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Raghav PS, Abirami S, Gupta A, Khan Yusufi FN, Afroz S. Effect of different impression techniques on marginal fit of restoration - An In Vitro study. Indian J Dent Res 2023; 34:294-299. [PMID: 38197350 DOI: 10.4103/ijdr.ijdr_991_22] [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] [Indexed: 01/11/2024] Open
Abstract
Introduction Impression making is one such important clinical step, which is critical in the accurate fitting of resulting prostheses. Impression making itself depends on the type of material and the impression technique used to record the details. Various combinations of material and the technique have been described in the literature. Aim To evaluate the effect of three different impression techniques on the marginal fit of computer-aided designed/computer-aided manufactured (CAD/CAM) single unit composite fixed dental prostheses (FDP), different consistencies of addition silicone impression material and different tray design were utilized. Method Impression of prepared tooth on typodont was made using Matrix impression system, two-step putty wash technique, and individual tooth tray technique. Prosthesis was fabricated using CAD/CAM technology and marginal accuracy was evaluated using scanning electron microscopy (SEM). Result In the present study, the matrix impression system resulted in less microgap in both mid-buccal and mid-mesial region, whereas putty wash technique showed very high standard deviation in the interproximal region. Conclusion Matrix impression system had the best results at both mid-buccal and mid-mesial position with least marginal discrepancy. Clinical Implication The findings of this study could be used by clinicians to help them choose the viscosity of polyvinylsiloxane material and impression techniques for FDP that will result in high-accuracy impressions and well-fitting prostheses.
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Affiliation(s)
- Priyanka S Raghav
- Department of Prosthodontics/Dental Materials, Dr. Z. A. Dental College, Aligarh, Uttar Pradesh, India
| | - S Abirami
- Department of Prosthodontics/Dental Materials, Dr. Z. A. Dental College, Aligarh, Uttar Pradesh, India
| | - Abhinav Gupta
- Department of Prosthodontics/Dental Materials, Dr. Z. A. Dental College, Aligarh, Uttar Pradesh, India
| | - Faiz Noor Khan Yusufi
- Department of Statistics and Operations Research, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shaista Afroz
- Department of Prosthodontics/Dental Materials, Dr. Z. A. Dental College, Aligarh, Uttar Pradesh, India
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Evaluating the Three-Dimensional Printing Accuracy of Partial-Arch Models According to Outer Wall Thickness: An In Vitro Study. MATERIALS 2021; 14:ma14226734. [PMID: 34832136 PMCID: PMC8625861 DOI: 10.3390/ma14226734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022]
Abstract
The printing accuracy of three-dimensional (3D) dental models using photopolymer resin affects dental diagnostic procedures and prostheses. The accuracy of research into the outer wall thickness and printing direction data for partial-arch model printing has been insufficient. This study analyzed the effects of wall thickness and printing direction accuracy. Anterior and posterior partial-arch models were designed with different outer wall thicknesses. After 3D printing, a trueness analysis was performed. Those with full-arch models were the control group. The full-arch model had an error value of 73.60 ± 2.61 µm (mean ± standard deviation). The error values for the partial-arch models with 1-, 2-, and 3-mm thick outer walls were 54.80 ± 5.34, 47.58 ± 7.59, and 42.25 ± 9.19 μm, respectively, and that for the fully filled model was 38.20 ± 4.63 μm. The printing accuracies differed significantly between 0 degrees and 60 degrees, at 49.54 ± 8.16 and 40.66 ± 6.80 μm, respectively (F = 153.121, p < 0.001). In conclusion, the trueness of the partial-arch model was better than that of the full-arch model, and models with thick outer walls at 60 degrees were highly accurate.
