Digitalized analysis of the gingival and bone morphology in the maxillary anterior teeth in patient with posterior dental implant / 中华口腔医学杂志

Objective: To explore and analyze the correlation between labial gingival morphology and alveolar bone morphology of maxillary anterior teeth in patients with posterior dental implant, so as to provide reference basis for restoration design and esthetic reconstruction of anterior teeth. Methods: Sixty-four patients [24 males, 40 females (25.6±3.3) years old] who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University from May 2020 to May 2021. According to the visibility of periodontal probe through gingival margin, the subjects were divided into thin and thick gingival biotypes, including 29 cases of thin biotype and 35 cases of thick biotype. The 3Shape software was used to perform oral scanning, and cone beam CT (CBCT) was taken for each patient. Geomagic and Mimics software were used to measure and record the labial crown width and length, gingival papilla height, gingival angle, bone papilla height and bone margin angle of maxillary anterior teeth. Results: The crown width length ratios of maxillary central incisors, lateral incisors and canines were 0.85±0.08, 0.80±0.08 and 0.86±0.09 (F=10.71, P<0.01). The height of gingival papilla between maxillary central incisors, between central incisors and lateral incisors, between lateral incisors and canines were (3.93±0.86), (3.47±0.84) and (3.38±0.91) mm respectively (F=7.44, P<0.01), and the height of corresponding bone papilla were (3.44±0.88), (3.12±0.75) and (2.72±0.63) mm respectively (F=14.26, P<0.01). The gingival margin angles of maxillary central incisors, lateral incisors and canines were 88.3°±7.7°, 84.7°±8.9° and 81.2°±6.6° (F=13.15, P<0.01), and the bone margin angles were 103.2°±13.1°, 99.5°±11.2° and 110.6°±13.0° (F=13.25, P<0.01). The crown width length ratio (0.81±0.08), gingival margin angle (82.2°±7.4°) and bone margin angle (99.4°±12.9°) of thin gingival subjects were significantly lower than those of thick gingival subjects (0.85±0.09, 86.5°±8.6°, 108.5°±11.4°) (t=-2.79, 3.63, 5.20, P<0.01). The height of gingival papilla [(3.93±0.81) mm] and bone papilla [(3.43±0.80) mm] in thin gingival subjects were significantly lower than those in thick gingival subjects [(3.34±0.84) and (2.85±0.71) mm, respectively] (t=-4.89, -5.36, P<0.01). The height of labial gingival papilla of upper anterior teeth was positively correlated with that of bone papilla in all patients (r=0.66, P<0.01); the ratio of crown width to length of upper anterior teeth was positively correlated with the angle of bone margin (r=0.42, P<0.01); the height of anterior gingival papilla was negatively correlated with the angle of bone margin (r=-0.58, P<0.01), and the height of bone papilla was negatively correlated with the angle of bone margin (r=-0.82, P<0.01). Conclusions: The crown shape, gingival shape and alveolar bone shape of maxillary anterior teeth were different in different tooth positions. Patients with different periodontal phenotypes had different crown width length ratio, gingival papilla height, bone papilla height, gingival margin angle, and bone margin angle.

Digital analysis of the correlation between gingival thickness and alveolar bone thickness in the maxillary anterior teeth region / 中华口腔医学杂志

Objective: To measure the labial gingival thickness and bone lamella thickness in the maxillary anterior area using digital method, and to analyze the correlation between the two, so as to provide a reference for esthetic restoration and implantation treatment of the upper anterior area. Methods: Fifty-seven patients [23 males, 34 females, (25.8±4.5) years old] who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University from May 2020 to October 2020. The 3Shape software was used to perform oral scanning, and cone beam CT (CBCT) was taken for each patient. The image data was fitted and registered by the 3Shape software. The gingival thickness at 2 mm below the gingival margin, bone thickness and gingival thickness at 2 and, 4 mm below the crest of the labial alveolar crest in maxillary central incisors, lateral incisors and canines, were measured. Results: The gingival thickness at 2 mm below the gingival margin of maxillary central incisors, lateral incisors and canines was (1.42±0.21), (1.19±0.17) and (1.23±0.20) mm respectively (F=12.47, P<0.001). The gingival thickness at 2 mm below gingival margin and 4 mm below crest of residual ridge in the male patients were (1.31±0.21) and (0.67±0.22) mm, and those in the female patients were (1.26±0.22) and (0.58±0.19) mm respectively, and there were statistically significant differences in the gingival thickness between the "2 mm below gingival margin" group and the "4 mm below crest of residual ridge" group (t=2.01 and 3.97, P<0.05). There was a positive correlation between gingival thickness and alveolar bone thickness at 2 mm and 4 mm below the crest of residual ridge in maxillary anterior region, and the correlation coefficients (r) were 0.387 and 0.344 respectively (P<0.05). Conclusions: Gingival thickness of maxillary anterior area is related to the tooth position and gender. The gingival thickness of men is greater than that of women.The gingival thickness at 2 and 4 mm below the crest of the alveolar crest is positively correlated with the thickness of the alveolar bone.

