ABSTRACT
Purpose: De-bonding strength of ceramic veneers by laser use needs to be evaluated in detail. The aim of this study, is to determine the contribution of ceramic thickness and cementing agents to the de-bonding strength of ceramic veneers using Er,Cr:YSGG laser. Methods: A total of 120 maxillary central incisors specimens were randomly divided into twelve groups on the basis of disc thickness, cementing agent, and Er,Cr:YSGG laser use. Under laboratory conditions, 120 IPS Empress II system discs 0.5mm, 1mm, and 2mm in thickness were applied to the tooth surfaces, for laser use. An Er,Cr:YSGG laser system was applied to the central surface of the IPS Empress II discs on specimens in all laser groups (Groups 1,3,5,7,9,11). Then the shear bond strength (SBS) for all specimens were tested with a testing machine at a speed of 0.5mm/min. The SBS values were considered as the de-bonding strength. Results: The mean de-bonding strength values for Groups 9 and 11 (0,5 mm disc thickness + laser application) have the lowest median load (0.000 N), while Group 4 (2mm disc thickness + no laser) has the highest median load (573.885 N). The de-bonding strengths of all the groups without laser application were higher than those of all groups with laser use. When laser is applied, the mean de-bonding strength decreases with decreasing disc thickness, and it reaches zero at 0.5mm thickness of discs cemented by self- or total-etch adhesives. Conclusions: The de-bonding strength decreases with laser use, and decreasing disc thickness. In the absence of laser, the mean de-bonding values of discs cemented by a total etch adhesive system are always higher than those of discs cemented with a self-etch adhesive system. Without any extra load, all 0.5mm thick discs were dislodged from teeth while applying or testing the laser.
Propósito: La resistencia de desunión de las carillas de cerámica mediante el uso del láser debe evaluarse en detalle. El objetivo de este estudio es determinar la contribución del espesor de la cerámica y los agentes de cementación a la resistencia de desunión de las carillas de cerámica utilizando el láser Er, Cr: YSGG. Métodos: Un total de 120 incisivos centrales maxilares se dividieron al azar en doce grupos según el grosor del disco, el agente de cementación y el uso del láser Er, Cr: YSGG. En condiciones de laboratorio, se aplicaron en las superficies de los dientes 120 discos del sistema IPS Empress II de 0,5mm, 1mm y 2mm de grosor, para uso con láser. Se aplicó un sistema láser Er, Cr: YSGG a la superficie central de los discos IPS Empress II en muestras de todos los grupos de láser (Grupos 1,3,5,7,9,11). Luego, la resistencia de la unión al cizallamiento (SBS) para todas las muestras se probó con una máquina de prueba a una velocidad de 0.5mm/min. Los valores de SBS se consideraron como la fuerza de desunión. Resultados: Los valores medios de resistencia de desunión para los Grupos 9 y 11 (espesor de disco de 0,5mm + aplicación de láser) demostró la carga media más baja (0,000 N), mientras que el Grupo 4 (espesor de disco de 2 mm + sin láser) tuvo la carga media más alta (573.885 N). Las fuerzas de desunión de todos los grupos sin aplicación de láser fueron superiores a las de todos los grupos con uso de láser. Cuando se aplica el láser, la fuerza media de desunión disminuye al disminuir el grosor del disco, y llega a cero con el grosor de 0,5mm de los discos cementados, para ambos adhesivos de grabado. Conclusiones: la fuerza de desunión disminuye con el uso del láser y disminuye con el grosor del disco. En ausencia de láser, los valores medios de desunión de los discos cementados con un sistema de adhesivo de grabado total son siempre más altos que los de los discos cementados con un sistema de adhesivo de autograbado. Sin ninguna carga adicional, todos los discos de 0,5mm de grosor se desprendieron de los dientes al aplicar el láser.
