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Alshabib A, Jurado CA, Azpiazu-Flores FX, Aldosary K, Tsujimoto A, Algamaiah H. Mechanical properties and degree of conversion of resin-based core build-up materials and short fiber-reinforced flowable resin-based composite. Dent Mater J 2024:2023-207. [PMID: 38692907 DOI: 10.4012/dmj.2023-207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
To evaluate the degree of conversion (DC), surface hardness (SH), and flexural strength (FS) of resin-based core build-up materials. Core build-up materials used were: MultiCore Flow (MCF); Activa (ACT); Core-X Flow (CXF); and everX flow (EVX), and DC, SH and FS were measured. An increase of DC was identified for all materials post-cure, except for EVX. The DC change percentage ranged from 5%-33%, and EVX was displayed the greatest DC rate. All materials displayed an SH increase after 30 days and the greatest increase was observed in ACT. At 1 h, the SH of EVX and CXF was different from the other materials. At 30 days, MCF displayed the greatest SH. All materials displayed an increase in their FS after 30 days except for EVX, and ranging 3%-36% were noticed. Differences observed between materials, thus clinician should be acquainted mechanical properties of these materials to ensure the success of the restorations.
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Affiliation(s)
| | - Carlos A Jurado
- Division of Operative Dentistry, Department of General Dentistry, The University of Tennessee Health Science Center College of Dentistry
| | - Francisco X Azpiazu-Flores
- Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba
- Center for Implant, Esthetic, and Innovative Dentistry, Department of Prosthodontics, Indiana University School of Dentistry
| | - Khalid Aldosary
- Dental Department, King Abdulaziz University Hospital, King Saud University
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Aichi Gakuin University School of Dentistry
- Department of Operative Dentistry, University of Iowa College of Dentistry
- Department of General Dentistry, Creighton University School of Dentistry
| | - Hamad Algamaiah
- Department of Restorative Dentistry, King Saudi University College of Dentistry
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Afrashtehfar KI, Jurado CA, Abu Fanas SH, Del Fabbro M. Short-term data suggests cognitive benefits in the elderly with single-implant overdentures. Evid Based Dent 2024:10.1038/s41432-024-00999-4. [PMID: 38570647 DOI: 10.1038/s41432-024-00999-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024]
Abstract
DESIGN This study was an extension of a randomized crossover clinical trial approved by the institutional ethics committee (approval number: D2014-148) and adhered to the CONSORT guidelines. The original study juxtaposed patient contentment with single-implant overdentures (1-IODs) against conventional complete dentures (CCDs), with patient satisfaction being the primary focus. In this follow-up study, the cognitive function of edentulous patients receiving 1-IODs was assessed, specifically monitoring for the emergence of mild cognitive impairment (MCI) throughout a three-year period. Patient outcomes were systematically recorded at predetermined intervals: initially, two months post-1-IOD placement, after one year (with groups alternated between denture types at eight-month marks), then after two and three years. A prosthodontist with a decade of expertise performed all denture-related procedures. This follow-up emphasized the cognitive outcomes using the Montreal Cognitive Assessment (MoCA-J), considering it alongside previously documented results on masticatory function, bone resorption, survival rates, and patient-reported outcomes. CASE SELECTION Between 2015 and 2016, a follow-up study enrolled edentulous patients over 50 years of age who were proficient in Japanese, had sufficient mandibular bone for implants, and were free of systemic health issues and habits that could impact oral health. The participants were randomly divided into two groups after receiving a central mandibular implant. Group 1 initially used 1-IODs, and Group 2 used unloaded CCDs. After two months and subsequent periods, they swapped denture types. Eventually, all patients chose 1-IODs for continued use. Implant success was monitored over three years. The design featured block randomization and accounted for a sample size of 22, determined to be sufficient for evaluating the primary outcome of patient satisfaction. All patients underwent careful allocation and received customized dental interventions, with detailed radiographic planning and surgical precision guiding the implantation process. DATA ANALYSIS Multivariable linear mixed models were used to assess within-group changes in both overall and specific cognitive function scores across five timepoints. Age, assessment interval, and upper jaw denture status were incorporated as consistent variables, while individual participants were considered variable elements in the analysis. SPSS software version 22.0 was utilized to conduct the statistical tests, and a p value threshold of 0.05 was predetermined to establish statistical significance. RESULTS Twenty-two patients with edentulous mandibles received 1-IODs. Memory and executive functions saw significant score increases at multiple timepoints over the three-year period, with statistical significance. Though one participant dropped out and another passed away, and two did not complete the 3-year follow-up, the remaining 18 participants provided comprehensive data. Age and type of maxillary denture were significant factors, influencing MoCA-J scores with older participants and those with fixed dentures showing lower scores in certain domains. Overall, the findings illustrated the positive correlation between 1-IODs and cognitive function in older adults. CONCLUSIONS Older adults with no natural teeth left in their mandible showed improved cognitive function after one and three years of using 1-IODs, as reflected by their total and specific cognitive domain scores. The study suggests that such implant therapy may offer protective benefits against cognitive decline, demonstrating clinical relevance for patient care, regardless of the maxillary arch (antagonist) condition.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
- College of Dentistry, Ajman University, Ajman City, UAE.
- Dental Consultant, Private Practice limited to Prosthodontics & Implantology, Abu Dhabi, UAE.
| | - Carlos A Jurado
- Director of the Operative Dentistry Division, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Floriani F, Jurado CA, Abuhammoud S, Vargas M, Fischer NG, Rojas-Rueda S, Lopes GC. A Comparative Study of Shade-Matching Reproducibility Using an Intraoral Scanner and a Spectrophotometer. Dent J (Basel) 2024; 12:62. [PMID: 38534286 DOI: 10.3390/dj12030062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND We compared the repeatability of the shade determination of resin composite restorations and acrylic teeth in light and darker shades at baseline and after an aging process through two digital tooth color-matching methods: using a Trios 3Shape intraoral scanner and using a Vita Easyshade Compact spectrophotometer. MATERIAL AND METHODS Forty upper central incisor acrylic teeth in the shade A1 (n = 10) and A3 (n = 10) were randomly assigned to be restored with Filtek Bulk Fill in the shade A1 (n = 10) or A3 (n = 10). Subsequently, 20 Class V cavities were prepared in a standardized manner (mesio-distal = 3.0 mm, cervical-occlusal = 2.0 mm, depth = 1.5 mm). Cavities were restored using an universal adhesive system and resin composite in two increments and were light-cured. The shade difference between the resin composite Class V restorations in acrylic teeth of the A1 and A3 shades was evaluated at baseline and after aging. Aging was simulated using ultraviolet light for 120 h. An Easyshade device and an intraoral scanner were used under D65 illumination. Measurements were taken five times, on top of the restoration and on the acrylic teeth, in a randomized manner. RESULTS Data analysis was on the calculation of the arithmetic mean for the percentage of repeatability conducted by the Trios scanner and the Easyshade device. There was no statistically significant comparison between the shade measurement devices (p > 0.05). At baseline, the repeatability for both the Trios intraoral scanner and the Vita Easyshade Compact device for artificial teeth in the shades A1 and A3 was 100%. After aging, the trueness recorded by the intraoral scanner and the Easyshade device for artificial teeth in the shade A1 was 80%. For Class V restoration with shade A1, the intraoral scanner recorded 80% trueness and the Easyshade device recorded 60% trueness at baseline. For shade A3, the intraoral scanner recorded 60% trueness and the Easyshade device recorded 60% trueness. CONCLUSIONS The intraoral scanner and Easyshade device are reliable for baseline shade selection, but their accuracy decreases after aging, particularly for darker shades.
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Affiliation(s)
- Franciele Floriani
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Carlos A Jurado
- Division of Operative Dentistry, Department of General Dentistry, The University of Tennessee Health Science Center College of Dentistry, Memphis, TN 38103, USA
| | - Salahaldeen Abuhammoud
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Marcos Vargas
- Department of Family Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55108, USA
| | | | - Guilherme Carpena Lopes
- College of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil
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Jurado CA, Sadid-Zadeh R, Watanabe H, Robbins CE, Afrashtehfar KI, Fischer NG, Lee DJ. Effect of incisal preparation design on the fracture strength of monolithic zirconia-reinforced lithium silicate laminate veneers. J Prosthodont 2024; 33:281-287. [PMID: 37014263 DOI: 10.1111/jopr.13689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/01/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
PURPOSE This study aimed to assess the fracture resistance of monolithic zirconia-reinforced lithium silicate laminate veneers (LVs) fabricated on various incisal preparation designs. MATERIALS AND METHODS Sixty maxillary central incisors with various preparation designs were 3D-printed, 15 each, including preparation for: (1) LV with feathered-edge design; (2) LV with butt-joint design; (3) LV with palatal chamfer; and (4) full-coverage crown. Restorations were then designed and manufactured from zirconia-reinforced lithium silicate (ZLS) following the contour of a pre-operation scan. Restorations were bonded to the assigned preparation using resin cement and following the manufacturer's instructions. Specimens were then subjected to 10,000 thermocycles at 5 to 55°C with a dwell time of 30 s. The fracture strength of specimens was then assessed using a universal testing machine at a crosshead speed of 1.0 mm/min. One-way ANOVA and Bonferroni correction multiple comparisons were used to assess the fracture strength differences between the test groups (α = 0.001). Descriptive fractographic analysis of specimens was carried out with scanning electron microscopy images. RESULTS Complete coverage crown and LV with palatal chamfer design had the highest fracture resistance values (781.4 ± 151.4 and 618.2 ± 112.6 N, respectively). Single crown and LV with palatal chamfer had no significant difference in fracture strength (p > 05). LV with feathered-edge and butt-joint designs provided significantly (p < 05) lower fracture resistance than complete coverage crown and LV with palatal chamfer design. CONCLUSION The fracture resistance of chairside milled ZLS veneers was significantly influenced by the incisal preparation designs tested. Within the limitation of this study, when excessive occlusal forces are expected, LV with palatal chamfer display is the most conservative method of fabricating an indirect restoration.
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Affiliation(s)
- Carlos A Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Ramtin Sadid-Zadeh
- Department of Restorative Dentistry, University of Buffalo School of Dental Medicine, Buffalo, New York, USA
| | - Hidehiko Watanabe
- Department of Restorative Dentistry, Oregon Health and Sciences University School of Dentistry, Portland, Oregon, USA
| | - Craig E Robbins
- Department of Restorative Dentistry, Oregon Health and Sciences University School of Dentistry, Portland, Oregon, USA
| | - Kelvin I Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Damian J Lee
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Jurado CA, Azpiazu-Flores FX, Fu CC, Rojas-Rueda S, Guzman-Perez G, Floriani F. Expediting the Rehabilitation of Severely Resorbed Ridges Using a Combination of CAD-CAM and Analog Techniques: A Case Report. Medicina (Kaunas) 2024; 60:260. [PMID: 38399547 PMCID: PMC10890117 DOI: 10.3390/medicina60020260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
With the life expectancy increasing, there is a growing need for prosthetic dental treatments to restore the oral health, function, and quality of life of edentulous patients. Presently, only a few articles are available describing the oral rehabilitation of patients with severely resorbed ridges with milled complete dentures. This clinical case report provides a straightforward protocol consisting of a combination of analog and digital techniques for the rehabilitation of edentulous patients with severely resorbed ridges with milled fixed and removable complete dentures. This technique permits the minimization of the number of appointments, improves patient comfort, allows for the digital archiving of important clinical data, and permits the manufacture of prostheses with improved mechanical properties. These favorable outcomes were achieved by using the patient's existing PMMA complete denture as a custom tray for a final impression with light-bodied Polyvinylsiloxane. Subsequently, the resulting models were digitized, and a digital complete denture was designed and manufactured in an expedited manner using CAD-CAM techniques. Therefore, this case report highlights the potential of CAD/CAM technology to predictably restabilize oral functions and improve patients' quality of life.