Minimal invasive microscopic tooth preparation based on endodontic, periodontal and functional health / 华西口腔医学杂志

Tooth preparation is the primary and core operation technique for dental esthetic restoration treatment, due to its effect of providing restoration space, bonding interfaces and marginal lines for dental rehabilitation after tooth tissue reduction. The concept of microscopic minimal invasive dentistry put forward the issue of conducting high-quality tooth preparation, conserve tooth-structure, protect vital pulp and periodontal tissue simultaneously. This study reviewed the concepts, physiology background, design and minimal invasive microscopic tooth preparation, and in the meantime, individualized strategies and the two core elements of tooth preparation (quantity and shape) are listed.

An 8-year follow-up study of Cerec2 computer aided design and computer aided manufacture of all-ceramic crowns / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical performance of the crowns made by Cerec2 computer aided design and computer aided manufacture (CAD/CAM) system.</p><p><b>METHODS</b>Twenty four teeth were restored with Cerec2 CAD/CAM crowns. Eight years after delivery of the prostheses, the all-ceramic crowns were evaluated using modified standard of California Dental Association quality evaluation system. Patients filled out a satisfaction questionnaire at the same time. And Kaplan-Meier analysis was carried out.</p><p><b>RESULTS</b>Three out of 24 restorations were rated as failure. Kaplan-Meier analysis showed that the success rate of Cerec2 crowns eight year following delivery was 88%.</p><p><b>CONCLUSIONS</b>Crowns made by Cerec2 CAD/CAM system can survive in oral condition and function well for 8 years.</p>

The study on fabrication of dental restoration using PMMA-ZrO2 composites via CAD/CAM / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To obtain dental restorations by machining PMMA-ZrO2 organic-inorganic composites with the dental CAD/CAM system.</p><p><b>METHODS</b>Partially sintered Zirconia compacts (PSZC) were prepared via isostatic pressing and partially sintering, with Zirconia nanopowder as raw materials. PMMA-Zirconia organic-inorganic composites were prepared by vacuum infiltrating the prepolymerized MMA into the PSZC, followed by in-situ polymerization. The mechanical properties and machinability of composites were studied. The composites were machined on the dental CAD/CAM system to obtain dental restoration.</p><p><b>RESULTS</b>At 71.44% TD of PSZC, the composite had a 3-point bending strength of (202.56 +/- 3.09) MPa, fracture toughness of (4.30 +/- 0.16) MPa.m(1/2), elasticity modulus of (58.71 +/- 1.98) GPa, and Vickers hardness of (3.82 +/- 0.34) GPa, respectively. A premolar crown was fabricated by CAD/CAM system in 16 mins, and was verisimilitude, without any cracks.</p><p><b>CONCLUSIONS</b>The composite at 71.44% TD of PSZC has good mechanical properties and dental restorations can be manufactured by PMMA-Zirconia composites via dental CAD/CAM system.</p>

Influence of eugenol-containing temporary cement on efficacy of dentin-bonding systems / 中华口腔医学杂志

<p><b>OBJECTIVE</b>This study investigated the influence of eugenol-containing temporary cement on the efficacy of two relatively new dentin-bonding systems.</p><p><b>METHODS</b>Thirty-two freshly extracted bovine central incisors were randomly divided into four groups. Dentin was exposed and polished with 320#, 400#, and 600# sand papers. After embedded, Group 3 and 4 specimens were covered with ZOE. Specimens in Group 1 and 2 were served as control. All specimens were stored for 1 week in distilled water at 37 degrees C. Then, the ZOE was mechanically removed. The dentin surfaces of Group 1 and 3 were treated with Prime & Bond NT bonding system and the dentin surfaces of Group 2 and 4 were treated with GLUMA adhesive system according to manufacturer's instructions. Thereafter composite resin columns (6 mm diameter, 2 mm high) were applied. After specimens stored in distilled water at 37 degrees C for 24 hours, the shear bond testing was carried out using a SHIMADZU universal testing machine with a cross-head speed of 0.5 mm/minute. The mode of failure was examined using SEM. The data were analyzed using ANOVA test at a significance level of 0.05.</p><p><b>RESULTS</b>The medians of shear bond strength for each group were as follows: Group 1 (Prime & Bond NT) 9.57 MPa, Group 3 (Prime & Bond NT + ZOE) 10.72 MPa, Group 2 (GLUMA) 16.89 MPa, Group 4 (GLUMA + ZOE) 16.78 MPa. Group 1 and 3 had significantly lower bonding strength than did Groups 2 and 4. But no significant difference was found between the control groups and the groups treated with ZOE temporary cement.</p><p><b>CONCLUSION</b>Pretreatment of the dentin with ZOE temporary cement has no adverse influence on the efficacy of two relatively new dentin-bonding systems.</p>