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Eggmann F, Orta AL, Abdulmajeed A, Att W, Beuer F, Bergler M, Blatz MB, Brief J, Castro VE, Cooper LF, Han S, Ortiz MA, Paravina RD, Pizzi P, Tholey MJ, Conejo J. Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth. J ESTHET RESTOR DENT 2024. [PMID: 39093128 DOI: 10.1111/jerd.13289] [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: 03/22/2024] [Revised: 07/05/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and nonmetallic biomaterials in posterior teeth. OVERVIEW The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five databases to gather evidence. The recommendations, informed by findings from systematic reviews and formulated based on a two-phase e-Delphi survey, emphasize a comprehensive treatment strategy that includes noninvasive measures alongside restorative interventions for managing dental caries and tooth wear. The recommendations advocate for selecting between direct and indirect restorations on a case-by-case basis, favoring inlays and onlays over crowns to align with minimally invasive dentistry principles. The recommendations highlight the critical role of selecting restorative biomaterials based on clinical performance, esthetic properties, and adherence to manufacturer guidelines. They emphasize the importance of precision in restorative procedures, including tooth preparation, impression taking, contamination control, and luting. Regular follow-up and maintenance tailored to individual patient needs are crucial for the longevity of ceramic and nonmetallic restorations. CONCLUSIONS These PROSEC recommendations provide a framework for dental practitioners to deliver high-quality restorative care, advocating for personalized treatment planning and minimally invasive approaches to optimize oral health outcomes. CLINICAL SIGNIFICANCE The PROSEC North America recommendations highlight the importance of minimally invasive techniques in posterior tooth restorations using ceramic and non-metallic biomaterials. These principles prioritize tooth structure conservation and personalized treatment planning, essential for enhancing clinical outcomes and long-term oral health.
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Affiliation(s)
- Florin Eggmann
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Amelia L Orta
- Department of Advanced Oral Sciences and Therapeutics, Division of Prosthodontics, University of Maryland School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Department of Restorative Sciences, Advanced Education in Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Awab Abdulmajeed
- Department of General Practice and Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wael Att
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Michael Bergler
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jakob Brief
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | | | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sean Han
- Master's Arch, Phoenix, Arizona, USA
| | - Miguel A Ortiz
- Department of Restorative Dentistry, University of Illinois College of Dentistry, Chicago, Illinois, USA
| | - Rade D Paravina
- Department of Restorative Dentistry and Prosthodontics, John M. Powers, PhD, Center for Biomaterials and Biomimetics, The University of Texas School of Dentistry at Houston, Houston, Texas, USA
| | - Peter Pizzi
- Pizzi Dental Studio, Staten Island, New York, USA
| | - Michael J Tholey
- PROSEC gGmbH, Bad Säckingen, Germany
- VITA Zahnfabrik, Bad Säckingen, Germany
| | - Julián Conejo
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Puri N, Atria PJ, Oquendo A, Blatz MB, Sampaio CS. A fully digital workflow involving 3D printed tooth reduction guides and injection resin-indexes to restore an impacted canine. J ESTHET RESTOR DENT 2024. [PMID: 38923112 DOI: 10.1111/jerd.13273] [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: 04/22/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The present clinical report describes a long-term temporary restorative approach using injectable composite to reshape a canine into a central incisor, within the context of an ongoing orthodontic treatment. This treatment protocol describes a fully-digital workflow, incorporating digital designed and 3D printed diagnostic wax up, reduction guides and resin-injection index. CLINICAL CONSIDERATIONS Effective planning is important when aiming to deliver a comprehensive and multidisciplinary workflow, and digital tools serve as invaluable aids. CONCLUSION The use of a fully digital workflow in a comprehensive dental treatment resulted in a predictable and successful outcome for a restoration of a canine that was transformed into a central incisor. CLINICAL SIGNIFICANCE This approach highlights the efficacy of digital technology in achieving precise and successful dental restorations, emphasizing its significance in modern dental practice.
