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Jurado CA, Afrashtehfar KI, Robles M, Alaqeely RS, Alsayed HD, Lindquist TJ, Alhotan A. Effect of preparation design and endodontic access on fracture resistance of zirconia overlays in mandibular molars: An in vitro study. J Prosthodont 2024. [PMID: 38734932 DOI: 10.1111/jopr.13865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
PURPOSE To evaluate the fracture resistance of zirconia overlays, considering various preparation designs and the presence of endodontic access. MATERIALS AND METHODS Ninety translucent zirconia (5Y-PSZ) overlay restorations were divided into six groups (n = 15/group) based on different preparation designs, with and without endodontic access: chamfer margin 4 mm above the gingival level without (group 1) and with endodontic access (group 2); margin 2 mm above the gingival level without (group 3) and with endodontic access (group 4); overlay with no chamfer margin without (group 5) and with endodontic access (group 6). Restorations were bonded to mandibular first molar resin dies, and the groups with endodontic access were sealed with flowable resin composite. All restorations underwent 100,000 cycles of thermal cycling between 5°C and 55°C, followed by loading until fracture. Maximum load and fracture resistance were recorded. ANOVA with Tukey post-hoc tests were used for statistical comparison (α < 0.05). RESULTS Fracture resistance significantly varied among overlay designs with and without endodontic access (p < 0.001), except for the no-margin overlays (groups 5 and 6). Overlays with a 2 mm margin above the gingival margin with endodontic access (group 4) exhibited significantly higher fracture resistance compared to both the 4-mm supragingival (group 2) and no-margin (group 6) designs, even when compared to their respective intact groups (groups 1 and 5). There were no significant differences between the no-margin and 4-mm supragingival overlays. CONCLUSION The more extensive zirconia overlay for mandibular molars is the first choice since the 2 mm margin above the gingival level design withstood considerable loads even after undergoing endodontic access. A no-margin overlay is preferred over the 4-mm supragingival design as it preserves more tooth structure and there was no outcome difference, irrespective of endodontic access. Caution is warranted in interpreting these findings due to the in vitro nature of the study.
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Affiliation(s)
- Carlos A Jurado
- Operative Dentistry Division, Department of General Dentistry, University of Tennessee Health Science Center College of Dentistry, Memphis, Tennessee, USA
| | - Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology (RekGero), School of Dental Medicine, University of Bern, Bern, Switzerland
- Evidence-Based Practice Unit (EBPU), Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, UAE
- Prosthodontics Private Practice, Dental Clinics, Abu Dhabi, UAE
- Artificial Intelligence Research Center (AIRC), Ajman University, Dubai, UAE
| | - Manuel Robles
- Department of Restorative Dentistry, Universidad del Valle De Mexico, Hermosillo, Sonora, Mexico
| | - Razan S Alaqeely
- Department of Periodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hussain D Alsayed
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saudi University, Riyadh, Saudi Arabia
| | - Terry J Lindquist
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Abdulaziz Alhotan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Oulghazi I, El Yamani A, Morchad B. Factors Influencing Vertical Radicular Fractures in Teeth Supported by Metallic Dental Core: A Scoping Review. Clin Cosmet Investig Dent 2024; 16:101-114. [PMID: 38665472 PMCID: PMC11044889 DOI: 10.2147/ccide.s458697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Purpose The aim of this work is to conduct a literature review to highlight all the parameters involved in sub-prosthetic radicular fractures of teeth supported by metallic dental core. Materials and Methods The following research was performed among published studies over the last 10 years in two PubMed/Medline and Scopus and supplemented by manual searching within the bibliographies. The search was restricted to publications in English and French. Results Out of the 1464 articles initially identified, 18 studies met our inclusion criteria and were subsequently included in the literature review. These consisted of eight Finite Element Analysis Studies, two Retrospective Studies and one Randomized Controlled Trial. The results of this review show that radicular fractures are influenced by several variables, including predisposition, with maxillary premolars and mandibular molars being the most commonly affected teeth. Intracanal preparation can induce crack formation, leading to localized high stress concentrations. Increased ferrule height to 2 mm significantly enhances dental fracture resistance. Using high modulus of elasticity alloys results in nearly complete stress transmission to dentin due to their limited deformability and absorption capacity. The highest fracture resistance is achieved when posts are sealed using resin-modified glass-ionomer cement. Longer posts may be preferable to prevent vertical fractures. Additionally, occlusal factors, through repetitive stresses, contribute to crack propagation from surface defects, a phenomenon termed fatigue fracture. Conclusion These findings have significant implications. Practitioners should be aware of the predisposition of certain teeth, the importance of preserving the ferrule effect, the choice of root post materials, post Cement Material and the role of occlusal forces in managing and preventing vertical root fractures.
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Affiliation(s)
- Ichraq Oulghazi
- Prosthodontics Department, Mohammed V University, Rabat, Morocco
| | - Amal El Yamani
- Prosthodontics Department, Mohammed V University, Rabat, Morocco
| | - Bouabid Morchad
- Prosthodontics Department, Mohammed V University, Rabat, Morocco
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Alghauli MA, Alqutaibi AY, Borzangy S. Clinical benefits of immediate dentin sealing: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00206-3. [PMID: 38570282 DOI: 10.1016/j.prosdent.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024]
Abstract
STATEMENT OF PROBLEM The clinical complications, success, and survival rates of indirect restorations delivered with the immediate dentin sealing protocol are unclear. PURPOSE The purpose of this systematic review and meta-analysis was to find and collect evidence on the clinical complication, success, and survival rates of indirect restorations delivered with immediate dentin sealing. MATERIAL AND METHODS Electronic databases were searched for clinical studies on immediate dentin sealing up to December 2023, without language or time limitations. The records were included if they were clinical trials evaluating the clinical complication and survival rates of indirect restorations bonded to tooth substrate sealed immediately after preparation with suitable resin bonding. The extracted data were analyzed via Review Manager 5.4 for meta-analysis (α=.05). RESULTS A total of 11 studies were included in this review. The clinical complication rate was lower for immediately sealed dentin than for protocols without dentin sealing. The survival rate of restorations luted with the immediate dentin sealing protocol was higher (96.4% to 100%) than that of immediate dentin sealing (81.8% to 96.7%), negatively correlated with the observation time. The intensity and incidence of postoperative sensitivity were statistically significantly lower for restorations with immediate dentin sealing than for those without dentin sealing or conventionally cemented (P<.05). CONCLUSIONS Immediate dentin-sealed indirect restorations had fewer clinical complications and higher success and survival rates than those delivered without dentin sealing. To avoid postoperative sensitivity or reduce its intensity, dentin surfaces should be sealed immediately after preparation. More long-term randomized clinical trials are recommended to confirm these evidence-based conclusions.
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Affiliation(s)
- Mohammed Ahmed Alghauli
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Ahmed Yaseen Alqutaibi
- Associate Professor of Prosthodontics, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia; and Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Sary Borzangy
- Associate Professor, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
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Mhatre S, Srichand R, Sethumadhavan J, Mishra PB, Patil SD, Chavan RS, Joshi M, Shetty U. Dry Mouth Dilemma: A Comprehensive Review of Xerostomia in Complete Denture Wearers. Cureus 2024; 16:e58564. [PMID: 38770459 PMCID: PMC11102879 DOI: 10.7759/cureus.58564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
Xerostomia, commonly known as dry mouth, presents a significant challenge for individuals wearing complete dentures, affecting their oral health and quality of life. This review explores the relationship between saliva and complete dentures, highlighting the varied management strategies for xerostomia. Saliva plays a critical role in denture retention, lubrication, and oral environment buffering. Complete denture wearers often experience reduced salivary flow, aggravating symptoms of xerostomia. Various management approaches are discussed, including general measures such as hydration and salivary stimulation techniques which aim to boost saliva production naturally. The use of salivary substitutes provides artificial lubrication and moisture to alleviate dry mouth discomfort. Oral lubricating devices, such as sprays, gels, and lozenges, offer relief by mimicking saliva's lubricating properties, thereby improving denture stability and comfort. This review addresses the etiology of xerostomia in complete denture wearers and explores preventive measures to reduce its impact. A comprehensive approach has been discussed for the management of xerostomia which will help to improve the oral health and well-being of complete denture wearers experiencing dry mouth.
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Affiliation(s)
- Swapnali Mhatre
- Department of Prosthodontics and Crown and Bridge, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Reema Srichand
- Department of Prosthodontics and Crown and Bridge, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Jyotsna Sethumadhavan
- Department of Prosthodontics and Crown and Bridge, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Pallavi B Mishra
- Medical School, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Srushti D Patil
- Medical School, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Riddhi S Chavan
- Medical School, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Mridula Joshi
- Department of Prosthodontics and Crown and Bridge, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
| | - Uttam Shetty
- Department of Prosthodontics and Crown and Bridge, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be University), Navi Mumbai, IND
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Albaqawi AH, Aljanakh MD, Alshammari BN, Alshammari MA, Alshammari RH, Alshammari GD, Alshammari BZ, AlShammari RA, Alturki RF, Madfa AA. Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia. Cureus 2023; 15:e51063. [PMID: 38269215 PMCID: PMC10806941 DOI: 10.7759/cureus.51063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The objective of the study was to retrospectively assess the clinical performance of dental prostheses, single crowns, and three-unit bridges to identify clinical biological and mechanical complications in the Ha'il province of Saudi Arabia. METHODS The study was conducted between March 2021 to October 2021 and included 421 patients who underwent crown and tooth-supported fixed partial denture (FPD) procedures at the Dental Polyclinics Center in the Ha'il region of Saudi Arabia from 2010-2020. The planned sampling approach was applied. Patients who underwent crown and FPD placements at the dental center within the scheduled period were identified through clinical assessments. The inclusion criteria were met by patients with three-unit FPDs and a single crown containing a natural contralateral tooth or teeth. A total of six general dentists conducted clinical exams. Patient satisfaction and technical and biological issues were the evaluation criteria for crowns and FPDs. The frequency and percentage of the various characteristics employed in the current investigation were ascertained using cross-tabulation. The Chi-square test was employed to assess the associations between categorical variables, with p-values ≤ 0.05 considered significant. Results: Marginal integrity was recorded in 332 participants (78.9%), which was satisfactory for the majority of the restoration. The acceptance morphology was present in 252 (59.9%) restorations. The highest rate of the restorations 274 (66.2%) had satisfactory color. In 86 cases (20.4%), there was visible periodontal depth of at least 5 mm. Three hundred and six (72.7%) of the fixed restorations had gingival bleeding connected to them, and 96 (22.8%) teeth had periapical lesions. A total of 311 patients (73.9%) reported they were satisfied with their fixed restorations. CONCLUSIONS The technical and biological complications noted in the current study were not higher compared with other studies of crowns and fixed dental prostheses. The majority of patients were satisfied with the restoration.
