Fracture strength and failure load of CAD/CAM fabricated endocrowns performed with different designs

Aim: Endocrown restorations are commonly used to rehabilitate endodontically treated posterior teeth and their use is well-founded in these cases. However, to date, there is little scientific evidence of their behavior in anterior teeth. The aim of this in vitro study was to evaluate the compressive strength of upper central incisors teeth, restored with glass-ceramic total crowns by the conventional anatomical core technique, and compare them to teeth restored with endocrowns with and without the presence of ferrule. Methods: Thirty teeth were randomly distributed into three groups: GE2 - endocrown group with 2 mm ferrule, GE0 - endocrown group without a ferrule, and GC - conventional crown with intraradicular post group. Crowns were cemented and teeth submitted to the 45o compression test until the fracture happened. Fractured specimens were analyzed to determine the fracture pattern. Descriptive analysis of the variables was performed and one-way analysis of variance was utilized to analyze the data for significant differences at p < 0.05. Results: The results of the control group (284.5 ± 201.05N) showed the highest fracture resistance value, followed by the 2mm group (274.54 ± 199.43N) and by the 0mm group (263.81 ± 80.05N). There was no statistically significant difference between all the groups (p = 0.964). Conclusions: The absence of a cervical enamel necklace favored a debonding of the pieces and endodontically treated anterior teeth could be restored with endocrown, which could be considered a conservative and viable treatment option

Amelogenesis Imperfecta Restorations Survival Rate: A Retrospective Study

@#Introduction: Amelogenesis imperfecta (AI) is a rare genetic disease affecting both dentitions. Factors such as age, socioeconomic status, dentition and AI type and severity should be taken into consideration in treatment planning. Aim: This retrospective study aimed to assess the survival rate of AI main restorative options and the effects of gender and dentition type. Methods: The study sample comprised 28 dental records of patients aged 5-17 years affected by AI (15 females, 13 males) and with anterior and/or posterior restoration in primary and/or permanent tooth/teeth. The fate of each restoration was classified into three categories: failed, withdrawn and censored and analyzed by the life table method of survival analysis. Results: Out of 233 restorations performed, the most frequently used restoration was preformed metal crowns (PMCs), followed by anterior composite, posterior composite, adhesive casting, Ketac fill and amalgam respectively. The two main restorations, PMCs and anterior composite were included in the statistical analysis. The survival rate of PMCs was significantly higher than anterior composite (p<0.001). The anterior composite restorations survived significantly longer in males (p<0.05). Females had significantly better survival rate of PMCs (p<0.05). There was no statistically significant effect of the operator group of restoration survival. Conclusion: The anterior composite restorations survived significantly longer in males and females had significantly better survival rate of PMCs than males.

Fit of metal-ceramic crowns: effect of coping fabrication method and veneering ceramic application

Aim: To evaluate the influence of cobalt-chromium (Co-Cr) coping fabrication methods and ceramic application on the marginal and internal fit of metal-ceramic crowns. Methods: Co-Cr copings for metal-ceramic crowns were prepared by lost wax casting or CAD-CAM machining of sintered blocks. The fit was analyzed using the silicone replica technique at four assessment points: marginal gap (MG), axial wall (AW), axio-occlusal (AO) angle, and central occlusal (CO) wall. After the initial analysis, the copings were ceramic-veneered with the layering technique, and the fit was again determined. Data were statistically analyzed by paired and unpaired Student's-t test (α=0.05). Results: Marginal and internal fit before ceramic application according to the coping manufacturing method showed significant differences only at CO (p < 0.001), with milled copings (137.98±16.71 µm) showing higher gap values than cast copings (112.86±8.57 µm). For cast copings, there were significant differences at MG (before 109.13±8.79 µm; after 102.78±7.18 µm) and CO (before 112.86±8.57 µm; after 104.07±10.63 µm) when comparing the fit before and after ceramic firing. For milled copings, there was significant difference only at AO (before 116.39±9.64 µm; after 108.54±9.26 µm). Conclusion: This study demonstrated that the coping fabrication method influenced the internal fit. Ceramic firing maintained or improved the fit of the metal-ceramic crowns. The marginal discrepancy of all restorations, before and after ceramic firing, can be considered clinically acceptable

Presentation of infrequent clinical case of dental gemination of the permanent upper left lateral incisor

Introduction: Gemination is the division of a dental follicle that results in a tooth with two crowns, where the number of teeth in the arch does not vary. It constitutes an anomaly that is little diagnosed due to its presentation and therefore little treated, which requires an adequate study. Objective: To present an infrequent clinical case of dental gemination of the permanent upper left lateral incisor. Clinical case: 20-year-old patient with 30 weeks of gestational status treated for periodic review by appointment of her dentist. The intraoral examination revealed: the permanent upper left lateral incisor (tooth 22) with two crowns, one of which had lost the gingival wall and the other had second degree dental caries on the mesial side. Periapical radiography performed 1 year earlier showed tooth 22 with a partially divided pulp chamber and a broad, bifid, well-defined crown. Dental gemination of the permanent maxillary left lateral incisor was diagnosed. The geminated tooth was extracted, and the patient was referred to a dental prosthesis for rehabilitation. Conclusions: Dental gemination of the permanent upper left lateral incisor in a pregnant patient, constitutes an anomaly of the shape of the teeth that is infrequent in consultations.

