Endodontic and Esthetic Management of Hypolplastic Turner’s Teeth with Severely Dilacerated Roots.

Dilaceration refer to an angulation or sharp bend or curve in the root or crown of formed tooth. It is usually occur due to trauma that lead to white or yellow brown discoloration, crown dilaceration, root dilacerations, crown duplication, root duplication, odontoma like malformation etc. This paper elaborated a useful clinical considerations for diagnosis and treatment planning of a severely dilacerated root of malformed tooth having turner’s hypoplasia.

Fabrication of a metal-ceramic crown to fit an existing partial removable dental prosthesis using ceramic pressed to metal technique: a clinical report

Fabricating a crown to retrofit an existing abutment tooth for a partial removable dental prosthesis (PRDP) is one of the most time-consuming and labor-intensive clinical procedures. In particular, when the patient is concerned with esthetic aspects of restoration, the task of fabricating becomes more daunting. Many techniques for the fabrication of all-metallic or metal-ceramic crowns have been discussed in the literature. This article was aimed to describe a simple fabrication method in which a retrofitting crown was fabricated for a precise fit using a ceramic-pressed-to-metal system.

Analysis of stress distribution of tooth restored with metal-ceramic crown covering abfraction lesion according to its finish line location under occlusal load / 대한치과보철학회지

PURPOSE: When the full veneer crown was treated in the tooth with abfraction lesion due to various causes, the prognosis of it may be compromised according to the location of the finish line, but there is few study about the location of its buccal finish line. The purpose of this study was to investigate the effect of location of the finish line of the full veneer crown on stress distribution of the tooth with abfraction lesion. MATERIALS AND METHODS: The two dimensional finite element model was developed to express tooth, surrounding tissue and full veneer crown. The stress distribution under eccentric 144 N occlusal load was analyzed using finite element analysis. The location of finish line was set just at the lower border of the lesion (Group 0), 1 mm (Group 1) and 2 mm (Group 2) below the lower border of the lesion. RESULTS: In the Group 0, von Mises stress was concentrated at the finish line and the apex of the lesion. Also, the stress at the bucal finish line propagated to the lingual side. In the Group 1 and Group 2, stress distribution was similar each other. Stress was concentrated at the apex of lesion, but the stress at the buccal finish line did not propagate to the lingual side. That implied decrease of the possibility of horizontal crown fracture. CONCLUSION: Full veneer crown alleviated the stress concentrated at the apex of the abfraction lesion, when the finish line of full veneer crown was set below the lower border of abfraction lesion.

Influence of porcelain re-firing on the formation of surface bubble and on the change in shade of metal-ceramic crown exposed to artificial saliva / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the influence of porcelain re-firing on the formation of surface bubble and on the change in shade of metal-ceramic crown exposed to artificial saliva. MATERIALS AND METHODS: Thirty disk-shaped specimens were made in 10 mm diameter with 0.5 mm metal core thickness and 1 mm ceramic thickness. A spectroradiometer was used to determine the CIE Lab coordinates. The number and size of surface bubble were observed with a stereomicroscope. After the exposure to artificial saliva for 7 days, re-firing was performed at glazing temperature. After re-firing, the CIE Lab were calculated, and the number and size of surface bubble were observed again. The change in shade was expressed with DeltaE. Statistical analysis was done with paired t-test for the change in the number of surface bubble and student t-test for the change in the size of surface bubble (alpha= 0.05). RESULTS: Shade difference was calculated 2.14 DeltaE units. The mean number of surface bubble was 1.33 +/- 1.49 before re-firing, 3.27 +/- 2.90 after re-firing. After re-firing, the number of surface bubble was significantly increased (P<.05). The mean size of surface bubble was 81.97 +/- 32.03 microm before re-firing, 142.94 +/- 47.40 microm after re-firing. After re-firing, the size of surface bubble was significantly increased (P<.05). CONCLUSION: Shade change after re-firing was perceptible (DeltaE < 2.0) and clinically acceptable (DeltaE < 3.7). The number and size of surface bubble was significantly increased after re-firing. Further investigation to decrease the surface bubble on the extra oral repair of metal-ceramic crown, will be needed in future study.