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Affiliation(s)
- Carlos A. Jurado
- Department of Prosthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA
| | - Francisco X. Azpiazu-Flores
- Department of Restorative Dentistry, Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 3N4, Canada
- Center for Implant, Esthetic, and Innovative Dentistry, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
| | - Chin-Chuan Fu
- Department of Restorative Dentistry, University of Alabama at Birmingham School of Dentistry, Birmingham, AL 35233, USA
| | | | - Gerardo Guzman-Perez
- Department of Periodontology, Centro Educative Multidisciplinario en Rehabilitation Oral (CEMRO), Morelia 58880, Mexico
- Department of Periodontology, Quetzalcoatl University, Irapuato 36615, Mexico
| | - Franciele Floriani
- Department of Prosthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA
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Jurado CA, Alhotan A, Mekled S, Cho SH, Afrashtehfar KI. Impact of restoration thickness and tooth shade background on the translucency of zirconia laminate veneers: An in vitro comparative study. Saudi Dent J 2024; 36:140-145. [PMID: 38375383 PMCID: PMC10874791 DOI: 10.1016/j.sdentj.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 02/21/2024] Open
Abstract
Purpose Our in vitro comparative study aimed to investigate the impact of thickness and tooth shade background on the translucency of highly translucent zirconia veneers. Materials and Methods A total of 75 5Y-TZP zirconia veneers of shade A1 were fabricated with thicknesses of 0.50 mm (n = 25), 0.75 mm (n = 25), and 1.0 mm (n = 25). The translucencies were measured on composite resin teeth with shades A1, A2, A3, A3.5, and A4 using a digital color imaging spectrophotometer. Data were analyzed using ANOVA and post hoc Tukey's test (p < 0.05). Results The translucency values were optimal for the veneers placed over the substrate teeth with shades A1 and A2, regardless of the veneer thickness. Additionally, veneers with a thickness of 0.50 mm exhibited significantly higher translucency than those with thicknesses of 0.75 mm and 1.0 mm. Conclusions Our study demonstrated that the translucency of the highly translucent zirconia veneers was influenced by both veneer thickness and tooth shade background. The optimal veneer thickness for achieving the highest translucency was 0.50 for the veneers with A1 and A2 shades placed over the substrate teeth. Clinical Relevance The optimal thickness for achieving the highest translucency of the highly translucent zirconia laminate veneers was 0.50 mm for the veneers with A1 and A2 shades placed over the substrate teeth. Clinicians and dental technicians could consider this when selecting materials for aesthetic restorations.
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Affiliation(s)
- Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Abdulaziz Alhotan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Salwa Mekled
- Department of Restorative Dentistry, Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, PA, USA
| | - Seok-Hwan Cho
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
- Artificial Intelligence Research Center (AIRC), Ajman University, PO Box 346, Dubayy, United Arab Emirates
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Jurado CA, Lee D, Ramirez P, Cortes-Treviño DA, Tsujimoto A. Fracture Resistance of Chairside CAD/CAM Lithium Disilicate-reinforced Ceramic Occlusal Veneers With and Without Margin and Full Coverage Crowns. Oper Dent 2024; 49:84-90. [PMID: 38058016 DOI: 10.2341/23-043-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The aim of this investigation was to compare the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate-reinforced ceramic occlusal veneers with and without margin and traditional full coverage premolar crowns. METHODS AND MATERIALS A total of 60 chairside CAD/CAM lithium disilicate-reinforced ceramic (Amber Mill, Hass Bio) restorations were designed and fabricated with a chairside CAD/CAM system (CEREC Dentsply Sirona). The restorations were divided into three groups (n=20): 1) occlusal veneer with 1.0-mm uniform occlusal thickness and with chamfer margin; 2) occlusal veneer with 1.0-mm uniform occlusal thickness and without margin; and 3) full coverage crown with uniform occlusal thickness and gingival margin. Occlusal veneers and crowns were cemented with dual cured resin luting cement (Multilink, Ivoclar Vivadent) to printed resin dies, load cycled (5 million load cycles at 1 Hz with 275 N force), and then loaded until fracture. Load at break (LB) and peak load (PL) until fracture were recorded. Scanning electron microscope images of the tested restorations on the abutments were obtained. RESULTS Fracture strengths were different depending on the design of the restoration. There was no significant difference in fracture strength between the two types of occlusal veneer (LB: 1132.45 N; PL: 1143.30 N for veneers with margin; LB: 1149.25 N; PL: 1219.05 N for veneers without margin). Full coverage crowns showed the lowest fracture resistance (LB: 936.26 N, PL: 976.42 N), which was significantly lower than both designs of occlusal veneer. CONCLUSIONS The fracture resistance of the CAD/CAM lithium disilicate-reinforced ceramic restorations was influenced by the design. Occlusal veneers with and without margin displayed higher fracture resistance than traditional crowns.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, clinical associate professor, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - D Lee
- Damian Lee, DDS, MS, associate professor and chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - P Ramirez
- Paulette Ramirez, BS, dental student, Texas Tech University Health Sciences Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - D A Cortes-Treviño
- Daniel Alberto Cortes-Treviño, DDS, MS, private practice, Dallas, TX, USA
| | - A Tsujimoto
- *Akimasa Tsujimoto, DDS, PhD, professor and chair, Department of Operative Dentistry, Aichi Gakuin University School of Dentistry, Nagoya, Aichi, Japan; adjunct associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA; visiting associate professor, Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
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Abdelraouf RM, Moussa TA, Hamdy TM, Abuhaimed RA, Alotaibi AM, Jurado CA, Alhotan A, Alhelal B, Habib NA. Effect of Ceramic Thickness and Technician Variability on the Shade Duplication of Dental Ceramo-Metallic Restorations. J Funct Biomater 2023; 15:12. [PMID: 38248679 PMCID: PMC10816963 DOI: 10.3390/jfb15010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Ceramic thickness and technicians' manipulative variables are critical factors affecting the resultant shade of dental ceramo-metallic restorations. This study investigated the effect of the following variables on shade duplication of ceramo-metallic specimens: (a) ceramic thickness; (b) differences between several technicians (inter-technician variability); and (c) the ability of each technician to repeat the resultant shade (intra-technician variability). Ninety ceramo-metallic specimens were prepared and divided into three main groups (n = 30/gp) according to the different technicians who built up the veneering ceramic of the specimens. Each group was further subdivided into three subgroups (n = 10/subgroup) according to the thickness of the ceramic (1, 1.5, and 2 mm built over a 0.5 mm-thick metal substructure). Three different technicians were asked to follow the same protocol as regards the same ceramic batch (Shade 3M2, Vita VM13, Zahnfabrik, Germany), firing temperature, and number of firing cycles. Meanwhile, each technician followed his own protocol with regard to other ceramic manipulative variables. The duplicated shades of the specimens were investigated using the Vita Easyshade spectrophotometer by using the verify shade mode. Color difference (∆E) values were calculated between the target shade (3M2) and the duplicated shades of the specimens automatically by the Vita Easyshade spectrophotometer (Vita, Zahnfabrik, Germany). The effect of ceramic thickness and inter- and intra-technician variability on the duplication of the target shade was investigated. The results showed that the effect of ceramic thickness on the duplicated shades depended on inter-technician variability. High inter-technician variability (∆E = 2-6.4) was noticed in contrast to low intra-technician variability (∆E = 0.2-1.5). It could be concluded that proper shade-duplication of ceramo-metallic restoration was a cumulative technique intimately related to manipulative variables and ceramic thickness.
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Affiliation(s)
- Rasha M. Abdelraouf
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt; (R.M.A.); (T.A.M.); (N.A.H.)
| | - Taheya A. Moussa
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt; (R.M.A.); (T.A.M.); (N.A.H.)
| | - Tamer M. Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), El Bohouth St., Dokki, Giza 12622, Egypt;
| | - Reem A. Abuhaimed
- Dental Interns, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia; (R.A.A.); (A.M.A.); (B.A.)
| | - Alanoud M. Alotaibi
- Dental Interns, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia; (R.A.A.); (A.M.A.); (B.A.)
| | - Carlos A. Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA;
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 12372, Saudi Arabia
| | - Bushra Alhelal
- Dental Interns, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia; (R.A.A.); (A.M.A.); (B.A.)
| | - Nour A. Habib
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt; (R.M.A.); (T.A.M.); (N.A.H.)
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Flores-Espinoza AI, Garcia-Contreras R, Guzman-Rocha DA, Aranda-Herrera B, Chavez-Granados PA, Jurado CA, Alfawaz YF, Alshabib A. Gelatin-Chitosan Hydrogel Biological, Antimicrobial and Mechanical Properties for Dental Applications. Biomimetics (Basel) 2023; 8:575. [PMID: 38132514 PMCID: PMC10742194 DOI: 10.3390/biomimetics8080575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Chitosan, a natural polysaccharide sourced from crustaceans and insects, is often used with hydrogels in wound care. Evaluating its cytotoxicity and antimicrobial properties is crucial for its potential use in dentistry. OBJECTIVE To investigate the mechanical properties of gelatin hydrogels based on decaethylated chitosan and antimicrobial activity against Streptococcus mutans and their biological effects with stem cells from apical papilla (SCAPs). MATERIAL AND METHODS Gelatin-chitosan hydrogels were synthesized at concentrations of 0%, 0.2% and 0.5%. Enzymatic and hydrolytic degradation, along with swelling capacity, was assessed. Fourier transform infrared spectroscopy (FTIR) analysis was employed to characterize the hydrogels. The interaction between hydrogels and SCAPs was examined through initial adhesion and cell proliferation at 24 and 48 h, using the Thiazolyl Blue Tetrazolium Bromide (MTT assay). The antimicrobial effect was evaluated using agar diffusion and a microdilution test against S. mutans. Uniaxial tensile strength (UTS) was also measured to assess the mechanical properties of the hydrogels. RESULTS The hydrogels underwent hydrolytic and enzymatic degradation at 30, 220, 300 min and 15, 25, 30 min, respectively. Significantly, (p < 0.01) swelling capacity occurred at 20, 40, 30 min, respectively. Gelatin-chitosan hydrogels' functional groups were confirmed using vibrational pattern analysis. SCAPs proliferation corresponded to 24 h = 73 ± 2%, 82 ± 2%, 61 ± 6% and 48 h = 83 ± 11%, 86 ± 2%, 44 ± 2%, respectively. The bacterial survival of hydrogel interaction was found to be 96 ± 1%, 17 ± 1.5% (p < 0.01) and 1 ± 0.5% (p < 0.01), respectively. UTS showed enhanced (p < 0.05) mechanical properties with chitosan presence. CONCLUSION Gelatin-chitosan hydrogels displayed favorable degradation, swelling capacity, mild dose-dependent cytotoxicity, significant proliferation with stem cells from apical papilla (SCAPs), substantial antimicrobial effects against S. mutans and enhanced mechanical properties. These findings highlight their potential applications as postoperative care dressings.
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Affiliation(s)
- Andrea Itzamantul Flores-Espinoza
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES), Leon Unit, National Autonomous University of Mexico (UNAM), Leon 37689, Mexico; (A.I.F.-E.); (R.G.-C.); (D.A.G.-R.); (B.A.-H.); (P.A.C.-G.)
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES), Leon Unit, National Autonomous University of Mexico (UNAM), Leon 37689, Mexico; (A.I.F.-E.); (R.G.-C.); (D.A.G.-R.); (B.A.-H.); (P.A.C.-G.)
| | - Dulce Araceli Guzman-Rocha
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES), Leon Unit, National Autonomous University of Mexico (UNAM), Leon 37689, Mexico; (A.I.F.-E.); (R.G.-C.); (D.A.G.-R.); (B.A.-H.); (P.A.C.-G.)
| | - Benjamin Aranda-Herrera
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES), Leon Unit, National Autonomous University of Mexico (UNAM), Leon 37689, Mexico; (A.I.F.-E.); (R.G.-C.); (D.A.G.-R.); (B.A.-H.); (P.A.C.-G.)
| | - Patricia Alejandra Chavez-Granados
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES), Leon Unit, National Autonomous University of Mexico (UNAM), Leon 37689, Mexico; (A.I.F.-E.); (R.G.-C.); (D.A.G.-R.); (B.A.-H.); (P.A.C.-G.)
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA;
| | - Yasser F. Alfawaz
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 11545, Saudi Arabia;
| | - Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 11545, Saudi Arabia;
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Jurado CA, Afrashtehfar KI, Hyer J, Alhotan A. Effect of sintering on the translucency of CAD-CAM lithium disilicate restorations: A comparative in vitro study. J Prosthodont 2023; 32:861-866. [PMID: 36609993 DOI: 10.1111/jopr.13644] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The available independent data on the translucency of novel pre and fully sintered chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate are limited. This comparative in vitro study evaluated the translucency degree of pre and fully sintered chairside CAD-CAM lithium disilicate crowns after optional, required, and additional firing processes. MATERIALS AND METHODS One hundred and five maxillary left central incisor crowns manufactured by three different CAD-CAM lithium disilicate brands shade A1 were assigned into seven groups as follows (n = 15): (1) Straumann n!ce without sintering; (2) Straumann n!ce with one additional sintering process; (3) Straumann n!ce with two additional sintering processes; (4) Amber Mill with one sintering process; (5) Amber Mill with two sintering processes; (6) IPS e.max CAD with one sintering process; and (7) IPS e.max CAD with two sintering processes. The translucency of all crowns was evaluated with a color imaging spectrophotometer. All statistical analyses were performed using statistical software. A standard level of significance was set at α < 0.05. RESULTS All the milled crowns presented different degrees of translucency, and additional sintering processes altered it. IPS e.max CAD with two (4.33 ± 0.26) and one (4.01 ± 0.15) sintering processes displayed the highest translucency, whereas Straumann n!ce with no sintering process provided the lowest value (2.82 ± 0.16). CONCLUSIONS The translucency of chairside lithium disilicate single-unit full-coverage restorations manufactured with subtractive technology was significantly influenced by the brand and the number of sintering processes. The traditional presintered IPS e.max CAD and the fully crystallized glass-ceramic Straumann n!ce considerably increased the translucency after one additional firing process, whereas Amber Mill decreased its translucency.
