Therapeutic solutions for discoloration of calcified teeth based on CBCT diagnosis.

Single tooth orange discoloration secondary to root canal calcification occurs as a consequence of dental trauma, orthodontic treatment, or for unknown rea- sons. A correct case history must be compiled and a CBCT study carried out in order to establish the diag- nosis and define the best treatment plan in each case. The aim of the present study was to offer a therapeutic protocol involving a clinical decision-making tree dia- gram based on the presence or absence of apical dis- ease and the degree of canal calcification. Dental bleaching and the use of ceramic veneers allow es- thetic restoration in such cases.

Polytetrafluoroethylene relative isolation for adhesive cementation of dental restorations.

Tooth isolation is essential to isolate a prepared tooth from saliva, oral humidity, and gingival fluids and facilitate the removal of excess subgingival cement in adhesive cementation procedures. However, the isolation of prepared teeth can be challenging, especially with vertical preparations. A technique for achieving relative isolation by using polytetrafluoroethylene tape is described for adhesive cementation with vertical tooth preparations.

Prospective study of monolithic zirconia crowns: clinical behavior and survival rate at a 5-year follow-up.

Purpose To evaluate the clinical behavior and survival of full coverage monolithic zirconia crowns on posterior teeth over a 5-year follow-up.Methods Fifty patients were recruited and underwent restoration with a Lava Plus monolithic zirconia crown (Lava™ Frame Zirconia, 3M Espe, Germany) on premolars or molars. Patients were monitored over a 5-year follow-up (2014-19), recording any biological and/or mechanical complications; these data were used to estimate the crowns' success rate. Periodontal clinical parameters were recorded (pocket probing depth (PPD), plaque index (PLI), bleeding on probing (BOP), and gingival recession (GR)). Wear to the zirconia crowns and antagonist teeth were also evaluated with Geomagic software (3D Systems, U.S.A.). Patients' satisfaction with treatment was evaluated in a questionnaire.Results For the 50 monolithic zirconia crowns analyzed, the survival rate was 98% after 5 years. Only 6% of the crowns presented some type of complication (two debonding and one root fracture). No fracture or fissures were detected. GR and BOP were the only clinical parameters found to be significantly greater around teeth restored with crowns. The monolithic zirconia crowns suffered less wear than the enamel of antagonist teeth. Patient's general satisfaction with treatment was high.Conclusions Monolithic zirconia crowns on posterior teeth are a highly predictable treatment option, with a high survival rate. The single treatment failure was due to a biological complication arising from root fracture. This treatment may be recommended as a treatment that conserves dental structure, and requires minimal dental preparation.

In vitro comparison of the efficacy of two fractured implant-prosthesis screw extraction methods: Conventional versus mechanical.

STATEMENT OF PROBLEM: Implant-supported prostheses may be subject to esthetic, biological, or mechanical complications. Protocols for dealing with these mechanical problems are sparse. PURPOSE: The purpose of this in vitro study was to compare the efficacy of a mechanical system for extracting fractured implant-prosthesis screws with the conventional method. MATERIAL AND METHODS: A total of 60 screws were divided into 2 groups according to their morphology (flat screws with a smooth shaft and threaded apical area and screws with a completely threaded body) and subjected to fatiguing and static load testing until fracture. The specimens were assigned to 3 operators with varying levels of clinical experience (high, medium, low) in extracting fractured screws by using the conventional method (explorer and ultrasound device) and a mechanical method (extractor kit). The extraction event (whether the screw fragment was extracted or not within 10 minutes) was recorded, and the time taken to perform the extraction was measured for each method in relation to screw type, operator experience, and damage to the threads. The influence of screw morphology, extraction method, operator experience, and fracture type on the time needed to extract a screw fragment was assessed with the Mann-Whitney and Kruskal-Wallis tests. Thread damage was compared by using the Fisher's exact test and the Kruskal-Wallis test (α=.05). RESULTS: The mechanical method was more effective for screw extraction than the conventional method (P=.032). Screw morphology also had a significant influence on extraction, whereby the screw design with apical thread took less time to extract (P=.022). Coronal fractures had a higher probability of extraction than apical fractures (P=.05). CONCLUSIONS: Mechanical extraction is more effective for extracting fractured implant-prosthetic screws, showing a higher probability of extraction than the conventional method. Prosthetic fixing screws with a smooth shaft and threaded apical area are the easiest to extract.

Fracture resistance and the mode of failure produced in metal-free crowns cemented onto zirconia abutments in dental implants.