Introducción: La geminación es la división de un folículo dentario que resulta en un diente de dos coronas, pero la cantidad de dientes de la arcada no varía. Constituye una anomalía poco diagnosticada por su presentación y por ende poco tratada, lo que necesita de un adecuado estudio. Objetivo: Presentar un caso clínico infrecuente de geminación dentaria del incisivo lateral superior izquierdo permanente. Caso clínico: Paciente de 20 años de edad, con 30 semanas de estado gestacional atendida para revisión periódica por citación de su estomatólogo. Al examen intraoral se detectó: el incisivo lateral superior izquierdo permanente (diente 22) con dos coronas, una de las cuales había perdido la pared gingival y la otra presentaba caries dental de segundo grado en cara mesial. La radiografía periapical realizada 1 año antes mostró el diente 22 con cámara pulpar parcialmente dividida y una corona ancha, bífida y bien definida. Se diagnosticó una geminación dentaria del incisivo lateral superior izquierdo permanente. Se realizó exodoncia del diente geminado y se remitió a la paciente a prótesis estomatológica para rehabilitación. Conclusiones: La geminación dentaria del incisivo lateral superior izquierdo permanente en una paciente embarazada es una anomalía de forma de los dientes poco frecuente en las consultas.

Cerâmicas Feldspáticas em Dentes Posteriores pela Técnica CAD/CAM: uma Revisão de Literatura / Feldspatich Ceramics in Posterioes Teeth by CAD/CAM Technique: a Literature Review

O objetivo do presente estudo foi avaliar a indicação do uso das cerâmicas feldspáticas em dentes posteriores, pela técnica CAD/CAM (Computer-aided design [CAD] e computer-aided manufacturing [CAM]) chairside, em uma unidade de alta demanda, por meio de uma revisão de literatura. Uma pesquisa avançada foi realizada a partir da base de dados do PubMed, compreendendo os últimos 15 anos e utilizando os seguintes termos MeSH para pesquisa: "dental crowns", "CAD/CAM system", "porcelain" e "review". Dos 47 artigos levantados inicialmente, 30 foram selecionados para compor a amostra final. A partir do presente estudo foi possível concluir que o uso das cerâmicas feldspáticas desenvolvidas pela técnica CAD/CAM é seguro em dentes posteriores, desde que respeitada a técnica. Esta técnica constitui-se em excelente opção para tratamento odontológico em instituições de alta demanda restauradora que possuem altos níveis de exigência e prontidão, promovendo celeridade, evitando o uso de restaurações provisórias, reduzindo também a quantidade de urgências em próteses.

The present study aims to evaluate the indication of the use of feldspathic ceramics in posterior teeth, by the CAD/CAM technique (Computer-aided design [CAD] and computer-aided manufacturing [CAM]), in a public institution, through a literature review. An advanced search was carried out in the PubMed database, covering the last 15 years and using the following MeSH search terms: "dental crowns", "CAD/CAM system", "porcelain" and "review". Thirty out of the 47 articles initially surveyed were selected to compose the final sample. From the present study, it was possible to conclude that the use of feldspathic ceramics developed by the CAD/CAM technique is safe in posterior teeth, whether the technique is respected. This technique is an excellent option for dental treatment in institutions of high restorative demand that have high levels of demand and readiness, promoting celerity, avoiding the use of temporary restorations, also reducing the number of urgencies in prosthesis.

Rehabilitación estética con coronas de resina personalizadas utilizando encerado digital en paciente pediátrico: informe de caso / Aesthetic rehabilitation with customized resin crowns using digital wax-up in pediatric patient: a case report

Resumen Introducción: El presente informe de caso clínico se enfoca en el diagnóstico y tratamiento para la rehabilitación de la dentición temporal en el sector anterosuperior utilizando tecnología CAD-CAM. Objetivo: Proponer una alternativa para mitigar el margen de error y tiempo de trabajo en el paciente pediátrico, reintegrando la estética y funcionalidad en la cavidad oral. Métodos: Se describe el caso de un paciente de sexo masculino de 6 años que acudió a la clínica universitaria de la Universidad UTE con lesiones cariosas extensas en sus dientes anterosuperiores y su rehabilitación a través de la utilización de coronas personalizadas de resina mediante un encerado digital realizado en CAD-CAM. Resultados: El tratamiento efectuado en el niño fue satisfactorio, se evidenció una mejoría en la dimensión vertical e incremento en la estética dental y facial, mejorando su aspecto y autoestima después de la rehabilitación. Conclusión: La utilización del encerado digital en pacientes pediátricos podría ser una alternativa que permita reducir el tiempo de trabajo del tratamiento en una rehabilitación estética dental.

