Biologic and Esthetic Outcome of CAD/CAM Custom Ceramic Implant Abutment: A Clinical Report.

A prerequisite of a functional and esthetical implant-supported crown is a proper surgical planning and an abutment with a design and color that maintain the initial soft-tissue contour. This clinical report describes the use of a custom ceramic implant abutment designed with computer-aided design and computer-aided manufacturing (CAD/CAM) technology. A zirconia framework was milled and cemented extra orally to a prefabricated titanium base, the new custom abutment being both precise and esthetic.

Surgical extrusion to provide a ferrule for restoring a tooth with a compromised prognosis: A clinical report.

A surgical extrusion technique was used to provide a ferrule for a tooth with significant tooth structure loss and an oblique coronal fracture. The maxillary lateral incisor was surgically repositioned coronally to provide sufficient dentinal wall for a good prognosis of the restorative treatment. The procedure is conservative and relatively straightforward and can be performed rapidly with minimal patient discomfort.

Prosthodontic management of an extreme atrophy of the mandible correlated with a prominent genial tubercle - a clinical report.

Extreme atrophy of the mandibular alveolar crest can pose a great prosthodontic challenge, especially when the genial tubercles remain as a bony projection in the floor of the mouth. This article is a clinical report on the prosthodontic management of a severe mandible atrophy correlated with a prominent genial tubercle. A complete denture was carefully designed and fabricated in order to restore both the function and esthetics of the patient.

Cone beam computed tomography observations of the lingual foramina and their bony canals in the median region of the mandible.

PURPOSE: To investigate by means of CBCT the presence of lingual foramina and their bony canals in the midline of the mandible and to describe their anatomical characteristics. MATERIALS AND METHODS: CBCT examinations of 36 patients were carefully examined in the median region of the mandible in order to detect the lingual foramina and their corresponding vascular canals. Their presence, number, position, diameter and trajectory were established. RESULTS: Lingual foramina in the midline of the mandible were observed in all 36 subjects. The number of canals varied from one to four, with the following distribution: one canal in 71.9% of the cases, two canals in 9.4%, three in 15.6%, and four canals in 3.1% of the cases. The average diameter of the canals was 0.84 mm. The average distance from the foramina to the base of the mandible was of 11.2 mm. 19.4% of the vascular canals penetrated only the lingual third of the width, 52.8% reached the middle third of the mandible and 27.8% of the canals spread to the buccal third. CONCLUSIONS: CBCT is a useful tool in planning an implant treatment. It can reveal multiple anatomic features of the mandible, including the presence and the morphology of the lingual foramina and their vascular canals in the median region of the mandible. Clinicians should acknowledge the presence of these anatomical structures and should be aware of their possible implications.

Clinical and histoenzymatic interrelations of the edentulous ridge's mucosa.

The edentulous ridge's mucosa presents various histological aspects and different histoenzymatic equipment. These aspects are determined by constitutional factors (genetic, nutritional), as well as by age and by the associated pathology. The purpose of this paper is to evidentiate, through histochemical techniques, the aerobe (NADH2-cytochrome-c reductase) and anaerobe (lactatdehydrogenase) oxidoreducing enzymatic activities, as well as the hydrolytic enzyme's activity (ATP-ases, pH 9.4), corroborated with the histological aspects of the edentulous ridge's mucosa. The enzymatic activity and the morphological alterations present various aspects, depending on the metabolic type (aerobe oxidative, anaerobe oxidative, hydrolytic), according to the mucosal area (epithelium, chorion), to the different cell types, or even within the same cellular type (especially at the level of the connective lamina propria cells). They also vary from one edentulous patient to another, depending on the existence of a previous prosthetic treatment and on the type of this treatment. The local clinical examination, sustained by a histoenzymatic investigation, reveals the importance of the structural alterations and they can offer guidance for the proper prosthetic treatment and for the achievement of functional prosthetic restorations that provide the oral mucosa its necessary trophicity for as long as possible.

A simple prosthetic restorative solution of a single peg-shaped upper central primary incisor in a case of ectodermal dysplasia.

