ABSTRACT
Applying the biomimetic principles, maximum preservation of the sound tooth structure may be achieved by means of adhesive restorations. Due to bonding, it is possible to conduct minimally invasive esthetic procedures with laminate veneers assuring a high mechanical resistance of the tooth/restoration bond. A clinical case of adhesive restorations is presented using the bonding protocol respecting the diversity of each product's commercial brands and manufacturer's recommendations.
Subject(s)
Ceramics , Dental Bonding/methods , Dental Veneers , Resin Cements , Acid Etching, Dental , Esthetics, Dental , Humans , Incisor , Male , Maxilla , Tooth Preparation, Prosthodontic/methodsABSTRACT
STATEMENT OF PROBLEM: Cracked teeth may traditionally require the use of complete coverage crowns. Alternative conservative treatments involve the use of adhesive inlays/onlays with the possibility of including a fiber patch to reinforce the cracked cusp. PURPOSE: The purpose of this study was to evaluate the fatigue strength of compromised molars restored with computer-aided-design/computer-assisted-manufactured (CAD/CAM) composite resin inlays/onlays with and without fiber-reinforced immediate dentin sealing (IDS). METHODS AND MATERIALS: Large mesio-occluso-distal preparations with cracked/undermined palatal cusps were simulated on 40 extracted maxillary molars. All teeth received IDS (Optibond FL, Kerr, Orange, CA, USA), and composite resin (Paradigm MZ100, 3M-ESPE, St. Paul, MN, USA) inlays (N = 20) and onlays (N = 20). A fiber patch (Ribbond, Ribbond Inc., Seattle, WA, USA) was applied in half of the preparations. Restorations were adhesively luted with pre-heated composite resin (Z100, 3-M ESPE) and submitted to cyclic isometric loading at 5 Hz, starting with a load of 50 N (5,000 cycles), followed by stages of 150, 300, 450, 600, 750, 900, and 1,050 N at a maximum of 25,000 cycles each. Specimens were loaded until fracture or to a maximum of 180,000 cycles. Groups were compared using the life table survival analysis. RESULTS: Differences in survival probability were found (p = 0.04). The inlay group with fiber patch failed at an average load of 870 N, and none of the specimens withstood all 180,000 load cycles; survival rates of inlays and onlays without fibers, and onlays with fibers were 10, 30, and 50%, respectively. CONCLUSIONS: Onlays (with or without fibers) increased the fatigue resistance of compromised molars in this in vitro study.
Subject(s)
Computer-Aided Design , Cracked Tooth Syndrome/therapy , Dental Prosthesis Design , Inlays , Resin Cements/therapeutic use , Tooth Crown/injuries , Composite Resins/chemistry , Dental Restoration Failure , Dental Stress Analysis , Humans , Molar/injuries , Polyethylenes , Survival AnalysisABSTRACT
A survey demonstrated that angled abutments for external-hex implant platforms are difficult to place because of the handling of the components and screwdriver. The purpose of this study was to evaluate the performance of a device facilitating the placement of prefabricated angled abutments. This new instrument features improved ergonomics and is based on the design of a modified pickup impression coping. Forty experienced professionals tested two methods of placing angled abutments in a typodont on implants replacing a maxillary central incisor and a maxillary first molar. Using the new device, the abutments could be placed with a 43.9% reduction in time compared to the original manufacturer's instrument.
Subject(s)
Dental Abutments , Dental Implantation, Endosseous/instrumentation , Dental Instruments , Dental Prosthesis Design , Dental Prosthesis Retention/instrumentation , Analysis of Variance , Dental Implantation, Endosseous/methods , Dental Implants , Equipment Design , Humans , Maxilla , Pilot Projects , Prosthesis FittingABSTRACT
This article presents a treatment option for a fractured maxillary central incisor root as part of an existing complete maxillary rehabilitation. After the root extraction and immediate implant placement into the extraction socket, an acrylic resin removable partial denture (RPD) was placed. Six months later, a screw-retained provisional restoration was placed to guide the development of soft tissue contours. An impression was made, and a custom abutment was fabricated to conform to the new gingival profile and the intaglio surface of the existing metal ceramic crown. The custom abutment was placed and the preexisting metal ceramic crown was then cemented.