Abstract Introduction: This case report focuses on the diagnosis and treatment for the rehabilitation of the primary dentition in the anterosuperior sector using CADCAM technology. Objective: To propose an alternative to mitigate the margin of error and working time in pediatric patients, reintegrating esthetics, and functionality in the oral cavity. Methods: We describe the case of a 6-year-old male patient who came to the clinic of Universidad UTE with extensive carious lesions in his anterosuperior teeth and his rehabilitation using personalized resin crowns by means of a digital waxup performed in CAD-CAM. Results: The treatment performed on the child was satisfactory, there was an improvement in the vertical dimension and an increase in dental and facial esthetics, improving his appearance and self-esteem after the rehabilitation. Conclusión: The use of digital wax-up in pediatric patients could be an alternative that allows the treatment time to be reduced in esthetic dental rehabilitation.

linical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors A randomized controlled trial

Background: Strip crowns are the first treatment of choice for restoring anterior teeth affected with early childhood caries. However, shade matching of resin composites is still an issue. The broad color matching ability of a recently introduced single shade composite, Omnichroma eliminates the need for shade-matching procedure, reduces composite inventory, and minimizes chair-side time. Aim: The aim is to evaluate the color match, color stability, and retention of one shade universal composite resin, Omnichroma and nanohybrid resin composite, Tetric-N-Ceram. Settings and Design: The study design involves split-mouth randomized controlled trial. Materials and Methods: The study was conducted on 25 children aged 3–5 years with multi-surface caries lesions in primary maxillary anterior teeth. Teeth were allocated to two groups randomly: Group 1 – One shade universal composite, Omnichroma (n = 25), Group 2 – Nanohybrid composite, Tetric-N-Ceram (n = 25). After caries excavation and tooth preparation, teeth were restored with corresponding materials using strip crowns. Color match at baseline, color stability, and retention after 6- and 12-month follow-up were evaluated using the Modified United States Public Health Services criteria. Statistical Analysis: The Mann–Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results: On comparison of Omnichroma and Tetric-N-Ceram groups, no statistically significant difference was observed in the color match at baseline (P = 0.716) as well as color stability (P = 0.575 at 6 months and 0.990 at 12 months) and retention (P = 0.153 at 6 months and 0.226 at 12 months) at both 6- and 12-month intervals. On intragroup comparison, the difference in the color stability at 6 and 12-month interval was statistically significant (P = 0.001) for both the groups, indicating that the color stability of restorations was better at 6-month interval compared to 12-month interval. In both Omnichroma and Tetric-N-Ceram groups, retention of restorations was better at 6-month interval compared to 12-month interval and this difference was statistically significant (P = 0.025 and 0.014, respectively). Conclusion: The clinical performance of Omnichroma in terms of color match, color stability, and retention was comparable to nanohybrid composite, Tetric-N-Ceram.

A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars

Background and Aim of Study: Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study. Aim: The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year. Methods: The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone. Results: After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option. Conclusion: Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.

The three-dimension finite element analysis on mandibular first molar restored with different designed fiber post-core and all ceramic crown / 中国医师杂志

Objective:To evaluate the effect of different numbers and location of fiber post on stress distribution of fiber post-all-ceramic crown restored mandibular first molar, with application of finite element method.Methods:Intact human mandibular first molars were used to build three-dimensional finite element models, restored with fiber post core and all ceramic crown. Three-dimension finite element model with 7 different post designs(according to the numbers and location of fiber post inserted into root canal) were created with soft wares of Mimics, Geomagic and Ansys. The von Mises criterion was applied for comparing the maximum von Mises stress value of dentin and stress concentration areas in 7 models maximum load (F1, 225 N), vertical load (F2, 225 N), inclined load (F3, 225 N) and horizontal load (F4, 225 N).Results:Under maximum load, vertical load, inclined load and horizontal load, the maximum von Mises stress value of dentin were 21.854-22.629 MPa (F1), 20.945-21.369 MPa (F2), 21.637-22.513 MPa (F3) and 37.922-38.277 MPa (F4), when the mandibular first molar defect was restored with fiber post core and all ceramic crown. There was little difference in maximum von Mises stress values and stress distribution among the 7 groups. Increasing the number of Posts has no significant effect on the stress distribution of the original post. The maximal Von Mises stress on dentine increased when the horizontal direct loads increased.Conclusions:The number and location of posts have little influence on maximum stress values and stress distribution, when the mandibular first molar defect was restored with fiber post core and all ceramic crown.

Does cad software affect the marginal and internal fit of milled full ceramic crowns?