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Affiliation(s)
- Carlos A Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Kelvin I Afrashtehfar
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jared Hyer
- A.T. Still University Arizona School of Dentistry and Oral Health, Mesa, Arizona, USA
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Guzman-Perez G, Jurado CA, Alshahib A, Afrashtehfar KI. An immediate implant approach to replace failing maxillary anterior dentition due to orthodontically induced severe root resorption. Int J Oral Implantol (Berl) 2023; 16:339-348. [PMID: 37994821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Incomplete orthodontic therapy can lead to severe root resorption, resulting in mobile and non-restorable teeth. This clinical report presents the diagnosis, treatment planning and oral rehabilitation of a young woman with failing dentition in the anterior maxilla due to orthodontically induced root resorption. The patient's chief complaint was mobile maxillary anterior teeth 2 years after discontinuing orthodontic treatment. Radiographic and clinical evaluations revealed a missing right first premolar and left premolars and grade III mobility from the right canine to the left lateral incisor. Due to a hopeless prognosis, extraction of the maxillary anterior teeth was planned, followed by grafting procedures. Four implants were immediately placed in the fresh sockets of the canine and central sites, and a removable provisional appliance was delivered to contour the soft tissues involved. The final restorations consisted of two three-unit layered zirconia implant-supported fixed dental prostheses. Well-planned immediate implant therapy and zirconia restorations can successfully replace mobile teeth with severe root resorption caused by external surface resorption from incomplete orthodontic treatment. Combining grafting procedures during implant placement can replace hard tissue lost due to extractions, whereas provisional restorations can re-establish optimal tissue architecture in the aesthetic zone. The present case offers insight into effective strategies for treating non-compliant or uncooperative patients with failing dentition due to orthodontically induced root resorption.
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Jurado CA, Arndt K, Azpiazu-Flores FX, Faddoul F, França R, Fischer NG, Watanabe H. Evaluation of Glazing and Polishing Systems for Novel Chairside CAD/CAM Lithium Disilicate and Virgilite Crowns. Oper Dent 2023; 48:689-699. [PMID: 37881035 DOI: 10.2341/23-017-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness of glazing, two zirconia, and two lithium disilicate polishing systems on surface roughness of a CAD/CAM lithium disilicate and virgilite ceramic with atomic force microscopy (AFM) and visual assessment performed by dental students and faculty. METHODS AND MATERIALS Sixty maxillary right central incisor crowns made of a novel chairside CAD/CAM lithium disilicate and virgilite (CEREC Tessera) were milled for glazing and polishing. The crowns were divided into six groups: no polishing/glazing provided (NoP/G); glazed (GZ); glazed and polished with Brasseler Dialite LD Lithium Disilicate (DiLD); glazed and polished with Meisinger Luster Lithium Disilicate (LuLD); glazed and polished with Brasseler Dialite ZR Zirconia (DiZR); and glazed and polished with Meisinger Luster Zirconia (LuZR). Surfaces were scanned with AFM to measure roughness (Ra) and root mean square roughness (Rq) and generate micrographs. Crowns were visually assessed by 10 dental students and 10 dental school faculty members to determine clinical acceptableness. RESULTS Glazing and all polishing kits significantly reduced Ra and Rq compared to no polishing/glazing. No significant Ra differences were found between glazing and all polishing kits (p>0.05). DiZR significantly reduced Rq compared to other groups (p<0.05). Visual assessment showed that GZ, LuLD, and DiZR were the most clinically acceptable crowns. CONCLUSION Polishing and glazing considerably improve the surface smoothness of maxillary central incisor crowns fabricated out of a chairside CAD/CAM lithium disilicate and virgilite ceramic. Altogether, zirconia polishing systems provided smoother and more clinically acceptable surfaces than the lithium disilicate kits.
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Affiliation(s)
- C A Jurado
- Carlos A Jurado, DDS, MS, associate professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - K Arndt
- Katlyn Arndt, BS, dental student, Texas Tech University Health Sciences Center El Paso, Woody L Hunt School of Dental Medicine, El Paso, Texas, USA
| | - F X Azpiazu-Flores
- Francisco X Azpiazu-Flores, DDS, MS, assistant professor, University of Manitoba, Gerald Niznick College of Dentistry, Winnipeg, Manitoba, Canada; ITI Scholar at the Implant Center and Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - F Faddoul
- Fady Faddoul, DDS, MSD, associate dean, Clinical Affairs, Texas Tech University Health Sciences Center El Paso, Woody L Hunt School of Dental Medicine, El Paso, Texas, USA
| | - R França
- Rodrigo França, DDS, MS, PhD, associate professor, University of Manitoba, Gerald Niznick College of Dentistry, Winnipeg, Manitoba, Canada
| | - N G Fischer
- *Nicholas G Fischer, PhD, fellow, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - H Watanabe
- Hidehiko Watanabe, DDS, MS, professor, Department of Restorative Dentistry, Oregon Health and Sciences University School of Dentistry, Portland, Oregon, USA
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Jurado CA, Villalobos-Tinoco J, Mekled S, Sanchez R, Afrashtehfar KI. Printed Digital Wax-up Model as a Blueprint for Layered Pressed-ceramic Laminate Veneers: Technique Description and Case Report. Oper Dent 2023; 48:618-626. [PMID: 37881104 DOI: 10.2341/22-144-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 10/27/2023]
Abstract
This article presents a clinical technique for transferring Digital Smile Design (DSD) information and a digital wax-up to fabricate highly personalized ceramic laminate veneers. The hybrid workflow of digitally designed wax-up and conventional hand-crafted veneers is showcased in a female adult who sought to improve her smile due to maxillary anterior incisal wear. The ceramic veneers, layered by feldspathic porcelain, followed the contours and shade blueprint planned with the digital wax-up. The DSD improved the harmony of the facial-and-smile relationship, and the ceramic restorations fulfilled the patient's esthetic and functional demands. Guides based on the printed model with the digitally designed wax-up can provide a reference for pressed lithium disilicate veneers layered with feldspathic porcelain.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting faculty, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - S Mekled
- Salwa Mekled, DDS, MBA, associate professor, Department of Restorative Dentistry, Temple University Kornberg School of Dentistry, Philadelphia, PA, USA
| | - R Sanchez
- Ramon Sanchez, MDT, dental technician, private practice, San Felipe, BC, Mexico
| | - K I Afrashtehfar
- *Kelvin I. Afrashtehfar, DDS, MSc, Dr, FDS RCS, FRCDC, assistant professor, Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, AE, UAE; adjunct research associate professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, BE, Switzerland
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Jimenez-Bueno I, Garcia-Contreras R, Aranda-Herrera B, Sakagami H, Lopez-Ayuso CA, Nakajima H, Jurado CA, Nurrohman H. Cytotoxicity, Differentiation, and Biocompatibility of Root-End Filling: A Comprehensive Study. Biomimetics (Basel) 2023; 8:514. [PMID: 37999155 PMCID: PMC10669418 DOI: 10.3390/biomimetics8070514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Assessing the biocompatibility of endodontic root-end filling materials through cell line responses is both essential and of utmost importance. This study aimed to the cytotoxicity of the type of cell death through apoptosis and autophagy, and odontoblast cell-like differentiation effects of MTA, zinc oxide-eugenol, and two experimental Portland cements modified with bismuth (Portland Bi) and barium (Portland Ba) on primary cell cultures. Material and methods: The cells corresponded to human periodontal ligament and gingival fibroblasts (HPLF, HGF), human pulp cells (HPC), and human squamous carcinoma cells from three different patients (HSC-2, -3, -4). The cements were inoculcated in different concentrations for cytotoxicity evaluation, DNA fragmentation in electrophoresis, apoptosis caspase activation, and autophagy antigen reaction, odontoblast-like cells were differentiated and tested for mineral deposition. The data were subject to a non-parametric test. Results: All cements caused a dose-dependent reduction in cell viability. Contact with zinc oxide-eugenol induced neither DNA fragmentation nor apoptotic caspase-3 activation and autophagy inhibitors (3-methyladenine, bafilomycin). Portland Bi accelerated significantly (p < 0.05) the differentiation of odontoblast-like cells. Within the limitation of this study, it was concluded that Portland cement with bismuth exhibits cytocompatibility and promotes odontoblast-like cell differentiation. This research contributes valuable insights into biocompatibility, suggesting its potential use in endodontic repair and biomimetic remineralization.
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Affiliation(s)
- Ignacio Jimenez-Bueno
- Department of Endodontics, Faculty of Dentistry, Autonomous University State of Mexico (UAEMex), Toluca 50130, State of Mexico, Mexico;
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory, Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Guanajuato, Mexico; (R.G.-C.); (C.A.L.-A.)
| | - Benjamin Aranda-Herrera
- Interdisciplinary Research Laboratory, Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Guanajuato, Mexico; (R.G.-C.); (C.A.L.-A.)
| | - Hiroshi Sakagami
- Meikai University Research Institute of Odontology (M-RIO), Meikai University School of Dentistry, Sakado 350-0283, Saitama, Japan;
| | - Christian Andrea Lopez-Ayuso
- Interdisciplinary Research Laboratory, Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Guanajuato, Mexico; (R.G.-C.); (C.A.L.-A.)
| | - Hiroshi Nakajima
- Division of Dental Biomaterials Science, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado 350-0283, Saitama, Japan
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Hamid Nurrohman
- Department of Restorative Dentistry & Prosthodontics, University of Texas School of Dentistry, Houston, TX 77054, USA
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Villalobos-Tinoco J, Jurado CA, Robles M, D'Atri E, Afrashtehfar KI. Tooth-reduction 3D-printed guides for facilitating the provision of ultrathin laminate veneers. A cross-shaped novel design. Int J Esthet Dent 2023; 18:390-404. [PMID: 37819566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Tooth-reduction guides offer a more controlled and conservative tooth preparation. Many types of tooth-reduction guides are available such as those with horizontal or vertical reduction grooves. A transparent cross-shaped tooth-reduction guide allows the clinician to make vertical and horizontal depth grooves to evaluate tooth reduction in all directions. The reference grooves on the guide enable the clinician to use a periodontal probe to measure the reduction accurately, and the transparent material provides a clear view of the entire tooth. Controlled tooth reduction offers a more conservative approach that is key for long-term bonded ceramic restorations. The multiaxial rigid transparent tooth-reduction guide could facilitate the provision of ultrathin handcrafted porcelain veneers to predictably fulfill patients' esthetic demands while preserving more tooth structure. The use of technically sound and artistically documented photographic evidence further underscores the effectiveness of this approach, particularly when intra-enamel preparations and adhesive luting under rubber dam isolation are employed. The present article describes a novel 3D-printed guide design that allows the clinician to perform the reduction grooves and evaluate the preparation in the horizontal and vertical directions within the same guide.
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Jurado CA, Amarillas-Gastelum C, Tonin BSH, Nielson G, Afrashtehfar KI, Fischer NG. Traditional versus conservative endodontic access impact on fracture resistance of chairside CAD-CAM lithium disilicate anterior crowns: An in vitro study. J Prosthodont 2023; 32:728-734. [PMID: 36471494 DOI: 10.1111/jopr.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/04/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate maxillary right central incisor crowns. MATERIALS AND METHODS Fifty-seven milled lithium disilicate maxillary right central incisor crowns were designed and fabricated with a chairside CAD-CAM system (Planmeca Romexis, Planmeca). The abutment preparation had a 1.0 mm incisal reduction and 1.0 mm chamfer finish. The restorations were bonded with resin cement to printed resin dies (n = 19 per group) and were treated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access. The endodontic access of the crowns was sealed with flowable resin composite. Restorations were subjected to 10,000 cycles of thermal cycling between 5° and 55°C. Then, restorations were loaded and exposed to compressive loading force, and the crack initiation (CI) and complete fracture (CF) were recorded. SEM micrographs of broken specimens on the printed dies were captured. ANOVA test and Bonferroni's correction were used for statistical comparison. RESULTS The fracture resistance among the three groups varied. Crowns with no endodontic access displayed significantly (p < 0.001) higher resistance [CI: 1025 (121) N; CF 1134 (127) N], followed by crowns with conservative ovoidal endodontic access [CI: 924 (60) N; CF: 1000 (72) N. Crowns with traditional triangular endodontic access showed the significantly (p < 0.001) lowest fracture resistance [CI: 635 (82) N; CF: 709 (75) N]. CONCLUSION The fracture resistance of chairside CAD-CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance than other types of endodontic access.
