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Huang B, Chen M, Wang J, Zhang X. Advances in zirconia-based dental materials: Properties, classification, applications, and future prospects. J Dent 2024; 147:105111. [PMID: 38866229 DOI: 10.1016/j.jdent.2024.105111] [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: 03/14/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES Zirconia (ZrO2) ceramics are widely used in dental restorations due to their superior mechanical properties, durability, and ever-improving translucency. This review aims to explore the properties, classification, applications, and recent advancements of zirconia-based dental materials, highlighting their potential to revolutionize dental restoration techniques. STUDY SELECTION, DATA AND SOURCES The most recent literature available in scientific databases (PubMed and Web of Science) reporting advances of zirconia-based materials within the dental field is thoroughly examined and summarized, covering the major keywords "dental zirconia, classification, aesthetic, LTD, applications, manufacturing, surface treatments". CONCLUSIONS An exhaustive overview of the properties, classifications, and applications of dental zirconia was presented, alongside an exploration of future prospects and potential advances. This review highlighted the importance of addressing challenges such as low-temperature degradation resistance and optimizing the balance between mechanical strength and translucency. Also, innovative approaches to improve the performances of zirconia as dental material was discussed. CLINICAL SIGNIFICANCE This review provides a better understanding of zirconia-based dental biomaterials for dentists, helping them to make better choice when choosing a specific material to fabricate the restorations or to place the implant. Moreover, new generations of zirconia are still expected to make progress on key issues such as the long-term applications in dental materials while maintaining both damage resistance and aesthetic appeal, defining the directions for future research.
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Affiliation(s)
- Bo Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mengbing Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Bömicke W, Schwindling FS, Rammelsberg P, Rues S. Bond Strength of Milled and Printed Zirconia to 10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP) Resin Cement as a Function of Ceramic Conditioning, Disinfection and Ageing. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2159. [PMID: 38730965 PMCID: PMC11085335 DOI: 10.3390/ma17092159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024]
Abstract
This study aimed to assess the suitability of printed zirconia (ZrO2) for adhesive cementation compared to milled ZrO2. Surface conditioning protocols and disinfection effects on bond strength were also investigated. ZrO2 discs (n = 14/group) underwent either alumina (Al2O3) airborne particle abrasion (APA; 50 µm, 0.10 MPa) or tribochemical silicatisation (TSC; 110 µm Al2O3, 0.28 MPa and 110 µm silica-modified Al2O3, 0.28 MPa), followed by disinfection (1 min immersion in 70% isopropanol, 15 s water spray, 10 s drying with oil-free air) for half of the discs. A resin cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) was used for bonding (for TSC specimens after application of a primer containing silane and 10-MDP). Tensile bond strength was measured after storage for 24 h at 100% relative humidity or after 30 days in water, including 7500 thermocycles. Surface conditioning significantly affected bond strength, with higher values for TSC specimens. Ageing and the interaction of conditioning, disinfection and ageing also impacted bond strength. Disinfection combined with APA mitigated ageing-related bond strength decrease but exacerbated it for TSC specimens. Despite these effects, high bond strengths were maintained even after disinfection and ageing. Adhesive cementation of printed ZrO2 restorations exhibited comparable bond strengths to milled ZrO2, highlighting its feasibility in clinical applications.
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Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
| | - Stefan Rues
- Department of Prosthetic Dentistry, University of Heidelberg, 69120 Heidelberg, Germany; (P.R.); (S.R.)