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Affiliation(s)
- Nikita Puri
- APA Advanced Clinical Fellowship Program in Aesthetic Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Pablo J Atria
- Advanced Clinical Fellowship Program in Operative and Digital Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Anabella Oquendo
- APA Advanced Clinical Fellowship Program in Aesthetic Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, Center for Innovation & Precision Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Camila S Sampaio
- APA Advanced Clinical Fellowship Program in Aesthetic Dentistry, New York University College of Dentistry, New York, New York, USA
- Advanced Clinical Fellowship Program in Operative and Digital Dentistry, New York University College of Dentistry, New York, New York, USA
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Giordani G, Ottoboni T, Ottoboni G, Martini CA, Almeida G, Falacho RI. Digital resources for surgical and restorative treatment of excessive gingival display in one session. J ESTHET RESTOR DENT 2024. [PMID: 38837612 DOI: 10.1111/jerd.13269] [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: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE This article aims to showcase the implementation of a digital workflow in addressing a case of multifactorial excessive gingival display in a patient with high esthetic demands, incorporating both surgical and restorative interventions in a single session. CLINICAL CONSIDERATIONS A 28-year-old female patient presented with excessive gingival display, attributed to a combination of short teeth due to altered passive eruption, lip hyperactivity, and a sub-nasal depression that lodged the upper lip during spontaneous smiling. The multidisciplinary treatment strategy encompassed surgical crown lengthening, the placement of a biovolume in the maxillary concavity, and the rehabilitation of the six anterior teeth with direct composite resin, all done in a single session. Smilecloud Biometrics was used to digitally plan the smile, and the final wax-up/mock-up was approved by the patient prior to any irreversible procedure. A digital planning center (GuiderLab) enabled the materialization of the virtual planning and the printing of the periodontal surgical guide, the biovolume, and the resin layering guides for the restorative technique. CONCLUSIONS Adopting a digital workflow in multidisciplinary cases with excessive gingival display leads to predictable and more expedited outcomes, ensuring a favorable result between soft and hard tissues. CLINICAL SIGNIFICANCE Excessive gingival display is a condition with multifactorial etiologies, including dentoalveolar, periodontal, skeletal, or muscular origins, or a combination of these factors. The diagnoses of altered passive eruption and a hypermobile upper lip are common in daily clinical practice and can be successfully managed through surgical crown lengthening and filling of the maxillary concavity, respectively. To achieve the desired outcome, restorative procedures often complement these surgical interventions.
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Affiliation(s)
| | - Thiago Ottoboni
- Private Practice, Blumenau, Santa Catarina, Blumenau, Brazil
| | | | | | - Gabriela Almeida
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui I Falacho
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Almeida G, Marques JA, Van Meerbeek B, Ramos JC, Falacho RI. Particle abrasion as a pre-bonding dentin surface treatment: A scoping review. J ESTHET RESTOR DENT 2024; 36:746-760. [PMID: 38130045 DOI: 10.1111/jerd.13183] [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: 10/30/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This scoping review aims to assess the influence of air abrasion with aluminum oxide and bioactive glass on dentin bond strength. MATERIALS AND METHODS An electronic search was conducted in three databases (PubMed, Cochrane Library, and Embase), on March 3rd, 2023, with previously identified MeSH Terms. A total of 1023 records were screened. Exclusion criteria include primary teeth, air abrasion of a substrate other than sound dentin, use of particles apart from aluminum oxide or bioactive glass, and studies in which bond strength was not assessed. RESULTS Out of the 1023 records, title and abstract screening resulted in the exclusion of 895 and 67 studies, respectively, while full-text analysis excluded another 25 articles. In addition, 5 records were not included, as full texts could not be obtained after requesting the authors. Two cross-references were added. Thus, 33 studies were included in this review. It is important to emphasize the absence of standardization of air abrasion parameters. According to 63.6% of the studies, air abrasion does not influence dentin bond strength. Moreover, 30.3% suggest improving bonding performance, and 6.1% advocate a decrease. CONCLUSIONS Air abrasion with aluminum oxide does not enhance or impair dentin bond strength. The available data on bioactive glass are limited, which hinders conclusive insights. CLINICAL SIGNIFICANCE Dentin air abrasion is a widely applied technique nowadays, with numerous clinical applications. Despite the widespread adoption of this procedure, its potential impact on bonding performance requires a thorough analysis of the existing literature.