Subject(s)
Humans , Ceramics/therapeutic use , Dental Bonding , Shear Strength , Lasers, Solid-State/therapeutic use , Dental Enamel/radiation effects , Dental Materials/chemistry , Dental VeneersABSTRACT
PURPOSE: The purpose of this study is to report retrospectively the clinical results of cast metal slot-retained resin-bonded fixed dental prostheses (RBFDPs) used in the restoration of single missing second premolar teeth, as this kind of prostheses provides acceptable clinical outcomes in a minimally invasive and esthetic treatment for the average patient requiring cheaper and faster treatment alternative for a single missing posterior tooth. However, the data present in the literature are scarce. MATERIALS AND METHODS: Clinical follow-up was reported up to 7.5 years in nine different cast metal slot-retained RBFDPs patients of both genders between 21 and 49 years of age. Routine clinical controls were performed 6 and 12 months after treatment, followed by regular intervals every year afterward. The Kaplan-Meier survival estimation method was used to determine the overall and functional survival rates and times of the RBFDPs at the end of the observation period. RESULTS: At the end of the follow-up, all of the RBFDPs were still functional with a mean follow-up of 6.7 years. The Kaplan-Meier estimation for the overall survival was calculated as 89% for up to 7.5 years with one failure due to debonding. The functional survival rate was 100% with the lowest and highest observation periods being 5.8 and 7.5 years, respectively. CONCLUSIONS: Within the limitations of this retrospective clinical study, it seems that the design and cementation regimen used for the RBFDPs presented can guarantee clinical success in the restoration of single missing second premolar teeth.
ABSTRACT
Amelogenesis imperfecta (AI) affects enamel on primary and permanent dentition. This hereditary disorder is characterized by loss of enamel, poor esthetics, and hypersensitivity. Functional and cosmetic rehabilitation is challenging with variety of treatment options. This report presents the treatment of an AI patient using conventional fixed dentures and discusses issues related to posttreatment complications and prosthetic treatment outcome after 1 year of follow-up. A 19-year-old male AI patient with impaired self-esteem presented with hypersensitive, discolored, and mutilated teeth. Clinical examination revealed compromised occlusion and anterior open-bite. After hygiene maintenance full-coverage porcelain-fused-to-metal fixed restorations were indicated and applied. At the end of the treatment acceptable functional and esthetic results could be achieved. However, nearly a year after treatment a gingival inflammation in the esthetic zone complicated the outcome. Insufficient oral hygiene was to be blamed. Tooth sensitivity present from early childhood in these patients may prevent oral hygiene from becoming a habit. The relaxation due to relieve of hypersensitivity after treatment makes oral hygiene learning difficult. Continuous oral hygiene maintenance motivation may be crucial for the success of the treatment of AI patients. Treatment of AI patients should be carefully planned and an acceptable risk-benefit balance should be established.
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PURPOSE: To evaluate under controlled clinical conditions the outcomes of cast-metal slot-retained resin-bonded fixed dental prostheses (RBFDPs) in which resin composite interlocked the restoration retainers in place after cementation in cases with single missing first molars, and to collect survival data on this esthetic RBFDP design combined with an economical metal fit-surface treatment method and resin luting system. MATERIALS AND METHODS: Forty-one tub-shaped inlay-retained RBFDPs were clinically observed for up to 7.7 years in 35 recipients of both genders between 18 and 52 years of age. Clinical examinations were performed at baseline and 6 and 12 months after restoration placement, and thereafter at regular 1-year intervals. Modified US Public Health Service (USPHS) parameters, sulcus bleeding index, Silness-Löe plaque index, pocket depths, tooth mobility, pulp vitality, and periapical radiographs regarding the abutment teeth were assessed at these follow-up appointments. The Kaplan-Meier survival estimation method was performed to detect the overall and functional survival rates and mean survival times of the RBFDPs at the end of the study. The Breslow (Generalized Wilcoxon) test was used to evaluate the influence of restoration location and age and gender of the patient regarding the overall survival probability at the end of the follow-up (α = 0.05). RESULTS: At the end of the study, 34 RBFDPs (83%) were still functioning with a mean follow-up of 6.3 years. According to the Kaplan-Meier survival curve, the overall and functional survival probabilities were calculated as 76% and 83%, with mean survival times of 6.8 years and 7.2 years, respectively. All clinical parameters monitored throughout the follow-up period predominantly revealed clinically acceptable results. Breslow test statistics presented nonsignificant differences with better results for the RBFDPs placed in the mandible of female recipients younger than 30 years of age. The most common failure noted with the RBFDPs was fracture of the occlusal veneering composite restoration over the retainer of a single abutment, leading to a predisposition of the restoration to partial debonding. CONCLUSION: Within the limitations of this prospective cohort study, it can be concluded that cast-metal slot-retained RBFDPs utilizing the interlocking mechanism of a resin composite to obtain additional retention from the abutment cavities show acceptable clinical success rates, and can be considered a minimally invasive, economical, and time-saving treatment alternative for the prosthetic rehabilitation of single missing first molars.