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Kasem AT, Abo-Madina M, Al-Zordk W. Influence of retainer design and number of inlay boxes on the biomechanical behavior of zirconia cantilever resin bonded fixed dental prosthesis. J ESTHET RESTOR DENT 2024; 36:652-662. [PMID: 37737460 DOI: 10.1111/jerd.13130] [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: 03/26/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES The development of dental adhesives with enhanced bond strength has assisted minimally invasive dentistry. The aim of this study was to evaluate the fracture load and stress distribution pattern of two retainer designs for posterior cantilever resin bonded fixed dental protheses (RBFDPs). MATERIALS AND METHODS Forty human mandibular molars were divided into two groups according to the retainer design; lingual coverage (LC) and occlusal coverage (OC) retainers. Each main group was then divided according to the number of inlay boxes (n = 10); one inlay and two inlay boxes. High translucency (3Y) zirconia was used to manufacture all restorations, and a dual-polymerizing adhesive resin cement was used for bonding. All specimens underwent 10,000 cycles of thermocycling (5-55°C), 240,000 cycles of dynamic loading (50 N, descending speed v = 30 mm/second, frequency = 1.6 Hz), and failure load test. Both one-way and two-way ANOVA tests were used to analyze the data. The four models included in the in-vitro study are part of the finite element analysis (FEA). When the restorations failed, maximal principal stress values on restorations, enamel, dentin, and luting resin were investigated. RESULTS A statistically significant (p = 0.018) higher failure load was recorded for OC1 (627.00 ± 153.4 N) than the other groups; (548.0 ± 75.6 N, 521.20 ± 11.3 N, and 509.20 ± 14.9 N for LC1, LC2, and OC2, respectively). With regard to failure mode, one inlay box designs showed more favorable failure pattern than those of two inlay boxes. FEA showed higher stress magnitude transmitted to the tooth structure in models LC2 and OC2. CONCLUSIONS Lingual coverage and occlusal coverage retainers are promising designs capable to withstand the normal occlusal force for cantilever RBFDP in premolar area. The use of two inlay boxes decreased the fracture load of the two retainer designs and increased the stress transmitted to the tooth and resulted in high incidence of catastrophic failure. CLINICAL SIGNIFICANCE Monolithic high translucent zirconia RBFDP could be considered as a viable treatment option to substitute missing posterior tooth, with improved esthetics and biocompatibility.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Chaar MS, Passia N, Becker M, Kern M. Long-term clinical outcome of three-unit fixed-fixed posterior zirconia ceramic inlay-retained FDPs with a modified design. J Dent 2024; 140:104781. [PMID: 37981045 DOI: 10.1016/j.jdent.2023.104781] [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: 09/16/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To assess the long-term clinical outcome of posterior inlay-retained fixed dental prostheses (IRFDPs) with a modified design made from zirconia ceramic. METHODS In 30 patients thirty 3-unit IRFDPs were placed to replace 7 premolars (4 in the maxilla, 3 in the mandible), and 23 first molars (15 in the maxilla, 8 in the mandible). Preparations were accomplished in agreement with the general principles for ceramic inlay restorations and modified with a short retainer-wing bevel preparation within the enamel at the buccal and oral sides. The frameworks were milled from 3Y-TZP ceramic, and the pontics were veneered with feldspathic ceramic. All IRFDPs were bonded with a phosphate monomer containing luting resin after air-abrasion of the intaglio surfaces. The patients were recalled 6-12 months after placement, and then annually. Kaplan-Meier analysis was used to calculate the survival and complication rates of the IRFDPs. RESULTS The mean observation time was 10.6 ± 1.5 years. The 10-year cumulative survival rate was 89% with 4 failures, two of them were due to deep secondary caries with loss of retention, one due to repeated debonding with enamel fractures, and one due to generalized progressive periodontitis. The most common complication was chipping of the veneering ceramic (20.1%). Eighteen IRFDPs were free of any type of complication up to 15.4 years, which corresponds to a 10-year cumulative success rate of 70.4%. CONCLUSION The long-term clinical performance of modified IRFDPs made of veneered zirconia ceramics was favorable after 10 years, therefore, they represent a treatment alternative to replace posterior single missing teeth. CLINICAL SIGNIFICANCE Zirconia-based IRFDPs fabricated in the modified design may represent a substance-preserving alternative to conventional posterior FDPs to replace posterior single missing teeth, particularly in cases where implants cannot be placed, and when the adjacent teeth already have small restorations or defects.