Abstract: Although the effects of different intraoral scanners, model scanners, and CAM units on the marginal and internal fitting of restorations have been investigated, the effects of CAD software in particular has not been evaluated. The marginal and internal fit of indirect restorations may vary according to the CAD software used, even when using the same intraoral scanner and milling machine. The purpose of this study was to evaluate the marginal and internal fit of milled full ceramic crowns designed with three different CAD systems. Eleven typodont maxillary first premolar teeth were prepared and scanned using a 3Shape TRIOS Intraoral Dental Scanner. The obtained STL scan data were exported and used to design a full crown using three different CAD systems (CEREC, KaVo, and Planmeca). An independent milling unit was used to manufacture the crowns for each group (n = 11). The marginal and internal fit were evaluated for each restoration using 2D and 3D micro-CT analysis. For 2D analysis, 18 measurements for each sample were made, covering the marginal (Marginal Gap Buccal (MG-A), Marginal Gap Palatinal (MG-B), Finish Line Buccal (FL-A), Finish Line Palatinal (FA-B)) and internal fit locations (Axial Wall Buccal (AW-A), Axial Wall Palatinal (AW-B), Lingual Cusp (LC), Buccal Cusp (BC), and Occlusal Central Fossa (OCF)). Statistical analyses were performed using Open Source R Statistical Software (α = 0.05) The results of Duncan's multiple range test showed that the values for the marginal measurement points MG-A, MG-B, FL-A, and FL-B in the Planmeca group were significantly higher than the values obtained in the CEREC and KaVo groups (p < 0.05). In AW1, values of the CEREC group were found to be higher than those of the KaVo and Planmeca groups (p < 0.05). CAD software showed an effect on the marginal fit values of crowns whereas no significant difference was observed in terms of the internal fit, except for a single measurement point made from the buccal direction.

In Vitro Microscopic Evaluation of Metal- And Zirconium-Oxide-Based Crowns' Marginal Fit

ABSTRACT Objective To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p<0.05. Results There were no differences in the four surfaces revealed by АNOVА in the three groups when considered altogether. Two-way ANOVA of each surface discovered no differences among all groups as well. Conclusion The CAD/CAM crowns revealed a comparable and satisfactory marginal adaptation compared to conventional metal-ceramic crowns.

Endocrown as a restorative strategy in endodontically treated teeth: an integrative literature review / Endocrown como estratégia restauradora em dentes tratados endodonticamente: uma revisão integrativa da literatura

ABSTRACT With the consolidation of Adhesive Dentistry and the emergence of new aesthetic restorative materials, Endocrown has been studied as a rehabilitative option for endodontically treated teeth. This is an Integrative Literature Review, based on the PICO strategy, with articles selected from the databases of PubMed and BVS, with a period of time from 2011-2021. The database search strategy included the following keywords: ("Endocrown" OR "Endocrowns" OR "Endocrown Restoration" OR "no-post buildup" OR "adhesive endodontic crowns"). Inclusion criteria for this review were laboratory studies and observational clinical studies. Exclusion criteria were clinical case studies, literature review, systematic review and meta-analysis. Furthermore, articles that addressed only intraradicular retainers or other restorative strategies were also excluded. The selection of articles was based on abstracts. 5 articles were selected for analysis, obtaining data on the endocrown in relation to the stress on the tooth structure, aging, marginal adaptation, fracture resistance, endocrown versus conventional crown and integrity of the tooth structure. The findings in the literature are not yet established regarding the integrity of the dental structure, as the supporting evidence is limited. Only 1 in vitro article showed that dental failures in endocrowns are more favorable to repair and another 2 in silico studies show lower stress distribution on enamel, dentin and cement in the same restoration. Moreover, the restorative material seems to influence the possibility of fracture for both conventional crowns and endocrown restorations.

RESUMO Com a consolidação da Odontologia Adesiva e o surgimento de novos materiais restauradores estéticos, a Endocrown vem sendo estudada como uma opção reabilitadora para dentes tratados endodonticamente. Trata-se de uma Revisão Integrativa da Literatura, baseada na estratégia PICO, com artigos selecionados nas bases de dados da PubMed e BVS, com lapso temporal de 2011-2021. A estratégia de busca nas bases de dados foi utilizando as palavras chaves: ("Endocrown" OR "Endocrowns" OR "Endocrown Restoration" OR "no-post buildup" OR "adhesive endodontic crowns"). Os critérios de inclusão nesta revisão foram estudos laboratoriais e estudos clínicos observacionais. Os critérios de exclusão foram estudos de caso clínico, revisão de literatura, revisão sistemática e metanálise. Ademais, também foram excluídos artigos que abordavam apenas retentores intrarradiculares ou outras estratégias restauradoras. A seleção dos artigos foi realizada com base nos resumos. 5 artigos foram selecionados para análise, obtendo-se dados sobre a endocrown em relação à tensão sobre a estrutura dental, envelhecimento, adaptação marginal, resistência à fratura, endocrown versus coroa convencional, integridade da estrutura dental. Os achados da literatura ainda não estão estabelecidos em relação a integridade da estrutura dental, devido às evidências de apoio serem limitadas. Apenas 1 artigo in Vitro apresentou que as falhas dentais em endocrowns são mais favoráveis ao reparo e outros 2 estudos in Silico mostram menor distribuição de tensão sobre esmalte, dentina e cemento na mesma restauração. Além disso, o material restaurador parece influenciar a possibilidade de fratura tanto para as coroas convencionais quanto para as restaurações do tipo endocrowns.