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Affiliation(s)
- Ahmed H Albaqawi
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Mohammad D Aljanakh
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | | | | | | | | | | | | | | | - Ahmed A Madfa
- Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
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Bandiaky ON, Clouet R, Le Bars P, Soueidan A, Le Guehennec L. Marginal and internal fit of five-unit zirconia-based fixed dental prostheses fabricated with digital scans and conventional impressions: A comparative in vitro study. J Prosthodont 2023; 32:846-853. [PMID: 36627825 DOI: 10.1111/jopr.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of five-unit zirconia-based fixed dental prostheses (FDPs) fabricated using digital scans and conventional impressions. MATERIALS AND METHODS Nine master models with three zirconia abutments were scanned with an intraoral scanner (test group), and nine conventional impressions (control group) of these same models were also made. The stone casts from these impressions were scanned with a laboratory extraoral scanner (D700, 3Shape, Copenhagen, Denmark). A total of 18 five-unit zirconia-based FDP frameworks (test group, n = 9; control group, n = 9) were manufactured. Marginal and internal fit (in μm) were evaluated using the replica method under micro-computed tomography. Analysis of variance (one-way ANOVA) and Kruskal-Wallis tests were used to compare continuous variables across two groups. A level of p < 0.05 was accepted as statistically significant. RESULTS The mean ± standard deviation of the marginal fit was 95.03 ± 12.74 μm in the test group and 106.02 ± 14.51 μm in the control group. The lowest marginal mean value was observed in the test group, with a statistically significant difference compared to the control group (F = 14.56, p < 0.05). The mean ± standard deviation of the internal fit was 103.61 ± 9.32 and 106.38 ± 7.64 μm, respectively, in the test and control groups, with no statistically significant difference (F = 1.56, p > 0.05). The mean values of both groups were clinically acceptable. CONCLUSIONS The five-unit zirconia-based FDPs fabricated with digital scans showed better fit than those in the conventional impression group. Within the limitations of this study, these results are encouraging, and continued progress in the digital field should allow for more accurate long-span restorations.
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Affiliation(s)
- Octave Nadile Bandiaky
- Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Roselyne Clouet
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Pierre Le Bars
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Laurent Le Guehennec
- Department of Prosthodontics, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
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Nishio F, Morita K, Doi K, Kato M, Abekura H, Yamaoka H, Kakimoto N, Tsuga K. Radiopaque properties of polyetheretherketone crown at laboratory study. J Oral Biosci 2023; 65:253-258. [PMID: 37230464 DOI: 10.1016/j.job.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVES There have been no reports on the radiopaque properties of new polyetheretherketone (PEEK) crowns for locating crowns during accidental ingestion or aspiration and detection of secondary caries, which is essential information for clinical application. This study aimed to investigate whether the radiopaque properties of PEEK crowns could be used to identify the site of accidental ingestion or aspiration and detect secondary caries. METHODS Four types of crowns were fabricated: three non-metal crowns (PEEK, hybrid resin, and zirconia) and one full metal cast crown (gold-silver-palladium alloy). Initially, the images for these crowns were compared using intraoral radiography, chest radiography, cone-beam computed tomography (CBCT), and multi-detector computed tomography (MDCT); computed tomography (CT) values were calculated. Subsequently, the images for the crowns placed on the secondary caries model with two artificial cavities were compared using intraoral radiography. RESULTS The PEEK crowns displayed the lowest radiopaque properties on radiography and very few artifacts were observed on CBCT and MDCT. On the other hand, the CT values of the PEEK crowns were a little lower than those of the hybrid resin crowns and considerably lower than the zirconia and full metal cast crowns. The cavity could be detected in the PEEK crown-placed secondary caries model through intraoral radiography. CONCLUSIONS This simulated study of radiopaque properties with four types of crowns suggested that a radiographic imaging system can be used to identify the site of accidental ingestion and aspiration of PEEK crowns and to detect secondary caries of the abutment tooth within a PEEK crown.
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Affiliation(s)
- Fumiko Nishio
- Department of Fixed Prosthetic Dentistry, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Koji Morita
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Kazuya Doi
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masamichi Kato
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hidehisa Yamaoka
- Section of Imaging Diagnosis, Department of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Han S, Yi Y, Revilla-León M, Yilmaz B, Yoon HI. Feasibility of software-based assessment for automated evaluation of tooth preparation for dental crown by using a computational geometric algorithm. Sci Rep 2023; 13:11847. [PMID: 37481612 PMCID: PMC10363138 DOI: 10.1038/s41598-023-39089-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/20/2023] [Indexed: 07/24/2023] Open
Abstract
The purpose of this study was to propose the concept of software-based automated evaluation (SAE) of tooth preparation quality using computational geometric algorithms, and evaluate the feasibility of SAE in the assessment of abutment tooth preparation for single-unit anatomic contour crowns by comparing it with a human-based digitally assisted evaluation (DAE) by trained human evaluators. Thirty-five mandibular first molars were prepared for anatomical contour crown restoration by graduate students. Each prepared tooth was digitized and evaluated in terms of occlusal reduction and total occlusal convergence using SAE and DAE. Intra-rater agreement for the scores graded by the SAE and DAE and inter-rater agreement between the SAE and DAE were analyzed with the significance level (α) of 0.05. The evaluation using the SAE protocol demonstrated perfect intra-rater agreement, whereas the evaluation using the DAE protocol showed moderate-to-good intra-rater agreement. The evaluation values of the SAE and DAE protocols showed almost perfect inter-rater agreement. The SAE developed for tooth preparation evaluation can be used for dental education and clinical skill feedback. SAE may minimize possible errors in the conventional rating and provide more reliable and precise assessments than the human-based DAE.
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Affiliation(s)
- Sangjun Han
- School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yuseung Yi
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
- Research and Digital Dentistry, Kois Center, Seattle, WA, USA
- Department of Prosthodontics, Tufts University, Boston, MA, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, USA
| | - Hyung-In Yoon
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Republic of Korea.
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Suliman O, Rayyan MR. The Effect of Cement Space Parameters on the Marginal Adaptation of Milled Endocrowns: An In Vitro Study. Cureus 2023; 15:e38688. [PMID: 37292555 PMCID: PMC10246932 DOI: 10.7759/cureus.38688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
Background Cement film space plays a significant role in achieving good adaptation of indirect restorations. The objective of this study is to investigate the effect of cement space parameters on the marginal adaptation of computer-aided design (CAD)/computer-assisted manufacturing (CAM) endocrowns. Methodology The coronal part of 10 freshly extracted human mandibular molars was reduced to a level of 1.5 mm above the cementoenamel junction (CEJ); then, root canal treatment was performed. On each tooth, four lithium disilicate endocrowns with different cement space parameters (40, 80, 120, and 160 µm) were designed and fabricated using CAD/CAM. Endocrowns were seated to their prepared teeth, and the vertical marginal gap was measured in 20 equidistant points for each endocrown using a stereomicroscope on 90× magnification. The mean marginal gaps of the four groups were compared using a one-way analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test considering p<0.05 as the cutoff for statistical significance. Results The mean marginal gap of the 40 µm, 80 µm, 120 µm, and 160 µm groups were 46.25±21.20 µm, 21.75±11.10 µm, 15.94±06.62 µm, and 13.10±07.08 µm, respectively. One-way ANOVA showed a significant difference in the marginal gaps between groups (p<0.001). The Tukey post hoc test showed a statistically significant mean difference between 40 µm and each of the other three groups (p<0.001). Conclusion The cement space parameter variation affects the marginal adaptation of endocrowns. The cement space of 40 µm resulted in a higher marginal gap than cement spaces of 80, 120, and 160 µm.
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Affiliation(s)
- Oubada Suliman
- Prosthodontic Department, Riyadh Elm University, Riyadh, SAU
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Kalsekar BG, Gandhi PV, Patil R, Sabane AV, Kadam PP, Bhosale NS. Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings Fabricated Using Three Different Techniques: An In Vitro Study. J Contemp Dent Pract 2023; 23:991-997. [PMID: 37073911 DOI: 10.5005/jp-journals-10024-3399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
AIM This study was conducted to comparatively assess the retention and vertical marginal fit of cobalt-chromium copings fabricated by the conventional casting technique, 3D-printed resin pattern, and with direct metal laser sintering (DMLS) technique. MATERIALS AND METHODS Out of the total 60 test samples, 20 copings were obtained from inlay-casting wax and 20 from casting of 3D-printed resin patterns. In total, 20 copings were obtained from the laser sintering technique. All 60 test samples were then cemented serially on the prepared maxillary-extracted premolars and were evaluated for vertical marginal gap in 8 pre-established reference areas. Retention was evaluated using a universal testing machine. RESULTS Results obtained for both marginal gap and retention were statistically analyzed, and the values fall within the clinically acceptable range. The DMLS technique proved precedence over the other two techniques used, as it exhibited maximum retention and marginal accuracy, which is an area of prime concern. CONCLUSION The results from this study encourage further research with different pattern-forming materials and techniques and the need to identify the factors that facilitate better marginal fit and retention of cast restorations. CLINICAL SIGNIFICANCE This study has myriad of applications in clinical dentistry mainly in decision-making for casting procedure to provide better retention and marginal accuracy for fabrication of Co-Cr crowns. It also aims to aid the clinician to minimize errors by using different techniques for fabrication of wax pattern as well as the coping, keeping abreast with the recent technology to evaluate the accuracy of 3D-printed resin pattern over conventional wax pattern.
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Affiliation(s)
- Bhagyashree G Kalsekar
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India, Phone: +91 9890876681, e-mail:
| | - Paresh V Gandhi
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Rupali Patil
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Ajay V Sabane
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Pankaj P Kadam
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Nishita S Bhosale
- Department of Periodontology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
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Piangsuk T, Dawson DV, El-Kerdani T, Lindquist TJ. The Accuracy of Post and Core Fabricated with Digital Technology. J Prosthodont 2023; 32:221-226. [PMID: 35413146 DOI: 10.1111/jopr.13522] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/31/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To compare the accuracy of post and cores created with three different fabricating techniques: direct conventional, machine milling, and three-dimensional (3D) printing. MATERIALS AND METHODS Thirteen extracted single root central incisors were selected. Root canal treatment and tooth preparation for crown were performed on all teeth. Post space preparation of 11 mm was created using prefabricated fiber post drill to standardize post space width and length. Root canal impressions were performed on all teeth using polyvinyl siloxane impression material. Each impression was then three dimensionally scanned using an extraoral lab scanner. The scanned impressions were used to design digital files of post and cores with 3Shape CAD software. The digitally designed post and cores were used to fabricate 3D printed and milled post and core resin patterns. The same teeth were used to fabricate post and core with conventional technique (direct duplication of root canal with resin pattern). All posts were then scanned before being invested and then cast using base metal educational alloy. The metal post and cores were tried in with sample teeth and manually adjusted until found to be clinically acceptable. The post and cores were scanned in different stages to perform digital volume measurement using Geomagic Control software to determine accuracy. Pairwise comparisons were accomplished using exact version of the sign test (α = 0.05). RESULTS These three techniques of post and core fabrication showed different results in the various stages of fabrication. The accuracy of 3D printed resin pattern (26.89 ±11.09 mm3 ) was found to be inferior compare to milled resin pattern (28.20 ±11.41 mm3 , p = 0.0002). However, dimensional stability of the 3D printed resin pattern before and after casting (0.56 ±0.95 mm3 ) was found to be superior to milled resin pattern (0.79 ±0.89 mm3 ) and direct resin pattern (2.51 ±1.38 mm3 , p = 0.00002). All three techniques showed significant volume reduction after adjustment (p = 0.0002). In the final stage, the adjusted metal post and core fabricated with three different techniques showed no statistical different in accuracy (p = 0.15). CONCLUSION Digitally fabricated post and cores have the same degree of accuracy as those fabricated using the gold standard direct conventional post and core technique.
