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Urkande NK, Mankar N, Nikhade PP, Chandak M. Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors. Cureus 2023; 15:e51258. [PMID: 38288201 PMCID: PMC10823198 DOI: 10.7759/cureus.51258] [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: 11/18/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.
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Affiliation(s)
- Neha K Urkande
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pradnya P Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Manoj Chandak
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Moreira MA, Silveira VR, Alcantara VO, Sousa FB, Sousa BC. Prior Restorative Procedures to Endodontic Treatment. Cureus 2023; 15:e37106. [PMID: 37153307 PMCID: PMC10158847 DOI: 10.7759/cureus.37106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Tooth loss due to fracture and the failure of endodontic treatment (ET) are common situations in teeth with extensive tissue destruction. This is due to the fragility of the remaining dental structure and the difficulty in sealing cavities, which is sometimes associated with the violation of the supracrestal insertion tissue. The previous restoration of marginal ridges or cusps with composite resin (CR) restores their fracture resistance, due to the adhesive characteristics of the restorative material, while also protecting the quality of endodontic treatment through better sealing. However, the protocol adopted in teeth requiring endodontic treatment involves performing the restorative procedure only after the endodontic procedures. The objective of this study was to report a case in which restoration of marginal ridges and/or cusps was performed prior to endodontic treatment, focusing on maintaining the tooth in function without dental fracture. The restoration was performed with an inverted operative sequence before the endodontic treatment. There was a violation of the supracrestal insertion tissue, requiring crown lengthening surgery (CLS) prior to the restorative procedure. Clinical and radiographic evaluations were performed postoperatively at seven days, three, six, and nine months, and five years. Tooth function was maintained without dental fractures or restoration loss. Periradicular space healing occurred with the disappearance of the lesion. Performing the restorative procedure prior to endodontic treatment in teeth with extensive coronal destruction is an alternative technique that facilitates clinical procedures, reduces the likelihood of dental loss due to fracture, and promotes endodontic treatment success.
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Hawthan MA, Chrcanovic BR, Larsson C. Long-term retrospective clinical study of tooth-supported fixed partial dentures: A multifactorial analysis. J Prosthodont Res 2022; 67:238-245. [PMID: 36031347 DOI: 10.2186/jpr.jpr_d_21_00222] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the influence of several factors on the survival of tooth-supported fixed partial dentures (FPDs) with vital and non-vital abutments. MATERIALS AND METHODS The present retrospective cohort study was based on the records of patients treated with 3-to-7-unit tooth-supported FPDs with a minimum follow-up time of 6 months after prosthesis delivery. Cumulative survival rate (CSR) was calculated over the maximum follow-up period. Cox regression models were used to evaluate the association between the clinical covariates and prosthesis failure. RESULTS A total of 331 FPDs in 229 patients were included. The CSRs were 90.1% and 77.6% after 5 and 10 years and 67.9% and 52.1% after 15 and 20 years, respectively. Tooth-supported FPD failure was more prevalent within the first years of prosthesis delivery. Loss of one or more abutment teeth and loss of prosthesis retention were the main reasons for failure. Smoking and type of prosthesis material significantly influenced the survival of FPDs. Abutment vitality, position of the non-vital abutment, or prosthesis length did not show any significant influence on the occurrence of prosthesis failure. CONCLUSION Smoking and the type of prosthesis material are suggested to contribute to an increased rate of FPD failure irrespective of abutment vitality.
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Affiliation(s)
- Mohammed Abdullah Hawthan
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Bruno R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Retrospective Study Comparing Clinical Outcomes of Fixed Dental Prostheses in Matched Groups of Bruxer and Nonbruxer Patients. Int J Dent 2022; 2022:6818170. [PMID: 35386548 PMCID: PMC8977310 DOI: 10.1155/2022/6818170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/12/2022] [Indexed: 02/03/2023] Open
Abstract
Background Tooth-supported fixed dental prosthesis (FDP) is one of the most reliable treatment options to replace missing teeth. The longevity of the treatment could, however, be affected by several general and local factors, especially bruxism. Objective To investigate the influence of bruxism on the long-term survival of tooth-supported FDPs in bruxers compared to a matched group of nonbruxers, taking several clinical variables into account. Materials and Methods The present retrospective cohort study was based on records of patients treated with 3–7-unit tooth-supported FDPs with a minimum follow-up time of 6 months after prosthesis delivery. The criteria for the diagnosis of “possible” and “probable” sleep or awake bruxism were used. A matched group of nonbruxers was selected on the basis of similarities in four factors, patients' gender and age, number of prosthetic units of the FDPs, and follow-up time. The paired-samples t-test or Wilcoxon signed rank test were used to compared mean values between the two groups. Contingency tables of categorical data were analyzed by McNemar's test. Results The cohort group consisted of 62 noncantilevered FDPs in each group, followed up for a mean of 110.1 and 106.5 months (bruxers and nonbruxers, respectively). Tooth-supported FDPs in bruxers presented significantly higher failure rate than in nonbruxers (32.3% vs. 25.8%, respectively; p = 0.001). Loss of retention and tooth loss were the main reasons for failures in both groups. For nonsmokers, the FDP failure rate was higher in nonbruxers. Technical and biological complications were significantly more prevalent in bruxers compared to nonbruxers. Conclusions Bruxism is suggested to increase technical and biological complications and FDP failure.