Percepção e conhecimento de odontopediatras sobre o uso de coroas pré-fabricadas de aço e zircônia na reabilitação de dentes decíduos / Perception and knowledge of pediatric dentists about the use of prefabricated steel and zirconia crowns in the rehabilitation of deciduous teeth

Objetivo: O presente trabalho tem como objetivo avaliar o conhecimento dos odontopediatras e suas percepções, conhecendo as dificuldades que estes encontram frente ao desafio da reabilitação de dentes decíduos. Métodos: A pesquisa foi realizada por meio da aplicação de questionários on-line e a análise estatística foi descritiva e comparativa, com tabelas de frequência para as variáveis quantitativas. O teste não paramétrico de Qui-quadrado foi utilizado para estimar a associação entre as diferentes categorias dos dados e em todo o estudo, estipulou-se o nível de significância em 5%. Resultados: Os resultados da pesquisa mostraram que a maioria dos entrevistados conhecem as coroas pré-fabricadas de aço, porém sua aplicação em atendimentos de crianças com extensas destruições coronárias limita-se a 34,1% destes profissionais, sendo que a baixa utilização se deve à dificuldade de aquisição do material e falta de habilidade técnica. Já com relação às coroas pré-fabricadas de zircônia, 82,4% das odontopediatras as conhecem, mas a grande maioria não as utiliza devido à dificuldade de aquisição, falta de habilidade técnica e o seu alto custo. Não foi encontrada associação entre a dificuldade de planejamento dos casos e a consideração estética e o âmbito de trabalho do entrevistado, bem como o fato de conhecer as coroas pré-fabricadas e utilizá-las. Conclusão: Conclui-se que os materiais reabilitadores, como coroas pré-fabricadas de aço e de zircônia, são de certa forma bem conhecidos pelos odontopediatras, mas sua utilização em reabilitação de dentes decíduos ainda é limitada.

Aim: The present study aims to evaluate the knowledge of pediatric dentists and their perceptions, knowing the difficulties they face in the challenge to rehabilitate deciduous teeth. Methods: This study was carried out through the application of online questionnaires. The statistical analysis was descriptive and comparative, with frequency tables for the quantitative variables. The non-parametric chi-square test was used to estimate the association between the different categories of data, and the significance level was set at 5%. Results:The survey results showed that most respondents know about prefabricated steel crowns, but their application in the care of children with extensive coronary destruction is limited to 34.1% of these professionals. The low use is due to the difficulty of acquiring the material and the lack of technical skills. It was found that 82.4% of the pediatric dentists have knowledge about prefabricated zirconia crowns, but the vast majority do not use them due to the difficulty of acquisition, their lack of technical skills, and the product's high cost. No association was found between the difficulty of planning the cases and the esthetic consideration and sphere of work of the interviewee, nor regarding the fact of their having knowledge about the prefabricated crowns and using them. Conclusion: It can therefore be concluded that rehabilitation materials, such as prefabricated steel and zirconia crowns, are well-known by pediatric dentists, but their use in the rehabilitation of deciduous teeth is still limited.

Endocorona, un enfoque diferente en rehabilitación oral

RESUMEN Introducción: Con el avance de la tecnología adhesiva, nuevas técnicas y materiales restauradores están siendo utilizados para el tratamiento de dientes endodonciados, por ello, las endocoronas son una alternativa clínica para su tratamiento. La ventaja de esta restauración es que tiene mejores características macro retentivas, requiere menor tiempo clínico y de laboratorio. Objetivo: Proporcionar información bibliográfica actual sobre esta nueva alternativa para aplicar una nueva guía en rehabilitación oral con el uso de la endocorona mediante una revisión de la literatura. Método: Se realizó una revisión bibliográfica detallada, con la consideración de artículos originales o casos clínicos que incluían información relacionada a las restauraciones de tipo endocorona. La búsqueda se efectuó en las bases de datos PubMed, SciELO, Science Direct, Elsevier y Google Académico. Resultados: Las restauraciones de tipo endocorona son un monobloque único que devuelve la anatomía completa de la corona dental, la cual aprovecha la cámara pulpar para así lograr una mayor adhesión y macro retención mecánica. Este enfoque restaurador proporciona una función adecuada y estética, así como la integridad biomecánica de las estructuras no vitales. Conclusiones: Actualmente en la Odontología moderna se emplea el término de mínima intervención, conservando en su mayor cantidad posible el tejido dental de manera que los dientes tengan mayor funcionalidad, por ello las endocoronas son una opción segura y con buen pronóstico a largo plazo en rehabilitación oral para tratar piezas endodonciadas, debido a que es un procedimiento técnicamente más conservador, estético, sencillo y de menor costo.