INTRODUCTION: This clinical report describes the oral rehabilitation of a 7-year-old male diagnosed with hypohidrotic ectodermal dysplasia and anodontia. BACKGROUND: Ectodermal dysplasia (ED) comprises a large, heterogeneous group of inherited disorders, which are defined by primary defects in the development of two or more tissues derived from the embryonic ectoderm (skin, hair follicles, nails, teeth, sebaceous and sweat glands). Our patient exhibited the typical general and cranio-facial features of ED as well as emotional and behavioral problems. The patient presents only one conical primary central incisor. CLINICAL MANAGEMENT: The treatment was focused to improve his esthetic needs and oral functions and included the fabrication of removable prostheses and of an acrylic crown on the single tooth existing in his mouth, manufactured by an original simple method. Six months follow-up points out that restorative treatment provided psychosocial and functional comfort to the young boy. CONCLUSIONS: This clinical report demonstrates the importance of the prosthodontic treatment for oral rehabilitation in children with ED. The partial and complete removable dentures associated with the acrylic crown can be a reversible and inexpensive method of treatment for ED patients.

Phenotypic and molecular methods used for identification of oral streptococci and related microorganisms.

The oral cavity contains the greatest biodiversity, over 70 species being isolated from mouth mucosa, saliva, denture surfaces and/or dental-plaque. The oral streptococci, representing over 80% of the mouth micro flora, are able to synthesize glucosyl-transferases, enzymes involved in glucans production. Glucans are involved in production of an extracellular slime layer promoting adhesion and formation of a dental plaque biofilm. The 43 isolates studied obtained from partially and/or totally edentulous, were identified by VITEK system using gram-positive identification cards. Species-specific regions within the genes coding for glucosyl-transferases (gtf genes) were targeted for PCR identification of isolates. Sequencing of 16S rRNA was used as gold standard for strain confirmation. VITEK system identified a number of 11 strains as S. mitis/oralis, 12 strains as S. anginosus/gordonii, 12 strains as S. sanguinis/parasanguinis, 3 strains as S. salivarius, 3 strains as S. plurianimalium, 1 strain as S. cristatus and 1 strain as S. alactolyticus, respectively. The PCR system targeting gtf genes was able to identify S. oralis, S. salivarius and S. gordonii strains. Sequence of 16S rRNA discriminated among streptococci species and revealed 16 strains of Leuconostoc mesenteroides. Many studies are needed in order to select the most reliable phenotypic and genotypic methods in order to improve the identification algorithm for oral streptococci used by clinical laboratories. Their accurate identification is mandatory for better understanding their role in human infections.

Correct complete denture rehabilitation, a chance for recovering abused tissues.

The prosthodontic treatment must provide for the edentulous patients bio-functional prosthetic restorations, bio-prophylactic for the surrounding tissues. In this aim, an edentulous patient must be submitted to a methodical clinical examination in order to establish the quality of hard and soft tissues, which will indicate the degree of difficulty of the prosthetic treatment. Additional investigation as a microbiologic examination and cephalometric radiographs can be useful in a modern investigation. In our daily practice, we are rarely confronted with a normal morphology of the denture bearing oral structures. The problem of managing abused tissues in a patient with morphologic abnormalities due to faulty prostheses is sometimes difficult to solve. Preventing the deterioration of oral status must be a condition in providing a chance for the success of the following rehabilitations, mainly in the situation when the complete edentulousness succeeds in a young or middle age patient.

Clinical, histological and therapeutic study regarding the variations of the edentulous ridge's mucosa.

The oral mucosa of the edentulous ridges presents many morphological macroscopic and microscopic variations, from one area of the edentulous ridge to another, as well as from one patient to another. Because the mobile prosthetic treatment realizes a direct contact between the dental prosthesis and the mucosa of the denture supporting structures and of the peripheral structures, the prosthetic success depends on establishing a correct and long lasting relation between them. The present article's purpose is to present the pro-prosthetic and prosthetic treatment possibilities for partial or complete edentulous patients who have variations of the mucosa of the residual ridges, as well as to present the histopathological importance of these variations. The mucosal characteristics essentially influence the attitude in the different treatment phases of a mobile dental prosthesis, the prosthetic success depending on the establishment of a correct and long lasting relation between the dental prosthesis and the oral mucosa.