Alternate metal framework designs for the metal ceramic prosthesis to enhance the esthetics

PURPOSE: The objective of the present study was to evaluate the effect of five different metal framework designs on the fracture resistance of the metal-ceramic restorations. MATERIALS AND METHODS: For the purpose of this study, the central incisor tooth was prepared, and the metal analogue of it and a master die were fabricated. The counter die with the 0.5 mm clearance was used for fabricating the wax patterns for the metal copings. The metal copings with five different metal framework designs were designed from Group 1 to 5. Group 1 with the metal collar, Group 2, 3, 4 and 5 with 0 mm, 0.5 mm, 1 mm and 1.5 mm cervical metal reduction respectively were fabricated. Total of fifty metal ceramic crown samples were fabricated. The fracture resistance was evaluated with the Universal Testing Machine (Instron model No 1011, UK). The basic data was subjected to statistical analysis by ANOVA and Student's t-test. RESULTS: Results revealed that the fracture resistance ranged from 651.2 to 993.6 N/m2. Group 1 showed the maximum and Group 5 showed the least value. CONCLUSION: The maximum load required to fracture the test specimens even in the groups without the metal collar was found to be exceeding the occlusal forces. Therefore, the metal frameworks with 0.5 mm and 1 mm short of the finish line are recommended for anterior metal ceramic restoration having adequate fracture resistance.

Infraestructura de oro para prótesis metal-cerámicas obtenidas mediante técnica de electrodeposición / Infrastructure gold for metal-on-ceramic obtained by electrodeposition technique

La electrodeposición es un proceso químico por el cual se realiza una deposición galvánica de oro del 99% de pureza con el fin de obtener infraestructuras en prótesis metal-cerámicas. Las infraestructuras presentan, en promedio, un espesor de 0,2 mm y un desajuste marginal inferior la 20 µm, posibilitando la utilización de un mayor espesor de cerámica si la comparamos a técnicas convencionales. Esta técnica posibilita la disminución de la citotoxicidad, de las reacciones alérgicas y de la corrosión, determinando una mayor duración de las restauraciones. La coloración dorada del material permite al ceramista conseguir una estética más depurada, favoreciendo las tonalidades en la cerámica aplicada. Sin embargo, la necesidad de mano de obra calificada y de equipos modernos y de alto costo son factores que todavía hacen inviable la utilización de la electrodeposición de oro puro como práctica clínica habitual. El objetivo de este estudio es contribuir, a través de una revisión de la literatura, a la comparación en los siguientes factores: calidad del asentamiento marginal, durabilidad, biocompatibilidad, estética de las restauraciones cuyas estructuras hayan sido obtenidos por la técnica de electrodepoisición frente a restauraciones realizadas con técnicas metal-cerámicas convencionales y sistemas cerámicos

Electrodeposition is the galvanic deposition of 99% pure gold to obtain the framework for metal-ceramic prostheses. The framework is 0.2 mm thick, on average, with marginal maladjustment of less than 20 µm, enabling the use of greater ceramic thickness than that of conventional techniques. This new technique reduces cytotoxicity, allergic reactions and corrosion, resulting in longer restoration longevity. The golden coloration of the material allows the ceramist to develop a more evolved esthetic, favoring the tonality of the ceramic applied. However, the need for qualified labor and modern high-cost equipment are factors that hinder the use of electrodeposited pure gold in everyday clinical practice. The aim of this study is to perform a literature review to compare the quality of the marginal fit, longevity, biocompatibility, and esthetic of restorations whose copings were obtained by the electrodeposition technique using conventional metal-ceramics and ceramic systems

Fracture strength of zirconia monolithic crowns and metal-ceramic crowns after cyclic loading and thermocycling / 대한치과보철학회지

