Comparison of marginal and internal fit of pressed lithium disilicate veneers fabricated via a manual waxing technique versus a 3D printed technique.

OBJECTIVE: The purpose of this in vitro study was to compare the marginal and internal fit of pressed lithium disilicate veneers fabricated from a 3D printed castable wax resin versus a manual waxing technique. MATERIALS AND METHODS: A typodont model central incisor was prepared for a porcelain veneer. Following stone model fabrication from a polyvinyl siloxane impression, the model was digitized using a laboratory scanner. Group 1 veneers were designed digitally and 3D printed with a castable wax resin, then pressed. Group 2 veneers were fabricated using a manual wax and press approach. Veneers from both groups were bonded to printed dies. Following measurements of marginal adaptation under a stereo microscope, the dies were sectioned and measurements were made for internal adaption. Statistical analysis included a Kolmogorov test and a Mann-Whitney U test. RESULTS: Average marginal gap (µm) for Group 1 was 40.37 ± 11.75 and 50.63 ± 16.99 for Group 2 (p = 0.51). Average internal gap (µm) for Group 1 was 61.21 ± 18.20 and 68.03 ± 14.07 for Group 2 (p = 0.178). CONCLUSION: There was no difference in marginal fit or internal fit between pressed lithium disilicate veneers fabricated with a 3D printed castable resin and those fabricated with a manual waxing technique. The use of digital technologies and 3D printing provide significant advantages in the fabrication of pressed glass ceramic veneers, with marginal and internal adaptation comparable to manual wax and press techniques.

Rehabilitation of the esthetic zone using multiple adjacent individual implant-supported restorations: Where are the limits? / Rehabilitación de la zona estética mediante múltiples restauraciones individuales adyacentes apoyadas por implantes: ¿cuáles son los límites?

ABSTRACT Rehabilitation of the partially edentulous anterior maxilla is considered one of the most difficult challenges for the restorative dentist due to the esthetic, functional and psychological implications. Implant-supported restorations provide an appealing treatment alternative that responds to today's patient expectations. The gold standard for this scenario has been the use of an implant-supported fixed partial denture with pontics that masks the soft tissue deficiencies, with acceptable esthetic results. However, nowadays patients are looking for individual single crowns since they believe that this type of restorations resemble the natural dentition, are easy to clean and floss. From the dentist perspective, they are easy to maintain and in case of prosthetic complications they can be repaired or changed without compromising the adjacent restorations. Three parameters have been identified that could guide the decision-making process when multiple adjacent implant supported restorations (MAISR) are selected as the treatment of choice: 1) Smile line 2) Inter-implant distance and tooth-implant distance 3) Patient's expectations and ability to clean.

RESUMEN La rehabilitación del maxilar anterior parcialmente edéntulo se considera uno de los retos más difíciles para el dentista restaurador debido a las implicaciones estéticas, funcionales y psicológicas. Las restauraciones apoyadas por implantes proporcionan una alternativa de tratamiento atractiva que responde a las expectativas actuales de los pacientes. El patrón de referencia en este contexto ha sido el uso de una prótesis parcial fija con implantes con pónticos para enmascarar las deficiencias de tejido blando, el cual ha tenido resultados estéticos aceptables. Sin embargo, hoy en día los pacientes están buscando coronas individuales ya que creen que este tipo de restauraciones se asemejan a la dentición natural y son fáciles de limpiar con cepillado e hilo dental. Desde la perspectiva del dentista, son fáciles de mantener y en caso de complicaciones protésicas pueden ser reparadas o cambiadas sin comprometer las restauraciones adyacentes. Se han identificado tres parámetros que podrían guiar el proceso de toma de decisiones cuando se seleccionan varias restauraciones compatibles con implantes adyacentes como el tratamiento de elección: 1) Línea de sonrisa 2) Distancia entre implantes y distancia de implante dental 3) Las expectativas del paciente y la facilidad de limpieza.

Visual labels to facilitate hygiene around implant-supported complete fixed dental prostheses.

This article reports a protocol for facilitating the oral hygiene and maintenance of supporting tissues in patients who wear implant-supported complete fixed dental prostheses. Small notches are placed on the acrylic resin below the prosthesis flange where the hygiene instrument should be inserted. These notches are filled with colored composite resin (blue) so that patients can see the sites of interest, which contributes to adequate plaque control and long-term periimplant health.

A novel diagnostic and prognostic classification for the clinical management of endodontically treated single anterior teeth.

The restoration of endodontically treated anterior teeth (ETAT) may pose a significant clinical challenge given the wide variety of therapeutic options available. Accurate analysis of the remaining tooth structure is critical in the diagnostic process, leading to selection of the proper treatment option. A novel, simple, and precise classification that allows the evaluation of ETAT is presented. Important factors related to the crown or abutment such as height, wall thickness, and circumferential integrity and root-related factors such as diameter of the canal, depth of the preparation, and canal shape are discussed. This classification may serve to establish a comprehensive diagnosis and assign prognosis to ETAT, which may be helpful for interclinician communication and standardized comparisons in clinical research.

