Color and translucency of enamel in vital maxillary central incisors.

STATEMENT OF PROBLEM: Limited data, especially in vivo data, exist regarding translucency parameter (TP) values for vital anterior nonrestored dentition. Additionally, published information on the CIELab values of vital enamel at a theoretical infinite thickness is lacking. Obtaining TP and CIELab values in a population that varies in terms of ethnicity, age, and sex would be useful to inform the development and placement of esthetic dental restorations that more accurately capture the complex optical qualities of enamel. PURPOSE: The purpose of this clinical study was to investigate in vivo the TP and CIELab values of vital anterior incisor enamel at a theoretical infinite thickness in a diverse pool of participants who varied in age, ethnicity, and sex. MATERIAL AND METHODS: Spectral reflectance measurements (380 to 780 nm at 2-nm intervals) of the mid-incisal region of vital, unrestored maxillary anterior teeth were made in 120 participants, equally divided into 2 sexes, 4 racial or ethnic groups, and 5 age ranges. Instruments were oriented to achieve 0-degree observation and 45-degree illumination, and spectral measurements were made with white and black silicone backgrounds. Reflectance spectra of the incisal enamel from both the black and white silicone backing were used to fit to the Kubelka-Munk (K-M) reflectance theory. The CIEDE2000 color difference formula was used to determine TP, and data were compared among participant demographics. CIELab color coordinate values for enamel at an infinite thickness were calculated by using a D65 illumination and CIE standard human (2-degree) observer. To determine value ranges and significant differences among participant groups, CIELab values were analyzed with a 4-way ANOVA, and TP values were analyzed with a generalized linear mixed model. Pairwise comparisons of interest were evaluated with Bonferroni-corrected Student t tests. RESULTS: For maxillary central incisor enamel, the average TP was 10.1 ±3.6, and the average CIELab color coordinates were L∗=73.5 ±7.6, a∗=2.2 ±1.8, b∗=11.9 ±8.4. TP values of incisal enamel significantly differed among specific age and ethnic groups, with general significant interactions of age and sex (P=.009), as well as ethnicity and age (P=.042). CIE color coordinates of enamel at an infinite thickness were found in the L∗ coordinate among different age groups with the same sex and ethnicity, specifically when comparing CIELab direction with the population characteristics of age (P=.011) and the interaction between age, sex, and ethnicity (P=.035). CONCLUSIONS: In vivo L∗ values and TP values of incisal enamel differed significantly among groups determined by ethnicity, age, and sex.

Cost and complications associated with implant-supported overdentures with a resilient-attachment system: A retrospective study.

STATEMENT OF PROBLEM: Implant-supported overdentures with a splinted or nonsplinted attachment system have been a successful treatment option for edentulous mandibles with excessive hard tissue resorption. Currently, the 2 most common treatment approaches for an implant overdenture uses either a bar attachment system (splinted) or resilient (LOCATOR)-attachment system (nonsplinted). The LOCATOR-attachment system is often chosen for the lower initial cost. However, whether the ongoing maintenance costs of the LOCATOR-attachment system increase the overall cost of this system is unclear. PURPOSE: The purpose of this retrospective study was to investigate the frequency of maintenance procedures, complications, and costs associated with the LOCATOR-supported overdenture treatment. MATERIAL AND METHODS: The retrospective data of 75 patients who had received implant-supported overdentures with LOCATOR-attachments at the University of Colorado School of Dental Medicine in the previous 10 years were collected and screened to evaluate the number of maintenance visits, type of complications, and cost (actual fees for the service) of the maintenance visits. The data were analyzed, and the mean values calculated. RESULTS: The average number of maintenance visits was 7.7 in the mean observation time of 5.2 years. Replacement of the attachment was the most frequent complication (63%). The average maintenance cost charged to the patient for maintenance was 56.2% ($795) of the initial cost over the average 5.2 years of follow-up. The average total maintenance cost (actual fees for the service) was 95.4% ($1349) of the initial cost over the average of 5.2 years of follow-up. The average maintenance cost adjusted or lost over the 5.2 years follow-up was 39.2%. CONCLUSIONS: The 5-year costs for the maintenance of mandibular overdentures with a LOCATOR-attachment system were equal to or higher than the initial cost of the treatment. The number of maintenance visits and the cost were higher for patients who were older than 75 years.