ABSTRACT Introduction: With the advancement of adhesive technology, new techniques and restorative materials are being used for the treatment of root canals; therefore endocrowns are a clinical alternative for their treatment. The advantage of this restoration is that it has better macro retentive characteristics, requires less clinical and laboratory time. Objective: To provide current bibliographic information on this new alternative to apply a new guide in oral rehabilitation with the use of endocrown through a literature review. Method: A detailed bibliographic review was carried out, with the consideration of original articles or clinical cases that included information related to endocrown-type restorations. The search was carried out in the databases PubMed, SciELO, Science Direct, Elsevier and Google Scholar. Results: Endocrown restorations are a single monoblock that rebuilds the complete anatomy of the dental crown, which takes advantage of the pulp chamber to achieve greater adhesion and macro mechanical retention. This restorative approach provides adequate function and aesthetics, as well as the biomechanical integrity of non-vital structures. Conclusions: The term minimal intervention is currently very used in modern dentistry, preserving the dental tissue as much as possible so that the teeth have greater functionality. Endocrowns are a safe option with a good long-term prognosis in oral rehabilitation to treat root canals, because it is a technically more conservative, aesthetic, simple and lower-cost procedure.

RESUMO Introdução: Com o avanço da tecnologia adesiva, novas técnicas e materiais restauradores estão sendo utilizados para o tratamento de dentes endodônticos, portanto os endocrowns são uma alternativa clínica para seu tratamento. A vantagem dessa restauração é que ela apresenta melhores características macro retentivas, requer menos tempo clínico e laboratorial. Objetivo: Fornecer informações bibliográficas atuais sobre esta nova alternativa de aplicação de um novo guia na reabilitação oral com o uso de endocrown por meio de uma revisão da literatura. Método: Foi realizada uma revisão bibliográfica detalhada, considerando artigos originais ou casos clínicos que incluíam informações relacionadas a restaurações do tipo endocrown. A busca foi realizada nas bases de dados PubMed, SciELO, Science Direct, Elsevier e Google Scholar. Resultados: As restaurações do tipo endocrown são um único monobloco que devolve a anatomia completa da coroa dentária, que aproveita a câmara pulpar para obter maior adesão e retenção macromecânica. Esta abordagem restauradora fornece função e estética adequadas, bem como a integridade biomecânica de estruturas não vitais. Conclusões: Atualmente na odontologia moderna é utilizado o termo de intervenção mínima, preservando-se o tecido dentário o máximo possível para que os dentes tenham maior funcionalidade, portanto endocrowns são uma opção segura e com bom prognóstico em longo prazo na reabilitação oral para tratamento da endodontia dentes, por ser um procedimento tecnicamente mais conservador, estético, simples e de menor custo.

Comparison of parental satisfaction with strip crowns and primary anterior zirconia crowns in 3–5 years old children over 1 year

Background: During the past decade, parental involvement for the selection of full coronal restorations for the primary anterior teeth of their children has been increased. Two most common anterior aesthetic full coronal restorations, the strip crowns and the preformed zirconia crowns, are available options. Aim: The aim of this study is to compare parental satisfaction with strip crowns and preformed primary anterior zirconia crowns over 1 year in 3–5 years old children. Materials and Methods: Forty maxillary primary incisors were restored by either strip crown or zirconia crown in 24 children. Permuted block randomization method was used for the allocation of participants. Twenty-four parents participated were recalled to fill the questionnaire over 1 year. One parent dropped out at the end of 1 year. Data were analyzed using the t-test and Chi-square test. P < 0.05 considered statistically significant. Results: Parents were satisfied with both types of restorations. Statistically significant relationship was found between overall satisfaction and durability (P = 0.004) with strip crowns and with the color (P = 0.043) in the zirconia crowns. The parents with the lower satisfaction levels with the durability of strip crowns and color of zirconia crowns rated high overall satisfaction. Conclusion: Parental overall satisfaction was higher for preformed primary anterior zirconia crowns than strip crowns. Almost equal number of parents was satisfied with all other parameters except for durability, which was more for zirconia crowns.

Esthetic rehabilitation with indirect resin on anterior teeth: a clinical report / Reabilitação estética com resina indireta em dentes anteriores: um relato clínico / Rehabilitaciónestética con resina indirecta en dientes anteriores: reporte clínico

Introduction:The aesthetic rehabilitation of endodontically treated teeth depends on the destruction degree of the crown, the bone support, type of prosthesis, andchewing forces. In these cases, indirect restorations with composite resins are an excellent alternative. The indirect composite resins have improved physical and mechanical properties due toincorporatingof inorganic fillersand multifunctional monomers. These components offer a greater bonding strength to the indirect restorations, which is advantageous for further rehabilitations with ceramic crowns. Objective:To present an aesthetic rehabilitation of anterior teeth with indirect composite resin as a feasible and less expensive treatment alternative.Case Report:Upon clinical examination, extensive and deficient restorations were observed in the upper anterior teeth. The proposed treatment plan was the aesthetic rehabilitation of endodontically treated teeth with indirect restorations using ceromer.Conclusions:This treatment represented an excellent alternative for aesthetic rehabilitation of endodontically treated teeth in cases of great dental crown destruction or small dental absences (AU).