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Dawson VS, Fransson H, Wolf E. Coronal restoration of the root filled tooth - a qualitative analysis of the dentists' decision-making process. Int Endod J 2020; 54:490-500. [PMID: 33159810 PMCID: PMC7983980 DOI: 10.1111/iej.13442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 01/25/2023]
Abstract
Aim To describe the decision‐making process of the general dental practitioner (GDP) underlying the choice of coronal restoration of a root filled tooth. Methodology GDPs were strategically selected with respect to gender, age, undergraduate dental school, service affiliation and duration of professional experience. Semistructured in‐depth interviews were conducted, focusing on the informant’s personal experience of the process which leads to a decision as to how to restore a root filled tooth. The informants were invited to describe in their own words the latest two cases involving decisions of direct or full crown restorations respectively. The interviews were digitally recorded and transcribed verbatim. Interviews from 14 informants, aged 27–64 (mean age 46 years), were included and analysed according to Qualitative Content Analysis. Results A theme (latent content) was identified: Clinical factors were considered important but were overruled by context and patient opinions, if in conflict. Three main categories, including seven subcategories (manifest content), were identified. The categories were clinical factors, contextual factors and patient's views. Clinical factors underlying the GDPs' decision included the current dental status and the estimated longevity of the intended restoration. In certain cases, contextual factors were also of importance, either supporting the GDPs' decision or modifying it. However, the patient's views played a decisive role in the final choice of coronal restoration, leading to either mutual acceptance or a compromise, taking into account the patient's economic status and opinions. Conclusions With respect to coronal restoration of a root filled tooth, the GDPs’ decision‐making process was based not only on clinical factors, but also on decisive contextual factors and consideration of the patients’ views.
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Affiliation(s)
- V S Dawson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - H Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Endodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Wolf
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
Life expectancy has increased as a result of advancements in health care services; thus, maintaining healthy dentition is an important factor in overall health. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatment in elderly patients. Root canal therapy is an essential phase of such treatments. Elderly patients may exhibit one or more systemic conditions that require special care, in addition to other changes that occur within the dentition and oral mucosa as a result of aging. These make root canal treatment in elderly patients a great challenge. The aim of this review was to characterize pathologic and physiologic changes in elderly patients that can interfere with root canal treatment procedures, as well as attitudes of elderly patients toward such treatment, guidelines and clinical considerations for management of root canal treatment in elderly patients.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Further Treatments of Root-filled Teeth in the Swedish Adult Population: A Comparison of Teeth Restored with Direct and Indirect Coronal Restorations. J Endod 2017; 43:1428-1432. [PMID: 28673492 DOI: 10.1016/j.joen.2017.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/20/2017] [Accepted: 03/16/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the frequencies of nonsurgical retreatment, root-end surgery, extraction, and further restoration of root-filled teeth in Sweden in 2009 during a follow-up period of 5 years and to compare the outcomes in teeth restored with direct or indirect restorations. METHODS Data from the Swedish Social Insurance Agency were analyzed, and the frequencies of nonsurgical retreatment, root-end surgery, extractions, and further restoration were calculated for all teeth registered as root filled during 2009. Chi-square tests were applied to detect any significant differences in the frequency of further treatment in teeth registered as restored with either a direct or an indirect restoration within 6 months of root filling. RESULTS Of the 248,299 teeth reported root filled in Sweden in 2009, nonsurgical retreatment was registered in 2.2%, root-end surgery in 1.0%, and extractions in 9.2% during the follow-up period. Of the teeth restored with a direct restoration within 6 months after the root filling, 30.3% were registered as having undergone at least 1 further direct restoration; the corresponding percentage of teeth with indirect restorations was 6.4%. A statistically significant difference in the frequency of nonsurgical retreatment, extraction, and further restoration was found; teeth restored with an indirect restoration within 6 months of root filling had fewer of these treatments than those restored by direct restoration. CONCLUSIONS Low frequencies of nonsurgical retreatment and root-end surgery were reported 5 years after root filling, whereas extraction was more common. Fewer additional treatment procedures were registered for teeth with indirect restorations than for those with direct restorations.