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Affiliation(s)
- Tarin Piangsuk
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Deborah V Dawson
- Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA
| | - Tarek El-Kerdani
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Terry J Lindquist
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
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Aljanakh MD. Restorative and Endodontic Management of a Mandibular Canine With Two Roots and Two Canals: A Case Report. Cureus 2023; 15:e36460. [PMID: 37090338 PMCID: PMC10116843 DOI: 10.7759/cureus.36460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
The existence of a permanent mandibular canine with two roots and two canals is rare. This case report presents restorative and endodontic management of a mandibular canine with two roots and two canals of a 32-year-old Saudi woman with multiple periradicular lesions of mandibular anterior teeth. Cone beam computed tomography (CBCT) was used for accurate diagnosis of the root canal morphology. CBCT helped to accomplish the restorative and endodontic treatment in a conservative approach.
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Affiliation(s)
- Mohammad D Aljanakh
- Department of Restorative Dentistry, College of Dentistry, University of Ha'il, Ha'il, SAU
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13
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Aziz A, El-Mowafy O. Six-year clinical performance of lithium disilicate glass-ceramic CAD-CAM versus metal-ceramic crowns. J Adv Prosthodont 2023; 15:44-54. [PMID: 36908754 PMCID: PMC9992700 DOI: 10.4047/jap.2023.15.1.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 12/19/2022] [Indexed: 03/06/2023] Open
Abstract
PURPOSE To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.
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Affiliation(s)
- Ahmed Aziz
- Department of Restorative and Preventive Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Omar El-Mowafy
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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14
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Malament KA, Margvelashvili-Malament M, Natto ZS, Polyakov V, Thompson V, Rekow D. Incidence of endodontic therapy after complete or partial coverage glass-ceramic restorations with a follow-up time of over 30 years: A prospective clinical study. J Prosthet Dent 2023; 129:49-60. [PMID: 36116949 DOI: 10.1016/j.prosdent.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Long-term clinical data are lacking on the comparison of the incidence of endodontic therapy in adhesively luted complete and partial coverage glass-ceramic restorations, as well as on the effect of technique and clinical variables. PURPOSE The purpose of this prospective clinical study was to assess the long-term incidence of teeth requiring endodontic therapy after receiving either complete or partial coverage glass-ceramic restorations. MATERIAL AND METHODS Participants requiring single anterior complete, posterior complete, or posterior partial (inlay or onlay) coverage restoration, or a combination of these on a vital tooth were recruited from a clinical private practice. Only the participants who chose glass-ceramic partial and complete coverage restorations without the need of endodontic therapy were included in the study. The overall clinical performance of these glass-ceramic restorations was assessed by clinical factors determined at recall. The effect of various clinical parameters (type of restoration, dental arch, tooth position in the dental arch, age and sex of participant, and ceramic thickness) was evaluated by using Kaplan-Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined by using the log rank test (α=.05). RESULTS A total of 1800 participants requiring 4511 glass-ceramic anterior and posterior restorations were evaluated. The mean age of the participants at the time of restoration placement was 62 (range 20 to 99 years, 710 men and 1090 women). Of 4511 restorations, 1476 were anterior complete coverage, 2119 posterior complete coverage, and 916 posterior partial coverage. Endodontic therapy after restoration placement was needed for 76 restorations (10 anterior complete, 50 posterior complete, and 16 posterior partial). The total time at risk was 50 436 years providing an estimated need for endodontic therapy risk of 0.15% per year. The estimated 35-year cumulative survival was 97.36%. The majority of endodontic treatments (67%, 52/76) occurred in the first 5 years. The estimated cumulative survival of anterior complete coverage, posterior complete coverage, posterior partial inlay, and posterior partial onlay restorations was 98.89% (n=1476, 10 endodontic treatments), 96.38% (n=2119, 50 endodontic treatments), 96.78% (n=553, 11 endodontic treatments), and 98.53% (n=363, 5 endodontic treatments), respectively. Statistically significant differences occurred between anterior complete coverage, posterior complete coverage, and posterior partial coverage inlay restorations, with a higher incidence in posterior complete coverage and posterior partial inlay restorations (P<.05). First molars had the highest rate of endodontic therapy after restoration in both arches. Age and restoration thickness were significant factors, recording statistically higher number of endodontic treatments in participants >52 years and restorations with all surfaces ≥1 mm (P<.05). Other clinical variables, dental arch and sex of the participants, were not significantly related to endodontic treatments (P>.05). CONCLUSIONS The clinical performance of 4511 units over 30 years in service was excellent, with the estimated cumulative survival of 97.36%. Posterior complete coverage and posterior partial inlay restorations had a significantly higher need for endodontic therapy than anterior complete coverage restorations. Their overall clinical performance relative to endodontic treatment was excellent with a cumulative survival of 96.38% and 96.78% over 30 years. There was no difference in the endodontic treatment rate between posterior complete and partial coverage restorations. Thickness of the restoration affected the endodontic treatment rate, with ≥1 mm resulting in higher incidence. The age of the participants influenced the endodontic treatment rate, with higher incidence in the >52-year age group. Other confounding clinical variables did not have a significant effect on the endodontic treatment rate.
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Affiliation(s)
- Kenneth A Malament
- Clinical Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
| | | | - Zuhair S Natto
- Assistant Professor, Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Adjunct Assistant Professor, Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass
| | | | - Van Thompson
- Professor Emeritus, King's College London Faculty of Dentistry, Oral and Craniofacial Sciences, London, UK
| | - Dianne Rekow
- Professor Emeritus, King's College London Faculty of Dentistry, Oral and Craniofacial Sciences, London, UK
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15
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Rădulescu V, Boariu M, Rusu D, Boldeanu C, Christodorescu R, Roman A, Surlin P, Didilescu AC, Vela O, Kardaras G, Veja I, Martu I, Stratul SI. Is the Diagnosis of Generalized Stage IV (Severe) Periodontitis Compatible with the Survival of Extended Stabilizing Prosthetic Restorations? A Medium-Term Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12123053. [PMID: 36553060 PMCID: PMC9776696 DOI: 10.3390/diagnostics12123053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of the study was to identify the most relevant patient-related factors directly involved (alone or in combinations) in the long-term survival and functionality of the abutment teeth of extensive stabilizing bridges and removable prosthesis, in patients treated for Stage IV periodontitis, adhering to SPT over a period of at least 5 years. Seventy-six patients treated between 2000-2022, rehabilitated with FDPs and RDPs, adhering to SPT for at least 5 years were included. Patient-related factors influencing retention of RDPs and FDP, survival rates in regular (RCs) and irregular compliers (ICs), and incidence of biological and technical complications were assessed. During a follow-up of 69 months, from 57 patients with FDPs and 19 patients with RDPs, 39 (51.32%) were ICs, while 37 (48.68%) were RCs. An overall statistically significant association (p = 0.04) was identified between biological complications and the type of prostheses. The RDP patients had more complications than FDP patients. In 5.26% of the RDP patients, root caries were identified, and 10.53% were diagnosed with a periapical (endodontic) lesion, while 3.51% of the FDPS patients presented root caries. In five (6.57%) cases, abutment loss resulted in the loss of the prosthesis. Statistically significant correlations were observed between systemic diseases and tooth loss, and between type of tooth lost and the reason for tooth loss, irrespective of the type of prosthesis. A total of 66.67% of the lost incisors, 85.71% of the lost premolars, and 88.89% of the lost molars occurred due to periodontal causes. Furthermore, 93% of the FDPs and RDPs were still in place and in function.
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Affiliation(s)
- Viorelia Rădulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Camelia Boldeanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ruxandra Christodorescu
- Department V Internal Medicine, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: ; Tel.: +40-744641279
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Veja
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Martu
- Department of Dental Technology, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Awadalkreem F, Khalifa N, Satti A, Suliman AM. Rehabilitation of Patients with Compromised Ridge Support Using Immediately Loaded Corticobasal Implant-supported Prostheses: A Prospective Observational Study. J Contemp Dent Pract 2022; 23:971-978. [PMID: 37073908 DOI: 10.5005/jp-journals-10024-3416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
AIM The aim of this prospective study is to evaluate the treatment outcomes and patient satisfaction following the use of fixed immediately loaded corticobasal implant-supported prostheses. MATERIALS AND METHODS One hundred and seventy-four corticobasal implants (basal cortical screw, BCS implant design) were inserted in 20 consecutive patients with compromised ridge support. Implant survival and success were assessed using the James-Misch implant health quality scale and the Albrektsson criteria for implant success. The peri-implant health was evaluated at 1 week and 3, 6, 9, 12, and 18 months postoperatively. Moreover, the radiographic and prosthetic parameters and patient satisfaction were assessed. RESULTS The implants showed optimum implant health and a 100% survival rate with none (0%) of the implants failing, mobile, lost, or fractured. Using Wilcoxon signed-rank test, significant decreases in both the modified gingival indexes and the probable pocket depth (PPD) and slight significant increases in the plaque index (PI) at 3, 9, 12, and 18 months and a nonsignificant increase at 6-month follow-up were reported with a range of 0-1. The calculus index (CI) was zero at all follow-up visits. Radiographic evaluations revealed increases in the bone-to-implant contact. Evaluation of the prostheses showed some treatable complications, and all the patients were satisfied. CONCLUSION The use of corticobasal implant-supported prosthesis meets the patient's demand for an immediate, fixed treatment modality, with high survival and success rates, optimum peri-implant soft tissue health, and high reported satisfaction. CLINICAL SIGNIFICANCE Corticobasal implants can improve the patient's esthetic, phonetic, mastication, and quality of life with the advantage of eliminating the need of bone grafting procedures.