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Biological Response Induced in Primary Human Gingival Fibroblasts upon Exposure to Various Types of Injectable Astringent Retraction Agents. MATERIALS 2021; 14:ma14082081. [PMID: 33924145 PMCID: PMC8074361 DOI: 10.3390/ma14082081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 12/30/2022]
Abstract
Traditional chemo-mechanical retraction/displacement materials can impact the gingival margin tissues. This study was undertaken to analyze biological responses induced in human gingival fibroblasts (HGFs) upon application of injectable astringent-based agents used in the cordless retraction technique. HGFs were exposed to hemostatic agents (five gels, three pastes, and one foam) based on aluminium chloride, aluminium sulphate and ferric sulphate. Changes in cell viability and proliferation were evaluated using an MTT assay and a BrdU assay. The cytoskeleton structure organization (zyxin and F-actin) was visualized by confocal laser scanning microscopy. Oxidative stress was determined using the Griess Reagent System. The RNA expression levels of antioxidant enzymes were quantified by real-time RT-PCR. The statistical significance was evaluated using Student’s t-test and one-way ANOVA with post-hoc Tukey HSD test. The evaluated agents did not downregulate fibroblast viability or proliferation. No significant cytoskeleton reorganization was observed. Only one agent (Expasyl) induced oxidative stress, demonstrated by the increased level of nitrites. Incubation with the studied agents significantly increased the RNA expression of some antioxidant enzymes (SOD1, SOD3, GPX1). However, no significant influence on the expression of SOD2 and HMOX1 was detected. The injectable forms of chemical retraction agents revealed biocompatibility with HGFs, suggesting their potential clinical usefulness in gingival margin retraction.
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McCracken MS, Litaker MS, Thomson AES, Slootsky A, Gilbert GH. Laboratory Technician Assessment of the Quality of Single-Unit Crown Preparations and Impressions as Predictors of the Clinical Acceptability of Crowns as Determined by the Treating Dentist: Findings from the National Dental Practice-Based Research Network. J Prosthodont 2020; 29:114-123. [PMID: 31893566 DOI: 10.1111/jopr.13137] [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: 12/18/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE In-laboratory assessment by laboratory technicians may offer insight to increase clinical success of dental crowns, and research in this area is lacking. MATERIALS AND METHODS Dentists in the National Dental Practice-Based Research Network enrolled patients in a study about single-unit crowns; laboratory technicians evaluated the quality of tooth preparations and impressions. The primary outcome for each crown was clinical acceptability (CAC), as judged by the treating dentist. A secondary outcome was "Goodness of Fit (GOF)," a composite score of several aspects of clinical fit, also judged by the study dentist. A mixed-effects logistic regression was used to analyze associations between laboratory technician ratings and the CAC and GOF. RESULTS Dentists (n = 205) evaluated 3731 crowns. Technicians ranked the marginal detail of impressions as good or excellent in 92% of cases; other aspects of the impression were ranked good or excellent 88% of the time. Regarding tooth preparation, about 90% of preparations were considered adequate (neither excessive nor inadequate reduction). Factors associated with higher CAC were more preparation taper, and use of optical imaging. Factors associated with better GOF were higher impression quality, greater occlusal reduction, more preparation taper, and optical imaging. CONCLUSIONS Overall quality of preparations and impressions was very high, as evaluated by laboratory technicians. Several clinical parameters were associated with higher CAC and GOF. Clinicians who struggle with crown remakes might consider less conservative tooth preparation, as well as using digital impression technology.