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Outcomes of implants and restorations placed in general dental practices: a retrospective study by the Practitioners Engaged in Applied Research and Learning (PEARL) Network. J Am Dent Assoc 2016; 145:704-13. [PMID: 24982276 DOI: 10.14219/jada.2014.27] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. METHODS All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. RESULTS The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [CI], 1.41-3.34]) or type IV bone (OR = 1.99; 95 percent CI, 1.12-3.55) were associated with a greater risk of implant failure. Of the 908 surviving implants, 20 (2.2 percent) had restorations replaced or judged as needing to be replaced. The majority of P-Is and patients were satisfied with the esthetic outcomes for both the implant and restoration. CONCLUSIONS These results suggest that implant survival and success rates in general dental practices may be lower than those reported in studies conducted in academic or specialty settings. PRACTICAL IMPLICATIONS The results of this study, generated in the private general practice setting, add to the evidence base to facilitate implant treatment planning.
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Survival of Root-filled Teeth in the Swedish Adult Population. J Endod 2016; 42:216-20. [DOI: 10.1016/j.joen.2015.11.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/02/2015] [Accepted: 11/11/2015] [Indexed: 02/07/2023]
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Vena DA, Collie D, Wu H, Gibbs JL, Broder HL, Curro FA, Thompson VP, Craig RG. Prevalence of persistent pain 3 to 5 years post primary root canal therapy and its impact on oral health-related quality of life: PEARL Network findings. J Endod 2014; 40:1917-21. [PMID: 25220076 DOI: 10.1016/j.joen.2014.07.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/30/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The frequency of persistent pain 3-5 years after primary root canal therapy and its impact on the patient's perceived oral health-related quality of life was determined in a practice-based research network. METHODS All patients presenting to participating network practices who received primary root canal therapy and restoration for a permanent tooth 3-5 years previously were invited to enroll. Persistent pain was defined as pain occurring spontaneously or elicited by percussion, palpation, or biting. The patient also completed an oral health-related quality of life questionnaire (Oral Health Impact Profile-14). RESULTS Sixty-four network practices enrolled 1323 patients; 13 were ineligible, 12 did not receive a final restoration, and 41 were extracted, leaving 1257 for analysis. The average time to follow-up was 3.9 ± 0.6 years. Five percent (63/1257) of the patients reported persistent pain, whereas 24 of 63 (38%) exhibited periapical pathosis and/or root fracture (odontogenic pain). No obvious odontogenic cause for persistent pain was found for 39 of 63 (62%). Teeth treated by specialists had a greater frequency of persistent pain than teeth treated by generalists (9.3% vs 3.0%, respectively; P < .0001). Sex, age, tooth type, type of dentist, and arch were not found to be associated with nonodontogenic persistent pain; however, ethnicity and a preoperative diagnosis of pulpitis without periapical pathosis were. Patients reporting pain with percussion tended to experience pain with other stimuli that negatively impacted quality of life including oral function and psychological discomfort and disability. CONCLUSIONS These results suggest that a small percentage (3.1%) of patients experience persistent pain not attributable to odontogenic causes 3-5 years after primary root canal therapy that may adversely impact their quality of life.
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Affiliation(s)
- Donald A Vena
- The EMMES Corporation, Rockville, Maryland; PEARL Network Coordinating Center, New York, New York
| | | | - Hongyu Wu
- The EMMES Corporation, Rockville, Maryland
| | - Jennifer L Gibbs
- Department of Endodontics, New York University College of Dentistry, New York, New York
| | - Hillary L Broder
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, New York
| | - Frederick A Curro
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, Clinical Pharmacology/Regulatory Affairs, Bluestone Center for Clinical Research, New York University College of Dentistry, New York, New York
| | - Van P Thompson
- PEARL Network, New York, New York; Department of Biomaterials, Biomemitics and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, United Kingdom
| | - Ronald G Craig
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, New York; Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York.
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