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Affiliation(s)
- M Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany.
| | - Nicole Passia
- Department of Prosthodontics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Merlind Becker
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, Kiel 24105, Germany
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Kasem AT, Abo-Madina M, Tribst JPM, Al-Zordk W. Cantilever resin-bonded fixed dental prosthesis to substitute a single premolar: Impact of retainer design and ceramic material after dynamic loading. J Prosthodont Res 2023; 67:595-602. [PMID: 36775338 DOI: 10.2186/jpr.jpr_d_22_00226] [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: 02/12/2023]
Abstract
PURPOSE To evaluate the influence of retainer design and ceramic materials on the durability of minimally invasive cantilever resin-bonded fixed dental prostheses (RBFDPs) after artificial aging. METHODS One hundred caries-free human mandibular molars were prepared as abutments for all-ceramic cantilevered fixed dental prostheses using the following retainer designs: One wing (OW), Two wings (TW), Inlay ring (IR), Lingual coverage (LC), and Occlusal coverage (OC). Two ceramic materials were used: monolithic high translucent zirconia(z) and zirconia-reinforced lithium disilicate (ZLS2) (n=10). All restorations were adhesively bonded with resin cement. The thermocycling of the specimens were performed between 5°C and 55°C for 10,000 cycles and then exposed to 240.000 cycles of dynamic loading on a chewing simulator. All surviving specimens were loaded onto the pontic until failure using a universal testing machine. RESULTS The mean failure load ranged from 124.00 to 627.00 N for the zirconia groups and from 133.30 to 230.00 N for the ZLS2 groups. Regarding the materials, a significantly higher failure load was recorded in the zirconia groups than in the ZLS2 groups (P<0.001), except for OW (P=0.748). Regarding the retainer designs, a significant different failure load was recorded between the different designs except for IR and LC in the zirconia groups, IR and OC, OW and TW, and TW and LC in the ZLS2 groups (P<0.001). CONCLUSIONS Zirconia IR, LC, and OC can be used as cantilever RBFDP in the premolar region. The fracture resistance of the ZLS2 design was below the normal bite force and should not be recommended as the first option.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Kasem AT, Tribst JPM, Abo-Madina M, Al-Zordk W. Evaluation of different designs for posterior cantilever zirconia inlay-retained fixed dental prostheses in missing tooth replacement: Stage one results with 18-month follow-up assessment. J Dent 2023; 137:104688. [PMID: 37669722 DOI: 10.1016/j.jdent.2023.104688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/19/2023] [Accepted: 09/01/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This clinical study aimed to investigate the outcomes and survival rates of different variations of inlay-retained fixed dental prostheses (IR-FDPs) composed of monolithic zirconia ceramic. The IR-FDPs with a single-retainer design were used for replacing missing mandibular second premolars. The research evaluated the effectiveness and longevity of these prostheses in clinical settings. METHODS A total of 30 IR-FDPs (n = 30) were placed for 27 female patients who presented with missing mandibular second premolar teeth. For this study, the mandibular first molar was chosen as a retainer for the cantilever IR-FDPs and the study involved a random assignment of participants into three distinct groups, each comprising 10 individuals (n = 10). The criterion for the grouping was the retainer design: inlay ring (IR), lingual coverage (LC), and occlusal coverage (OC). The three groups included mesial inlay box with the same dimensions (3 mm height, 3 mm width and 2 mm depth). All IR-FDPs were manufactured using monolithic high translucent 3Y zirconia and the connector area to the cantilever pontic was adjusted to dimensions of 3 × 3 mm for all designs. The restorations were bonded using adhesive resin cement. The clinical and radiographic evaluations of the restorations were conducted for a duration of 18 months, following the modified FDI (World Dental Federation) criteria. RESULTS The restorations were observed in stage one for a period of 18 months. Only one restoration in group LC was debonded after 10 months and re-bonded. The clinical quality of all crowns and the patient's satisfaction were high. No adverse soft tissue reactions around the crowns were observed and only one abutment in group IR was endodontically treated after 12 months. CONCLUSIONS Zirconia cantilever IR-FDPs offer a viable short-term treatment option for replacing missing posterior teeth, providing esthetic and functional benefits while minimizing invasiveness. Over an 18-month observation period, these prostheses have demonstrated a remarkable survival rate of 100% and a success rate of 96.6%. These findings suggest the effectiveness and reliability of zirconia cantilever IR-FDPs as a short-term solution for replacing missing posterior teeth. CLINICAL SIGNIFICANCE Zirconia cantilever IR-FDPs could present a practical solution for addressing posterior tooth loss, especially in cases where implant placement is not recommended and conventional fixed dental prostheses entail excessive invasiveness.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - João Paulo M Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, LA 1081, The Netherlands