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Affiliation(s)
- Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | | | - Alan Slootsky
- Department of Prosthodontics, Nova Southeastern University, College of Dental Medicine, Davie, FL.,Private Practice of Dentistry, Pompano Beach, FL
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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Clinical acceptance of single-unit crowns and its association with impression and tissue displacement techniques: Findings from the National Dental Practice-Based Research Network. J Prosthet Dent 2019; 123:701-709. [PMID: 31590974 DOI: 10.1016/j.prosdent.2019.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 05/06/2019] [Accepted: 05/22/2019] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM The definitive impression for a single-unit crown involves many material and technique factors that may affect the success of the crown. PURPOSE The purpose of this prospective cohort study was to determine whether impression technique (tray selection), impression material, or tissue displacement technique are associated with the clinical acceptability of the crown (CAC). MATERIAL AND METHODS Dentists in the National Dental Practice-Based Research Network documented details of the preparation, impression, and delivery of 3730 consecutive single-unit crowns. Mixed-effects logistic regression analyses were performed to evaluate associations between impression techniques and materials and the CAC and to assess associations between the presence of a subgingival margin with the displacement technique and the outcome variables CAC and number of impressions required. RESULTS Of the 3730 crowns, 3589 (96.2%) were deemed clinically acceptable. A significant difference in the CAC was found with different impression techniques (P<.001) and different impression materials (P<.001). The percentage of the CAC for digital scans was 99.5%, 95.8% for dual-arch trays, 95.2% for quadrant trays, and 94.0% for complete-arch impression trays. Although no statistically significant difference was found in the CAC produced with dual-arch trays without both mesial and distal contacts, crowns fabricated under these conditions were less likely to achieve excellent occlusion. The percentage of the CAC for digital scans was 99.5%, 97.0% for polyether impressions, 95.5% for polyvinyl siloxane impressions, and 90.5% for other impression materials. Accounting for the location of the margin, the use of a dual-cord displacement technique was significantly associated with lower rates of requiring more than 1 impression (P=.015, odds ratio=1.43). CONCLUSIONS Dual-arch trays produced clinically acceptable crowns; however, if the prepared tooth was unbounded, the occlusal fit was more likely to have been compromised. Digital scans produced a slightly higher rate of CAC than conventional impression materials. The use of a dual-cord technique was associated with a decreased need to remake impressions when the margins were subgingival.
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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Shimizu S, Sato Y, Shirai M, Matsumoto T, Abe M, Ohkubo C. Occlusion accuracy of restorations and removable partial dentures fabricated using the impression under occlusal force with functionally generated path recording. J Oral Sci 2018; 60:484-492. [PMID: 30158340 DOI: 10.2334/josnusd.17-0461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
To evaluate the occlusion accuracy of a novel impression technique, excessively high occlusion and the occlusal contact area during lateral movements were compared between metal restorations (restorations) and removable partial dentures (RPDs) fabricated using conventional and novel techniques. Both restorations and RPDs were fabricated on the simulation model with the precise displacement of the remaining teeth and soft tissue. For the novel technique, functionally generated path (FGP) recording and impression under occlusal force were simultaneously performed using a custom tray with an FGP table. For the two conventional techniques, definitive casts were mounted on an average value articulator and a semi-adjustable articulator in the typical manner. Prostheses were placed on the simulation models, and excessively high occlusion in the intercuspal position and occlusal contact areas during lateral movements were measured. Statistical analyses were performed using Kruskal-Wallis and Steel-Dwass tests (α = 0.05). For both prostheses, conventional techniques showed significantly higher occlusion in the intercuspal position than the novel technique. Moreover, the new technique demonstrated better guidance contact during lateral movements than conventional techniques. This novel technique can be recommended for the fabrication of highly accurate prostheses with appropriate occlusal contact without corrections at delivery.
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Affiliation(s)
- Satoshi Shimizu
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Yohei Sato
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Mai Shirai
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | | | - Minoru Abe
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Chikahiro Ohkubo
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
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Minyé HM, Gilbert GH, Litaker MS, Mungia R, Meyerowitz C, Louis DR, Slootsky A, Gordan VV, McCracken MS. Preparation Techniques Used to Make Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network. J Prosthodont 2018; 27:813-820. [PMID: 30311319 PMCID: PMC6283672 DOI: 10.1111/jopr.12988] [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] [Accepted: 09/25/2018] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To: (1) determine which preparation techniques clinicians use in routine clinical practice for single-unit crown restorations; (2) test whether certain practice, dentist, and patient characteristics are significantly associated with these techniques. MATERIALS AND METHODS Dentists in the National Dental Practice-Based Research Network participated in a questionnaire regarding preparation techniques, dental equipment used for single-unit crown preparations, scheduled chair time, occlusal clearance determination, location of finish lines, magnification during preparation, supplemental lighting, shade selection, use of intraoral photographs, and trimming dies. Survey responses were compared by dentist and practice characteristics using ANOVA. RESULTS Of the 2132 eligible dentists, 1777 (83%) responded to the survey. The top two margin configuration choices for single-unit crown preparation for posterior crowns were chamfer/heavy chamfer (65%) and shoulder (23%). For anterior crowns, the most prevalent choices were the chamfer (54%) and the shoulder (37%) configurations. Regarding shade selection, a combination of dentist, assistant, and patient input was used to select anterior shades 59% of the time. Photographs are used to communicate shade selection with the laboratory in about half of esthetically demanding cases. The ideal finish line was located at the crest of gingival tissue for 49% of respondents; 29% preferred 1 mm below the crest; and 22% preferred the finish line above the crest of tissue. Average chair time scheduled for a crown preparation appointment was 76 ± 21 minutes. Practice and dentist characteristics were significantly associated with margin choice including practice type (p < 0.001), region (p < 0.001), and years since graduation (p < 0.001). CONCLUSIONS Network dentists prefer chamfer/heavy chamfer margin designs, followed by shoulder preparations. These choices were related to practice and dentist characteristics.