Introdução:A reabilitação estética de dentes tratados endodonticamente depende do grau de destruição da coroa, do dente em questão, do suporte ósseo, do tipo de prótese e dos tipos de forças a que esses dentes serão submetidos. As resinas compostas indiretas apresentam propriedades físicas e mecânicas aprimoradas graças à incorporação de componentes inorgânicos e monômeros multifuncionais com maior número de pontos de união, tornando-os capazes de solucionar os problemas em que seriam indicadas restaurações cerâmicas. Objetivo:Apresentar um relato de caso clínico de uma reabilitação estética de dentes anteriores com resina composta indireta como alternativa de tratamento viável e de menor custo.Relato de Caso:Ao exame clínico foram observadas restaurações amplas e deficientes nos dentes anteriores superiores. O plano de tratamento proposto reabilitação estética dos elementos dentários com cerômeros.Conclusões:Este tratamento representou uma opção viável e demenor custo que pode ser utilizado tanto em situações de grande destruição dentária como em pequenas ausências dentárias, em substituição às restaurações de cerâmica (AU).

Introducción: La rehabilitación estética de los dientes tratados endodónticamente depende del grado de destrucción de la corona, el diente en cuestión, el soporte óseo, el tipo de prótesis y los tipos de fuerzas a las que estos dientes serán sometidos. Las resinas compuestas indirectas tienen propiedades físicas y mecánicas mejoradas gracias a la incorporación de componentes inorgánicos y monómeros multifuncionales con mayor número de puntos de unión, lo que las hace capaces de resolver los problemas en los que estarían indicadas las restauraciones cerámicas. Objetivo: Presentar un caso clínico de rehabilitación estética de dientes anteriores con resina compuesta indirecta como alternativa de tratamiento viable y menos costosa. Reporte de Caso:En el examen clínico, se observaron restauraciones extensas y deficientes en los dientes anteriores superiores. El plan de tratamiento propuesto para la rehabilitación estética de elementos dentales con cerómeros. Conclusiones:Este tratamiento representó una opción viable y menos costosa que se puede utilizar tanto en situaciones de gran destrucción dentaria como en pequeñas ausencias dentales, en sustitución de las restauraciones cerámicas (AU).

Mantenedor de espacio funcional elaborado con corona de NuSmile / Elaborated functional space maintainer with zirconia NuSmile crown

La caries de la infancia temprana, al igual que otras formas de caries, se caracteriza por ser multifactorial, infecciosa y de rápida evolución. Puede presentarse como lesiones cavitadas o no cavitadas, se diagnostica principalmente en menores de seis años en la superficies de los dientes anterosuperiores, debido a que son los primeros órganos dentales en erupcionar y tienen mayor contacto con el estímulo cariogénico. En casos severos pueden llegar a ocasionar la pérdida de órganos dentales, influyendo en la salud general del paciente y repercutiendo en su autoestima y desarrollo psicosocial. Para devolver las características y funciones perdidas en ausencia de algún órgano dental, se recurre a sustituirlo mediante aparatología, mayormente en forma de un mantenedor de espacio funcional. Las necesidades estéticas individuales de cada caso generan diversas alternativas para adaptarnos a la situación del paciente (AU))

Early childhood caries, like other forms of caries, is characterized by being multifactorial, infectious, and rapidly evolving. It can present as cavitated or uncavitated lesions, it is mainly diagnosed in children under six years of age on the surfaces of the anterior superior teeth, because they are the first dental organs to erupt and have greater contact with the cariogenic stimulus. In severe cases they can cause the loss of dental organs, influencing the general health of the patient and impacting on their self-esteem and psychosocial development. In order to restore the lost features and functions in the absence of any dental organ, it is resorted to by means of appliances, mostly in the form of a functional space maintainer. The individual aesthetic needs of each case generate various alternatives to adapt to the patient's situation (AU)

Mimetización de corona cerámica libre de metal de un incisivo central superior. Reporte de caso / Mimicry of metal-free ceramic crown of an upper central incisor. Case report

Actualmente, la estética dental presenta un papel relevante dentro de las relaciones interpersonales y la autoestima de los pacientes, es por eso que la demanda de tratamientos estéticos y conservadores son cada vez más frecuentes en la consulta dental, esta demanda compromete a los profesionales a una mayor preparación para identificar los procedimientos más adecuados a ejecutarse. Para el odontólogo es un reto conseguir una completa armonización e integración de los tratamientos efectuados en el sector anterior y más aún cuando se requiere reemplazar un único elemento dentario. El presente reporte de caso tiene por objetivo describir un caso de rehabilitación de alta complejidad de un incisivo central superior fracturado, cuyas características de color y forma fueron recrea- das a través de un correcto intercambio de información entre el odontólogo y el técnico dental, obteniendo una corona de disilicato de litio con una excelente mimetización.

