal preparation and irrigation using sonics.

Dental Pulp Cavity↗