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Affiliation(s)
- Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, Texas
| | | | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthetics, University of Sao Paulo School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - Gentry Nielson
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, Texas
| | - Kelvin I Afrashtehfar
- Clinical Sciences Department, Ajman University Dental College, Ajman City, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
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Lee JH, Pfeffer J, Jurado CA, Azpiazu-Flores FX. Using the foundation restoration as a blueprint: An uncomplicated approach to retrofitting crowns to existing removable partial dentures using CAD-CAM technology. J Prosthet Dent 2023:S0022-3913(23)00544-9. [PMID: 37741726 DOI: 10.1016/j.prosdent.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 09/25/2023]
Abstract
Removable partial dentures have been used to rehabilitate partially edentulous patients for decades. A challenging but commonly encountered procedure is retrofitting a crown to an existing removable partial denture. Several techniques have been proposed for fabricating these complex prostheses, some involving the intraoral application of polymers to the abutment tooth or making impressions of the preparation with the removable prosthesis seated. The present technique presents an approach that simplifies the design and fabrication of retrofitted crowns for fractured abutment teeth needing foundation restorations. This approach involves the implementation of computer-aided design and computer-aided manufacturing technology to record and utilize the contours of the foundation restoration established intraorally as a blueprint for the retrofitted crown.
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Affiliation(s)
- Jae-Hoon Lee
- Dental student, General Dentistry Program, Dr. Gerald Niznick College of Dentistry University of Manitoba, Winnipeg, Manitoba, Canada
| | - Juliana Pfeffer
- Assistant Professor, Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carlos A Jurado
- Associate Professor, Department of Prosthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, Iowa
| | - Francisco X Azpiazu-Flores
- ITI Scholar, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN; Assistant Professor, Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada..
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Jurado CA, Bora PV, Azpiazu-Flores FX, Cho SH, Afrashtehfar KI. Effect of resin cement selection on fracture resistance of chairside CAD-CAM lithium disilicate crowns containing virgilite: A comparative in vitro study. J Prosthet Dent 2023:S0022-3913(23)00558-9. [PMID: 37739880 DOI: 10.1016/j.prosdent.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/24/2023]
Abstract
STATEMENT OF PROBLEM Studies on the fracture performance of a recently introduced computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate ceramic containing virgilite with different cements are lacking. PURPOSE The purpose of this in vitro study was to evaluate the fracture resistance of crowns made of a recently introduced chairside CAD-CAM lithium disilicate containing virgilite cemented with different types of adhesive luting cement. MATERIAL AND METHODS Sixty complete coverage crowns for a maxillary right central incisor were milled out of a lithium disilicate with virgilite (CEREC Tessera) (n=48) and a traditional lithium disilicate (e.max CAD) (n=12) using a chairside CAD-CAM system (Primescan). The central incisor tooth preparation included a 1.5-mm incisal reduction, a 1.0-mm axial reduction, and a 1.0-mm chamfer finish line. The restorations were bonded with different types of resin cement to 3D printed dies of the tooth preparation and were divided into 5 groups (n=12 per group): e.max CAD with Multilink Automix (E.Mu); Tessera with Multilink Automix (T.Mu); Tessera with Calibra (T.Ca); Tessera with Unicem (T.Un); and Tessera with Speedcem (T.Sp). The cemented restorations were stored in water for 30 days and then loaded until they were fractured in compression. The load at fracture was analyzed with a 1-way analysis of variance (ANOVA) and the honestly significant difference (HSD) Tukey test (α=.05). RESULTS The mean fracture resistance of traditional lithium disilicate and virgilite lithium disilicate anterior crowns significantly differed depending on the type of resin cement used (P<.05). Group E.Mu displayed the highest values (946.35 ±155 N), followed by group T.Un (819.59 ±232 N), group T.Sp (675.52 ±153 N), and group T.Mu (656.95 ±193 N). The lowest values were displayed by group T.Ca (567.94 ±184 N). CONCLUSIONS The fracture resistance of lithium disilicate containing virgilite and traditional lithium disilicate crowns cemented with the same cement displayed statistically similar values. However, significant differences were observed when the virgilite lithium disilicate crowns were cemented with different types of adhesive luting cement. The crowns in the T.Ca group displayed the lowest fracture resistance.
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Affiliation(s)
- Carlos A Jurado
- Clinical Associate Professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.
| | - Pranit V Bora
- Resident, Master of Sciences in Dental Materials Program, School of Dentistry, University of Alabama at Birmingham, Birmingham, Ala.
| | - Francisco X Azpiazu-Flores
- Assistant Professor, Department of Restorative Dentistry, Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada; ITI Scholar, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind.
| | - Seok-Hwan Cho
- Associate Professor and Department Chair, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.
| | - Kelvin I Afrashtehfar
- Assistant Professor and Director of Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, AE, United Arab Emirates; Adjunct Research Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Senior Scientific Researcher, Artificial Intelligence Research Center (AIRC), Ajman University, Dubai, United Arab Emirates; and Visiting Professor, Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Republic of Korea..
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Afrashtehfar KI, Jurado CA, Assaleh NK, Lee H. AUTONOMOUS ROBOTIC SURGERY SEEMS PROMISING AS AN ACCURATE TECHNOLOGY FOR SINGLE-TOOTH IMPLANT PLACEMENT IN THE ESTHETIC ZONE. J Evid Based Dent Pract 2023; 23:101915. [PMID: 37689457 DOI: 10.1016/j.jebdp.2023.101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Yang S, Chen J, Li A, Deng K, Li P, Xu S. Accuracy of autonomous robotic surgery for single-tooth implant placement: a case series. J Dent. 2023;132:104451. doi:10.1016/j.jdent.2023.104451. Epub 2023 Feb 11. PMID: 36781099. SOURCE OF FUNDING This case series study was supported by grants from the Guangdong Basic and Applied Basic Research Foundation, Science and Technology Projects in Guangzhou, Science Research Cultivation Program, and Clinical Research Initiation Plan of the Stomatological Hospital, Southern Medical University, China. TYPE OF STUDY/DESIGN Case series. No a priori power calculation or pilot data. Nonconsecutive participant recruitment.
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Rahhal MM, Awad R, Fayyad A, Nurrohman H, Jurado CA. A Modified Ridge-Splitting Technique to Restore a Completely Edentulous Maxillary Arch With a Cement-Retained Implant Prosthesis. Cureus 2023; 15:e45299. [PMID: 37846271 PMCID: PMC10576958 DOI: 10.7759/cureus.45299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
The present report describes a technique in which the maxillary bone was molded to the desired location using a series of instruments for ridge-splitting procedures. This technique aims to improve bone quality all around the implants at both the crest and apex locations. In some clinical scenarios, insufficient horizontal bone with less than 3 mm prevents implant placement. Thus, ridge splitting is a treatment of choice, and this technique creates bone expansion to form a better receptor site for endosteal implants. A case report is presented involving a completely edentulous 52-year-old male patient presented to the clinic with a horizontal bone defect. The patient complained of having difficulty eating and wants to improve his smile. In this clinical case, a modified ridge-splitting technique was employed, differing from the conventional procedure that uses mallets, chisels, or osteotomes. A lancet and spatula were used for precise ridge splitting, followed by the placement of four endosseous tapered implants-two on each side (Dentis USA, La Palma, USA). Each implant had a diameter of 3.7 mm and a length of 10 mm. These implants were clinically placed in a single visit, with a torque of 30 N/cm² applied to ensure secure fixation. To accommodate the patient's unique maxillary bone anatomy, 25-degree angulated abutments were chosen for the four implants, ensuring a common path of insertion, and optimal angulation for long-term stability and aesthetics. Subsequently, a cemented provisional dental prosthesis restoration was fitted, and the patient reported satisfaction with both function and aesthetics. After a period of five months of osseointegration, the stability of the implants was assessed using a resonance frequency analyzer, yielding positive results. The average resonance frequency values for the maxillary left (canine and premolar) were ISQ 68 and ISQ 71, respectively, while for the maxillary right (lateral incisor and premolar), the values were ISQ 69 and ISQ 73. These readings indicate satisfactory implant stability following the osseointegration process. The postoperative cone-beam computed tomography (CBCT) showed gain to the bone width besides better function and good results concerning the esthetics. This report describes a modified ridge-splitting technique with a predictable and satisfactory outcome that fulfilled the patient's demands. The presented approach overcomes the disadvantages of two-staged implant placement bone grafting procedures and is also a more affordable option for the patient. CBCT evaluation confirmed bone gain with minimal morbidity after the procedure.
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Affiliation(s)
- Mohamed M Rahhal
- Restorative Dentistry, A.T. Still University, Kirksville, USA
- Prosthodontics, Fayoum University, Fayoum, EGY
| | - Rawda Awad
- Restorative Dentistry, A.T. Still University, Kirksville, USA
| | | | - Hamid Nurrohman
- Restorative Dentistry & Prosthodontics, University of Texas School of Dentistry, Houston, USA
| | - Carlos A Jurado
- Prosthodontics, University of Iowa College of Dentistry and Dental Clinic, Iowa City, USA
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Afrashtehfar KI, Jurado CA. THE DENTAL PROFESSION EXPERIENCES HIGH PREVALENCE RATES OF BURNOUT AND EMOTIONAL EXHAUSTION. J Evid Based Dent Pract 2023; 23:101886. [PMID: 37689455 DOI: 10.1016/j.jebdp.2023.101886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Moro JDS, Soares JP, Massignan C, Oliveira LB, Ribeiro DM, Cardoso M, Canto GL, Bolan M. Burnout syndrome among dentists: a systematic review and meta-analysis. J Evid Based Dent Pract. 2022 Sep;22(3):101,724. doi: 10.1016/j.jebdp.2022.101724. Epub 2022 Apr 2. PMID: 36162888 SOURCE OF FUNDING: University funds. TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Afrashtehfar KI, Oh KC, Jurado CA, Lee H. Lack of keratinized mucosa increases peri-implantitis risk. Evid Based Dent 2023; 24:118-120. [PMID: 37537217 PMCID: PMC10516747 DOI: 10.1038/s41432-023-00913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023]
Abstract
DESIGN A systematic appraisal and statistical aggregation of primary studies in humans. DATA SOURCES The researchers utilized PubMed (Medline) and Scopus databases as the primary data sources for this study. They performed a comprehensive literature search based on free keywords and Medical Subject Heading (MeSH) terms to enhance the search accuracy. The database search was concluded on November 13, 2022. Furthermore, a meticulous examination of the references cited in the selected studies was conducted to identify additional relevant articles that could be incorporated into the analysis. STUDY SELECTION The systematic review focused on partially or fully edentulous patients receiving dental implants and aimed to determine if the lack of keratinized mucosa at the implant site increased the risk of peri-implantitis compared to patients with adequate keratinized mucosa. Human studies with a minimum of 100 implants, cross-sectional, cohort, or case-control designs, and a follow-up period of at least one year were included. Studies lacking a clear case definition or information on peri-implantitis and those that did not investigate keratinized mucosa as a risk indicator were excluded. DATA EXTRACTION AND SYNTHESIS Two reviewers independently utilized a systematic review screening website (Rayyan, Qatar Computing Research Institute, Qatar Foundation) to select potential articles, and conflicts were resolved through discussion or consultation with a third reviewer. The data extraction process involved recording information from the included articles, such as study design, patient and implant numbers, prosthesis type (fixed or removable), follow-up duration, peri-implantitis case definition, prevalence at patient and implant levels, keratinized mucosa cutoff value, odds ratio (OR) of peri-implantitis considering keratinized mucosa, and conclusions on the potential effect of keratinized mucosa from each study. The Newcastle Ottawa scale (NOS) and a modified version of NOS were used, respectively, to assess the quality of cohort and cross-sectional studies. Studies scoring below 6 out of 9 points were classified as low quality. For the meta-analysis, the relationship between peri-implantitis and keratinized mucosa was evaluated using the odds ratio (OR) and standard error (SE). Heterogeneity was assessed through the Chi2 test and I2 index, determining whether a random-effects or fixed-effects model should be applied. Subgroup and cluster analyses were conducted based on specific criteria, and forest plots and funnel plots were generated to visualize results and identify potential study bias. Sensitivity analysis was performed to verify the robustness of the meta-analysis, with statistical significance set at p < 0.05. The Review Manager (RevMan) software facilitated data analysis. The GRADE rating system was used to determine the level of evidence, considering factors such as bias risk, imprecision, inconsistency, indirectness, and publication bias. The certainty of the evidence was evaluated based on the overall outcomes of analyzed subgroups. RESULTS Twenty-two primary studies were identified, and a meta-analysis was conducted on 16 cross-sectional studies. The prevalence of peri-implantitis ranged from 6.68% to 62.3% at the patient level and from 4.5% to 58.1% at the implant level. The overall analysis revealed a significant association between the lack of keratinized mucosa and a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Subgroup analyses with a consistent case definition of peri-implantitis (MBL ≥ 2 mm) showed similar results (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001). Studies focusing on fixed prostheses only demonstrated that the lack of keratinized mucosa was associated with an increased prevalence of peri-implantitis (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001). Among patients under regular implant maintenance, the absence of keratinized mucosa significantly raised the occurrence of peri-implantitis (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002). Studies adjusting for other variables also confirmed a higher risk of peri-implantitis with inadequate keratinized mucosa (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Although some publication bias was observed, the certainty of evidence based on the GRADE system was judged to be "moderate." CONCLUSIONS The lack of keratinized mucosa increased the risk of peri-implantitis, emphasizing the need to consider it during dental implant placement. Inadequate data on patient-specific factors and the predominance of cross-sectional studies influenced the evidence quality (i.e., moderate). Future studies with consistent methodologies shall confirm these findings and identify additional risk indicators to improve implant dentistry practices.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Adjunct Research Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
- Assistant Professor and Director of the Evidence-Based Practice Unit, Ajman University College of Dentistry, Ajman City, UAE.