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Affiliation(s)
- Fadia Awadalkreem
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan Phone: +00971508094225, e-mail: ,
| | - Nadia Khalifa
- Chair of the Department of Preventive and Restorative Dentistry, University of Sharjah/Faculty of Dental Medicine, Sharjah, United Arab Emirates
| | - Asim Satti
- Department of Computing and Research, Federal Ministry of Health, Khartoum Teaching Dental Hospital, Khartoum, Sudan
| | - Ahmed Mohamed Suliman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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17
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Goto M, Oki K, Koyano K, Ayukawa Y. The 3-year cumulative survival rates of posterior monolithic zirconia crowns and their antagonist teeth, and their influencing factors. J Oral Sci 2022; 64:286-289. [PMID: 36104182 DOI: 10.2334/josnusd.22-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the 3-year cumulative survival rates of posterior single monolithic zirconia crowns (MZCs) and their antagonists, and to analyze the influencing factors. METHODS The clinical outcomes of posterior single MZCs and their abutment teeth with antagonists, and the antagonists between April 2014 and September 2020 were evaluated retrospectively. The 3-year cumulative survival rates were calculated and associations between the survival time and predictor variables ("Jaw", "Tooth", and "Pulpal condition") were also verified using Cox proportional hazards models and hazard ratios (HRs). RESULTS The 3-year cumulative survival rate of single MZCs was 89.8% (9 of 177 MZCs, 95% confidence interval (CI): 80.0-95.1%). Cox proportional hazards models showed non-vital teeth were significantly associated with failure (HR: 2.76e + 9, P = 0.012). The 3-year cumulative survival rate of antagonists was 94.8% (7 of 171 antagonists, 95% CI: 89.3-97.6%). Non-vital antagonists were also identified as an independent predictor for failure in Cox proportional hazards models (HR: 7.83, P = 0.03). CONCLUSION Although posterior single MZCs were clinically acceptable, non-vital pulpal condition could be a potential risk factor for failures in the abutment and antagonist teeth of MZCs.
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Affiliation(s)
- Midori Goto
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kyosuke Oki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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18
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Adawi H, Jain S, Hakami AH, Mtwam NA, Koriri AYA, Adawi AAA. A Prospective Study to Assess Patients' Understanding and Retention of Postoperative Instructions following a Fixed Partial Denture, Using Different Information Delivery Techniques. Eur J Dent 2022. [PMID: 36063842 DOI: 10.1055/s-0042-1750774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE This study was aimed to evaluate the effect of using different modes of at-home maintenance information delivery on patients' understanding and the level of information retention. MATERIALS AND METHODS Sixty patients were asked to answer a questionnaire while undergoing mouth preparations for receiving a fixed partial denture. The questionnaire includes questions related to at-home maintenance procedures and recall visits. After finishing the first questionnaire, these patients were randomly assigned into three groups, and each group was given education about at-home maintenance procedures and recall visits by different means. Group 1 participants were educated by giving live demonstrations. Group 2 participants were shown a prerecorded video, whereas group 3 participants were given written instructions. All Participants were recalled after 1 week of the last visit and were asked to fill out the same questionnaire. STATISTICAL ANANLYSIS Collected data were tabulated in a Microsoft Excel Spreadsheet and were analyzed using the Chi-square test, one-way ANOVA, paired t-test, and post hoc Bonferroni test. A p-Value < 0.05 was regarded as statistically significant for all the analyses. RESULTS Group 1 showed greatest information retention as compared with groups 2 and 3 (p = 0.045). There was significant difference in the knowledge of group 1 as compared with groups 2 (p = 0.020) and 3 (p = 0.048). CONCLUSION The mode of delivering postoperative instructions after fixed partial denture treatment does have an effect on the patient understanding level and information retention. Patients who were given live demonstrations showed the best results compared with video recordings and written leaflets.
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Affiliation(s)
- Hafiz Adawi
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Saurabh Jain
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Aeshah H Hakami
- Dental Intern, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Naseem A Mtwam
- Dental Intern, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Almaha Y A Koriri
- Dental Intern, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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19
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Datta A, Sandhu H. Success of fixed partial denture prostheses observed in a military dental centre: A cross-sectional study. Med J Armed Forces India 2022; 78:S206-S212. [PMID: 36147385 PMCID: PMC9485757 DOI: 10.1016/j.mjafi.2020.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 08/19/2020] [Indexed: 11/30/2022] Open
Abstract
Background Fixed dental prostheses have been provided in the Armed Forces for a long time, yet definite evidence-based guidelines on the success and failure of different types of prostheses are currently lacking. A cross-sectional observational study was conducted as a step towards addressing this lacuna. Methods The study included 156 patients and 538 prostheses based on pre-established inclusion criteria. The types of prostheses that were evaluated included crowns, fixed partial dentures (FPDs), post and core restorations, dental implants and veneers. Visual, tactile and radiographic examination was used for evaluating the prostheses. Success, survival and failure of prostheses were evaluated, and the types of complications leading to the failure were also recorded. In addition, the oral hygiene status of the included patients was also evaluated using the Oral Hygiene Index-Simplified. Results The overall failure rate in all prostheses combined together was 28.81%. The failure rate in cantilever FPDs was the highest at 44.44%. It was 16.67% in veneers, 35.37% in conventional FPDs, 23.81% in single crowns and 30.56% in all post and core restorations. Conclusion Barring the all-ceramic prostheses and fibre post and core restorations, the rate of occurrence of both complications and failures in the remaining categories of prostheses was higher than that mentioned in the literature.
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Affiliation(s)
- A. Datta
- Graded Specialist (Prosthodontics), 200 Military Dental Centre, C/o 56 APO, India
| | - H.S. Sandhu
- Commandant, Command Military Dental Centre (Western Command), Chandimandir, Haryana, India
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20
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Piangsuk T, Henprasert P, Boonsiriphant P, Lindquist TJ. The accuracy comparison of 3D-printed post and core using castable resin and castable wax resin. J Prosthodont 2022. [PMID: 36008357 DOI: 10.1111/jopr.13594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/14/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this research was to compare the accuracy of three dimensionally (3D) printed post and core fabricated with two different materials: reinforced wax and castable resin. METHODS AND METHODS Fifteen extracted single root central incisors were selected. Root canal treatment and tooth preparation for crown were performed on all teeth. Eleven millimeters post space was created with standardized prefabricated fiber post drill. Polyvinylsiloxane impression material was used for root canal impressions. Each impression was then 3D scanned using an extraoral scanner and cast posts and cores were designed using 3Shape software. The digitally designed post and cores were 3D printed with two different materials: castable wax resin and resin. The castable resin patterns were scanned before and after complete polymerization. The wax patterns were also scanned. Digital volumetric measurement using Geomagic® Control X࣪ software was performed to determine accuracy. RESULTS The printed post and core had reduced volume (16.09 ±3.839 mm3 ) compared to the digital design (17.828 ±3.904, p<0.05). Before complete polymerization, the accuracy of 3D printed resin pattern (16.464 ±3.017) was found to be superior to post and core printed with wax (16.193 ±3.018, p<0.05). However, no volume difference was found between completely polymerized resin (16.09 ±3.839) and wax (16.044±3.834, p = 1). CONCLUSION 3D printed post and core showed significant volume shrinkage from the digital files used to create them. However, different materials have no effect on the accuracy of 3D printed post and core. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tarin Piangsuk
- Department of Restorative Dentistry and Periodontics, Chiang Mai University, Chiangmai, Thailand
| | - Pantip Henprasert
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | | | - Terry J Lindquist
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
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21
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Hawthan M, Chrcanovic BR, Larsson C. Retrospective clinical study of tooth-supported single crowns: A multifactor analysis. Eur J Oral Sci 2022; 130:e12871. [PMID: 35613306 PMCID: PMC9546353 DOI: 10.1111/eos.12871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
The purpose of the study was to investigate the influence of multiple factors on the survival of tooth‐supported single crowns and assess the biological and technical complications. This retrospective study included patients rehabilitated with single crowns with a minimum follow‐up time of 6 months after delivery. The cumulative survival rate was calculated over the maximum period of follow‐up time and reported in a life‐table survival analysis. Univariate and multivariate Cox regression was used to evaluate the associations between clinical covariates and crown failure. The included cohort group consisted of 1037 single crowns delivered in 401 patients and followed for a mean of 134.8 ± 80.2 months. Cumulative survival rate was 89.9% and 80.9% after 5 and 10 years and 70.5% and 61.8% after 15 and 20 years, respectively. The main reasons for single crown failure were loss of retention, tooth loss, and fracture. Anterior placement, non‐vital abutments, and bruxism significantly influenced the survival of single crowns. The survival of single crowns was not influenced by patient's age and sex, location of the crowns in relation to the jaws, type of tooth, presence of post and core, and type of crown material, treatment providers, or smoking. Anterior placement, non‐vital abutments, and bruxism are factors suggested to increase the risk of single crown failure and the prevalence of technical and biological complications.
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Affiliation(s)
- Mohammed Hawthan
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Bruno R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Dunn K, Funez MAU, Pace-Balzan A. Debonding of cast metal-based cantilever and fixed-fixed resin-retained bridgework: A review of the literature. Prim Dent J 2022; 11:35-49. [PMID: 35383495 DOI: 10.1177/20501684221085835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Cast metal-based resin-retained bridgework (RRB) offers a practical, conservative approach when restoring edentulous spaces. This review examines the debonding of cast metal-based RRB, comparing cantilever resin-retained bridgework (CRRB) and fixed-fixed resin-retained bridgework (FRRB) designs taking into context developments in RRB design, construction, and cementation over time. METHODS An electronic search was conducted through Medline and Embase with the aid of Boolean operators to combine the following key words: "adhesive bridges", "resin-bonded bridges", "resin-retained bridges", "resin-bonded fixed partial dentures", "cantilever", "debond", "fixed-fixed", "decementation", "failure", "success", "outcome", "longevity" and "survival". The search was limited to peer-reviewed articles written in English and published from 1995 through to 2019. MAIN FINDINGS Thirty-one studies were included. Five studies compared the longevity of CRRB versus FRRB, five assessed the clinical performance of CRRBs alone, and 21 studies assessed the clinical performance of FRRBs. There was great variability in study design and the reporting of clinical outcomes, and an analysis and critique of the included papers is provided. Overall, CRRB tend to debond less and hence provide longer-term and more reliable clinical service when compared to FRRB. PRINCIPAL CONCLUSIONS More high-level, long-term, prospective and clinical controlled trials are required to further analyse and evaluate the long-term outcomes of cast metal-based RRB.