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Affiliation(s)
- Helena M Minyé
- Private practice of general dentistry, Odessa and Fort Worth, TX
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Rahma Mungia
- Department of Periodontics University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - David R Louis
- Private practice of general dentistry with HealthPartners, Woodbury, MN
| | - Alan Slootsky
- Private practice of general dentistry, Pompano Beach, FL
| | - Valeria V Gordan
- Restorative Dental Sciences Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL
| | - Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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McCracken MS, Litaker MS, Gordan VV, Karr T, Sowell E, Gilbert GH. Remake Rates for Single-Unit Crowns in Clinical Practice: Findings from The National Dental Practice-Based Research Network. J Prosthodont 2018; 28:122-130. [PMID: 30412320 DOI: 10.1111/jopr.12995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Some crowns returned from the laboratory are clinically unacceptable, and dentists must remake them. The objectives of this study were to: (1) quantify the remake rate of single-unit crowns; and (2) identify factors significantly associated with crown remakes and intraoral fit. MATERIALS AND METHODS Dentists participating in the National Dental Practice-Based Research Network recruited patients needing crowns and documented fabrication techniques, patient characteristics, and outcomes. Crowns were considered clinically acceptable or rejected. Also, various aspects of the clinical fit of the crown were graded and categorized as 'Goodness of Fit (GOF).' Dentist and patient characteristics were tested statistically for associations with crown acceptability and GOF. RESULTS More than 200 dentists participated in this study (N = 205) and evaluated 3750 single-unit crowns. The mean age (years) of patients receiving a crown was 55. The remake rate for crowns was 3.8%. The range of rejection rates among individual practitioners was 0% to 42%. Most clinicians (118, or 58%) did not reject any crowns; all rejections came from 42% of the clinicians (n = 87). The most common reasons for rejections were proximal misfit, marginal errors, and esthetic failures. Fewer years in practice was significantly associated with lower crown success rates and lower fit scores. GOF was also associated with practice busyness and patient insurance status, patient gender (dentists reported better fit for female patients), and patient ethnicity. CONCLUSIONS The crown remake rate in this study was about 4%. Remakes and crown GOF were associated with certain dentist and practice characteristics.