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Affiliation(s)
- Gabriela Almeida
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joana A Marques
- Faculty of Medicine, Institute of Endodontics, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Bart Van Meerbeek
- Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, KU Leuven (University of Leuven), Leuven, Belgium
| | - João Carlos Ramos
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Institute of Operative Dentistry, University of Coimbra, Coimbra, Portugal
| | - Rui I Falacho
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Saleem NE, Baitalmal AY, Alsamman RM, Sembawa SN. Attitude of Dental Students Toward Rubber Dam Application: A Cross-Sectional Study. Cureus 2024; 16:e60503. [PMID: 38883128 PMCID: PMC11180472 DOI: 10.7759/cureus.60503] [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: 05/17/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction The rubber dam (RD) system is globally recognized as an indispensable component of dental treatments, ensuring the highest standards of care. The use of RD isolation profoundly impacts the clinical aspects of dental procedures. The aim of this study was to assess the attitudes of dental students toward the use of RD, with an emphasis on evaluating the factors influencing its use among students at Umm Al-Qura University in Makkah city, Kingdom of Saudi Arabia. Methods An online questionnaire was distributed to a population sample of 203 undergraduate dental students in their clinical years at Umm Al-Qura University. Questions covered various aspects, including the frequency of RD use, perceptions of its effectiveness, and prospective intentions for its future use, as well as factors influencing these attitudes. Statistical analysis was performed using SPSS software Version 26 (IBM Corp., Armonk, NY, USA). In addition, the chi-square test and Fisher-Freeman-Halton exact test were used for the comparison of the data at a significance level of p<0.05. Results The questionnaire was completed by 191 participants, with a response rate of 95.5%. Of the students, 189 (99%) used RD during operative procedures for adhesive restorations. Furthermore, 157 (82.2%) students agreed that proper isolation cannot be achieved without RD application. All the advantages of RD application were recognized by 165 (85.9%) of the students. Notably, there was a significant association between the factors limiting the RD application and the students' academic year (p<0.05), with senior students reporting fewer limitations. Responses indicated that 163 (85.3%) of the students received satisfactory training for RD and 165 (86.4%) students had a high intention to continue using RD following graduation. Conclusion Within the limitations of this study, it can be concluded that the results presented a positive attitude toward RD use. However, there is a continued necessity to enhance education and advocate consistent RD application for improved patient care and clinical outcomes.
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Affiliation(s)
- Nagham E Saleem
- College of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Reham M Alsamman
- Division of Operative Dentistry, Department of Restorative Dentistry, College of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| | - Shahinaz N Sembawa
- Division of Dental Public Health, Department of Preventive Dentistry, College of Dental Medicine, Umm Al-Qura University, Makkah, SAU
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Bresser RA, Hofsteenge JW, Buijs GJ, van den Breemer CRG, Özcan M, Cune MS, Gresnigt MMM. Partial glass-ceramic posterior restorations with margins beyond or above the cemento-enamel junction: An observational retrospective clinical study. J Prosthodont Res 2024:JPR_D_23_00219. [PMID: 38684406 DOI: 10.2186/jpr.jpr_d_23_00219] [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: 05/02/2024]
Abstract
PURPOSE This observational retrospective clinical study aimed to investigate the survival and success rates of partial indirect lithium disilicate restorations with margins extending above or beyond the cementoenamel junction (CEJ). METHODS The study included patients who underwent partial indirect lithium disilicate restorations with immediate dentin sealing (IDS) between January 2008 and October 2018. All the restorations were placed in a single general dental practice following a standardized protocol. The impact of various predictive variables on the survival rates was assessed. Moreover, modified United States Public Health Service (USPHS) criteria were used to evaluate the survival quality. RESULTS Totally 1146 partial indirect lithium disilicate restorations in 260 patients were evaluated over an average period of 7.5 years. The cumulative survival and success rates were 97.3% and 95.3%, respectively. Margins extending beyond the cemento-enamel junction did not increase the risk of success or survival failure (P > 0.05). Patients with a high risk of caries, male sex, or non-vital teeth had a significantly higher risk of restoration failure (P < 0.05). Restorations with longer clinical service times exhibited marginally lower clinical quality (P < 0.001). CONCLUSIONS Partial indirect glass-ceramic restorations demonstrated survival and success rates of 97.3% and 95.3%, respectively, over an extended period. However, a higher risk of restoration failure existed in patients with a high caries risk for (pre)molars that had undergone endodontic treatment and in males. In terms of the risk of success or survival failure, comparable results were obtained for the positions of the restoration margin in relation to the cemento-enamel junction.