- Visiting Professor, Department of Prosthodontics, Yonsei University Dental Hospital, Seoul, South Korea.
| | - Kyung Chul Oh
- Assistant Professor, Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Carlos A Jurado
- Associate Professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Hyeonjong Lee
- Clinical Associate Professor, Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, South Korea.
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Villalobos-Tinoco J, Jurado CA, Afrashtehfar KI, Fischer N. Combination of minimal- and non-preparation techniques with ceramic veneers for managing esthetic deficiencies. Int J Esthet Dent 2023; 18:232-243. [PMID: 37462377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Non-preparation (non-prep) ceramic veneers are a convenient and conservative treatment option, but controversy exists about their predictability. Concerns remain about possible overcontouring, poor-quality margins, and early esthetic failure. The present clinical report describes the combination of minimally invasive and non-prep ceramic laminate veneers in the esthetic zone with a 6-year follow-up to replace stained composite resin veneers on both maxillary central incisors. Composite resin veneers on the maxillary central incisors were replaced with ceramic veneers, and a non-prep ceramic veneer was placed on the maxillary right lateral incisor. A diagnostic additive wax-up was done, followed by a mock-up guide to conservatively prepare both maxillary central incisors. The three feldspathic porcelain veneer restorations were cemented under rubber dam isolation. The 6-year follow-up showed that stained composite resin veneers can successfully be replaced with minimally invasive and non-prep ceramic veneers to meet the patient's esthetic wishes. Overall, well-planned and well-executed restorative procedures combining minimal preparation and non-prep for ceramic laminate veneers can achieve esthetically pleasing outcomes and maximize tooth structure preservation in the maxillary anterior region.
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Assery NM, Jurado CA, Assery MK, Afrashtehfar KI. Peri-implantitis and systemic inflammation: A critical update. Saudi Dent J 2023; 35:443-450. [PMID: 37520600 PMCID: PMC10373087 DOI: 10.1016/j.sdentj.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 08/01/2023] Open
Abstract
Peri-implantitis is an inflammatory condition induced by bacterial biofilm that affects the soft and hard tissues surrounding dental implants, compromising the success of implant therapy. Recent studies have highlighted the potential links between peri-implant health and systemic inflammation, including uncontrolled diabetes mellitus, psychological stress, cardiovascular disease, obesity, and infectious diseases such as COVID-19. As an inflammatory disease, peri-implantitis may trigger systemic inflammation by elevating circulating levels of pro-inflammatory cytokines, which could have unknown impacts on overall health. While the relationship between periodontal health and systemic conditions is better understood, the association between peri-implant disease and systemic inflammation remains unclear. Therefore, this comprehensive review aims to summarize the most recent evidence on the relationship between peri-implantitis and systemic inflammation, focusing on biological complications, microbiology, and biomarkers. This review aims to enhance our understanding of the links between peri-implantitis and systemic inflammation and promote further research in this field by discussing the latest insights and clinical implications.
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Affiliation(s)
- Nasser M. Assery
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14642, USA
| | - Carlos A. Jurado
- Department of Prosthodontics, School of Dentistry, Iowa University, Iowa City, IA 52242, USA
| | - Mansour K. Assery
- College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit (EBPU), Clinical Sciences Department, College of Dentistry, Ajman University, PO Box 346, Ajman City, AE, United Arab Emirates
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Berne, BE, Switzerland
- Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, 8032 Zurich, ZH, Switzerland
- Artificial Intelligence Research Center (AIRC), Ajman City, P.O. Box 346, AE, United Arab Emirates
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Villalobos-Tinoco J, Jurado CA, Sanchez-Hernandez RA, Elgreatly A, Alshabib A, Tsujimoto A. Injectable Flowable Resin-based Composite Veneers Prior to Ceramic Veneers. Oper Dent 2023:493891. [PMID: 37352465 DOI: 10.2341/22-048-t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 06/25/2023]
Abstract
OBJECTIVES This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. CLINICAL CONSIDERATION The patient's primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. CONCLUSIONS Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.
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Affiliation(s)
- J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting professor, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - C A Jurado
- Carlos A Jurado, DDS, MS, associate professor, Texas Tech University Health Sciences Center El Paso Woody L Hunt School of Dental Medicine. El Paso, TX, USA
| | | | - A Elgreatly
- Amira Elgreatly, BDS, MS, assistant professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - A Alshabib
- Abdulrahman Alshabib, DDS, PhD, assistant professor, Department of Restorative Dentistry, College of Dentistry, King Saud University, Saudi Arabia
| | - A Tsujimoto
- *Akimasa Tsujimoto, BDS, PhD, associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
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Afrashtehfar KI, Jurado CA, Al-Hadi D, Shetty KP. Pulpotomy versus root canal treatment in permanent teeth with spontaneous pain: comparable clinical and patient outcomes, but insufficient evidence. Evid Based Dent 2023; 24:54-56. [PMID: 37188923 PMCID: PMC10289894 DOI: 10.1038/s41432-023-00878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 05/17/2023]
Abstract
DESIGN A systematic appraisal and statistical aggregation of primary studies. DATA SOURCES Scopus/ELSEVIER, PubMed/MEDLINE, Clarivate Analytics' Web of Science (i.e., Web of Science Core Collection-WoS, Korean Journal Database-KJD, Russian Science Citation Index-RSCI, SciELO Citation Index-SCIELO), and Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library.The complementary searches consisted of OpenGrey, Google Scholar (first 100 returns), Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, DART-Europe E-theses Portal-DEEP, Opening access to UK theses-EThOS. STUDY SELECTION Human clinical trials studies in English language with at least 10 patients with mature or immature permanent teeth with pulpitis characterized by spontaneous pain in each arm (i.e., root canal treatment [RCT] and pulpotomy) at the end of the study, comparing the patient- (Primary: survival, pain, tenderness, swelling assessed by clinical history, clinical examination, and pain scales; Secondary: tooth function, need for further intervention, adverse effects; OHRQoL using a validated questionnaire) and clinical-reported outcomes (Primary: emerging apical radiolucency as per intraoral periapical radiograph or limited FOV CBCT scan; Secondary: radiological evidence of continued root formation and presence of sinus tract). DATA EXTRACTION AND SYNTHESIS Two independent review authors conducted study selection, data extraction and risk of bias (RoB) assessment and a third reviewer was consulted for solving disagreements. When insufficient or absent information, the corresponding author was reached out to for further explanation. The Cochrane RoB tool for randomized trials (RoB 2.0) was evaluated the quality of studies.The meta-analysis was performed on a fixed-effect model to estimate pooled effect size such as odds ratio (OR) and 95% confidence intervals (CIs) were performed using the R software. The quality of evidence assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach (GRADEpro GDT: GRADEpro Guideline Development Tool [software], McMaster University, 2015). RESULTS Five primary studies were included. Four studies referred to a multicentre trial assessing postoperative pain and long-term success rate after pulpotomy compared with one-visit RCT in 407 mature molars. The other study was a multicentre trial assessing postoperative pain in 550 mature molars treated with pulpotomy and pulp capping with the calcium-enriched mixture (CEM), pulpotomy and pulp capping with mineral trioxide aggregate (MTA) and one-visit RCT. Both trials primarily reported first molars from young adults. When looking at the results of postoperative pain, all the trials included had a low RoB. However, when evaluating the clinical and radiographic outcomes of the included reports, it was determined that there was a high RoB. The meta-analysis found that the likelihood of experiencing pain (i.e., mild, moderate, or severe) at the 7th postoperative day was not affected by the type of intervention (OR = 0.99, 95% CI 0.63-1.55, I2 = 0%).The study design, risk of bias, inconsistency, indirectness, imprecision, and publication bias domains were used to grade the quality of evidence for postoperative pain between RCT and full pulpotomy, resulting in a 'High' grade. In the first year, clinical success was high for both interventions, with a rate of 98%. However, the success rate declined over time, with pulpotomy showing a 78.1% success rate and RCT showing a 75.3% success rate at the 5-year follow up. CONCLUSIONS This systematic review was limited by the inclusion of only two trials, indicating a lack of sufficient evidence to draw definitive conclusions. Nonetheless, the available clinical data suggests that patient-reported pain outcomes do not differ significantly between RCT and pulpotomy at Day 7 postoperatively, and that the long-term clinical success rate of both treatments is comparable, as demonstrated by a single randomized control trial. However, to establish a more robust evidence base, additional high-quality randomized clinical trials, conducted by diverse research groups, are needed in this field. In conclusion, this review underscores the insufficiency of current evidence to draw solid recommendations.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Assistant Professor and Director of the Evidence-Based Practice Unit, Ajman University College of Dentistry, Ajman City, UAE.
- Visiting Research Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Carlos A Jurado
- Associate Professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Dunia Al-Hadi
- Lecturer in Endodontology, Ajman University College of Dentistry, Ajman City, UAE
| | - Krishna P Shetty
- Lecturer in Endodontology, Ajman University College of Dentistry, Ajman City, UAE
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Jurado CA, Alresayes S, Rojas-Rueda S, Alqahtani A, Tsujimoto A, Fischer NG, Afrashtehfar KI. Ceramic versus Composite Resin Polishing Systems on the Surface Roughness of Milled Leucite-Reinforced Ceramics. Medicina (Kaunas) 2023; 59:1048. [PMID: 37374252 DOI: 10.3390/medicina59061048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Background and Objective: This study aimed to compare the surface finish of milled leucite-reinforced ceramics polished with ceramic and composite polishing systems based on the manufacturers' recommendations. Materials and Methods: Sixty subtractive computer-aided manufactured (s-CAM) leucite-reinforced glass-ceramic specimens (IPS-Empress-CAD) were assigned into six groups: no polishing, a ceramic polishing kit, and four composite kit groups. The roughness average (Ra) was evaluated in microns using a profilometer, and scanning electron micrographs were obtained for qualitative analysis. A Tukey HSD posthoc test (α = 0.05) was used to determine significant intergroup differences. Results: After surface evaluation of the ceramics, the Ra values of the polishing systems ranked OptraFine (0.41 ± 0.26) < Enhance (1.60 ± 0.54) < Shofu (2.14 ± 0.44) < Astropol (4.05 ± 0.72) < DiaComp (5.66 ± 0.62) < No Polishing (5.66 ± 0.74). Discussion: Composite polishing systems did not provide as smooth surfaces as the ceramic polishing kit for CAD-CAM leucite-reinforced ceramics. Thus, using ceramic polishing systems, polishing leucite ceramics is recommended, whereas composite polishing systems should not be considered as an alternative for use in minimally invasive dentistry.