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Affiliation(s)
- Katharine Dunn
- Specialty Trainee in Restorative Dentistry, Edinburgh Dental Institute, The University of Edinburgh, UK
| | | | - Adrian Pace-Balzan
- Consultant in Restorative Dentistry, Edinburgh Dental Institute, The University of Edinburgh, UK
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Piemjai M, Santiwarapan P. An Enamel Based Biopolymer Prosthesis for Dental Treatment with the Proper Bond Strength and Hardness and Biosafety. Polymers (Basel) 2022; 14:polym14030538. [PMID: 35160527 PMCID: PMC8839297 DOI: 10.3390/polym14030538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
Although dental prosthesis materials such as metal alloys, ceramics, and cured resin composite have long been utilized to restore teeth, their bond strength and hardness values are not well matched to human enamel. Prosthesis detachment and opposing enamel wear are major concerns in restorative dentistry. An experimental biopolymer, hybridized enamel, was synthesized and utilized as a dental prosthesis to compare hardness and tensile bond strength (TBS) with those of commercial materials. Vickers hardness (VHN) with a 100 g loading for 15 s at eight indentations on each specimen (n = 20) was measured. TBSs between prostheses and two types of resin luting agents (n = 10), Super-Bond C&B and All-Bond2 + Duo-Link, were tested. Fractured surfaces and the luting resin-prosthesis interface were examined under a stereomicroscope or a scanning electron microscope (SEM). Statistically significant differences in the TBS and hardness were revealed (p < 0.05). The experimental biopolymer provided a hardness value comparable with human enamel and the highest TBS for both luting agent types. The SEM micrograph demonstrated a honeycomb-like pattern interface between the experimental biopolymer and luting resin. These results suggest that this experimental biopolymer may be a better restorative material to protect from natural enamel loss from tooth reduction or attrition and prevent prosthesis detachment during mastication.
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Haroon TM, Dewan H, Mogla S, Gupta A, Loganathan J, Ahammed AN, Kommuri S. Assessment of failure rate of fixed partial dentures: A clinical study. J Pharm Bioallied Sci 2022; 14:S262-S263. [PMID: 36110713 PMCID: PMC9469224 DOI: 10.4103/jpbs.jpbs_718_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Materials and Methods: Results: Conclusion:
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25
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Shekarian M, Ghodsi S, Aghamohseni M, Arzani S, Rasaeipour S. Cement selection criteria for different types of intracanal posts. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.351339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Abusteit OE, Hosney S, ElSheshtawy AS, Zapata RO. Outcome of Endodontic Treatment through Existing Full Coverage Restorations: An Endodontic Practice Case Series. J Endod 2021; 48:388-395. [PMID: 34843799 DOI: 10.1016/j.joen.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/31/2021] [Accepted: 11/20/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION This case series assessed the outcome of nonsurgical endodontic treatment completed through retained full coverage restorations (FCRs) in a board-certified endodontist private practice. The number of cases completed by the first author was 153. METHODS All cases were performed following a standardized protocol for treatment and restoration depending on the type of FCR. Number of cases that showed up for 2- to 4-year follow-up was 127, with 83% recall rate. The age range of patients was 33-95 years, with mean age of 54.734 years. The mean recall time was 2.448 years. FCRs and their distribution were as follows: 4 anterior teeth, 14 premolars, and 109 molars. There were 103 nonsurgical root canal treatments and 24 retreatments. Patients who presented for recall had 74 porcelain fused to metal crowns, 17 zirconia crowns, 15 abutments of porcelain fused to metal bridges, 14 lithium disilicate crowns, 5 gold crowns, 1 full metal crown, and 1 gold onlay. RESULTS There were no endodontically related failures. Six cases failed; 3 were due to vertical root fractures, 1 was due to horizontal root fracture, and 2 were due to extensive recurrent caries causing restorative failure. The percentage of healed cases following the American Association of Endodontists outcome criteria adopted in 2004 with intact retained FCR was 95.3%. CONCLUSIONS The results suggest predictable favorable outcomes for nonsurgical endodontic treatment through FCR following the proposed protocol for diagnosis, treatment, and restoration.
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Affiliation(s)
- Omar E Abusteit
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota.
| | - Sherif Hosney
- Division of Prosthodontics, College of Dentistry, University of Florida, Gainesville, Florida
| | - Ahmed S ElSheshtawy
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ronald Ordinola Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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Montero E, Molina A, Palombo D, Morón B, Pradíes G, Sanz-Sánchez I. Efficacy and risks of tooth-supported prostheses in the treatment of partially edentulous patients with stage IV periodontitis. A systematic review and meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:182-207. [PMID: 34786742 DOI: 10.1111/jcpe.13482] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/26/2021] [Accepted: 03/31/2021] [Indexed: 01/08/2023]
Abstract
AIM The aim was to evaluate the efficacy and effectiveness of tooth-supported fixed prostheses in partially edentulous patients with stage IV periodontitis. MATERIAL AND METHODS Randomized and controlled clinical trials (RCTs and CCTs) and prospective/retrospective cohort studies or case series were searched in three databases. Survival rate of abutment teeth was considered the primary outcome. Meta-analyses were performed whenever possible. RESULTS Twenty-four publications were included. No RCTs or CCTs compared the efficacy of tooth-supported fixed prostheses between patients with severe periodontitis or non-periodontitis patients. Most of the data retrieved were derived from case series. The incidence of abutment-tooth loss after a follow-up period from 2 to 35.4 years was low (n = 17 studies; weighted mean incidence (WMI) = 4.8%; confidence interval (CI) [3.2, 6.5]). The corresponding figure for prostheses failure was WMI = 6.9% (n = 18; 95% CI [4.1, 9.7]). Technical complications seemed to be more frequent than biological complications (caries, endodontic failure, root fracture, etc.). Periodontal outcomes tended to remain stable over time. CONCLUSION Tooth-supported fixed prostheses seemed to be a valid treatment approach to restore masticatory function in patients with stage IV periodontitis once periodontal therapy has been accomplished. However, the comparative efficacy of this treatment among periodontitis and non-periodontitis patients is unclear due to the absence of clinical trials.
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Affiliation(s)
| | - Ana Molina
- Universidad Complutense de Madrid, Madrid, Spain
| | | | - Belén Morón
- Universidad Complutense de Madrid, Madrid, Spain
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Pousette Lundgren G, Davidson T, Dahllöf G. Cost analysis of prosthetic rehabilitation in young patients with Amelogenesis imperfecta. J Dent 2021; 115:103850. [PMID: 34656659 DOI: 10.1016/j.jdent.2021.103850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood. METHODS Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3 ± 1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used. RESULTS The mean number of visits was significantly higher in the AI group: 43.3 ± 19.7 (controls: 17.5 ± 19.8; p < .001). Mean total costs were 8.5 times higher for patients with AI: €16,257 ± 5,595 (controls: €1,904 ± 993). Mean number of crowns made in patients with AI was 12 ± 7 (range 1 - 31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were €18,475 for prosthetic rehabilitation began at age 12 years compared with €20,227 if treatment began at 20 years of age. CONCLUSIONS Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits. CLINICAL IMPLICATIONS Early crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.
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Affiliation(s)
- Gunilla Pousette Lundgren
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Thomas Davidson
- Division of Health Care Analysis, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Oral Health Services and Research, Mid-Norway, TkMidt, Trondheim, Norway
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Shelar P, Abdolvand H, Butler S. On the behaviour of zirconia-based dental materials: A review. J Mech Behav Biomed Mater 2021; 124:104861. [PMID: 34600431 DOI: 10.1016/j.jmbbm.2021.104861] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022]
Abstract
Zirconia-based dental materials are extensively used in clinical practice due to their tooth-like appearance, biofunctionality, biocompatibility, and affordability. However, premature clinical failures of veneering porcelains raise a concern about their integrity. Extensive studies have been performed over a decade to resolve this issue, but it is challenging to reference all information effectively. A single source identifying the significance of potential parameters on material performance has not previously been available. An evidence-based meta-narrative review technique was used to review the characteristic parameters that can affect the overall behaviour of zirconia-based materials. Keywords were chosen to assess manuscripts based on scientific coherence with this paper's research objective. Online keyword searches were carried out on ScienceDirect, PubMed, and SAGE databases for relevant published manuscripts from year 1985-2020.261 out of 3170 identified manuscripts were included. A total of 10 parameters were identified and classified into the material, manufacturing, and geometric aspects. The effect of every parameter was reviewed on the performance of the material. A discrepancy in findings was observed and is attributed to the fact that there is no standard methodology. This review acts as a single source that summarizes various parameters' contribution to zirconia-based dental materials' performance. This review facilitates manufacturing improvements by accounting for every parameter's effect on overall performance.
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Affiliation(s)
- Prashant Shelar
- Department of Mechanical & Materials Engineering, Western University, London, Ontario, Canada
| | - Hamidreza Abdolvand
- Department of Mechanical & Materials Engineering, Western University, London, Ontario, Canada
| | - Sheila Butler
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
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30
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Kohli S, Bhatia S, Al-Haddad A, Pulikkotil SJ, Jamayet NB. Pulpal and Periapical Status of the Vital Teeth Used as Abutment for Fixed Prosthesis-A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:102-114. [PMID: 34516686 DOI: 10.1111/jopr.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This is a systematic review to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed partial dentures (FPDs). MATERIALS AND METHODS Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots. RESULTS Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I2 = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I2 = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I2 = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I2 = 95.01%. CONCLUSIONS The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
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Affiliation(s)
- Shivani Kohli
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Shekhar Bhatia
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
| | - Shaju Jacob Pulikkotil
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Nafij Bin Jamayet
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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31
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Kao RT, Lin GH, Kapila Y, Sadowsky S, Curtis DA. A commentary on strategic extraction. J Periodontol 2021; 93:11-19. [PMID: 34435680 DOI: 10.1002/jper.20-0855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/23/2021] [Accepted: 08/10/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Advancements in strategies to maintain compromised teeth combined with a greater understanding of risks associated with dental implants invite a reassessment of the benefits of strategic extraction of a tooth with a questionable prognosis or of limited strategic value. METHODS Evidence of the management of compromised teeth and decision making for strategic extraction was reviewed. Additionally, the risks for peri-implantitis were evaluated from the perspective of patient centric, biologic, and biomechanical complications. RESULTS Recent clinical innovations support a more predictable maintenance of compromised dentition, and the clinical literature provides evidence of the risks associated with dental implants. CONCLUSIONS Because of the improvements in dental management of compromised dentition, strategic extraction should be deferred, whenever possible, to avoid complications associated with peri-implantitis.
