Awareness about emergency management of avulsed tooth among intern dentists-a cross-sectional observational study.

Tooth avulsion is a frequently encountered dental emergency. Children are commonly reported group due to frequent sports activities, trauma, accidents and falls. Prompt emergency management is vital for long term success and to avoid morbidity. The study was aimed to assess the understanding of intern dentists about the emergency handling of avulsed teeth cases as mostly they are first responders among health care personnel. In this study a fourteen-item questionnaire with predefined responses was shared as online Google survey form with intern dentists of 5 different dental teaching hospitals of Islamabad, Pakistan. The duration of the study was 6 months (01 March 2022 to 31 August 2022). The questions were intended to collect personal information and to check level of knowledge and awareness about the management of avulsed tooth among the dental interns. The data was analyzed by statistical methods and is presented through tables and descriptive methods. In total, 152 participants completed the shared questionnaire. The vast majority (71%) of them were aware of the initial management of avulsed teeth, 49% were aware of the ideal transport medium for an avulsed tooth, (43%) were aware of the critical time for successful replantation, while (62%) had knowledge of the multiple factors responsible for the outcome of the tooth replantation. For majority of the statements, female participants had better knowledge as compared to their male counterparts. Statistically significant difference was noted for the statement "If you found the knocked-out tooth and it is dirty what will be your initial approach?" with female participants having better knowledge as compared to the male (p value = 0.005). Based on our study results, generally dental interns are well-informed but still lack expected level of awareness regarding the proper management protocol for avulsed tooth. Hence, improvement is needed regarding the effective handling of avulsed teeth cases.

Effect of Repressing Lithium Disilicate Glass Ceramics on The Shear Bond Strength of Resin Cements.

The aim of this study was to investigate the effect of repeated pressing of lithium disilicate ceramic on the shear bond strength (SBS) of three types of resin cement. METHODOLOGY: A lithium disilicate ceramic (IPS e.max® Press) was first heat-pressed to form rectangular disk specimens. Then, leftovers were used for the second and third presses. A total of 90 specimens were prepared and separated, according to the number of pressing cycles, into three groups: 1st, 2nd, and 3rd presses (n = 30). Each group was further subdivided into three groups (n = 10) according to the type of resin cement used, as follows: Multilink N (MN), Variolink Esthetic DC (VDC), and Variolink Esthetic LC (VLC). All the cement was bonded to the ceramic surface, which was etched with hydrofluoric acid and primed with Monobond Plus. All samples were light-cured and stored for 24 h. Shear bond strength was tested on a universal testing machine. RESULTS: A two-way ANOVA was used to evaluate the influence of repeated pressing cycles and cement type as well as their interaction. The results indicated that cement type has a significant impact (p < 0.001) but not the number of pressing cycles (p = 0.970) or their interaction (p = 0.836). The Bonferroni post-hoc test showed that the SBS of MN was significantly higher than that of VDC and VLC in the first press and second press cycles, respectively. The SBS of MN was significantly higher than that of VDC and VLC cements in the third pressing cycle. There was no significant difference in the SBS between VLC and VDC in all three pressing cycles. CONCLUSION: The results of the current study did not report a detrimental effect of repeated pressing up to three cycles on the shear bond strength of the IPS e.max® Press. Multilink resin cement showed the highest SBS to IPS e.max® Press at the third pressing cycle. For all types of cement and heat pressing cycles, the majority of cement failures were adhesive. No cohesive failures occurred in any of the tested resin cements, regardless of the cement type or the number of heat pressing cycles tested.

A Comparative Study of the Marginal Fit of Endocrowns Fabricated From Three Different Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Ceramic Materials: An In Vitro Study.

INTRODUCTION: The marginal seal and adaptation are important factors for successful restoration. An inadequate marginal seal can lead to bacterial microleakage, plaque accumulation, and eventually treatment failure This in vitro study aimed to compare the marginal gap of endocrowns fabricated from three different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic materials. METHODS: Thirty extracted mandibular molars were selected for the study. Endocrown preparations were completed after root canal treatment. Teeth were divided into three groups to receive endocrowns fabricated of lithium disilicate ceramic (IPS-e.max CAD, Ivoclar Vivadent AG, Schaan, Liechtenstein), zirconia-reinforced lithium silicate ceramic (VITA Suprinity®, VITA Zahnfabrik, Bad Säckingen, Germany), and polymer-infiltrated ceramic (VITA Enamic®, VITA Zahnfabrik). The digital impressions were transferred to the design software to construct the endocrowns. The endocrowns were milled and cemented. The marginal fit was examined using a digital camera stereomicroscope at a magnification of 80X. Images were transferred to Image-J software (National Institutes of Health, Bethesda, Maryland, United States) to measure the marginal gap. RESULTS: One-way ANOVA showed a significant difference in the marginal gap between the different ceramic groups (P=0.006). Tukey's Honest Significant Difference (HSD) post-hoc test showed that VITA Suprinity had significantly higher gap width values than VITA Enamic (P=0.005). No significant differences in gap width values were found between VITA Enamic and IPS e.max CAD or between VITA Suprinity and IPS e.max CAD (P>0.05). CONCLUSION: The marginal gap of endocrown restorations varies with different CAD/CAM materials (zirconia-reinforced lithium silicate glass-ceramic, polymer-infiltrated hybrid ceramic, and lithium disilicate glass-ceramic), but are all within clinically acceptable marginal gap width.

Flexural Strength Properties of Five Different Monolithic Computer-Aided Design/Computer-Aided Manufacturing Ceramic Materials: An In Vitro Study.