Nowadays, dental aesthetics has a relevant role within interpersonal relationships and the self-esteem of patients, that is the reason the demand for aesthetic and conservative treatments are more frequent in dental practice, this demand commits professionals to a greater preparation, in order to identify the most appropriate procedures to be executed. For the dentist it is a challenge to achieve a complete harmonization and integration of the treatments carried out in the anterior sector and even more when it is necessary to replace a single dental element. The objective of this case report is to describe a highly complex rehabilitation case of a fractured upper central incisor, whose color and shape characteristics were recreated through a correct exchange of information between the dentist and the dental technician, obtaining a lithium disilicate crown with excellent mimicry.

Modified Hall technique for severely hypomineralized molars. Report of cases / Técnica de Hall modificada para molares severamente hipomineralizados. Reporte de casos / Técnica de Hall modificada para molares severamente hipomineralizados. Relato de caso

Abstract This article reviews the indications, objectives and step by step process of the Modified Hall Technique in the management of primary and permanent molars affected by severe enamel hypomineralization. Scientific based biological principles are discussed in order to provide relevant clinical information for Pediatric and General dentists in order to provide support for the safe use the technique in clinical practice.

Resumen En este artículo se revisan las indicaciones, objetivos y proceso paso a paso de la Técnica de Hall Modificada en el manejo de molares primarios y permanentes afectados por hipomineralización severa del esmalte. Los principios biológicos basados en la evidencia se discuten con el fin de proporcionar información clínica relevante para los odontólogos pediátricos y generales con el fin de proporcionar apoyo para el uso seguro de la técnica en la práctica clínica.

Resumo Neste artigo foram revisadas as indicações, objetivos e o passo a passo da Técnica de Hall Modificada para o manejo de molares decíduos e permanentes afetados pela hipomineralização severa do esmalte. Os princípios biológicos baseados na evidência são discutidos com o objetivo de proporcionar informações clínicas relevantes para odontopediatras e clínicos gerais, a fim de lhes fornecer apoio para o uso seguro da técnica na prática clínica.

Different treatment modalities using dental implants in the posterior maxilla: a finite element analysis

Abstract The objective of this study was to compare the biomechanical behavior of peri-implant bone tissue and prosthetic components in two modalities of treatment for posterior region of the maxilla, using short implants or standard-length implants associated with bone graft in the maxillary sinus. Four 3D models of a crown supported by an implant fixed in the posterior maxilla were constructed. The type of implant: short implant (S) or standard-length implant with the presence of sinus graft (L) and type of crown retention: cemented (C) or screwed (S) were the study factors. The models were divided into SC- cemented crown on a short implant; SS- screwed crown on the short implant; LC- cemented crown on a standard-length implant after bone graft in the maxillary sinus and LS- crown screwed on a standard-length implant after bone graft in the maxillary sinus. An axial occlusal loading of 300 N was applied, divided into five points (60N each) corresponding to occlusal contact. The following analysis criteria were observed: Shear Stress, Maximum and Minimum Main Stress for bone tissue and von Mises Stress for the implant and prosthetic components. The use of standard-length implants reduced the shear stress in the cortical bone by 35.75% and the medullary bone by 51% when compared to short implants. The length of the implant did not affect the stress concentration in the crown, and the cement layer acted by reducing the stresses in the ceramic veneer and framework by 42%. Standard-implants associated with cemented crowns showed better biomechanical behavior.

Resumo O objetivo do estudo foi avaliar o comportamento biomecânico do tecido ósseo peri-implantar e dos componentes protéticos em duas modalidades de tratamento para região posterior da maxila, utilizando implantes curtos ou implantes de comprimento padrão associados a enxerto ósseo em seio maxilar. Foram construídos quatro modelos 3D de uma coroa suportada por um implante osseointegrado na região posterior da maxila. O tipo de implante: implante curto (S) ou implante de comprimento padrão com presença de enxerto sinusal (L) e tipo de retenção da restauração: cimentada (C) ou parafusada (S) foram os fatores de estudo. Foi aplicada uma força oclusal de 300N, dividida em cinco pontos (60 N cada) correspondentes ao contato oclusal de um primeiro molar superior. Foram observados os seguintes critérios de análise: tensão de cisalhamento, tensão principal máxima e mínima para o tecido ósseo e tensão de Von Mises para o implante e componentes protéticos. O uso de implantes de comprimento padrão reduziu a tensão de cisalhamento no osso cortical em 35,75% e no osso medular em 51% quando comparado aos implantes curtos. O comprimento do implante não afetou a concentração de tensão na restauração. A camada de cimento atuou reduzindo as tensões na cerâmica de cobertura e infraestrutura de cerâmica em 42%. Os implantes de tamanho padrão associados às coroas cimentadas apresentaram o melhor comportamento biomecânico.