PURPOSE: The purpose of this study was to compare the fracture strength of the zirconia monolithic all-ceramic crowns according to the thickness (0.5mm, 0.8mm, 1.1mm) and metal-ceramic crowns (1.0mm, 1.5mm). MATERIAL AND METHOD: Twelve crowns for each of 3 zirconia crown groups were fabricated using CAD/CAM system (Kavo, Germany) and twelve crowns for each of 2 metal-ceramic crown groups were made by the conventional method. All crowns were luted to the metal dies using resin cement. Half of the specimens were exposed to thermocycling (5-55degrees C, 1 Hz) and cyclic loading (300,000 cycles, 50N). Subsequently, all crowns were mounted on the testing jig in a universal testing machine. The load was directed at the center of crown with perpendicular to the long axis of each specimen until catastrophic failure occurred. Analysis of variance and Tukey multiple comparison test (P<.05) were used for statistical analysis of all groups, and paired t-test (P<.05) was followed for statistical comparison between each groups'fracture load before and after cyclic loading. RESULTS: 1. The fracture strength of the zirconia monolithic crowns and the metal-ceramic crown increased as thickness increased (P<.05). 2. The cyclic loading and thermocycling significantly decreased the fracture strength of the zirconia monolithic crowns (P<.05). 3. The standard deviation of fracture strength of the zirconia monolithic crowns was very low. CONCLUSION: The fracture strength of the zirconia monolithic crowns for the posterior area tends to be higher with thickness increased and 0.8mm or over in thickness is recommended to have similar or over the fracture strength of metal-ceramic crowns.

Marginal fit of the digident CAD/CAM zirconia ceramic crowns / 대한치과보철학회지

Statement of problem. There have been many studies about marginal discrepancy of single restorations made by various systems and materials. However most of the statistical inferences are not definite because of sample size, measurement number, measuring instruments, etc, and there have been few studies about the marginal fit of the Digident CAD/CAM zirconia ceramic crowns. Purpose. The purpose of this study was to compare the marginal fit of the anterior single restorations made by using the Digident CAD/CAM zirconia ceramic crowns with metal-ceramic restorations and to obtain more accurate information by using a large enough sample size and by making sufficient measurements per specimen. Material and Methods. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and 6.taper walls by milling machine. The in vitro marginal discrepancies of the digident CAD/CAM zirconia ceramic crowns and control groups(metal ceramic crowns) were evaluated and compared. Twenty crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. Conclusion. Within the limitations of this in vitro study, the following conclusions were drawn: 1. Mean gap dimensions and standard deviations at the marginal opening for maxillary incisal crowns were 88+/-10microm for the control (metal-ceramic crowns), 92+/-4microm for Digident CAD/CAM zirconia ceramic crowns. 2. Marginal gap between Digident CAD/CAM zirconia ceramic crowns and metal ceramic crowns did not show significant difference (P>.05). 3. The Digident CAD/CAM zirconia ceramic crowns and metal ceramic crowns showed clinically acceptable marginal discrepancy.

In vitro marginal fit of the computer-aided milled cercon crowns / 대한치과보철학회지

STATEMENT OF PROBLEM: There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But most of statistical inferences are not definite because of sample size, measurement number, measuring instruments, etc. And there have been few studies about the marginal fit of Computer-aided Cercon crowns. PURPOSE: The purpose of this study was to compare the marginal fit of the anterior single restorations made using computer-aided milled Cercon crowns with metal-ceramic restorations and to obtain more accurate information by using a large enough sample size and by making sufficient measurements per specimen. Material and methods. The in vitro marginal discrepancies of computer-aided milled Cercon crowns and control groups (metal ceramic crowns) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared by milling machine. 30 crowns per each system were fabricated. Measurements of a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Parametric statistical analysis was performed for the results. RESULTS: The means and standard deviations of the marginal fit were 85+/-22micrometer for the control group and 91+/-15micrometer for the Cercon crowns. The t-test of the marginal discrepancies between Cercon crowns and metal-ceramic crowns were performed. Significant differences were not found between groups (P=0.230>.05). Based on the criterion of 120micrometer as the limit of clinical acceptability, the mean marginal fits of Cercon crowns and metal-ceramic crowns were acceptable. Conclusion. Within the limitations of this in vitro study, the following conclusions were drawn: 1. Mean gap dimensions and standard deviations at the marginal opening for maxillary incisal crowns were 85+/-22micrometer for the control (metal-ceramic crowns), 91+/-15micrometer for Cercon crowns. 2. The Cercon crowns showed slightly larger marginal gap discrepancy than the control but marginal gap between Computer-aided milled Cercon crowns and metal ceramic crowns did not showed significant difference (P>.05). 3. The Cercon crowns and metal ceramic crowns showed clinically acceptable marginal discrepancy.