Objective The purpose of this in vitro study is to compare the flexural strength and Weibull modulus of 5 different monolithic computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics. Methods A total of 50 specimens were fabricated, 10 from each of the following materials: lithium disilicate-based ceramic (IPS e.max CAD), zirconia -reinforced lithium-silicate ceramic (Vita Suprinity), leucite-based glass ceramic (IPS Empress CAD), and two zirconia-based ceramics (Zenostar and CopraSmile). The specimens were 4 mm wide, 2 mm thick, and 16 mm long. Flexural strength test was executed using a universal testing machine (Model 5980, Instron Industrial Products, Norwood, MA, USA). The two-parameter Weibull distribution function was used to analyze the variability of flexural strength values. Statistical analysis was performed on SPSS Version 23 (IBM Corp., Armonk, NY, USA) using one-way analysis of variance (ANOVA) and post-hoc Tukey's test. Results Suprinity had the highest Weibull modulus value, while Empress CAD displayed the lowest value. One-way ANOVA showed significant difference in the flexural strength between the different materials tested (p<0.05). Post-hoc analysis revealed significant differences among all the test groups in terms of flexural strength. Zenostar presented the highest mean flexural strength value (1033.90 MPa), while Empress CAD had the lowest value. Conclusion High-translucency zirconia had superior flexural properties than translucent zirconia, lithium disilicate ceramics, zirconia-reinforced lithium silicate ceramics, and leucite-based glass ceramics.

The Use of a Coded Healing Abutment in the Restoration of a Single, Immediately Placed Implant in the Esthetic Zone: A Clinical Case Report.

For several years, the implant-level impression procedure started by removal of the healing abutment, followed by connection of the impression coping to the implant. Encode Complete (Encode, Biomet 3i, Biomet 3i, Palm Beach Gardens, FL) was introduced to eliminate implant-level impressions by offering a healing abutment-level impression protocol. This report illustrated the treatment of a single tooth in the anterior esthetic zone using Encode Complete. A 23-year-old female patient reported to the prosthodontics clinic complaining of a fractured maxillary anterior tooth that was deemed nonrestorable. After immediate implant placement, soft tissue preservation and temporization of the implant, healing abutment level impression was made. The codes embedded on the occlusal surface communicated the implant depth, hex-orientation, platform diameter, and interface. The definitive Encode gold-plated titanium abutment was anatomically designed virtually with customized margin, contour, taper, and emergence profile. The milling process was initiated, and the virtual design data were sent to the Robocast Center for analog placement in the original Encode master cast. The definitive abutment was placed on the master cast using Robocast technology, followed by the fabrication of the final porcelain fused to zirconia cement-retained all ceramic crown. The abutment was secured to the implant with a Gold-Tite abutment screw, followed by the final cement-retained implant crown placement. Recall visits were obtained at 1 week, 1 month, 3 months, and 1 year after final prosthesis insertion.

Radiographic Analysis of Posts Performed by Undergraduate Dental Students: A Cross-Sectional Study.

INTRODUCTION: Post and core restorations for endodontically treated teeth must meet certain prosthetic criteria to ensure the success of the final restoration. The aim of this study is to evaluate the quality of posts performed by dental students at King Abdulaziz University Dental Hospital (KAUDH), Jeddah, Saudi Arabia, utilizing periapical radiographs and whether the prosthetic criteria were strictly met by students. MATERIALS AND METHODS: This cross-sectional study included 661 digital periapical radiographs of posts performed by 6th-year dental students from September 2018 to April 2019. The assessment included the following factors: patient's age, patient's gender, tooth type, and arch. Post-related factors including post type, shape, diameter, length, and status of the remaining gutta percha were also evaluated. Statistical analysis was performed using SPSS. Descriptive statistics were generated, and the association between different variables was determined using chi-square test at p<0.05. RESULTS: Posts were used to restore maxillary teeth (67%), and were particularly placed in premolars (44%). The majority of used posts were prefabricated tapered fiber posts (90%). The results were as follows: post diameter equal to one-third of root diameter, 50% met criterion; post length equal to two-thirds of root length, 33%; post length equal to or more than crown height, 93%; absence of space between gutta percha (GP) and post, 74%; and length of the remaining GP equal to 3-5 mm, 68%. Overall, 11% of the posts met all the ideal prosthetics criteria. CONCLUSION: Most qualities of post and core restorations that were radiographically assessed were found to be acceptable and within the recommended prosthodontic criteria.

Technical Accuracy of Dental Laboratories in the Quality and Shade Matching of Porcelain Fused to Metal Crowns: An In Vitro Study.

Dental laboratories (LABs) are integral to the performance of a dentist in providing successful oral rehabilitation. The aim of this study was to compare the adaptation, contour, contacts, and shade matching of different government and commercial dental LABs in the fabrication of porcelain fused to metal (PFM) crowns. Thirty-two dental LABs were selected to fabricate PFM crowns (one PFM crown each). Marginal adaptation, contour, proximal contacts, and shade matching were evaluated. Evaluation of the crowns' quality was performed following modified USPHS/FDI criteria. Visual and colorimeter assessments were employed to evaluate shade matching. Differences between groups were examined by Pearson's Chi-square and Fisher's exact test. The quality of marginal adaptation of crowns was good in 81.25%, however the quality of contours, contacts, and shade matching was compromised in 43.75%, 59.38%, and 39% of all LABs, respectively. Visual and colorimeter shade matching was acceptable in 62.5% and 80% of LABs in the cervical third and middle third regions of crowns, respectively, however in the incisal third the shade matching was unacceptable in nearly 60% of LABs. Commercial laboratories showed significantly better contours and shade matching, but not marginal adaptation. However, no significant differences were found in comparison of proximal contacts between the groups.