Fixed rehabilitation of an ACP PDI Class IV dentate patient.

This clinical report describes the prosthodontic rehabilitation of a Class IV dentate patient. Maxillary and mandibular fixed restorations were constructed for the therapy. Canine-protected occlusion was developed in the definitive restorations to decrease lateral forces on the posterior dentition. Protrusive guidance was developed to distribute protrusive forces to the maxillary and mandibular incisors.

The efficacy of posterior three-unit zirconium-oxide-based ceramic fixed partial dental prostheses: a prospective clinical pilot study.

STATEMENT OF PROBLEM: Although zirconium-oxide-based restorations for fixed partial denture prostheses (FPDPs) are available for use, clinical studies evaluating their longevity and related complications have not been published. PURPOSE: The aim of this pilot clinical study was to assess the efficacy of zirconia-based posterior 3-unit FPDPs. MATERIAL AND METHODS: Twenty 3-unit posterior FPDPs (Lava) were placed in 16 subjects who were missing a second premolar or a first molar, met specific inclusion and exclusion criteria, and provided informed consent. All teeth were prepared in a standardized manner: occlusal reduction of 1.5 to 2 mm; axial reduction of 1 to 1.5 mm; a 1.0-mm, 360-degree rounded shoulder placed 0.5 mm subgingivally on the facial aspect and supragingivally on the lingual aspect on sound tooth structure; and rounded internal line angles. Impressions were made with vinyl polysiloxane (Express) impression material. Frameworks were fabricated using a computer-aided design/computer-assisted manufacturing technique with a retainer thickness of 0.6 mm, and a minimal connector surface area of 9 mm(2). Restorations were luted with resin-modified glass-ionomer cement (Rely X luting). Recall appointments were made after 2 weeks and 6, 12, 18, 24, and 36 months. Clinical fracture resistance, marginal discoloration, marginal adaptation, radiographic proximal recurrent decay, and periapical pathoses were assessed over time using modified Ryge criteria. The probability distributions of these variables were calculated for the baseline data as well as for recall data. RESULTS: Mean follow-up was 31.2 months. Fifteen restorations were rated Alpha in all measured parameters. Minor chipping of veneering porcelain was detected in 5 restorations rated Bravo for clinical fracture resistance and Alpha for all other assessed parameters. One restoration was rated Bravo in terms of marginal integrity at 36 months. CONCLUSIONS: Zirconia-based posterior 3-unit FPDPs performed well after short-term service.

In vitro fracture strength of teeth restored with different all-ceramic crown systems.

STATEMENT OF PROBLEM: There is insufficient knowledge of the strength of all-ceramic crowns bonded to natural teeth to warrant the use of all-ceramic crowns in place of metal-ceramic crowns. PURPOSE: The purpose of this study was to evaluate and compare fracture resistance of crowns made of 3 different types of 2 all-ceramic crown systems-0.4-mm and 0.6-mm aluminum oxide coping crowns and zirconia ceramic coping crowns-and metal-ceramic crowns. MATERIAL AND METHODS: Forty intact, noncarious human maxillary central incisors were divided into 4 groups (n=10): Group MCC (control), metal-ceramic crown (JRVT High Noble Alloy); Group AC4, crown with 0.4-mm aluminum oxide coping (Procera AllCeram); Group AC6, crown with 0.6-mm aluminum oxide coping (Procera AllCeram); and Group ZC6, crown with 0.6-mm zirconia ceramic coping (Procera AllZirkon). Teeth were prepared for complete-coverage all-ceramic crowns so that a final dimension of 5.5 +/- 0.5 mm was achieved incisocervically, mesiodistally, and faciolingually. A 1.0-mm deep shoulder finish line was used with a rounded internal line angle. All restorations were treated with bonding agent (Clearfil SE Bond) and luted with phosphate-monomer-modified adhesive cement (Panavia 21). Fracture strength was tested with a universal testing machine at a crosshead speed of 2 mm per minute with an angle of 30 degrees to the long axis of the tooth after restorations were stored in 100% relative humidity of a normal saline solution for 7 days. The mode of fracture was examined visually. Means were calculated and analyzed with 1-way ANOVA and Tukey's HSD (alpha=.05). RESULTS: The means of fracture strength were: Group MCC, 405 +/- 130 N; Group AC4, 447 +/- 123 N; Group AC6, 476 +/- 174 N; and Group ZC6, 381 +/- 166 N. There was no significant difference between groups ( P =.501). The mode of failure for all specimens was fracture of the natural tooth. CONCLUSIONS: There was no significant difference in the fracture strength of the teeth restored with all-ceramic crowns with 0.4- and 0.6-mm aluminum oxide copings, 0.6-mm zirconia ceramic copings, and metal ceramic crowns.

All-ceramic restorative system for esthetic implant-supported crowns: in vitro evaluations and clinical case report.

Patient demands for improved esthetics have prompted the development of all-ceramic restorative systems for dental implants, but material strength and restorative costs have presented clinical challenges. Therefore, a new restorative system with tooth-shaped ceramic copings for the anterior and premolar jaw regions has been introduced to address these problems. Fatigue and 17o. compression tests were conducted in vitro to assess the mechanical strength of the 6 tooth-shaped copings and several luting agents of the system. A case report on the clinical use of the components is presented. All 6 tooth-shaped copings significantly exceeded the range of forces associated with restoration in the anterior jaw. Crown-endurance limits for fatigue and 17o. compression were 70% higher and 46% higher, respectively, than the established minimum-fatigue-endurance limits in those categories. In clinical evaluation, the ceramic restorative system performed well and produced excellent results; it has potential for implant restorations in the anterior and premolar regions of the jaw.