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Affiliation(s)
- Rijkje A Bresser
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Jelte W Hofsteenge
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Gerrit J Buijs
- Buijs Tandartsen, Clinic for General Dentistry, Groningen, The Netherlands
| | - Carline R G van den Breemer
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
| | - Mutlu Özcan
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- University of Zurich, Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Zurich, Switzerland
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- St. Antonius Hospital, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, The Netherlands
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, The Netherlands
- Martini Hospital, Department of Special Dental Care, Groningen, The Netherlands
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Espona J, Roig E, Ali A, Vidal C, Garcia-Font M, Roig M, Figueras O. Optical impressions assessment for overlay restorations with rubber dam: A clinical trial. J Dent 2024; 143:104825. [PMID: 38157974 DOI: 10.1016/j.jdent.2023.104825] [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: 04/12/2023] [Revised: 12/13/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE The possibility of making impressions of teeth prepared with a rubber dam in place has been proposed; however, this requires trimming and rescanning the mesh, which has been described as a cause of accuracy loss. This study aims to clinically determine whether overlay restorations obtained from a scan with a rubber dam in place have equivalent marginal fit, contact points, and occlusal fit to the same type of restorations obtained from a scan without a rubber dam. MATERIAL AND METHODS Thirty patients who underwent overlay restoration of a molar with at least one neighbouring tooth were selected. After tooth preparation, two scans were performed: one without a rubber dam and the other with a rubber dam. Restorations were randomly created from one scan or another. The marginal fit, interproximal contact points, and occlusal fit were evaluated clinically. Two meshes, with and without rubber dams, were also compared. RESULTS No significant differences were observed in the clinical evaluation of the overlays made of the two meshes. The trueness of the mesh from the impression made with a rubber dam with respect to the mesh without a rubber dam was about 40 µm in the critical areas of the preparation (margins, intaglio, and interproximal contact points). CONCLUSIONS The results of this study show that under the conditions performed and with the equipment used, there are no significant clinical differences between overlay restorations made from a scan with a rubber dam and those made from a scan without a rubber dam. CLINICAL SIGNIFICANCE Scanning with a rubber dam in place may be a valid option for certain types of restorations under certain clinical conditions.
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Affiliation(s)
- José Espona
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elena Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain; Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Akram Ali
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Carla Vidal
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marc Garcia-Font
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Oscar Figueras
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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Bresser RA, Carvalho MA, Naves LZ, Melma H, Cune MS, Gresnigt MMM. Biomechanical behavior of molars restored with direct and indirect restorations in combination with deep margin elevation. J Mech Behav Biomed Mater 2024; 152:106459. [PMID: 38394767 DOI: 10.1016/j.jmbbm.2024.106459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
STATEMENT OF PROBLEM The existing knowledge is insufficient for comprehending the fatigue survival and fracture resistance of molars that have deep approximal direct and indirect restorations, whether with or without deep margin elevation (DME). PURPOSE The aim of this laboratory and in silico study is to investigate the fatigue survival, fracture strength, failure pattern and tooth deformation of molars restored with DME in combination with a direct or indirect restoration. MATERIAL AND METHODS This study utilized 45 extracted sound human molars, divided into three groups (n = 15). Standardized 100% inter-cuspal inlay preparations were performed, extending 2 mm below the CEJ and immediate dentin sealing (IDS) was applied. Group 1 (Co_1) was restored with direct composite; Group 2 (Hyb_2) with a 2 mm DME of direct composite and a glass-ceramic lithium disilicate restoration; Group 3 (Cer_3) a glass-ceramic lithium disilicate restoration. All specimens were exposed to a fatigue process involving thermal-cyclic loading (50N for 1.2 × 106 cycles at 1.7 Hz, between 5 and 55 °C), if teeth