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Affiliation(s)
- Richard T Kao
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California.,Private Practice, San Jose, California
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California
| | - Steven Sadowsky
- Department of Preventive and Restorative Dentistry, School of Dentistry, University of the Pacific, San Francisco, California
| | - Donald A Curtis
- Department of Restorative Dentistry, School of Dentistry, University of California, San Francisco, California
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Shelar P, Butler S. Effect of thermal gradient on structural relaxation and characterization of thermal stresses in dental porcelains - A finite element study. J Mech Behav Biomed Mater 2021; 122:104693. [PMID: 34293694 DOI: 10.1016/j.jmbbm.2021.104693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Zirconia-based materials veneered with glassy porcelain have become the material of choice for both dentists and their patients. This restoration material is now extensively used in clinical practice for the following reasons: material closely resembles tooth appearance, biofunctionality, biocompatibility and affordability. However, premature clinical failures due to the combination of subsurface flaws and tensile stresses within porcelains raise a concern about their reliability and integrity. This study evaluates structural relaxation in dental porcelain to form a suitable explanation for subsurface tensile stresses. Finite Element Method (FEM) is used for this analysis. User material subroutines, UEXPAN, and UTRS, were developed and integrated into a finite element solver to study the effects of structural relaxation on thermal stresses in veneer during final heat treatment. The predictions of the model were validated through qualitative and quantitave means. A validated model was used for Finite Element Analysis (FEA). Faster cooling rates and high veneer thickness predicted high subsurface tensile stresses due to ineffective structural relaxation. Slow cooling rates and lower veneer thickness showed desired compressive stresses in subsurface areas with visible structural relaxation. This work, emphasizing structural relaxation in veneering dental porcelain, provides a way forward for effective designing of dental restorations. Accordingly, it is useful to tailor the desired stress state for extended life in veneered dental porcelains on zirconia frameworks.
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Affiliation(s)
- Prashant Shelar
- Department of Mechanical & Materials Engineering, Western University, London, Ontario, Canada
| | - Sheila Butler
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
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Nejat AH, Dupree P, Kee E, Xu X, Zakkour W, Odom M, Bruggers K, Mascarenhas F. Effect of Endodontic Access Preparation on Fracture Load of Translucent versus Conventional Zirconia Crowns with Varying Occlusal Thicknesses. J Prosthodont 2021; 30:706-710. [DOI: 10.1111/jopr.13337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Amir H. Nejat
- Prosthodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Peter Dupree
- Comprehensive Dentistry and Biomaterials Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Edwin Kee
- Prosthodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Xiaoming Xu
- Oral and Craniofacial Biology Department, Division of Biomaterials Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Wael Zakkour
- Prosthodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Mark Odom
- Endodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Karen Bruggers
- Prosthodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
| | - Faye Mascarenhas
- Prosthodontics Department Louisiana State University Health Science Center, School of Dentistry New Orleans LA
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Schriwer C, Gjerdet NR, Arola D, Øilo M. The effect of preparation taper on the resistance to fracture of monolithic zirconia crowns. Dent Mater 2021; 37:e427-e434. [PMID: 33910755 DOI: 10.1016/j.dental.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/15/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Monolithic zirconia crowns have become a viable alternative to conventional layered restorations. The aim of this study was to evaluate whether the taper, and thus wall thickness, of the abutment or pre-defined cement space affect the fracture resistance or fracture mode of monolithic zirconia crowns. METHODS A model tooth was prepared with a taper of 15° and a shallow circumferential chamfer preparation (0.5 mm). Two additional models were made based on the master model with a taper of 10° and 30° using computer-aided design software. Twenty monolithic 3rd generation translucent zirconia crowns were produced for each model with pre-defined cement space set to either 30 μm or 60 μm (n = 60). The estimated cement thickness was assessed by the replica method. The cemented crowns were loaded centrally in the occlusal fossa at 0.5 mm/min until fracture. Fractographic analyses were performed on all fractured crowns. RESULTS The load at fracture was statistically significant different between the groups (p < 0.05). The crowns with 30° taper fractured at lower loads than those with 10° and 15° taper, regardless of the cement space (p < 0.05). The fracture origin for 47/60 crowns (78%) was in the cervical area, close to the top of the curvature in the mesial or distal crown margin. The remaining fractures started at the internal surface of the occlusal area and propagated cervically. SIGNIFICANCE The fracture resistance of the monolithic zirconia crowns was lower for crowns with very large taper compared to 10 and 15° taper even though the crown walls were thicker.
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Affiliation(s)
- Christian Schriwer
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway.
| | - Nils Roar Gjerdet
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway
| | - Dwayne Arola
- Materials Science and Engineering, University of Washington, USA; Department of Restorative Dentistry, Dental School, University of Washington, USA
| | - Marit Øilo
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway
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Radiographic periapical healing associated with root-treated teeth accessed through existing crowns: a historical controlled cohort study. Clin Oral Investig 2021; 25:5807-5814. [PMID: 33730213 DOI: 10.1007/s00784-021-03885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to determine the periapical healing rate and complications arising from non-surgical root canal treatment (NSRCT) conducted through the existing and retained restoration, compared to that conducted after removal of restoration (direct or indirect) with subsequent placement of a new crown. MATERIALS AND METHODS Two-hundred-and-forty-five teeth met the inclusion criteria and were followed up for 2 years. One-hundred-and-six teeth had NSRCT completed through existing cast restorations, and 57 and 82 had the existing crowns and direct restorations removed (respectively) and received a new crown after NSRCT. Periapical healing was assessed radiographically using strict (complete healing) and loose (complete and incomplete healing) criteria. Multivariable logistic regression models were used to investigate the effect of prior restoration removal on periapical healing following NSRCT, adjusting for potential confounding (p < 0.05). RESULTS There was no significant (p > 0.05) difference in the periapical healing rates amongst teeth accessed through existing crowns (72%, 90%) versus those where crowns (79%, 93%) or direct restorations (77%, 90%) were removed for NSRCT. The findings were adjusted for the significant influencing factor: size of pre-operative radiolucency (p < 0.05). Of the 109 teeth that were initially accessed through existing crowns, 9 (8%) displayed porcelain fracture or crown de-cementation. CONCLUSION Performing root canal treatment through an existing full coverage restoration did not compromise periapical healing and was associated with a low incidence of associated complications. CLINICAL RELEVANCE Crown removal before NSRCT is not mandatory for periapical healing but requires a judicious pre-assessment of current and future marginal and restorative integrity.
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Haralur SB, Al Ghaseb GA, Alqahtani NA, Alqahtani B. Comparison of microleakage between different restorative materials to restore marginal gap at crown margin. PeerJ 2021; 9:e10823. [PMID: 33665019 PMCID: PMC7916530 DOI: 10.7717/peerj.10823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background An occurrence of secondary caries around the indirect restoration margin is reported to remain a leading cause of failures. Objective This study aimed to test the interfacial microleakage of conventional glass-ionomer (CGI), resin-modified glass ionomer (RMGI) and Nano-hybrid composite (CR) restorations at a full veneer margin crown. Methods Ninety human extracted molar teeth were divided into three groups (n = 30). Each group was subdivided into three subgroups (n = 10) according to the extent of the structural defects; The structural defect in G1 had a depth of 1.5 mm, width and length at 2 mm and 1 mm intrusion within the crown cervical margin. The corresponding structural defect dimension values for G2 were 2, 5, 4 and 2 mm with defects extending onto the root structure. Meanwhile, G3: structural deficiency of 2 mm depth, 3 mm width and 3 mm length and with 1.5 mm extension into the prepared teeth. These structural defects in each subgroup were restored with CGI, RMGI and CR. Artificial carious lesion formation was induced at the cervical finish line with a demineralizing solution. The artificial carious lesions were restored as per the group distribution. Subsequently, teeth samples were prepared and cemented with Nickel-chromium full coverage restorations utilizing glass-ionomer luting cement. Teeth samples were thermocycled, isolated with nail varnish, and immersed in 0.1% methylene blue for 24 h. The teeth samples were sectioned longitudinally, dye penetration was evaluated with a stereomicroscope. The data were analyzed with Kruskal–Wallis and Mann–Whitney U tests. Results CGI-G1 recorded the highest micro-leakage score at 1.450; while CR-G3 recorded the least score (0.350). At a cementum-restoration interface, CR-G1 (0.850) documented the lowest micro-leakage; RMGI-G3 had a greater value at 1.700. Conclusions The hybrid CR could be effectively used to restore the restoration of a marginal gap around crown margins.
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Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Ghaseb Ahmed Al Ghaseb
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Norah Ali Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
| | - Bader Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Asir, Saudi Arabia
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Influence of Polymeric Restorative Materials on the Stress Distribution in Posterior Fixed Partial Dentures: 3D Finite Element Analysis. Polymers (Basel) 2021; 13:polym13050758. [PMID: 33670991 PMCID: PMC7957672 DOI: 10.3390/polym13050758] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 01/06/2023] Open
Abstract
Background: This study evaluated the effect of interim restorative materials (acrylic resin (AR), resin composite (RC) or polyetheretherketone (PEEK) for dental computer-aided design/computer-aided manufacturing (CAD/CAM)) on the stress distribution of a posterior three-unit fixed partial denture. Methods: The abutment teeth (first molar and first premolar) were modeled using the BioCAD protocol containing 1.5 mm of axial reduction and converging axial walls. A static structural analysis was performed in the computer-aided engineering software, and the Maximum Principal Stress criterion was used to analyze the prosthesis and the cement layers of both abutment teeth. The materials were considered isotropic, linearly elastic, homogeneous and with bonded contacts. An axial load (600 N) was applied to the occlusal surface of the second premolar. Results: Regardless of the restorative material, the region of the prosthetic connectors showed the highest tensile stress magnitude. The highest stress peak was observed with the use of RC (129 MPa) compared to PEEK and AR. For the cement layers, RC showed the lowest values in the occlusal region (7 MPa) and the highest values for the cervical margin (14 MPa) compared to PEEK (21 and 12 MPa) and AR (21 and 13 MPa). Conclusions: Different interim restorative materials for posterior fixed partial dentures present different biomechanical behavior. The use of resin composite can attenuate the stress magnitude on the cement layer, and the use of acrylic resin can attenuate the stress magnitude on the connector region.
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Tahani B, Rashno A, Haghighi H, Monirifard R, Khomami HN, Kafieh R. Automatic Evaluation of Crown Preparation Using Image Processing Techniques: A Substitute to Faculty Scoring in Dental Education. JOURNAL OF MEDICAL SIGNALS & SENSORS 2021; 10:239-248. [PMID: 33575196 PMCID: PMC7866943 DOI: 10.4103/jmss.jmss_5_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 11/09/2022]
Abstract
Background: This study presents a new and innovative experimental method, including software and its prerequisite instruments, to use image processing techniques for crown preparation analysis. Method: A platform was designed and constructed to take images from artificial teeth in different angles and directions and to process and analyze them by the proposed method to evaluate the quality and quantity of crown preparation. For each tooth, two series of images were taken from the artificial teeth before and after preparation, and image series were registered by two semi-automated and automated methods to transform them into one coordinate system. Region of interest was segmented by user interaction, and tooth region was segmented by substeps such as transformation to hue, saturation, and value color space, edge detection, morphology operations, and contour extraction. Finally, the amount and angle of crown preparation were computed and compared with standard measures to evaluate the quality of crown preparation. The proposed method was applied to a local dataset collected from Isfahan University of Medical Sciences. Results: Difference between the angle of crown preparation computed by the proposed method and that of the experts showed a mean absolute error of 7.17°. The correlation between the segmented regions by the proposed method and those of the experts was also evaluated by the Intersection over Union (IOU) criterion. The best and worst performances achieved in cases by IOU were 0.94 and 0.76, respectively. Finally, the segmentation results of the proposed method indicated an average IOU of 0.89 in all images. Conclusion: Students can use this method as an assessment tool in preclinical tooth preparation to compare their crown work with standard parameters.