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Affiliation(s)
- Carlos A Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Saad Alresayes
- Department of Prosthetic Dental Sciences, King Saud University College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Silvia Rojas-Rueda
- School of Dentistry, Pontifical Xaverian University, Bogota 110231, Colombia
| | - Ali Alqahtani
- Department of Periodontics and Community Dentistry, King Khalid University College of Dentistry, Abha 62529, Saudi Arabia
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Aichi Gakuin University School of Dentistry, Nagoya 646-8650, Japan
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kelvin I Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, Ajman University College of Dentistry, 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
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Jurado CA, Karimi K, Kim R, Nurrohman H, Deemer E, LE C, French K, Tsujimoto A. Effects of over-the-counter at-home whitening products with LED light on surface roughness of partially- and fully crystalized CAD/CAM lithium disilicate ceramics. Dent Mater J 2023:2022-219. [PMID: 37225497 DOI: 10.4012/dmj.2022-219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this study is to evaluate the effect of over-the-counter (OTC) at-home whitening products with LED light on partially- and fully-crystalized CAD/CAM lithium disilicate ceramics. Two partially-crystalized CAD/CAM lithium disilicate ceramics, Amber Mill and IPS e.max CAD, and one fully-crystalized CAD/CAM lithium disilicate ceramic, n!ce Straumann, were used. The specimens were divided based on treatment with OTC whitening products: no treatment provided, Colgate Optic, Crest 3D and Walgreens Deluxe. The surface roughness of the specimens was evaluated with an optical profilometer and scanning electron microscopy. The three LED whitening products significantly increased the surface roughness and changed surface morphology of Amber Mill and IPS e.max CAD but no differences for n!ce Straumann. OTC at-home whitening products with LED light can significantly increase the surface roughness of restorations fabricated with these partially-crystalized CAD/CAM lithium disilicate ceramic restorations. However, these products do not increase the surface roughness of restorations fabricated with this fully-crystalized lithium disilicate ceramic.
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Affiliation(s)
- Carlos A Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry
| | - Kiarash Karimi
- Section of Restorative Dentistry, University of California Los Angeles School of Dentistry
| | - Reuben Kim
- Section of Restorative Dentistry, University of California Los Angeles School of Dentistry
| | - Hamid Nurrohman
- Department of Restorative Dentistry & Prosthodontics, University of Texas School of Dentistry at Houston
| | - Eva Deemer
- University of Texas at El Paso Center for Inland Desalination Systems
| | - Christine LE
- A. T. Still University Arizona School of Dentistry & Oral Health
| | - Kennedee French
- A. T. Still University Missouri School of Dentistry & Oral Health
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Aichi Gakuin University School of Dentistry
- Department of Operative Dentistry, University of Iowa College of Dentistry
- Department of General Dentistry, Creighton University School of Dentistry
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Zamudio-Ceja RB, Garcia-Contreras R, Chavez-Granados PA, Aranda-Herrera B, Alvarado-Garnica H, Jurado CA, Fischer NG. Decellularized Scaffolds of Nopal ( Opuntia Ficus-indica) for Bioengineering in Regenerative Dentistry. J Funct Biomater 2023; 14:jfb14050252. [PMID: 37233362 DOI: 10.3390/jfb14050252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
Opuntia Ficus-indica, or nopal, is traditionally used for its medicinal properties in Mexico. This study aims to decellularize and characterize nopal (Opuntia Ficus-indica) scaffolds, assess their degradation and the proliferation of hDPSC, and determine potential pro-inflammatory effects by assessing the expression of cyclooxygenase 1 and 2 (COX-1 and 2). The scaffolds were decellularized using a 0.5% sodium dodecyl sulfate (SDS) solution and confirmed by color, optical microscopy, and SEM. The degradation rates and mechanical properties of the scaffolds were determined by weight and solution absorbances using trypsin and PBS and tensile strength testing. Human dental pulp stem cells (hDPSCs) primary cells were used for scaffold-cell interaction and proliferation assays, as well as an MTT assay to determine proliferation. Proinflammatory protein expression of COX-I and -II was discovered by Western blot assay, and the cultures were induced into a pro-inflammatory state with interleukin 1-β. The nopal scaffolds exhibited a porous structure with an average pore size of 252 ± 77 μm. The decellularized scaffolds showed a 57% reduction in weight loss during hydrolytic degradation and a 70% reduction during enzymatic degradation. There was no difference in tensile strengths between native and decellularized scaffolds (12.5 ± 1 and 11.8 ± 0.5 MPa). Furthermore, hDPSCs showed a significant increase in cell viability of 95% and 106% at 168 h for native and decellularized scaffolds, respectively. The combination of the scaffold and hDPSCs did not cause an increase in the expression of COX-1 and COX-2 proteins. However, when the combination was exposed to IL-1β, there was an increase in the expression of COX-2. This study demonstrates the potential application of nopal scaffolds in tissue engineering and regenerative medicine or dentistry, owing to their structural characteristics, degradation properties, mechanical properties, ability to induce cell proliferation, and lack of enhancement of pro-inflammatory cytokines.
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Affiliation(s)
- Ruth Betsabe Zamudio-Ceja
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Gto, Mexico
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Gto, Mexico
| | - Patricia Alejandra Chavez-Granados
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Gto, Mexico
| | - Benjamin Aranda-Herrera
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Gto, Mexico
| | - Hugo Alvarado-Garnica
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Gto, Mexico
| | - Carlos A Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN 55455, USA
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Villalobos-Tinoco JV, Fischer NG, Jurado CA, Flores-Reyes J, Karimi K, Tsujimoto A. Ultrathin Partial Ceramic Veneers in the Esthetic Zone with Tooth Whitening: A 5-year Case Report. Oper Dent 2023:492393. [PMID: 37079913 DOI: 10.2341/22-081-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 04/22/2023]
Abstract
OBJECTIVE This case report describes a minimally invasive approach with tooth whitening and partial ceramic veneers in the esthetic zone with a 5-year follow-up. CLINICAL CONSIDERATIONS The patient was initially concerned about the tooth color and previous direct resin composite restorations that chipped on the incisal edges of both maxillary central incisors. Tooth whitening and partial veneers for both central incisors were recommended after clinical evaluation. Two sessions of in-office tooth whitening, first with 35% hydrogen peroxide and later with 10% carbamide peroxide from first premolar to first premolar, were provided. Minimal tooth preparation that only removed the fractured composite restorations was performed followed by placement of feldspathic porcelain ultrathin partial ceramic veneers for both central incisors. We emphasize the benefits of minimal tooth preparation paired with partial ceramic veneers and the importance of masking discolored tooth structure with such thin veneers, including potential tooth whitening. CONCLUSIONS Overall, we demonstrate a well-planned and executed restorative procedure combining tooth whitening and ultrathin partial ceramic veneers to achieve desired results in the esthetic zone that remained successful for five years.
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Affiliation(s)
- J V Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, assistant professor, Oral Rehabilitation, Universidad Autonoma de Queretaro School of Dentistry. Queretaro, Mexico
| | - N G Fischer
- *Nicholas G. Fischer, PhD, fellow, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor, Department of Prosthodontics, University of Iowa College of Dentistry, IA, USA
| | - J Flores-Reyes
- Julio Flores-Reyes, CDT, dental technician, Morelia, Mexico
| | - K Karimi
- Kiarash Karimi, DMD, DDS, adjunct faculty, Department of Restorative Sciences, University of California Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - A Tsujimoto
- Akimasa Tsujimoto, DDS, PhD, associate professor, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA and visiting associate professor, Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Mekled S, Elwazeer S, Jurado CA, White J, Faddoul F, Afrashtehfar KI, Fischer NG. Ultra-Translucent Zirconia Laminate Veneers: The Influence of Restoration Thickness and Stump Tooth-Shade. Materials (Basel) 2023; 16:3030. [PMID: 37109865 PMCID: PMC10145317 DOI: 10.3390/ma16083030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/30/2023] [Accepted: 04/08/2023] [Indexed: 06/19/2023]
Abstract
This in vitro study aimed to evaluate the final shade of translucent zirconia laminate veneers with varying thicknesses over teeth with different shades. Seventy-five chairside computer-aided design/computer-aided manufacturing (CAD/CAM) shade A1 third-generation zirconia dental veneers, with thicknesses of 0.50 mm, 0.75 mm, and 1.00 mm, were placed on resin composite teeth with shades ranging from A1 to A4. The laminate veneers were divided into groups based on thickness and background shade. All restorations were evaluated with a color imaging spectrophotometer, to map the veneer surface from A1 to D4. Regardless of the thickness or background shade, all dental veneers showed color alteration from the original shade. Veneers with 0.5 mm thickness tended to display the B1 shade, while veneers with 0.75 mm and 1.0 mm thickness primarily exhibited the B2 shade. The thickness of the laminate veneer and background shade significantly modified the original shade of the zirconia veneer. One-way analysis of variance was performed and a Kruskal-Wallis test was used to determine the significance between the three veneer thicknesses groups. The results indicated that the thinner restorations showed higher values with the color imaging spectrophotometer, suggesting that thinner veneers may result in more consistent color matching. This study underscores the importance of carefully considering thickness and background shade when selecting zirconia laminate veneers, to ensure optimal color matching and overall aesthetic outcomes.
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Affiliation(s)
- Salwa Mekled
- Temple University Kornberg School of Dentistry, Philadelphia, PA 19140, USA
| | - Salma Elwazeer
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, TX 79905, USA
| | - Carlos A. Jurado
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - James White
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, TX 79905, USA
| | - Faddy Faddoul
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, TX 79905, USA
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, Ajman College of Dentistry, Ajman City P.O. Box 346, AE, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, BE, Switzerland
- Artificial Intelligence Research Center (AIRC), Ajman City P.O. Box 346, AE, United Arab Emirates
| | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA
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Azpiazu-Flores FX, Lee DJ, Jurado CA, Nurrohman H. 3D-Printed Overlay Template for Diagnosis and Planning Complete Arch Implant Prostheses. Healthcare (Basel) 2023; 11:healthcare11081062. [PMID: 37107896 PMCID: PMC10137737 DOI: 10.3390/healthcare11081062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Dental implants are a reliable alternative to treating edentulism. In clinical situations where the dentition has been severely affected by partial edentulism, advanced wear, or periodontal disease, establishing important occlusal elements such as the occlusal plane, incisal guidance, and esthetics can be hard to visualize at the diagnostic stage. Contemporary data-acquisition technologies such as 3D scanners and CAD/CAM systems permit the precise manufacture of highly complex devices applicable to any stage of restorative treatment. The present clinical report presents an alternative technique for evaluating the projected artificial tooth relationships, vertical dimension, and occlusal plane in patients with severely weakened dentition by using a 3D-printed overlay template.
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Affiliation(s)
- Francisco X Azpiazu-Flores
- Department of Restorative Dentistry, Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Damian J Lee
- Director Advanced Prosthodontics Residency Program, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Carlos A Jurado
- Department of Prosthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA
| | - Hamid Nurrohman
- Missouri School of Dentistry & Oral Health, A.T. Still University, Kirksville, MO 63501, USA
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Azpiazu-Flores FX, Lee DJ, Jurado CA, Afrashtehfar KI, Alhotan A, Tsujimoto A. Full-Mouth Rehabilitation of a Patient with Sjogren's Syndrome with Maxillary Titanium-Zirconia and Mandibular Monolithic Zirconia Implant Prostheses Fabricated with CAD/CAM Technology: A Clinical Report. J Funct Biomater 2023; 14:jfb14040174. [PMID: 37103264 PMCID: PMC10143958 DOI: 10.3390/jfb14040174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/28/2023] Open
Abstract
Dental implants have become a well-established treatment modality for the management of complete and partial edentulism. Recent advancements in dental implant systems and CAD/CAM technologies have revolutionized prosthodontic practice by allowing for the predictable, efficient, and faster management of complex dental scenarios. This clinical report describes the interdisciplinary management of a patient with Sjogren's syndrome and terminal dentition. The patient was rehabilitated using dental implants and zirconia-based prostheses in the maxillary and mandibular arches. These prostheses were fabricated using a combination of CAD/CAM and analog techniques. The successful outcomes for the patient demonstrate the importance of appropriate use of biomaterials and the implementation of interdisciplinary collaboration in treating complex dental cases.