The purpose of the investigation was to analyze fracture resistance and mode of failure of zirconium oxide (zirconia) abutments placed on dental implants bearing crowns of different esthetic materials: zirconia, lithium disilicate (LDS), and nano-ceramic resin, for replacing single teeth in the anterior sector. Eighty implant-abutment-crown units were divided into four groups: Group T-MC (control): 20 metal-ceramic crowns cemented onto titanium abutments; Group Z-Z: 20 zirconia crowns on zirconia abutments; Group Z-LD: 20 lithium disilicate crowns on zirconia abutments; and Group Z-NCR: 20 nano-ceramic resin crowns on zirconia abutments. Specimens underwent a fatiguing process (dynamic loading and thermocycling), followed by static loading to evaluate mechanical fracture resistance, and the mode of failure produced. Mean fracture resistance values were: Control Group T-MC, 575.85±120.01 N; Group Z-Z 459.64±66.52 N; Group Z-LD, 531.77±34.10 N; and Group Z-NCR, 587.05±59.27 N. In Group T-MC, fracture occurred in the prosthetic fixing screw in 100% of specimens. In Group Z-Z, 80% of fractures occurred in the fixing screw, 15% in the abutment, and 5% in the abutment and crown. In Group Z-LD, 60% of fractures were produced in the fixing screw and 40% in the abutment. In Group Z-NCR, 70% of fractures were produced in the fixing screw and 30% in the abutment. All the abutments and crowns analyzed have the potential to withstand the physiological occlusal forces to which they would be subject in the anterior region. Lithium disilicate and nano-ceramic resin crowns cemented onto zirconia abutments are a good restoration alternative for single implants in the anterior sector.

Comparative In Vitro Study of Implant-Supported Restorations: Implant-Abutment Complex With and Without Prosthetic Finishing Line.

PURPOSE: The aim of this study was to evaluate the mechanical behavior of implant-supported cemented restorations placed on two types of abutment design, with and without a prosthetic finish line, evaluating fracture resistance and the type of fracture produced in the abutment-crown complex. MATERIALS AND METHODS: Eighty zirconia restorations supported by tapered implants were divided into two groups: group I, with 40 zirconia crowns cemented onto individualized zirconia abutments with a chamfered finish line (1 mm deep); and group II, with 40 zirconia crowns cemented onto individualized zirconia abutments without a finish line. All specimens underwent thermocycling and dynamic loading before static load testing to evaluate their fracture resistance. RESULTS: Fracture resistance values (N) and the type of fracture were analyzed. The mean fracture resistance was 462.1 ± 66.3 N in group I and 343 ± 40 N in group II. In group I, fractures were produced in the prosthetic fixation screw; in group II, all mechanical failures were produced in the transepithelial abutment's cervical area. CONCLUSION: Group I specimens showed greater fracture resistance than group II. The fracture type in group I occurred in the prosthetic screw. Group II fractures occurred in the zirconium oxide abutment.

Mechanical behavior of provisional implant prosthetic abutments

INTRODUCTION: Implant-supported prostheses have to overcome a major difficulty presented by the morphology and esthetics of peri-implant tissues in the anterior sector. Diverse therapeutic techniques are used for managing the mucosa adjacent to the implant and the most noteworthy is immediate/deferred fixed provisionalization. OBJECTIVES: In vitro testing of strength and deformation of implant prosthetic abutments made from different materials(Titanium/PEEK/methacrylate).MATERIAL AND METHODS: Forty Sweden & Martina(R) implant prosthetic abutments (n=40) were divided into five groups: Group MP: methacrylate provisional abutments with machined titanium base; Group PP: Polyether etherketone (PEEK) provisional abutments; Group TP: titanium provisional abutments; Group TAD: titanium antirotational definitive abutments; Group TRD: titanium rotational definitive abutments. Their mechanical behavior under static loading was analyzed. Samples were examined under a microscope to determine the type of fractureproduced. Results and CONCLUSIONS: Definitive anti-rotational titanium abutments and definitive rotational titanium abutments achieved the best mean compression strength, while PEEK resin provisional abutments obtained the lowest. The group that showed the greatest elastic deformation was the group of titanium provisional abutments

Mechanical behavior of provisional implant prosthetic abutments.

INTRODUCTION: Implant-supported prostheses have to overcome a major difficulty presented by the morphology and esthetics of peri-implant tissues in the anterior sector. Diverse therapeutic techniques are used for managing the mucosa adjacent to the implant and the most noteworthy is immediate/deferred fixed provisionalization. OBJECTIVES: In vitro testing of strength and deformation of implant prosthetic abutments made from different materials (Titanium/PEEK/methacrylate). MATERIAL AND METHODS: Forty Sweden & Martina® implant prosthetic abutments (n=40) were divided into five groups: Group MP: methacrylate provisional abutments with machined titanium base; Group PP: Polyether ether ketone (PEEK) provisional abutments; Group TP: titanium provisional abutments; Group TAD: titanium anti-rotational definitive abutments; Group TRD: titanium rotational definitive abutments. Their mechanical behavior under static loading was analyzed. Samples were examined under a microscope to determine the type of fracture produced. RESULTS AND CONCLUSIONS: Definitive anti-rotational titanium abutments and definitive rotational titanium abutments achieved the best mean compression strength, while PEEK resin provisional abutments obtained the lowest. The group that showed the greatest elastic deformation was the group of titanium provisional abutments.