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Affiliation(s)
- Bahareh Tahani
- Department of Dental Public Health, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Khorramabad, Iran
| | - Abdolreza Rashno
- Department of Computer Engineering, Faculty of Engineering, Lorestan University, Khorramabad, Iran
| | - Hamed Haghighi
- School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Rasoul Monirifard
- Department of Prosthodontics, Dental Research Center, Dental Research Institute, Isfahan University of Medical Science, Isfahan
| | - Hooman Nosrati Khomami
- Department of Electrical Engineering, Sepahan Science and Technology Institute of Higher Education, Iran
| | - Rahele Kafieh
- Medical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Khorramabad, Iran
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Clinical performance of CAD-CAM crowns provided by predoctoral students at the University of Toronto. J Prosthet Dent 2021; 127:729-736. [PMID: 33423821 DOI: 10.1016/j.prosdent.2020.09.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM The clinical success of monolithic lithium disilicate glass-ceramic (LDGC) crowns manufactured with computer-aided design and computer-aided manufacturing (CAD-CAM) technology provided by predoctoral students has not been fully investigated. PURPOSE The purpose of this retrospective clinical study was to evaluate the performance of laboratory-fabricated monolithic posterior LDGC CAD-CAM crowns provided by predoctoral students at the University of Toronto. Specific patient- and provider-related factors were also investigated. MATERIAL AND METHODS A sample of posterior LDGC CAD-CAM crowns (IPS e.max) provided by predoctoral students was evaluated. Crown preparations were made according to specific criteria, and crowns were milled in an in-house laboratory by using the CEREC Bluecam system. The crowns were cemented with Rely-X Unicem (3M ESPE) and Calibra Universal (Dentsply Sirona) resin cements. Clinical assessments of the crowns and supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Intraoral photographs and periapical and bitewing radiographs were obtained for further assessment by 2 evaluators. Descriptive statistics, McNemar, t test, log rank (Mantel-Cox) tests, Pearson chi-squared tests, simple logistic regression, odds ratios, and Kaplan Meier survival analyses were performed (α=.05). RESULTS A total of 189 patients receiving 210 crowns (108 premolar and 102 molar) were examined with a follow-up period of up to 6 years. Altogether, 28 complications were observed (12 technical, 11 biological, and 5 esthetic). No significant association was found between patient age, sex, periodontal condition, tooth type, tooth vitality, cement type, and crown longevity. However, significantly lower survival and success rates were found for mandibular crowns than for maxillary crowns (P=.029). The provider's experience had no significant effect on the clinical performance of LDGC CAD-CAM crowns. The 6-year cumulative survival rate was 93.0%, and the success rate was 86.4%. CONCLUSIONS The ease of use of the CAD-CAM system and clinical performance of LDGC suggest that this technology should be used in the dental school setting by predoctoral students.
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Mani R, Thomas A, Kumar Reddy T, Ramaswamy H, Kumar SA, Elavarasu P. A survey assessing the knowledge and perception of dental practitioners on the need for prophylactic endodontic treatment in abutment teeth for fixed partial dentures. J Conserv Dent 2021; 24:384-388. [PMID: 35282583 PMCID: PMC8896141 DOI: 10.4103/jcd.jcd_180_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Tooth preparation for fixed prosthodontic procedures often induces enough thermal or mechanical stresses on the pulp. The extent of pulpal injury and ability to repair depends on factors like amount of remaining dentin, extent of heat produced, and permeability of dentinal tubules. However, there is no infallible method to predict the pulpal response and so the treatment outcome. Aim: This survey tries to assess the knowledge and perception among dental practitioners on the need for prophylactic endodontic therapy in abutment teeth for fixed partial denture (FPD). Setting and Design: Questionnaire-based survey. Methodology: An observational study was then conducted among 303 dental practitioners in the state of Tamil Nadu and 250 participants responded. Statistical Analysis Used: Descriptive statistics and multiple linear regression analysis. Results and Conclusion: The survey further imparts light on the clinical outcomes that help minimize the incidence of biological failure underneath a FPD.
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Sato E, Shigemitsu R, Mito T, Yoda N, Rasmussen J, Sasaki K. The effects of bone remodeling on biomechanical behavior in a patient with an implant-supported overdenture. Comput Biol Med 2020; 129:104173. [PMID: 33360261 DOI: 10.1016/j.compbiomed.2020.104173] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/18/2022]
Abstract
This study aimed to clarify the effects of bone remodeling on biomechanical behavior in a patient with a mandibular implant-supported overdenture by comparing computed tomography-based finite element analyses (CT-FEA) with two time points of CT data. The present FEA was based on CT data collected from a 62-year-old female subject, who wore a mandibular implant overdenture supported by four dental implants with bar attachment. Two kinds of FE models were constructed from CT data taken at two time points: pre-implantation (Original-model) and 12 years post-implantation (Aged-model). FE models consisted of patient-specific model geometry and heterogeneous material properties. The deviation analysis was carried out to assess the changes in bone mass over a period of 12 years. The results show an averaging of intraosseous stress and strain energy density between the implant regions in the Aged-model. The results of the morphological assessments demonstrated that the bone mass and quality had significantly changed over 12 years. Area-specific bone resorption was also observed at the bone surrounding each implant. The combined findings indicate that the averaging of mechanical variables was due to chronological changes in bone morphology, suggesting adaptation to mechanical loads by peri-implant bone remodeling.
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Affiliation(s)
- Emika Sato
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
| | - Ryuji Shigemitsu
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan; Department of Materials and Production, Aalborg University, Fibigerstrade 16, Aalborg East, DK, 9220, Denmark.
| | - Takehiko Mito
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
| | - John Rasmussen
- Department of Materials and Production, Aalborg University, Fibigerstrade 16, Aalborg East, DK, 9220, Denmark
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
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Ismail IA, Alhajj MN. Accuracy of different impression techniques for multiunit implant restoration: A qualitative in vitro study. J Prosthet Dent 2020; 124:729.e1-729.e5. [DOI: 10.1016/j.prosdent.2020.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
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Kim J, Son K, Lee KB. Displacement of scan body during screw tightening: A comparative in vitro study. J Adv Prosthodont 2020; 12:307-315. [PMID: 33149852 PMCID: PMC7604234 DOI: 10.4047/jap.2020.12.5.307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the occurrence of displacement while tightening the screw of scan bodies, which were compared according to the material type. MATERIALS AND METHODS Three types of scan bodies whose base regions were made up of polyether ether ketone (PEEK) material [Straumann Group, Dentium Group, and Myfit (PEEK) Group] and another scan body whose base region was made up of titanium material [Myfit (Metal) Group] were used (15 per group). The reference model was fabricated by aligning the scan body library on the central axis of the implant, and moving this position by the resin model. The screws of the scan bodies were tightened to the implant fixture with torques of 5 Ncm, 10 Ncm, and a hand tightening torque. After the application of the torque, the scan bodies were scanned using a laboratory scanner. To evaluate the vertical, horizontal, and 3-dimensional (3D) displacements, a 3D inspection software program was used. To examine the difference among groups, one-way analysis of variance and Tukey's HSD post hoc test were used (α=.05). RESULTS There were significant differences in 3D, vertical, and horizontal displacements among the different types of scan bodies (P<.001). There was a significantly lower displacement in the Straumann group than in the Myfit (PEEK) and Dentium groups (P<.05). CONCLUSION The horizontal displacement in all groups was less than 10 µm. With the hand tightening torque, a high vertical displacement of over 100 µm occurred in PEEK scan bodies (Myfit and Dentium). Therefore, it is recommended to apply a tightening torque of 5 Ncm instead of a hand tightening torque.
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Affiliation(s)
- JungHan Kim
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea
| | - KeunBaDa Son
- Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea.,Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea.,Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea
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Al-Odinee NM, Al-Hamzi M, Al-Shami IZ, Madfa A, Al-Kholani AI, Al-Olofi YM. Evaluation of the quality of fixed prosthesis impressions in private laboratories in a sample from Yemen. BMC Oral Health 2020; 20:304. [PMID: 33148226 PMCID: PMC7640478 DOI: 10.1186/s12903-020-01294-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/22/2020] [Indexed: 12/05/2022] Open
Abstract
Background Fixed prosthodontics require an accurate impression for the teeth and the area to be restored for the laboratory to fabricate the desired restoration without mistakes. This study evaluated the quality of impressions received by private laboratories for the fabrication of fixed prosthesis by describing the frequency of clinically detectable errors and by analyzing association between the various factors involved. Methods 165 impressions were collected from four dental laboratories. Jaw involved, type of tray, size of tray, number of prepared units, type of impression materials, techniques and viscosity in case of elastomeric impressions and type of prosthesis requested were recorded. Data referring to errors and visible defects including errors in finish line, in preparation area, in silicone impression technique and blood in impression were also documented. Factors affecting errors present were also assessed. Association between dentist gender and experience years and impression errors was assessed. Chi square and Fisher exact tests used to examine the association between categorical variables and outcomes. Results The total of error considering not immediately pouring as an error. Alginate was the most impression used. of impressions evaluated (50.9%), 97% were have at least one visible error; 92.1% had errors in finish line, 53.9% had errors in preparation area and (72.8%) of elastomeric impressions were have at least one error in technique. Blood in impression was detected in 52.1% of impressions. Significant association was found between material type and errors in finishing line and preparation area. Significant relationships were found between gender and errors in silicone impression technique (p < 0.05). Conclusion Within the limitations of this study, high frequency of detectable errors was found in fixed prosthesis impressions received by private dental laboratories. This high frequency is of serious concern, as this will result in poor fitted fixed prosthesis provided to patients.