Three-year clinical follow-up of posterior teeth restored with leucite-reinforced ips empress onlays and partial veneer crowns.

PURPOSE: The aim of this study was to analyze the survival rate and failure mode of IPS leucite-reinforced ceramic onlays and partial veneer crowns regarding thickness under the following clinical conditions: vital versus nonvital teeth, tooth location, and type of opposing dentition. MATERIALS AND METHODS: Teeth were prepared according to established guidelines for ceramic onlays and partial veneer crowns. Before cementation, the restorations were measured for occlusal thickness at the central fossa, mesial, and distal marginal ridges, and functional and nonfunctional cusps. A total of 210 ceramic restorations were cemented in 99 patients within a mean observation period of 2.9 ± 1.89 years. The mode of failure was classified and evaluated as (1) adhesive, (2) cohesive, (3) combined failure, (4) decementation, (5) tooth sensitivity, and (6) pulpal necrosis. Kaplan, log-rank, and Cox regression tests were used for statistical analysis. RESULTS: The failure rate was 3.33% (7/210). Increased material thickness produced less probability of failures. Vital teeth were less likely to fail than nonvital teeth. Second molars were five times more susceptible to failure than first molars. Tooth sensitivity postcementation and the type of opposing dentition were not statistically significant in this study. CONCLUSIONS: In this study, thickness of the restorations, tooth vitality, and location of teeth in the dental arch influenced restoration failures.

Clasificación de los defectos de extensión en dientes posteriores tratados con endodoncia: [revisión] / Classification of the extension defects of endodontically treated posterior teeth: [review]

La restauración de los dientes con endodoncia es un tema muy discutido y polémico en la odontología restauradora, pues existen muchas opciones para restaurar, total o parcialmente, las coronas dentales afectadas en su estructura, pero estas no se seleccionan simplemente a partir de un diagnóstico preciso del estado del remanente dental y menos aún cuando se tienen en cuenta las diferencias entre las características morfológicas y funcionales que se presentan entre los dientes posteriores y los anteriores tratados con endodoncia. Por lo tanto, en este articulo se presenta una clasificación simple y precisa que se recomienda para que sea aplicada de manera individual en los dientes posteriores que presentan tratamiento de endodoncia. Esta clasificación se fundamenta en el analisis del estado de 4 variables específicas: la altura y la distribucion de las paredes del remanente coronal supragingival o del muñón; la distancia entre el piso de la cámara pulpar y el techo de la furca; y el diámetro y la profundidad del canal. Esta clasificación pretende que el tratamiento elegido para la restauración de los dientes posteriores tratados con endodoncia debe partir de un diagnóstico preciso y que, además, permita hacer comparaciones estandarizadas en las investigaciones sobre los resultados de los tratamientos de restauración en este tipo de dientes.

Restoration of the endodontically treated teeth is a controversial topic in restorative dentistry, since many options exist to restore whole or partially dental crowns. The option for treatment is not selected based on a precise diagnosis of the state of the dental remanent and differences between anterior and posterior teeth are not evaluated. Therefore, a classification of the extension defects of endodontically posterior teeth (EPT) is presented. This classification is based on 4 specific variables: vertical height and walls distribution of supragingival remaining coronal tooth structure or core, diameter and root canal depth, and the distance of floor pulpar chamber and the root furcation. The correct application of this classification can help the operator to choose the best treatment option for the reconstruction of EPT, also this classification can help investigators to reach more organized results in future investigations on the reconstruction of EPT.

Propuesta de una clasificación para medir los defectos de extensión de dientes anteriores con tratamiento de conducto / Classification Proposal to measure extension defects of endodontically treated anterior teeth

Se presenta una clasificación para medir los defectos de extensión de los Dientes Anteriores Tratados con Endodoncia. Esta clasificación se basa en el remanente coronal y las características del canal intraradicular después de realizar los tratamientos que se consideren necesarios como la endodoncia, la eliminación de tejido cariado, la cirugía periodontal, la preparación dental para la colocación de un material de restauración directo (resina), o una restauración indirecta (carilla cerámica o corona completa) o la preparación del canal intraradicular para instalar un poste. Esta clasificación esta basada en 3 variables específicas: el remanente coronal supragingival o la altura del muñón, el diámetro y la profundidad del canal. El propósito de esta clasificación consiste en que el tratamiento elegido para la restauración de los dientes anteriores tratados endodónticamente debe partir de un diagnóstico preciso y que además permita hacer comparaciones estandarizadas en las investigaciones sobre este tipo de dientes.

A classification of the extension defects of endodontically anterior teeth is presented. This classification is based on the amount of remanent coronal tooth after an essential treatment has been done, such as: root canal therapy, removal of carious tissue, periodontal surgery whenever needed and tooth preparation either for the placement of a direct restoration material such as composite or a post and core and full crown restoration. This classification is based on 3 specific variables: supragingival remaining coronal tooth structure or core height, diameter and root canal depth.