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Affiliation(s)
- Francisco X Azpiazu-Flores
- Department of Restorative Dentistry, Gerald Niznick College of Dentistry University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Damian J Lee
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Carlos A Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Kelvin I Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman University College of Dentistry, Ajman City 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Abdulaziz Alhotan
- Dental Health Department, King Saud University College of Applied Medical Sciences, Riyadh 1145, Saudi Arabia
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Department of General Dentisry, Creigthon University School of Dentisry, Omaha, NE 68102, USA
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Guzman-Perez G, Jurado CA, Azpiazu-Flores F, Afrashtehfar KI, Tsujimoto A. Minimally Invasive Laminate Veneer Therapy for Maxillary Central Incisors. Medicina (Kaunas) 2023; 59:medicina59030603. [PMID: 36984604 PMCID: PMC10053945 DOI: 10.3390/medicina59030603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
Minimally invasive dentistry is a considered process that requires the clinician to be prepared with the ideal sequence and the tools needed. This report describes a well-planned ultraconservative approach using only two ceramic laminate veneers for the maxillary central incisors to significantly improve the patient's overall smile. A 30-year-old female presented with the chief complaints of having diastemas between the central and lateral incisors as well as incisal wear. Diagnostic wax-up and mock-up were performed, and the patient approved the minimally invasive treatment with veneers only for central incisors. A reduction guide aided the conservative tooth preparations, and hand-crafted feldspathic veneers were bonded under total isolation with a rubber dam. The two final conservative veneers significantly improved the smile and fulfilled the patient's expectations. Following proper planning and sequencing, predictable outcomes were obtained and fulfilled the patient's esthetic demands. Minimally invasive restorative dentistry with only two single veneers can impact the entire smile frame. Overtreatment in the esthetic zone is unnecessary to meet a patient's esthetic expectations.
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Affiliation(s)
| | - Carlos A Jurado
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Francisco Azpiazu-Flores
- Department of Restorative Dentistry, University of Manitoba Dr. Gerald Niznick College of Dentistry, Winnipeg, MB R3E 0W2, Canada
| | - Kelvin I Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman College of Dentistry, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, University of Bern School of Dental Medicine, 3010 Bern, Switzerland
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
- Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE 68102, USA
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Karimi K, Fischer NG, Jurado CA, Villalobos-Tinoco J, Tsujimoto A. Polychromatic Composite and Resin Infiltration Restorations in the Esthetic Zone: A Five-year Clinical Report. Oper Dent 2023:491444. [PMID: 36917631 DOI: 10.2341/22-033-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 03/15/2023]
Abstract
OBJECTIVE This case report describes the use of a combination of a polychromatic resin composite restoration and resin infiltration to achieve a satisfactory esthetic outcome that has lasted over five years. CLINICAL CONSIDERATIONS The patient's primary complaint was a desire to replace an existing stained resin composite on the facial and mesial surfaces of the maxillary left central incisor, and a white spot on the facial surface of the maxillary right central incisor. After clinical evaluation, the patient was offered either replacement of the restoration with a polychromatic restoration simulating a white spot, or a combined treatment with polychromatic composite and resin infiltration restorations, which was recommended. The patient selected the latter treatment. A putty matrix was fabricated, and a quick mock-up was done using various enamel and dentin shades of resin composite to determine proper material selection. The previous resin composite restoration was removed, and layers of new dentin, body, and enamel composite were placed. An interproximal matrix was used in order to provide ideal contour and contact. Finishing and polishing procedures were performed. The maxillary right central incisor was treated with resin infiltration in order to subdue the white spot on the facial surface. CONCLUSIONS Polychromatic resin composite and resin infiltration restorations to replace a stained restoration and mask a white spot can achieve desired results in the esthetic zone and maintain them for five years.
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Affiliation(s)
- K Karimi
- Kiarash Karimi, DDS, DMD, adjunct faculty, University of California Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - N G Fischer
- *Nicholas G Fischer, PhD, fellow, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor at University of Iowa College of Dentistry, Iowa City, IA, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, assistant professor, Universidad Autonoma de Queretaro School of Dentistry, Queretaro, Mexico
| | - A Tsujimoto
- Akimasa Tsujimoto, DDS, PhD, associate professor, University of Iowa College of Dentistry, Iowa City, IA, USA
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Afrashtehfar KI, Jurado CA, Wang HL. FOR PERI-IMPLANT SOFT TISSUE AUGMENTATION, SOFT TISSUE SUBSTITUTES MAY IMPROVE PATIENTS' SURGICAL AND POSTOPERATIVE EXPERIENCE COMPARED TO AUTOGENOUS GRAFTS. J Evid Based Dent Pract 2023; 23:101835. [PMID: 36914299 DOI: 10.1016/j.jebdp.2023.101835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Thoma DS, Strauss FJ, Mancini L, Gasser TJW, Jung RE. Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures. Periodontol 2000. 2022 Aug 11. doi:10.1111/prd.12465. Online ahead of print. PMID: 35950734. SOURCE OF FUNDING Not reported. TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Afrashtehfar KI, Jurado CA, Abu-Fanas SH, Jaber MA. Health and Well-Being through COVID-19 Vaccination: Physical, Oral, and Psychological Effects. Int J Environ Res Public Health 2023; 20:3117. [PMID: 36833813 PMCID: PMC9963193 DOI: 10.3390/ijerph20043117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 06/01/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic and its evolving variants have spurred a worldwide effort to control its transmission and reduce its impact [...].
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Affiliation(s)
- Kelvin I. Afrashtehfar
- Clinical Sciences Department, Ajman 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
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Salem H. Abu-Fanas
- Clinical Sciences Department, Ajman College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
| | - Mohamed A. Jaber
- Clinical Sciences Department, Ajman College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
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Afrashtehfar KI, Jurado CA, Al-Sammarraie A, Saeed MH. Consequences of COVID-19 and Its Variants: Understanding the Physical, Oral, and Psychological Impact. Int J Environ Res Public Health 2023; 20:3099. [PMID: 36833792 PMCID: PMC9967910 DOI: 10.3390/ijerph20043099] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 06/02/2023]
Abstract
The highly infectious severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic, which affects the lives of people worldwide in a variety of unprecedented ways [...].
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Affiliation(s)
- Kelvin I. Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman College of Dentistry, 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
| | - Carlos A. Jurado
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Amaweya Al-Sammarraie
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman College of Dentistry, Ajman City P.O. Box 346, United Arab Emirates
| | - Musab H. Saeed
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman College of Dentistry, Ajman City P.O. Box 346, United Arab Emirates
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Afrashtehfar KI, Jurado CA, Moshaverinia A. Dynamic navigation may be used for most implant surgery scenarios due to its satisfactory accuracy. J Evid Based Dent Pract 2022; 22:101797. [PMID: 36494104 DOI: 10.1016/j.jebdp.2022.101797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Wei SM, Zhu Y, Wei JX, Zhang CN, Shi JY, Lai HC. Accuracy of dynamic navigation in implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res. 2021 Apr;32(4):383-393. doi: 10.1111/clr.13719. SOURCE OF FUNDING Shanghai Jiao Tong University School of Medicine (grant no. DLY201822); Shanghai Clinical Research Center for Oral Diseases (grant no. 19,411,950,100); Clinical Research Plan of SHDC (grant no. 16CR3033A). TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, UAE; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland.
| | - Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine, El Paso, TX
| | - Alireza Moshaverinia
- UCLA School of Dentistry, Division of Advanced Prosthodontics and Biomaterials Innovations and Tissue Engineering (BITE) Lab, Los Angeles, CA
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Jurado CA, Barkmeier WW, Alshabib A, Alresayes SS, Fu CC, Teixeira EC, Baruth AG, Tsujimoto A. Effectiveness of Different Polishing Kits for Chairside CAD/CAM Provisional Restorative Materials. Oper Dent 2022; 47:670-677. [DOI: 10.2341/21-147-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective: To investigate the efficacy of three specially designed polishing kits for provisional restorations made from three chairside computer-aided design and computer-aided manufacturing (CAD/CAM) provisional resin blocks.
Method: Ninety-six chairside CAD/CAM provisional restorations were milled out of three chairside CAD/CAM provisional resin blocks: (1) ArtBloc Temp (Merz Dental); (2) Telio CAD (Ivoclar Vivadent); and (3) Vita CAD-Temp (VITA Zahnfabrik). The provisional restorations for each material were allocated into the following groups: (1) milled restorations (no polish); (2) polished with CADMaster CAD/CAM Adjustment & Polishing Kit (CM, Shofu); (3) polished with KUT Ultimate Bisacryl (Temporaries) Polishing Kit (KU, Dental Savings Club); and (4) polished with K0330 PMMA Adjusting, Finishing & Polishing (KP, Brasseler USA). Optical profilometry and atomic force microscopy (AFM) were used to assess the surface roughness (Ra) of each provisional restoration at the microscale and nanoscale, respectively, and obtain topographical images. In addition, the milled and polished restorations were visually evaluated by 16 dentists.
Results: There was a strong positive correlation with Ra values between optical profilometry and AFM. Only KP significantly improved the surface roughness of CAD/CAM provisional restorations compared to the milled equivalent, regardless of material type or measurement modality (ie, lateral length scale). Although surface topography imaging with AFM revealed some shallow scratches, even for KP polished specimens, all KP polished restorations were categorized as clinically acceptable for provisional restorations in visual inspections from dentists.
Conclusion: Specially designed polishing kits for provisional restorations did not all improve the surface roughness of chairside CAD/CAM provisional restorations, regardless of the measurement method. KP was more consistently effective in polishing milled chairside CAD/CAM provisional restorations than CM and KU.
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Affiliation(s)
- CA Jurado
- Carlos A. Jurado, DDS, MS, Texas Tech University Health Science Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - WW Barkmeier
- Wayne W. Barkmeier, DDS, MS, Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
| | - A Alshabib
- Abdulrahman Alshabib, BDS, PhD, Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - SS Alresayes
- Saad Saleh Alresayes, BDS, MS, Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - C-C Fu
- Chin-Chuan Fu, DDS, MS, The University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA
| | - EC Teixeira
- Erica C Teixeira, DDS, MS, PhD, Department of Operative Dentistry, The University of Iowa College of Dentistry, Iowa City, IA, USA
| | - AG Baruth
- Andrew G. Baruth, PhD, Department of Physics, Creighton University College of Arts and Sciences, Omaha, NE, USA
| | - A Tsujimoto
- *Akimasa Tsujimoto, BDS, PhD, Department of Operative Dentistry, The University of Iowa College of Dentistry, Iowa City, IA, USA
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Alshehri A, Alhalabi F, Mustafa M, Awad MM, Alqhtani M, Almutairi M, Alhijab F, Jurado CA, Fischer NG, Nurrohman H, Alshabib A. Effects of Accelerated Aging on Color Stability and Surface Roughness of a Biomimetic Composite: An In Vitro Study. Biomimetics (Basel) 2022; 7:biomimetics7040158. [PMID: 36278715 PMCID: PMC9624352 DOI: 10.3390/biomimetics7040158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this in vitro study is to compare the color stability and surface roughness of conventional and self-blending resin composites before and after staining and aging. Three conventional composites (Filtek Z350, IPS Empress Direct, and Estalite Palfique LX5) and one self-blending (Omnichroma) resin composite were used in this study. Sixty discs were prepared and polymerized in a metal mold (n = 15 per group). Samples were then finished and polished by Layan discs. Color testing and roughness testing were measured as a baseline (T0) by a spectrophotometer and profilometry. Samples were then stained with tea for 24 h, water aged for 30 days, and then a second reading (T1) was performed. Finishing and polishing were performed again, and a third reading (T2) was collected. All groups showed significant decrease in all color parameters (L*, a*, and b*); however, after polishing, all groups showed color enhancements matching pre-experiment baseline colors in all color parameters (L*, a*, and b*), except for Estelite Palfique LX5, which showed a significant difference in L relative to the baseline. Furthermore, Estalite Palfique LX5 showed increased roughness after staining compared to the baseline, unlike other groups. No significant differences in color stability were found between self-blending composites and other composite materials. Accelerated aging and staining had minimal effects on the surface roughness of self-blending composite.
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Affiliation(s)
- Abdullah Alshehri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Correspondence: (A.A.); (A.A.)
| | - Feras Alhalabi
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohamed M. Awad
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohammed Alqhtani
- Dental Intern, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mohammed Almutairi
- Dental Intern, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Faisal Alhijab
- Dental Intern, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Carlos A. Jurado
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
| | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA
| | - Hamid Nurrohman
- Restorative Dentistry, A. T. Still University Missouri School of Dentistry & Oral Health, Kirskville, MO 63501, USA
| | - Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 11545, Saudi Arabia
- Engr Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence: (A.A.); (A.A.)
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Jurado CA, Parachuru V, Villalobos Tinoco J, Guzman-Perez G, Tsujimoto A, Javvadi R, Afrashtehfar KI. Diagnostic Mock-Up as a Surgical Reduction Guide for Crown Lengthening: Technique Description and Case Report. Medicina (Kaunas) 2022; 58:1360. [PMID: 36295521 PMCID: PMC9608665 DOI: 10.3390/medicina58101360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.