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt; Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Güngör MB, Nemli SK, Inal CB, Aydin C. Effects of ceramic type, connector dimension, and thermomechanical-aging on the fracture resistance and fit of CAD-CAM produced inlay-retained fixed partial dentures. Dent Mater J 2023:2022-230. [PMID: 37271542 DOI: 10.4012/dmj.2022-230] [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: 06/06/2023]
Abstract
The purpose of the present study is to evaluate the fracture resistance and the fit of CAD-CAM produced inlay-retained fixed partial dentures. Eighteen experimental groups were generated according to different CAD-CAM ceramic materials (zirconia, lithium disilicate, and zirconia-reinforced lithium silicate), different connector dimensions (12, 14, and 16 mm2), and application of thermomechanical-aging (1,200,000 cycles of cyclic loading with simultaneous thermal cycling). Gap values of thermomechanically-aged groups were measured by using periapical radiographs. Then, the specimens were tested for fracture resistance and failure types were examined. The results were statistically analyzed (α=0.05). Higher gap values were observed after aging. Zirconia showed the highest fracture resistance values among the most of the experimental groups. In non-aged groups, the most frequent failure type was decementation in zirconia group. In the aged groups, the most frequent failure type was molar connector fracture. Thermomechanical-aging increased the gap values and decreased the fracture resistance values.
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Affiliation(s)
| | | | | | - Cemal Aydin
- Gazi University, Faculty of Dentistry, Department of Prosthodontics
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Kasem AT, Elsherbiny AA, Abo-Madina M, Tribst JPM, Al-Zordk W. Biomechanical behavior of posterior metal-free cantilever fixed dental prostheses: effect of material and retainer design. Clin Oral Investig 2023; 27:2109-2123. [PMID: 36456895 PMCID: PMC10160170 DOI: 10.1007/s00784-022-04813-2] [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: 07/06/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To study the fracture resistance and stress distribution pattern of translucent zirconia and fiber-reinforced composite cantilever resin-bonded fixed dental prostheses (RPFDPs) with two retainer designs. MATERIALS AND METHODS Forty human mandibular molars were divided into two groups according to the retainer design. The restorations included a premolar pontic and 2 retainer designs: (D1) inlay ring retainer and (D2) lingual coverage retainer. Each main group was then divided according to the material used (n = 10): zirconia (Z) or fiber-reinforced composite (FRC) (F). Restorations were cemented using dual polymerizing adhesive luting resin. All specimens were thermo-cycled (5-55 °C for 10,000 cycles), then subjected to dynamic loading (50 N, 240,000, and 1.6 Hz) and fracture resistance test. The finite element analysis includes the two models of retainer designs used in the in vitro test. Modified von Mises stress values on enamel, dentin, luting resin, and restorations were examined when the restorations failed. RESULTS A significantly higher failure load was recorded for zirconia groups (505.00 ± 61.50 and 548.00 ± 75.63 N for D1Z and D2Z, respectively) than for FRC groups (345.00 ± 42.33 and 375.10 ± 53.62 N for D1F and D2F, respectively) (P = 0.001). With regard to failure mode, D2 showed a more favorable failure pattern than D1. Model D2 resulted in lower stresses in tooth structure than model D1, and zirconia transmitted more stresses to the tooth structure than FRC. CONCLUSIONS The lingual coverage retainer (D2) enhanced the biomechanical performance of the restoration/tooth complex. Considering the failure mode and tooth stress, FRC is a promising treatment option when constructing a cantilever RPFDP. CLINICAL RELEVANCE Dentists should be aware of the biomechanical behavior during the selection of the material and for the replacement of a single missing mandibular premolar tooth with minimally invasive RBFDP.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Trushkowsky R, Asavanamuang P, Khurana D, Passaro L, Carnazza G. Conservatively replacing missing anterior teeth with resin bonded ceramic restorations. J ESTHET RESTOR DENT 2022; 35:567-576. [DOI: 10.1111/jerd.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/09/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Richard Trushkowsky
- Cariology and Comprehensive Care (Part Time Faculty), College of Dentistry, Advanced Program for International Dentists in Aesthetic Dentistry New York University College of Dentistry New York New York USA
| | - Praewvanit Asavanamuang
- Cariology and Comprehensive Care, College of Dentistry, Advanced Program for International Dentists in Aesthetic Dentistry New York University College of Dentistry New York New York USA
| | - Deepakshi Khurana
- Cariology and Comprehensive Care, College of Dentistry, Advanced Program for International Dentists in Aesthetic Dentistry New York University College of Dentistry New York New York USA