survived, they were fractured using a load-to-failure test and failure types were analyzed. Finite element analysis (FEA) was conducted to assess tooth deformation and tensile stress in the restorations. Statistical evaluation of fracture strength was conducted using the Kruskal-Wallis test. Fisher's exact test was utilized to analyze the fracture types and repairability. A statistical significance level of α < 0.05 was set for all analyses. RESULTS All specimens successfully withstood the fatigue testing procedure, and no statistically significant differences in fracture strength were observed among the three groups (P > 0.05). The Fisher's exact test indicated a significant association between the restorative material and fracture type (F2 = 18.315, df = 2, P = 0.004), but also for repairability (F2 = 13.725, df = 2, P = 0.001). Crown-root fractures were significantly more common in the Cer_3 group compared to the Co_1 group (P = 0.001) and the Co_1 group had significantly more repairable fractures (F2 = 13.197, df = 2, P = 0.001). FEA revealed comparable outcomes of deformation among models and higher maximum tensile stress on models with higher frequency of catastrophic failures. CONCLUSIONS All tested restoration materials exhibited comparable fatigue survival and fracture strength in this laboratory and in silico study. However, it is important to recognize the potential for more severe and irreparable fractures when opting for deeply luted glass-ceramic inlay restorations in clinical practice. In such cases, it would be prudent to consider the alternative option being a direct composite approach, because of its more forgiving fracture types and repairability. CLINICAL IMPLICATIONS Molars with deep approximal direct and indirect restorations, whether with or without DME, are comparable in their fatigue survival and fracture resistance to withstand intra-oral forces. Deep direct restorations exhibit more repairable fractures compared to deeply luted glass-ceramics.
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Affiliation(s)
- Rijkje A Bresser
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands.
| | - Marco A Carvalho
- Dental School, Evangelical University of Goias, Anapolis, Brazil
| | - Lucas Z Naves
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - H Melma
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands
| | - Marco S Cune
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands
| | - Marco M M Gresnigt
- University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
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da Rosa LS, Pilecco RO, Soares PM, Rippe MP, Pereira GKR, Valandro LF, Kleverlaan CJ, Feilzer AJ, Tribst JPM. Repair protocols for indirect monolithic restorations: a literature review. PeerJ 2024; 12:e16942. [PMID: 38406292 PMCID: PMC10893862 DOI: 10.7717/peerj.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.
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Affiliation(s)
| | | | | | | | | | | | - Cornelis Johannes Kleverlaan
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J. Feilzer
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
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Stoilov M, Boehmer T, Stoilov L, Stark H, Marder M, Enkling N, Kraus D. Influence of Cementation Mode and Ferrule Design on the Fatigue Resistance of Monolithic Zirconia Endocrowns. J Clin Med 2024; 13:1165. [PMID: 38398475 PMCID: PMC10889707 DOI: 10.3390/jcm13041165] [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: 01/30/2024] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Classic endocrowns made of dental ceramics are considered a promising alternative to traditional post-endodontic restorations. The use of circular ferrules in endocrowns is a topic of controversial discussion. Therefore, the present study aims to evaluate the effect of ferrule design and cementation mode on the fatigue resistance of zirconia endocrowns. Methods: Eighty human molars were divided into four groups (n = 20): NFC (no-ferrule, conventional cementation), NFA (no-ferrule, adhesive luting), FC (ferrule, conventional cementation) and FA (ferrule, adhesive luting). Both the classic and the modified endocrown preparation with a two-millimeter ferrule design were carried out. Endocrowns were fabricated from zirconia using the CEREC system. After thermocycling, specimens were loaded according to the step-stress test up to 1500 N. Results: Failure rate was low; 88.8% of total specimens passed the step-stress test. Fractures were distributed between all groups; no significant differences in fatigue resistance were detected for preparation design and cementation mode. Conclusions: Endocrowns appear to be a promising concept for endodontically treated molars. Ferrule and also cementation mode have only a minor influence on fatigue resistance of zirconia endocrowns. However, at very high forces, the marginal area of the ferrule represents a weak point.