Subject(s)
Chromium Alloys , Denture Design , Denture Retention/methods , Denture, Partial, Fixed, Resin-Bonded , Denture, Partial, Fixed , Inlays , Adolescent , Adult , Cementation/methods , Cohort Studies , Dental Abutments , Dental Casting Technique , Dental Restoration Failure , Dental Veneers , Denture Retention/instrumentation , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Mandible , Middle Aged , Molar , Nickel , Prospective Studies , Resin Cements , Statistics, Nonparametric , Young AdultABSTRACT
PURPOSE: To evaluate the clinical usefulness of directly fabricated glass and polyethylene resin-bonded fiberreinforced composite (FRC) inlay-retained fixed dental prostheses (FDPs) in posterior single missing teeth over a short period of time. MATERIALS AND METHODS: Fourteen inlay-retained FRC FDPs with tub-shaped or box-shaped retainers were directly constructed in patients of both genders. A baseline examination was performed and the patients were examined regularly at 6-month intervals. The sulcus bleeding index, Silness-Löe plaque index, and probing depths of the abutments were checked regularly. Modified US Public Health Service (USPHS) parameters were used to compare the restorations at baseline and final examination. The Kaplan-Meier survival estimation method was performed to detect the overall survival rates and mean survival times of the restorations at the end of the follow-up. RESULTS: The length of the clinical observation was between 16 and 40 months for the FDPs still functioning after the end of the follow-up. No partial or total debonding of the prostheses or fracture of the frameworks was detected. Four veneering composite fractures at the veneer layer/fiber framework interface occurred in the pontic elements of 2 glass FRC FDPs and 2 polyethylene FRC FDPs after 6 and 10 months, and 20 and 22 months, respectively. Periodontal evaluation revealed clinically acceptable results, as did the USPHS evaluation. The overall survival curves of Kaplan-Meier at the end of the follow-up illustrated a 71% survival rate for the both glass and polyethylene FRC FDPs with mean survival times of 27 and 35 months, respectively. CONCLUSION: This study reported a mean period of service of 19 and 31 months for directly fabricated inlayretained glass and polyethylene FRC FDPs, respectively, with a 71% survival rate for the two framework constructions. Within the limitations of the study, these results can only be considered as preliminary. However, because of the lack of clinical data available for directly fabricated inlay-retained FRC FDPs, the results of this clinical observation may contribute to the still-evolving clinical knowledge of the FRC restorations.
Subject(s)
Composite Resins/chemistry , Denture Retention/methods , Denture, Partial, Fixed, Resin-Bonded , Inlays , Adult , Aged , Bicuspid , Dental Abutments , Dental Restoration Failure , Female , Glass , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Molar , Polyethylenes , Statistics, NonparametricABSTRACT
Several ocular and orbital disorders require surgical intervention that may result in ocular defects. Immediate intervention is required to preserve the anophthalmic socket size and prevent scar tissue contractures that may follow surgery. Unfortunately, immediate fitting of an anophthalmic socket with an artificial eye may not always be possible, and a delayed prosthesis delivery may result in settling and sinking of the prosthesis into the socket, therefore requiring orbital cavity conformation. This article presents a short review of the most commonly used techniques for processing an ocular prosthesis, while suggesting a practical transition to the application of some of them. A technique for fabricating a custom-made provisional ocular prosthesis using digital imaging technology is described. This technique may be considered in order to avoid costly procedures that might be required as a result of delayed artificial eye insertion. The technique described in this article provides a cost-effective choice for optimal orbital cavity conformation and serves as a diagnostic aid for predicting the patient's compliance to ocular prosthetic treatment. The esthetic advantages and the relative ease of fabrication of this interim prosthesis allow it to be considered a first step in the management of untreated anophthalmic sockets.
Subject(s)
Eye, Artificial , Prosthesis Design , Acrylic Resins , Eye, Artificial/classification , Humans , Orbit/surgery , Orbital Implants/classification , Photography , Polyvinyls , Prosthesis Coloring , Prosthesis Design/instrumentation , Prosthesis Design/methods , Prosthesis Fitting , Siloxanes , Surface PropertiesABSTRACT
This clinical report describes a treatment approach for esthetically restoring peg-shaped lateral incisors. Four patients with peg-shaped lateral incisors were restored with direct resin composite laminate veneers.