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Affiliation(s)
- Nusaiba M Al-Odinee
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
| | - Mohsen Al-Hamzi
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.,Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen.,Restorative and Prosthodontic Department, College of Dentistry, University of Science and Technology, Sana'a, Yemen
| | - Ibrahim Z Al-Shami
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Ahmed Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
| | - Abdulwahab I Al-Kholani
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Yazeed M Al-Olofi
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
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Gomes MSS, Rossi NR, Uemura ES, Mesquita AMM, Nishioka RS, Andreatta‐Filho OD, Paes‐Junior TJA, Kojima AN. Development and validation of new methodologies for teaching preparations in fixed partial prosthesis. J Dent Educ 2020; 84:1230-1236. [DOI: 10.1002/jdd.12301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Michelle S. S. Gomes
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | - Natália R. Rossi
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | - Eduardo S. Uemura
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | | | - Renato S. Nishioka
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | - Osvaldo D. Andreatta‐Filho
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | - Tarcísio J. A. Paes‐Junior
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
| | - Alberto N. Kojima
- Department of Dental Materials and Prosthodontics Institute of Science and Technology São Paulo State University (UNESP) São José dos Campos São Paulo Brazil
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Malgaj T, Plut A, Eberlinc A, Drevenšek M, Jevnikar P. Anterior Esthetic Rehabilitation of an Alveolar Cleft Using Novel Minimally Invasive Prosthodontic Techniques: A Case Report. Cleft Palate Craniofac J 2020; 58:912-918. [PMID: 33063533 DOI: 10.1177/1055665620964709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Missing lateral incisors are the most frequent dental disorder associated with cleft alveolus. When orthodontic closure of the edentulous space is not possible, more aggressive prosthodontic treatments are required. Contemporary resin-bonded fixed dental prostheses (RBFDPs) represent a promising, time-efficient alternative treatment with fewer biological complications. This clinical report proposes a modified approach to the esthetic rehabilitation of a patient with a complete unilateral cleft lip and palate on the left side and an incomplete cleft lip and alveolar cleft on the right side. Digital diagnostics, treatment planning, and clinical procedures involved in the fabrication of facially bonded RBFDPs are presented. This modified technique enables the concurrent replacement of lateral incisors and correction of the malformed central incisors as well as increasing the retention of the restorations.
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Affiliation(s)
- Tine Malgaj
- Department of Prosthodontics, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alja Plut
- Department of Orthodontics and Dentofacial Orthopaedics, 37667University Medical Centre Ljubljana, Slovenia
| | - Andreja Eberlinc
- Department of Maxillofacial and Oral Surgery, 37667University Medical Centre Ljubljana, Slovenia
| | - Martina Drevenšek
- Department of Orthodontics and Dentofacial Orthopaedics, 37667University Medical Centre Ljubljana, Slovenia.,Department of Orthodontics and Dentofacial Orthopaedics, 37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Peter Jevnikar
- Department of Prosthodontics, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Prosthodontics, 37667University Medical Centre Ljubljana, Slovenia
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Malament KA, Margvelashvili-Malament M, Natto ZS, Thompson V, Rekow D, Att W. Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate glass-ceramic complete and partial coverage restorations in posterior teeth: Performance and outcomes as a function of tooth position, age, sex, and thickness of ceramic material. J Prosthet Dent 2020; 126:533-545. [PMID: 33010922 DOI: 10.1016/j.prosdent.2020.08.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022]
Abstract
STATEMENT OF PROBLEM Long-term clinical data are lacking on the comparison of the survival of adhesively luted pressed e.max lithium disilicate glass-ceramic complete and partial coverage restorations in posterior dentitions and the effect that different technical and clinical variables have on their survival. PURPOSE The purpose of this clinical study was to examine and compare the 16.9-year survival of posterior pressed e.max lithium disilicate glass-ceramic complete and partial coverage restorations and associated clinical parameters on the outcome. MATERIAL AND METHODS Patients requiring either single-unit posterior defect-specific partial coverage or complete coverage restorations were recruited in a clinical private practice. The participants were offered the options of direct restorations, partial coverage cast gold, or glass-ceramic (lithium disilicate) restorations. Those requiring complete coverage restorations were given the options of complete cast gold, metal-ceramic, or glass-ceramic restorations. Only participants who chose glass-ceramic partial and complete coverage restorations were included in the study. The overall survival of the glass-ceramic restorations was assessed by the clinical factors determined at recall. The effect of various clinical parameters (type of restoration, dental arch, tooth position in the dental arch, age and sex of participant, and ceramic thickness) was evaluated by using Kaplan-Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined using the log rank test (α=.05). RESULTS A total of 738 participants requiring 2392 lithium disilicate restorations in posterior teeth were evaluated. The mean age of the participants at the time of restoration placement was 62 (range: 20-99 years, 302 men and 436 women). Of 2392 units, 1782 were complete and 610 were partial coverage restorations. A total of 22 failures (bulk fracture or large chip) requiring replacement were recorded with the average time to failure 3.5 (0.02-7.9) years. The total time at risk computed for these units was 13227.9 years, providing an estimated failure risk of 0.17% per year. The 16.9-year estimated cumulative survival was 96.49%. The estimated cumulative survival of posterior complete (n=1782) and posterior partial coverage restorations (n=610) was 96.75% at 10.5 years and 95.27% at 16.9 years (P<.05). Of the 22, 16 failures were recorded for the complete coverage restorations. The total time at risk for these restorations was 10144.5 years, providing an estimated risk of 0.16 per year. The other 6 failures recorded occurred for the partial coverage restorations. The total time at risk for these restorations was 3083.5 years, providing an estimated risk of 0.19% per year. No statistically significant difference was found in the survival of posterior complete and partial coverage restorations among men and women, different age groups, or posterior tooth position in the dental arch (P>.05). The thickness of the restoration also had no influence on the survival of glass-ceramic posterior restorations (P>.05). CONCLUSIONS Pressed e.max lithium disilicate complete and partial coverage restorations showed high survival rates in posterior teeth over a 16.9-year period, with an overall failure rate of 0.17% per year. Risk of failure at any age was low for both men and women. No statistically significant difference was found in the survival of complete and partial coverage restorations, and none of the confounding variables, including the thickness of the restoration, appeared to have a significant effect on survival.
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Affiliation(s)
- Kenneth A Malament
- Clinical Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
| | | | - Zuhair S Natto
- Assistant Professor, Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Adjunct Assistant Professor, Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass
| | - Van Thompson
- Professor Emeritus, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Dianne Rekow
- Professor Emeritus, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Wael Att
- Professor and Chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Miura S, Yamauchi S, Kasahara S, Katsuda Y, Fujisawa M, Egusa H. Clinical evaluation of monolithic zirconia crowns: a failure analysis of clinically obtained cases from a 3.5-year study. J Prosthodont Res 2020; 65:148-154. [PMID: 32938882 DOI: 10.2186/jpr.jpor_2019_643] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The primary purpose of this study was to examine the clinical performance of monolithic zirconia single crowns in terms of short-term failure or complications. The secondary purpose was to detect the originating flaws of clinically failed monolithic zirconia crowns to find the causes of failure. METHODS A short-term prospective cohort study based on record evaluation and clinical examination of patients treated with tooth-supported monolithic zirconia crowns was performed in the Department of Fixed Prosthodontics, Tohoku University Hospital, Japan. The crowns were prepared during the follow-up period from April 2014 to July 2018. The 3.5-year cumulative success and survival rates were set as primary endpoints. Fractures of the crown or fragments were inspected under a scanning electron microscope for descriptive fractography. RESULTS During the study period, 40 monolithic zirconia crowns were placed. Four crowns experienced clinical complications, including: 1) fracture of the crown (two crowns), 2) abrasion of the crown (one crown), and 3) fracture of the antagonist tooth (one crown). The estimated Kaplan-Meier 3.5-year success and survival rates were 90.5% (95% confi dence interval [CI]: 73.1-97.1) and 92.8% (95% CI: 74.1-98.3), respectively. Fractography revealed that all fractures were initiated from the wear phase on the occlusal surface. CONCLUSIONS The results of this study suggest that the molar application of monolithic zirconia crowns requires detailed attention to interocclusal clearance and the restoration of the antagonist tooth.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado.,Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Shinobu Yamauchi
- Department of Biomaterials, Nihon University School of Dentistry at Matsudo
| | - Shin Kasahara
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Yusuke Katsuda
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai
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An investigation of tooth loss factors in elderly patients using panoramic radiographs. Oral Radiol 2020; 37:436-442. [PMID: 32809096 DOI: 10.1007/s11282-020-00475-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to observe the dental condition in a group of elderly patients over a period of 10 years in order to clarify important risk factors. MATERIALS AND METHODS Participants were elderly patients (in their eighties) who took panoramic radiographs between 2015 and 2016, and for whom panoramic radiographs taken around 10 year earlier were also available. The number of remaining and lost teeth, the Eichner Index, the presence or absence of molar occlusion, the respective condition of dental pulp, dental crowns, alveolar bone resorption, as well as periapical lesions were investigated through the analysis of panoramic radiographs. Additionally, other important variables were collected from patients' medical records. From the obtained panoramic radiograph sets, the patients' dental condition was investigated, and a systematic comparison was conducted. RESULTS The analysis of the panoramic radiographs showed that the number of remaining teeth decreased from an average of 20.8-15.5, and the percentage of patients with 20 or more teeth decreased from 69.2 to 26.9%. A factor analysis investigating tooth loss risk suggested that tooth loss was associated with the bridge, P2 or greater resorption of the alveolar bone, and apical lesions, and gender (with males having a higher risk compared to females). CONCLUSIONS Teeth showing P2 or greater alveolar bone resorption, bridge, and apical lesions on panoramic radiographs are most likely to be lost in an elderly patient's near future. Consequently, this group should be encouraged to visit their dental clinics regularly and receive comprehensive instruction on individual self-care methods.
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Lee SKY, Muller O, Rasmussen C. Prosthetic Rehabilitation with Amyloidosis of the Tongue. J Prosthodont 2020; 29:725-729. [PMID: 32794594 DOI: 10.1111/jopr.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/27/2022] Open
Abstract
Amyloidosis of the tongue can result in significant and irreversible alterations of tooth position and function due to prolonged application of imbalanced force on the teeth by the enlarged tongue. Due to the rarity of this oral form of systemic disease, little has been elucidated on management of the resulting impaired oral function. While surgery can address the size of the tongue, it carries significant morbidities, enlargement can recur, and does not address adverse tooth positioning. Prosthetic rehabilitation can more aptly restore oral function but it also needs to be tailored based on the patient's expectations and goals as well as biologic and mechanical parameters of treatment. This report discusses an effective and noninvasive application of a tooth-supported, removable prosthesis with an onlay occlusal design to restore occlusion, speech, and esthetics in a patient with tongue-based amyloidosis.
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Affiliation(s)
- Sarah Kay Youny Lee
- Department of Dental Specialties, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905
| | - Olivia Muller
- Department of Dental Specialties, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905
| | - Chad Rasmussen
- Department of Dental Specialties, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905
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