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Affiliation(s)
- Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Valeria V Gordan
- Restorative Dental Sciences Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL
| | | | - Ellen Sowell
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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Rayyan MM, Hussien ANM, Sayed NM, Abdallah R, Osman E, El Saad NA, Ramadan S. Comparison of four cordless gingival displacement systems: A clinical study. J Prosthet Dent 2018; 121:265-270. [PMID: 30722986 DOI: 10.1016/j.prosdent.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Although the conventional chemicomechanical cord technique is widely used, packing the cord into the sulcus may cause pain and bleeding. Cordless displacement techniques have been introduced, but a comparison of these systems is lacking. PURPOSE The purpose of this clinical study was to evaluate the efficiency and gingival response of 4 cordless gingival displacement systems. MATERIAL AND METHODS One hundred twenty teeth in 30 participants were allocated to 4 groups according to the material used: Tr (Traxodent; Premier Dental Products Co), Es (Expasyl; Acteon UK), Ez (Expazen; Acteon UK), and Mr (3M Retraction; 3M ESPE). Baseline measurements of periodontal indices and a digital scan were acquired. The cordless displacement pastes were applied according to the manufacturer's instructions. After removal, a second scan was acquired. Participants were recalled on the 2nd and 14th day to measure periodontal indices and for scans. Screenshots were superimposed to measure changes in the gingiva. Statistical differences among the different materials in achieving lingual and buccal vertical gingival displacement were tested using the related-samples Friedman 2-way ANOVA test by ranks at 3 time points such as immediate, at 2 days, and at 14 days (α=.05). RESULTS Immediate gingival displacement varied with the system used. For horizontal displacement, median values ranged between 150 μm (Tr) and 725 μm (Ez) for buccal displacement and between 93 μm (Tr) and 550 μm (Ez) for lingual displacement. Minimum and maximum displacements also varied and followed a similar trend, with Traxodent providing the lowest displacement. The plaque index and attachment level did not statistically differ before and after the treatment. The periodontal parameters were not statistically significant among the groups at all time intervals, except for the gingival index that increased for all the groups after 2 days. CONCLUSIONS Significant differences were found among the 4 tested systems in both vertical and horizontal gingival displacement. Expasyl, Expazen, and 3M Retraction exceeded the 200-μm requirements for horizontal displacement. Traxodent provided the least displacement in both vertical and horizontal dimensions.
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Affiliation(s)
- Mohammad M Rayyan
- Associate Professor, Prosthodontics, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon.
| | - Ahmed Naguib M Hussien
- Professor, Fixed Prosthodontics, Faculty of Dentistry, Cairo University; Future University, New Cairo, Egypt
| | - Nagwa M Sayed
- Associate Professor, Prosthodontics, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Rima Abdallah
- Clinical Assistant Professor, Periodontology, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon; Lecturer, Department of Periodontology, Lebanese University School of Dentistry, Beirut, Lebanon
| | - Essam Osman
- Professor, Dental Biomaterials, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Nayer Abo El Saad
- Associate Professor, Periodontology, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon; Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Samiha Ramadan
- Head, Diagnosis Clinics, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
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McCracken MS, Litaker MS, George AJ, Durand S, Malekpour S, Marshall DG, Meyerowitz C, Carter L, Gordan VV, Gilbert GH. Impression evaluation and laboratory use for single-unit crowns: Findings from The National Dental Practice-Based Research Network. J Am Dent Assoc 2017; 148:788-796.e4. [PMID: 28822536 DOI: 10.1016/j.adaj.2017.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/11/2017] [Accepted: 06/12/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates. METHODS The authors developed a questionnaire that asked dentists about techniques used to fabricate single-unit crowns. The authors showed dentists photographs of 4 impressions and asked them to accept or reject each impression. The authors correlated answers with dentist and practice characteristics. Other questions pertained to laboratory use and crown remake rates. RESULTS The response rate was 83% (1,777 of 2,132 eligible dentists). Of the 4 impressions evaluated, 3 received consistent responses, with 85% agreement. One impression was more equivocal; 52% accepted the impression. The likelihood of accepting an impression was associated significantly with the clinician's sex, race, ethnicity, and practice busyness. Clinicians produced 18 crowns per month on average, and 9% used in-office milling. Most dentists (59%) reported a remake rate of less than 2%, whereas 17% reported a remake rate greater than 4%. Lower remake rates were associated significantly with more experienced clinicians, optical impressions, and not using dual-arch trays. CONCLUSIONS Although dentists were largely consistent in their evaluation of impressions (> 85%), nonclinical factors were associated with whether an impression was accepted or rejected. Lower crown remake rates were associated with more experienced clinicians, optical impressions, and not using dual-arch trays. PRACTICAL IMPLICATIONS These results provide a snapshot of clinical care considerations among a diverse group of dentists. Clinicians can compare their own remake rates and impression evaluation techniques with those in this sample when developing best practice protocols.
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