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Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Tobias Boehmer
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Lea Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
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11
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Fernandes JB, Contreras SM, da Silva Spinola M, Batista GR, Bresciani E, Caneppele TMF. Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials. Clin Oral Investig 2023; 28:44. [PMID: 38153565 DOI: 10.1007/s00784-023-05414-3] [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: 09/18/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials? MATERIALS AND METHODS A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model. RESULTS Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value. CONCLUSION Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites. CLINICAL SIGNIFICANCE The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.
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Affiliation(s)
- Juliana Benace Fernandes
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | - Sheila Mondragón Contreras
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | | | - Graziela Ribeiro Batista
- A.T. Still University, Missouri School of Dentistry, 500 W Jefferson St, Kirksville, Missouri, USA
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil
| | - Taciana Marco Ferraz Caneppele
- Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, São José Dos Campos, Brazil.
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12
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Bresser RA, Hofsteenge JW, Wieringa TH, Braun PG, Cune MS, Özcan M, Gresnigt MMM. Clinical longevity of intracoronal restorations made of gold, lithium disilicate, leucite, and indirect resin composite: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4877-4896. [PMID: 37597003 PMCID: PMC10492736 DOI: 10.1007/s00784-023-05050-x] [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: 02/15/2023] [Accepted: 04/28/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials. MATERIAL AND METHODS This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I2 statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05). RESULTS A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I2 = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies. CONCLUSIONS According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations. CLINICAL SIGNIFICANCE Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
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Affiliation(s)
- R A Bresser
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - J W Hofsteenge
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - T H Wieringa
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P G Braun
- Central Medical Library, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M S Cune
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Prosthodontics and Special Dental Care, Department of Oral Maxillofacial Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - M Özcan
- Clinic for Reconstructive Dentistry, Division of Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, The Netherlands
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Robles M, Jurado CA, Azpiazu-Flores FX, Villalobos-Tinoco J, Afrashtehfar KI, Fischer NG. An Innovative 3D Printed Tooth Reduction Guide for Precise Dental Ceramic Veneers. J Funct Biomater 2023; 14:216. [PMID: 37103306 PMCID: PMC10146615 DOI: 10.3390/jfb14040216] [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: 02/17/2023] [Revised: 03/16/2023] [Accepted: 04/09/2023] [Indexed: 04/28/2023] Open
Abstract
Tooth reduction guides allow clinicians to obtain the ideal space required for ceramic restorations. This case report describes a novel design (CAD) for an additive computer-aided manufactured (a-CAM) tooth reduction guide with channels that permitted access for the preparation and evaluation of the reduction with the same guide. The guide features innovative vertical and horizontal channels that permit comprehensive access for preparation and evaluation of the reduction with a periodontal probe, ensuring uniform tooth reduction and avoiding overpreparation. This approach was successfully applied to a female patient with non-carious lesions and white spot lesions, resulting in minimally invasive tooth preparations and hand-crafted laminate veneer restorations that met the patient's aesthetic demands while preserving tooth structure. Compared to traditional silicone reduction guides, this novel design offers greater flexibility, enabling clinicians to evaluate tooth reduction in all directions and providing a more comprehensive assessment. Overall, this 3D printed tooth reduction guide represents a significant advancement in dental restoration technology, offering clinicians a useful tool for achieving optimal outcomes with minimal tooth reduction. Future work is warranted to compare tooth reductions and preparation time for this guide to other 3D printed guides.
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Affiliation(s)
- Manuel Robles
- Department of Restorative Dentistry, Facultad de Odontologia, Universidad Vizcaya de las Americas, Hermosillo 83240, Mexico
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Francisco X. Azpiazu-Flores
- Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Jose Villalobos-Tinoco
- Postgraduate Program in Periodontology and Implant Surgery, Facultad de Odontologia, Universidad Nacional de Rosario, Rosario S2002KTT, Argentina
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55108, USA
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