| | - Larry Passaro
- Cariology and Comprehensive Care (Part Time Faculty), College of Dentistry, Advanced Program for International Dentists in Aesthetic Dentistry New York University College of Dentistry New York New York USA
| | - Guy Carnazza
- Cariology and Comprehensive Care (Full Time Faculty), College of Dentistry, Advanced Program for International Dentists in Aesthetic Dentistry New York University College of Dentistry New York New York USA
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Limones A, Celemín-Viñuela A, Romeo-Rubio M, Castillo-Oyagüe R, Gómez-Polo M, Martínez Vázquez de Parga JA. Outcome measurements and quality of randomized controlled clinical trials of tooth-supported fixed dental prostheses: A systematic review and qualitative analysis. J Prosthet Dent 2022:S0022-3913(22)00282-7. [PMID: 36109260 DOI: 10.1016/j.prosdent.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The lack of consensus regarding a standardized set of outcome measurements and noncompliance with current reporting guidelines in clinical trials of tooth-supported fixed dental prostheses (FDPs) hamper interstudy comparability, compromise scientific evidence, and waste research effort and resources in prosthetic dentistry. PURPOSE The primary objective of this systematic review was to identify all primary and secondary outcome measurements assessed in randomized controlled trials (RCTs) of tooth-supported FDPs. Secondary objectives were to assess their methodological quality by using the Cochrane Collaboration's risk of bias tool (RoB, v2.0) and their reporting quality by means of a standardized 16-item CONSORT assessment tool through published reports. MATERIAL AND METHODS An electronic search was conducted in MEDLINE, EMBASE, and Cochrane library to identify all RCT-related articles published in the past 10 years. Differences in RoB were tested with the Pearson chi-square test, and those in CONSORT score with the Student t test. RESULTS A total of 64 RCTs from 79 publications were deemed eligible. The diversity of outcome measures used in the field is apparent. Twenty percent of the included studies had a low RoB, 79% showed some concerns, and 1% had a high RoB. The mean ±standard deviation CONSORT compliance score was 22.56 ±3.17. Trials adhered to the CONSORT statement reported lower RoB than those that did not adhere (P<.001). RCTs with a low RoB reported more comprehensive adherence to CONSORT guidelines than those with some concerns (MD 4 [95% CI 1.52-6.48]; P=.004). CONCLUSIONS A standardized core outcome reporting set in clinical research on tooth-supported FDPs remains evident. Adherence to the CONSORT statement continues to be low, with some RoB concerns that can be improved.
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Affiliation(s)
- Alvaro Limones
- Student, Assistant Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain.
| | - Alicia Celemín-Viñuela
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marta Romeo-Rubio
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Raquel Castillo-Oyagüe
- Cathedratic Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Miguel Gómez-Polo
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
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11
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Lee JH. Fully digital workflow for the fabrication of a tooth-colored space maintainer for a young patient. J ESTHET RESTOR DENT 2022; 35:561-566. [PMID: 35731166 DOI: 10.1111/jerd.12939] [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: 12/23/2021] [Revised: 05/20/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Preventive orthodontic therapy with a band and loop is recommended to reduce the prevalence and severity of malocclusion on premature loss of a primary molar. However, when young patients are less cooperative and have a severe gag reflex, using traditional impression methods may be challenging. The use of a conventional metal space maintainer (SM) requires manual laboratory procedures and does not provide optimal esthetics. Moreover, gingival submergence of the wire and gingivitis caused by metal structures may occur. This clinical report describes a complete digital workflow for the fabrication of a zirconia SM to overcome these limitations. CLINICAL CONSIDERATIONS An 8-year-old boy with a band and loop SM for a missing primary mandibular right second molar presented with plaque accumulation around the band, soft tissue impingement by the loop, and loss of cement. A reverse band and loop SM had been proposed for the restoration of the primary mandibular right first molar. After conservative tooth preparation, a digital impression procedure was performed. A customized band and loop SM was designed using a computer-aided design software and milled out of the zirconia block. After sintering, the SM was luted with adhesive resin cement. CONCLUSIONS Using an intraoral scanner, computer-aided design, and computer-aided manufacturing technology, the limitations of traditional impression procedures were overcome, and a zirconia SM with mechanical, biological, and esthetic advantages was fabricated. CLINICAL SIGNIFICANCE Advancements in dental materials and digital technologies allow for the efficient fabrication of a tooth-colored SM with an improved patient satisfaction and reduced human error.
