Long-Term Performance of Glass-Hybrid Restorations in Permanent Posterior Teeth.

Since their introduction in the early 1970s, glass-ionomer cements (GICs) have been broadly accepted for clinical applications such as crown buildups, cementation, and bases under fillings. However, their acceptance as a direct restorative material has been limited comparatively speaking, especially for permanent posterior teeth. This is due primarily to the perception that GICs are not as esthetic or durable as composite resin materials. Dentists tend to restrict their use of GIC to primary teeth, geriatric applications, and other clinical situations where patients exhibit poor oral hygiene or where a high level of fluoride release is desirable. Surprisingly, clinical studies have shown that while GICs do have a higher initial wear versus composites, they exhibit very similar long-term wear and retention over extended periods.

Preferences of Lay Persons and Dental Professionals Regarding the Recurring Esthetic Dental Proportion.

BACKGROUND: This study evaluated the preferences of dental professionals and lay persons with respect to the Recurring Esthetic Dental (RED) Proportion, an objective mathematical tool used in treatment planning the "apparent" widths of maxillary anterior teeth. MATERIALS AND METHODS: Stock dentofacial and facial images of a prototypical smiling male and female were digitally altered to demonstrate five different RED proportion relationships (0.62, 0.65, 0.70, 0.75, and 0.80). Four sets of the five altered images were presented to dental professionals and lay persons using a web-based survey site. The professional group included dentists and dental laboratory technicians. The lay group included anyone without previous dental education or experience. Study participants were asked to rank each series from most to least esthetic and their preferences were extracted from the data. RESULTS: Preference data from the five RED proportion relationships was consolidated into two categories: a narrow group including 0.62, 0.65, and 0.70 and a broad group including 0.75 and 0.80. Analysis shows that the level of professional training or experience does not play a significant role in the RED proportion preferences of study participants. Only in the prototypical male facial views was there any significant difference between professional and lay groups. For that view, a greater percentage of the layperson group preferred the narrow RED proportions. However, for the male dentofacial views that difference disappeared and both participant groups showed a slight preference for the broad proportion category. This may be due to the traditional esthetic stereotype for males to have broader, more vigorous appearing anterior teeth. For the prototypical female images, all participants expressed a clear, statistically significant preference for the narrower RED proportions in both full face and close up views. CONCLUSIONS: Based on the results above, dental professionals who are developing a treatment plan should attempt to utilize a RED proportion ≤ 0.70 for both male and female patients. CLINICAL SIGNIFICANCE: The RED proportion is an objective numeric tool for relating the apparent widths of maxillary anterior teeth. It may be used by dental professionals to help diagnose and develop an optimal esthetic treatment plan. This paper offers insight into whether there are specific RED proportions that are preferred, whether there is a difference in preference when considering the male or female smile and whether professional educational training changes those preferences.

Reconsidering glass-ionomer cements for direct restorations.

Glass-ionomer cements (GICs) have been used in dentistry for a number of applications, primarily as a base or liner under other direct filling materials or indirect restorative materials, for crown buildup/foundation restorations, or as luting cements for indirect restorations. However, GICs have many unique attributes that make them useful for either a full-contour restoration or sandwich/hybrid restorations where they are synergistic with composite resins. This article, which includes two brief case reports, discusses the potential advantages of GIC for some direct applications where composite resin or other materials may not be the most ideal choice.

Using fiber-optic transillumination as a diagnostic aid in dental practice.

Fiber-optic transillumination (FOTI) is a well-accepted and valuable adjunctive diagnostic tool with a wide range of clinical applications. In dentistry, FOTI has been primarily associated with caries diagnosis and has been corroborated through research studies to be a valid indicator of the histological presence or absence of bacterially infected tooth structure. In this review, techniques for using FOTI for tooth evaluation are presented along with examples of how FOTI can be effectively used as a supplemental diagnostic aid.

Low-shrink composite resins: a review of their history, strategies for managing shrinkage, and clinical significance.

Despite numerous advances in composite resin technology over the course of many decades, shrinkage behavior and the resultant stresses inherent to direct placed composite restorations continue to challenge clinicians. This overview of composite resins includes a review of their history and development along with a discussion of strategies for reducing polymerization shrinkage. An assessment of the clinical significance of these materials is also provided, including a discussion of the differences between polymerization shrinkage and stress, incremental layering versus bulk placement, and the emergence of lower shrinkage stress monomer chemistry.

Evolving technology in endodontic posts.

This article provides a brief overview of important, recent changes in the philosophy, materials, and technology that have impacted significantly on the art and science of endodontic post placement.