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Affiliation(s)
- Carlos A. Jurado
- Woody L Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Venkata Parachuru
- Woody L Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Jose Villalobos Tinoco
- Graduate Program in Periodontics, School of Dentistry, National University of Rosario, Rosario S2000CGK, Argentina
| | | | - Akimasa Tsujimoto
- Department of Operative Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA
- Department of General Dentistry, School of Dentistry, Creighton University, Omaha, NE 68102, USA
| | | | - 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, CH-3010 Berne, Switzerland
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Jurado CA, Amarillas-Gastelum C, Afrashtehfar KI, Argueta-Figueroa L, Fischer NG, Alshabib A. Ceramic and Composite Polishing Systems for Milled Lithium Disilicate Restorative Materials: A 2D and 3D Comparative In Vitro Study. Materials (Basel) 2022; 15:ma15155402. [PMID: 35955341 PMCID: PMC9369544 DOI: 10.3390/ma15155402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 05/20/2023]
Abstract
Purpose: This study aims to evaluate the effectiveness of two ceramic and two composite polishing systems for a novel chairside computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate ceramic with three-dimensional and two-dimensional microscopy images. This ceramic material can be used for implant-supported or tooth-borne single-unit prostheses. Materials and Methods: Sixty flat samples of novel chairside CAD/CAM reinforced lithium disilicate ceramic (Amber Mill, Hass Bio) were divided into five groups (n = 15/group) and treated as follows: Group 1 (NoP), no polished treatment; group 2 (CeDi), polished with ceramic Dialite LD (Brasseler USA); group 3, (CeOp) polished with ceramic OptraFine (Ivoclar Vivadent); group 4, (CoDi) polished with composite DiaComp (Brasseler USA), and group 5 (CoAs), polished with composite Astropol (Ivoclar Vivadent). The polished ceramic surface topography was observed and measured with three-dimensional and two-dimensional images. Results: All polishing systems significantly reduced the surface roughness compared with the non-polished control group (Sa 1.15 μm). Group 2 (CeDi) provided the smoothest surface arithmetical mean eight with 0.32 μm, followed by group 3 (CeOp) with 0.34 μm. Group 5 (CoAs) with 0.52 μm provided the smoothest surface among the composite polishing kits. Group 4 (CoDi) with 0.66 μm provided the least smooth surface among all polishing systems tested. Conclusions: Despite the effectiveness of ceramic polishing systems being superior to composite polishing systems of the CAD/CAM lithium disilicate restorative material, both polishing systems significantly improved the smoothness.
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Affiliation(s)
- Carlos A. Jurado
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
| | | | - Kelvin I. Afrashtehfar
- 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 Berne, Switzerland
| | | | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA
| | - Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 12372, Saudi Arabia
- Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence:
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Villalobos-Tinoco J, Jurado CA, Rojas-Rueda S, Fischer NG. Additive Wax-Up and Diagnostic Mockup As Driving Tools for Minimally Invasive Veneer Preparations. Cureus 2022; 14:e27402. [PMID: 36046283 PMCID: PMC9418764 DOI: 10.7759/cureus.27402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
This report describes the importance of and outlines steps for additive wax-up and diagnostic mockup for anterior teeth as diagnostic and driving tools for non-prep and minimally invasive veneer preparations. A 35-year-old male presented to the clinic with the chief complaint of spaces between his front teeth. Diagnostic additive wax-up provided the possibility of offering minimally invasive preparations, and the use of a diagnostic intraoral mockup fulfilled the patient’s esthetic demands for treatment approval. Veneer preparations over the diagnostic mockup were provided as they are minimally invasive. Ceramic veneers were hand-crafted following the previous diagnostic wax-up, and restorations were bonded under rubber dam isolation. Overall, additive wax-up provides information needed to know if minimally invasive veneer preparations are possible, and the diagnostic mockup displays a physical, tentative outcome for the patient’s evaluation before irreversible tooth preparations. These simple, but effective, techniques can drive the diagnosis and prognosis of minimally invasive veneer restorations.
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Abstract
One technique for placing of resin-based composite for large posterior cavities is the use of short fiber-reinforced resin-based composite (SFRC) to replace dentin in a biomimetic approach. As endurance under mastication cycles is a significant consideration in the clinical success of resin-based composite posterior restorations, the use of SFRC as a base material may prevent restorative fracture due to the fibers' effectiveness in stopping cracks. This review article specifies the characteristics of SFRC and describes the major underlying mechanisms of short fiber reinforcement for resin-based composite. Insights are further taken from laboratory studies used to define the short fiber-related properties of resin-based composite and the performance of currently available materials, focusing on aspects that are relevant to the reinforcement of resin-based composite. Finally, future standpoints on the development of SFRCs with nano fibers and different resin monomers, and their role in digital dentistry, are discussed.
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Affiliation(s)
- Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry.,Engr. Abdullah Bugshan Research Chair for Dental & Oral Rehabilitation, King Saud University
| | - Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso Woody L. Hunt School of Dental Medicine
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry.,Department of General Dentistry, Creighton University School of Dentistry
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Jurado CA, Pinedo F, Trevino DAC, Williams Q, Marquez-Conde A, Irie M, Tsujimoto A. CAD/CAM lithium disilicate ceramic crowns: Effect of occlusal thickness on fracture resistance and fractographic analysis. Dent Mater J 2022; 41:705-709. [PMID: 35793941 DOI: 10.4012/dmj.2022-018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study uses fracture tests and fractographical analysis to compare computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate molar crowns with the previous occlusal thickness recommendation of 1.5-mm, the new recommendation of 1.0-mm, and a less invasive thickness of 0.8-mm. After fatigue application, fracture tests and fractographic analysis were conducted. The fracture resistance of CAD/CAM lithium disilicate molar crowns was different depending on the occlusal thickness of the restoration, and decreased with lower the thickness. However, the fracture resistance of crowns of all three thicknesses exceeded the reported maximum bite force in the first molar region after the fatigue process, and can be considered acceptable for use in the clinic.
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Affiliation(s)
- Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso, Woody L. Hunt School of Dental Medicine
| | | | | | | | - Alberto Marquez-Conde
- Department of Restorative Dentistry, Autonomous University of San Luis Potosi, Doctor
| | - Masao Irie
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry.,Department of General Dentistry, Creighton University School of Dentistry
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Jurado CA, Fu CC, Guzman LG, Villalobos-Tinoco J, Tsujimoto A. Soft Tissue Management on Pontic and Implant Sites Before Implants Insertion. Cureus 2022; 14:e24621. [PMID: 35506118 PMCID: PMC9056014 DOI: 10.7759/cureus.24621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2022] [Indexed: 11/16/2022] Open
Abstract
Complex implant therapy can include methods requiring several phases of treatment, and they are usually referred to as one-stage and two-stage approaches. The reasons for the staged approach include the extraction of non-restorable teeth. Such a treatment approach may offer a fixed provisional prosthesis during implant osseointegration that enables the patient to avoid removable prostheses. However, this case aims to demonstrate how to manage the soft tissue in the pontic region prior to immediate implant placement. A 45- years old female patient presented with non-restorable teeth from the maxillary right lateral incisor to the left lateral incisor were removed, followed by socket preservation and fixed provisional restoration from right maxillary canine to left canine. Soft tissue was contoured to achieve ovate shape by first with a tooth-supported provisional restoration from the maxillary left canine to the right canine and then by re-shaping with carbide and diamond burs; after the tissue obtained the desired architecture, implants were inserted on sites of the maxillary right lateral incisor and left central lateral incisor without immediate loading, but the same provisional fixed restoration maintained the previously contour tissue. Once implant osseointegration was achieved, screw-retained provisional restoration was placed, followed by the definitive fixed implant restoration. Because the soft tissue was previously contoured, the screw-retained implant provisional restorations maintained the tissue architecture. These initial contouring procedures provided a more predictable outcome for the final tissue contour after implants were inserted. The final re-shaping with the implant screw-retained provisional restorations was minimum, and prostheses followed the previously provided tissue architecture. Before the endosteal implants are inserted, soft-tissue contouring prior to implant placement may provide a more predictable outcome of the final tissue architecture for pontic and implant areas. The patient and clinician can evaluate the success and limitations of tissue contouring prior to implant placement. It may also shorten the time required for tissue contouring with provisional implant restorations.
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Jurado CA, Fischer NG, Sayed ME, Villalobos-Tinoco J, Tsujimoto A. Rubber Dam Isolation for Bonding Ceramic Veneers: A Five-Year Post-Insertion Clinical Report. Cureus 2021; 13:e20748. [PMID: 35111437 PMCID: PMC8792124 DOI: 10.7759/cureus.20748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 11/27/2022] Open
Abstract
It has been well-documented that uncontaminated ground enamel provides the most predictable substrate for the bonding of ceramic veneers, and thus conservative tooth preparation with complete isolation using a rubber dam is key to the long-term success of the restorations presented with five years of follow-up. Rubber dam isolation provides several advantages to the clinician, such as preventing contamination of the working field by saliva, blood, and sulcular fluids, and improving direct visibility. However, it may be a challenge to the younger clinician to properly isolate teeth prior to bonding ceramic veneer. The present case report demonstrated the sequence and some clinical tips for a case in which the rubber dam is placed from a second premolar to the opposite second premolar and held with clamps, the rubber dam is gently invaginated into the sulcus, and clamps are selected and placed on each tooth to create an ideal situation for the adhesion of the ceramic veneer. This step-by-step sequence may help the younger clinician in understanding how to gently manage soft tissue in order to properly provide complete isolation with rubber dam for future bonding of ceramic veneers. Following these methods, the clinician can achieve complete isolation, invaginate the rubber dam in the sulcus without causing tissues to bleed, and reduce the time needed for bonding procedures.
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Affiliation(s)
- Carlos A Jurado
- Prosthodontics, Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, USA
| | - Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, USA
| | - Mohammed E Sayed
- Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, SAU
| | - Jose Villalobos-Tinoco
- Oral Rehabilitation, School of Dentistry, Autonomous University of Queretaro, Querétaro, MEX
| | - Akimasa Tsujimoto
- Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, USA
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Jurado CA, Amarillas-Gastelum C, Tsujimoto A, Alresayes S, French K, Nurrohman H. Light Transmission for a Novel Chairside CAD/CAM Lithium Disilicate Ceramic. J Contemp Dent Pract 2021; 22:1365-1369. [PMID: 35656672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM To evaluate light transmission in a novel chairside CAD/CAM lithium disilicate ceramic with different thicknesses and with and without polishing. MATERIALS AND METHODS Sixty flat samples (10 specimens/group) were fabricated from novel chairside CAD/CAM lithium disilicate ceramic blocks (Amber Mill, Hass Bio) with different thicknesses and with and without polishing as follows: (1) 1.0 mm thickness without polishing (1.0NoP); (2) 1.0 mm thickness with polishing (1.0Po); (3) 1.5 mm thickness without polishing (1.5NoP); (4) 1.5 mm thickness with polishing (1.5Po); (5) 2.0 mm thickness without polishing (2.0NoP); and (6) 2.0 mm thickness with polishing (2.0Po). Specimens were polished with a polishing system for lithium disilicate restorations following the manufacturer's recommendations. Light transmission was evaluated with a curing radiometer. Obtained data were subjected to two-way ANOVA followed by Tukey's post hoc tests (α = 0.05). SEM observations were conducted to evaluate surface microstructure. RESULTS The light intensity through the lithium disilicate blocks with and without polishing was 200.9 mW/cm2 (16.1%) and 194.4 mW/cm2 (15.6%) for 1.0 mm specimens, 119.3 mW/cm2 (9.5%) and 111.9 mW/cm2 (9.0%) for 1.5 mm specimens, and 102.3 mW/cm2 (8.2%) and 96.0 mW/cm2 (7.7%) for 2.0 mm specimens. SEM images showed a smoother surface with polishing compared to nonpolished specimens. CONCLUSION The thickness and polishing of the restorations were both significant influential factors in light transmission. CLINICAL SIGNIFICANCE The range of light transmission percentage through the novel chairside CAD/CAM lithium disilicate blocks was 7.7-16.1%, suggesting that light attenuation through the material may influence the polymerization reaction of resin luting cement in the bonding process.
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Affiliation(s)
- Carlos A Jurado
- Texas Tech University Health Sciences Center El Paso, School of Dental Medicine, El Paso, Texas, United States of America
| | - Clarisa Amarillas-Gastelum
- Department of General Dentistry, Stony Brook University School of Dental Medicine, Stony Brook, New York, United States of America
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, United States of America
| | - Saad Alresayes
- Department of Prosthetic Dental Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Kennedee French
- AT Still University-Missouri School of Dentistry and Oral Health, Kirksville, Missouri, United States of America
| | - Hamid Nurrohman
- AT Still University-Missouri School of Dentistry and Oral Health, Kirksville, Missouri, United States of America; Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, United States of America, Phone: +16606262882, e-mail:
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