Full maxillary rehabilitation with an all-ceramic system

With the appearance of all-ceramic systems, providing a choice of framework porcelains and allowing the samematerial to be used for the veneer, it is now possible to select the ideal structure in terms of both function andesthetics. Silicate ceramics allow porcelain laminate veneers and crowns to be used in the anterior region, providingexcellent esthetics; while for the posterior area, where function takes precedence, oxide ceramics, specificallyzirconium oxide, are preferred. The IPS e.max ceramic system, heir apparent to the IPS Empress 2 system,combines the advantages of zirconium oxide ceramics (IPS e.max Zircad) with the excellent esthetic qualities ofsilicate ceramics (IPS e.max Press).This paper presents a clinical case requiring complete maxillary rehabilitation for esthetic purposes. An overviewof some of the porcelains used in this system, analyzed from both the clinical and laboratory perspective is provided.The esthetic advantages of a single ceramic veneer, the need to select appropriate ceramics for anterior andposterior regions, and cementation and surface treatments are discussed (AU)

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In vitro experimental study of bonding between aluminium oxide ceramicsand resin cements

To evaluate bond strengths of different resin cements to two aluminum oxide-based ceramics. Methods: Onehundred ten ceramic cylinders were produced and given four different surface treatments. Resin cement cylinderswere then bonded to the ceramic cylinders using different resin cements and the bond strength was determinedby shear testing to the breaking point. We were thus able to obtain results for the different combinations of porcelain,surface treatments and cements. All data was analyzed using the Kruskal-Wallis test for more than twoindependent samples and the Bonferroni correction applied (a=0.01). An optical microscopy study was carriedout to analyze the type of failure, and an electronic microscopy examination was carried out in order to evaluatethe changes produced in the ceramic by the different surface treatments. Results: The best values correspondedto the control group, composed of silicate ceramics combined with Variolink II resin cement. In-Ceram Aluminashowed no significant differences with respect to the type of cement applied. Procera AllCeram obtained the bestvalues when silica coated using the CoJet System and applying Variolink II, or when sandblasted and applyingClearfil SE Bond + Porcelain Bond Activator and Panavia F cement. Significance: Surface treatment modifies theceramic surface and influences the bond strength, as does the type of cement used. Silica coating is recommendedto improve adhesion to Procera AllCeram, applying Variolink II, or sandblasting plus resin cement containingMDP (Panavia F) (AU)

No disponible

Full maxillary rehabilitation with an all-ceramic system.

With the appearance of all-ceramic systems, providing a choice of framework porcelains and allowing the same material to be used for the veneer, it is now possible to select the ideal structure in terms of both function and aesthetics. Silicate ceramics allow porcelain laminate veneers and crowns to be used in the anterior region, providing excellent aesthetics; while for the posterior area, where function takes precedence, oxide ceramics, specifically zirconium oxide, are preferred. The IPS e.max ceramic system, heir-apparent to the IPS Empress 2 system, combines the advantages of zirconium oxide ceramics (IPS e.max Zircad) with the excellent aesthetic qualities of silicate ceramics (IPS e.max Press). This paper presents a clinical case requiring complete maxillary rehabilitation for aesthetic purposes. An overview of some of the porcelains used in this system, analyzed from both the clinical and laboratory perspective is provided. The aesthetic advantages of a single ceramic veneer, the need to select appropriate ceramics for anterior and posterior regions, and cementation and surface treatments are discussed.

In vitro experimental study of bonding between aluminium oxide ceramics and resin cements.

UNLABELLED: To evaluate bond strengths of different resin cements to two aluminum oxide-based ceramics. METHODS: One hundred ten ceramic cylinders were produced and given four different surface treatments. Resin cement cylinders were then bonded to the ceramic cylinders using different resin cements and the bond strength was determined by shear testing to the breaking point. We were thus able to obtain results for the different combinations of porcelain, surface treatments and cements. All data was analyzed using the Kruskal-Wallis test for more than two independent samples and the Bonferroni correction applied (a=0.01). An optical microscopy study was carried out to analyze the type of failure, and an electronic microscopy examination was carried out in order to evaluate the changes produced in the ceramic by the different surface treatments. RESULTS: The best values corresponded to the control group, composed of silicate ceramics combined with Variolink II resin cement. In-Ceram Alumina showed no significant differences with respect to the type of cement applied. Procera AllCeram obtained the best values when silica coated using the CoJet System and applying Variolink II, or when sandblasted and applying Clearfil SE Bond + Porcelain Bond Activator and Panavia F cement. SIGNIFICANCE: Surface treatment modifies the ceramic surface and influences the bond strength, as does the type of cement used. Silica coating is recommended to improve adhesion to Procera AllCeram, applying Variolink II, or sandblasting plus resin cement containing MDP (Panavia F).