The safety and efficacy of anterior ceramic fixed partial dentures: A review of the literature.

As a result of the successful use of ceramic crowns and patient demands for metal-free, tooth-colored restorations, ceramic systems for anterior fixed partial dentures (FPDs) have become available. Although numerous in vitro studies have been published, clinical studies that evaluate anterior ceramic FPDs are few and limited. This article reviews data on ceramic FPDs published between 1966 and 2001 in the English language. Peer-reviewed articles were identified through a MEDLINE search and a hand search of relevant textbooks and annual publications; abstracts were not considered for inclusion. The available data suggest that more clinical studies (preferably randomized clinical trials) that assess the long-term outcome of anterior ceramic FPDs are required to determine whether they can serve as a viable replacement for a maxillary anterior missing tooth and, at the same time, provide patients with a safe and effective restoration, oral health, and social comfort.

The effect of amitriptyline on pain intensity and perception of stress in bruxers.

PURPOSE: The purpose of this clinical pilot study was to evaluate the effect of a tricyclic antidepressant, amitriptyline, on pain-intensity level and level of stress in bruxers. MATERIALS AND METHODS: In a randomized, double-blind, crossover experimental design, 10 subjects received active (amitriptyline 25 mg/night) and inactive (placebo 25 mg/night) medication, over a period of 4 weeks. RESULTS: The administration of amitriptyline for 4 weeks did not significantly (p >.05) reduce pain intensity. However, it significantly (p <.05) reduced the level of stress perception. CONCLUSION: The results of this limited study do not support the administration of small doses of amitriptyline over a period of 4 weeks for the management of pain resulting from sleep bruxism. However, the results support the administration of small doses of amitriptyline for the management of the perception of stress levels associated with sleep bruxism.

Psychosocial issues in women's oral health.

Oral health is a significant issue for women because of its association with overall health and quality of life. There is growing evidence that the casual factors and consequences of oral disease are not only physical, but are also social and psychologic. As the importance and implications of the psychosocial factors become better understood, a more comprehensive model for treatment is developing. Accepting this role can lead dentists to a more multidisciplinary approach to successful treatment for their female patients.

The effect of four-week administration of amitriptyline on sleep bruxism. A double-blind crossover clinical study.

The purpose of this study was to evaluate the effect of a tricyclic antidepressant (amitriptyline) on nocturnal masseteric activity and duration of sleep in bruxists. Using a randomized, double blind, crossover design, ten females (mean age 39 yrs, +/- sd seven yrs) received active (amitriptyline 25 mg/night) and inactive (placebo 25 mg/night) medication, over a period of four weeks each. A portable EMG integrator recorded the nocturnal, unilateral, and cumulative myoelectrical activity (microV/min of sleep) of the masseter muscle during the fourth and eighth weeks of the study. The results showed that amitriptyline did not significantly decrease the mean EMG activity (df = 9, alpha = 0.05, paired-t = 0.892, p = 0.3964), nor did it significantly increase the duration of sleep (df = 9, alpha = 0.05, paired-t = 2.140, p = 0.061). The results of this study do not support the administration of 25 mg of amitriptyline per night over a period of four weeks for the management of sleep bruxism.

Use of a customized rigid clear matrix for fabricating provisional veneers.

UNLABELLED: The fabrication of provisional veneers is time consuming, and may be unpredictable, especially in cases of multiple veneer preparations; however, functional and esthetic provisional veneers, may be used as diagnostic adjuncts for the fabrication of the definitive restoration. This article presents, in a step-by-step procedure, the use of a customized rigid clear matrix with light-cured composite resin as a fast alternative for the fabrication of functional and esthetic provisional composite resin veneers. CLINICAL SIGNIFICANCE: The use of a customized rigid clear matrix for the fabrication of light-cured composite resin provisional veneers has the following advantages: the shape and surface texture produced in the diagnostic wax-up are accurately transferred to the patient's mouth; the provisional restoration is fabricated without violation of the soft tissue and the margins of the preparations; use of the matrix can be repeated when needed; and esthetic and functional provisional veneers can be fabricated relatively quickly.

Using two surgical protocols to restore the edentulous patient with implant-supported overdentures.

Long-term success rates are reported for dental implant systems using both the two-stage and one-stage surgical protocols. Although the one-stage offers several advantages, prudent diagnosis is a key factor for selecting the appropriate surgical protocol. This article will review the relevant literature for both protocols and will illustrate their use in patient treatment.

Treatment planning extensively broken-down mandibular molars for post-and-core fabrication.

Because of their unique radicular anatomy, mandibular molars require careful treatment planning for post-and-core fabrication. Indications for post-and-core fabrication for endodontically treated mandibular molars are discussed, and immediate and cast post-and-core techniques are reviewed. An alternative design for a cast post and core is also presented.

Managing malrelated arches and limited vertical space for implant-supported overdentures: a case report.

Advancements in implant therapy have expanded the prosthetic options available to treat edentulous patients. The dental professional must be able to accurately diagnose the status of the intraoral environmental in order to provide the patient with appropriate treatment and a suitable restorative result. Skeletal relationships, arch malalignment, implant angulation, and ridge morphology must be evaluated during initial treatment planning and incorporated into the definitive prosthetic result. This case report demonstrates the application of an implant-supported prosthesis to address the various complications presented in the treatment of edentulous patients.

Electroforming technique.

Electroforming technology is used to form substructures for porcelain inlays and crowns. This technique may be used as an alternative to the currently available porcelain-fused-to-metal and all-ceramic systems. Composed of pure 24 K gold deposited directly onto a duplicate die, electroformed copings are relatively thin (0.2 mm), highly biocompatible, and present a marginal accuracy of 20 microns on average. The equipment is relatively easy to use and therefore makes this technique attractive to small ceramics laboratories. The esthetic advantages of a gold colored substructure, the reduced thickness of the coping, and the improved fit of the gold collar when it is used, present a restorative alternative to the dentist, to the ceramist, and to the patient.

A technique to stabilize record bases for Gothic arch tracings in patients with implant-retained complete dentures.

Clinicians have long expressed concern about the accuracy of the Gothic arch tracing for recording centric relation in edentulous patients. With the use of dental implants to assist in retaining complete dentures, the problem of inaccurate recordings, made for patients without natural teeth, can be significantly reduced. This article presents a technique that uses healing abutments to stabilize the record bases so that an accurate Gothic arch tracing can be made.

Prosthetic considerations in the fabrication of surgical stents for implant placement.

The utilization of surgical stents/templates for implant placement is of significant importance to the success of the definitive prosthesis. However, major conceptual differences exist between surgical stents designed for implant-supported crowns and bridges and those designed for implant overdentures. In addition, various types of surgical stents exist within each group. In either case, optimizing the prosthetic result by customization of the stent should be a major consideration in the fabrication process. The design of the stent must account for several treatment conditions, including position of the implant, the tissue present, and the anticipated prosthesis. The teaching objective of this article is to present the prosthetic considerations in the fabrication and customization of surgical stents. The article compares the two groups and offers specific guidelines for the fabrication of surgical stents for the various types of restorations within each group.