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Affiliation(s)
- Ju-Hyoung Lee
- Department of Predoctoral Clinical Education, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Daegu Dental Clinic Center for the Disabled, Dental Hospital, Kyungpook National University, Daegu, Republic of Korea
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Maillet C, Decup F, Dantony E, Iwaz J, Chevalier C, Gueyffier F, Maucort-Boulch D, Grosgogeat B, Clerc JL. Selected and simplified FDI criteria for assessment of restorations. J Dent 2022; 122:104109. [DOI: 10.1016/j.jdent.2022.104109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 12/18/2022] Open
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Khaled M, Sabet A, Ebeid K, Salah T. Effect of Different Preparation Depths for an Inlay-Retained Fixed Partial Denture on the Accuracy of Different Intraoral Scanners: An In Vitro Study. J Prosthodont 2021; 31:601-605. [PMID: 34837276 DOI: 10.1111/jopr.13457] [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] [Accepted: 11/20/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim was to evaluate the effect of different preparation depths for inlay-retained fixed partial dentures on the accuracy of intraoral scanners. MATERIALS AND METHODS Tooth preparations for two inlay-retained fixed partial dentures were done and divided according to depth of the preparation. Group A: 2mm pulpal floor depth, 3mm gingival floor depth and Group B: 3mm pulpal floor depth, 4mm gingival floor depth. The CEREC Omnicam4.4.4, Omnicam4.6.2. Trios3 and Medit i500 intraoral scanners were used in this study. Tooth preparations were scanned by each scanner 10 times. The STL files obtained from the intraoral scanners were compared to the reference models (trueness) and within each test group (precision) using a 3D comparison software. Data were then statistically analyzed. RESULTS Regarding trueness, two-way ANOVA revealed significant differences between the different types of scanners (p<0.001) (Omnicam4.4.4: 65.09 ±2.87 Omnicam4.6.1: 52.73 ±3.31 Medit i500: 58.45 ±2.63 Trios 3: 41.79 ±4.42). Preparation depth had no significant influence on the trueness (p = 0.083). For precision two-way ANOVA revealed significant differences between the different types of scanners (p<0.001). Preparation depth had no significant influence on the precision (p = 0.111). Statistically significant interactions were found between the different variables. CONCLUSIONS The depth of preparation did not have an influence on the accuracy of different scanners. However, the type of scanner influenced the accuracy of digital impressions with Trios3 showing the highest accuracy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mohamed Khaled
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ahmed Sabet
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.,Department of Fixed Prosthodontics, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Tarek Salah
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Abstract
Inlay-retained dental bridges can be a viable minimally invasive alternative when patients reject the idea of implant therapy or conventional retained full-coverage fixed dental prostheses, which require more tooth preparation. Inlay-retained dental bridges are indicated in patients with good oral hygiene, low susceptibility to caries, and a minimum coronal tooth height of 5 mm. The present study aims to evaluate, through the finite element method (FEM), the stability of these types of dental bridges and the stresses on the supporting teeth, under the action of masticatory forces. The analysis revealed the distribution of the load on the bridge elements and on the retainers, highlighting the areas of maximum pressure. The results of our study demonstrate that the stress determined by the loading force cannot cause damage to the prosthetic device or to abutment teeth. Thus, it can be considered an optimal economical solution for treating class III Kennedy edentation in young patients or as a provisional pre-implant rehabilitation option. However, special attention must be paid to its design, especially in the connection area between the bridge elements, because the connectors and the retainers represent the weakest parts.
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