Effect of the COVID-19 pandemic on anxiety in patients with masticatory muscle pain.

STATEMENT OF PROBLEM: Although psychological disorders have been established as one of the etiological factors for temporomandibular disorders, anxiety levels in individuals with masticatory muscle pain before and during the coronavirus 2019 (COVID-19) pandemic have not previously been compared. PURPOSE: The purpose of this clinical study was to evaluate anxiety levels in patients with masticatory muscle pain at times before and during the COVID-19 pandemic. MATERIAL AND METHODS: Eighty patients (18 to 68 years) with masticatory muscle pain were included in the study. All participants had completed the Generalized Anxiety Disorder 7 questionnaire (GAD-7) before the first COVID-19 infection had been reported in Turkey. After the onset of the COVID-19 pandemic, all participants were contacted by telephone to repeat the GAD-7 to evaluate changes in their psychology during the first lockdown. However, 18 of the 80 patients were unreachable. A statistical analysis was performed by using the Mann-Whitney U test. Proportion comparisons between sociodemographic characteristics and GAD-7 levels were performed by using the Fisher exact test (α=.05). RESULTS: Forty-eight (60%) of the study population were women, and 32 (40%) were men, with a mean age ±standard deviation of 36.63 ±13.85 years. Both before and during the pandemic, GAD-7 scores were statistically similar as was each demographic parameter, including sex, educational status, and occupational status (P>.05). Also, no significant correlation was recorded between age and GAD-7 global scores obtained before and during the pandemic (r=-0.098 and r=-0.052, respectively, P>.05). However, during-pandemic GAD-7 scores were statistically higher than before-pandemic GAD-7 scores (P<.001). CONCLUSIONS: Demographic parameters had no connection with anxiety levels in patients with masticatory muscle pain before and during the COVID-19 pandemic. However, the COVID-19 pandemic anxiety levels in the participants were higher than the levels before the pandemic.

Oral Health-Related Quality of Life in Patients with Temporomandibular Disorders and Effect of Anxiety: A Retrospective Case-Control Study.

PURPOSE: To evaluate oral health-related quality of life (OHRQoL) in patients with temporomandibular disorders (TMDs) involving masticatory muscle pain, disc displacement with reduction, or both and to determine the associations of these disorders with anxiety. MATERIALS AND METHODS: This study consisted of 150 patients with TMDs and 50 healthy controls. Patients were diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and then divided into three diagnostic groups: masticatory muscle pain (group MP), disc displacement with reduction (group DD), or both (group MPDD). The participants completed the Oral Health Impact Profile-14 (OHIP-14) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires for assessment of OHRQoL and anxiety, respectively. Statistical analyses were performed using Kruskal-Wallis test and Mann-Whitney U post hoc paired-comparison tests. RESULTS: A total of 121 of the patients (60.25%) were female and 79 (39.75%) were male, ranging from ages 18 to 68 years (mean age: 37.32 ± 13.62). Gender distribution, mean age, educational status, and occupational status were similar among groups. The OHIP-14 global and domain scores and distribution of GAD-7 levels were significantly different among groups (P < .001). For psychologic discomfort and disability domains, group MPDD statistically scored the highest, followed by group MP, group DD, and then the control group (P < .05). According to correlation analyses, there were positive correlations between the GAD-7 and all OHIP-14 scores (r = 0.438, P < .001) within group MPDD. CONCLUSION: OHRQoL is negatively affected by TMDs and worsens as the severity of anxiety increases. Therefore, physical conditions and anxiety levels in TMD patients should be simultaneously considered for treatment and maintenance. Int J Prosthodont 2023;36:148-154. doi: 10.11607/ijp.7587.

Effect of different denture cleansers on surface roughness and microhardness of artificial denture teeth.

PURPOSE: The aim of this study was to compare the effects of different denture cleansers on the surface roughness and microhardness of various types of posterior denture teeth. MATERIALS AND METHODS: 168 artificial tooth specimens were divided into the following four subgroups (n=42): SR Orthotyp PE (polymethylmethacrylate); SR Orthosit PE (Isosit); SR Postaris DCL (double cross-linked); and SR Phonares II (nanohybrid composite). The specimens were further divided according to the type of the denture cleanser (Corega Tabs (sodium perborate), sodium hypochlorite (NaOCl), and distilled water (control) (n=14)) and immersed in the cleanser to simulate a 180-day immersion period, after which the surface roughness and microhardness were tested. The data were analyzed using the Kruskal-Wallis test, Conover's nonparametric multiple comparison test, and Spearman's rank correlation analysis (P<.05). RESULTS: A comparison among the denture cleanser groups showed that NaOCl caused significantly higher roughness values on SR Orthotyp PE specimens when compared with the other artificial teeth (P<.001). Furthermore, Corega Tabs resulted in higher microhardness values in SR Orthotyp PE specimens than distilled water and NaOCl (P<.005). The microhardness values decreased significantly from distilled water, NaOCl, to Corega Tabs for SR Orthosit PE specimens (P<.001). SR Postaris DLC specimens showed increased microhardness when immersed in distilled water or NaOCl when compared with immersion in Corega Tabs (P<.003). No correlation was found between surface roughness and microhardness (r=0.104, P=.178). CONCLUSION: NaOCl and Corega Tabs affected the surface roughness and microhardness of all artificial denture teeth except for the new generation nanohybrid composite teeth.

Effect of engraving speeds of CO2 laser irradiation on In-Ceram Alumina roughness: a pilot study.

OBJECTIVES: The aim of the study was to determine the effect of CO2 laser on surface roughness of In-Ceram-Alumina-ceramic. MATERIALS AND METHODS: Four aluminum-oxide ceramic disc specimens were prepared of In-Ceram Alumina. Discs received CO2 laser irradiation with different engraving speeds (100, 400, 600 and 800 mm/min) as a surface treatment. The roughness of the surfaces was measured on digital elevation models reconstructed from stereoscopic images acquired by scanning-electron-microscope. Surface roughness data were analyzed with One-Way-Analysis-of-Variance at a significance level of p<0.05. RESULTS: There was no significant difference between the roughness values (p=0.82). Due to higher laser durations, partial melting signs were observed on the surfaces. Tearing, smearing and swelling occurred on melted surfaces. Swelling accompanying melting increased the surface roughness, while laser power was fixed and different laser engraving speeds were applied. CONCLUSION: Although different laser irradiation speeds did not affect the roughness of ceramic surfaces, swelling was observed which led to changes on surfaces.

Efficiency of pivot splints as jaw exercise apparatus in combination with stabilization splints in anterior disc displacement without reduction: a retrospective study.

OBJECTIVE: To evaluate efficiency of pivot splints in jaw exercises, in combination with stabilization splints, in cases of anterior disc displacement without reduction of temporomandibular joint. SUBJECTS AND METHODS: Twenty-three patients who referred to the prosthodontics clinic in 1995-1997 were included in the study, where anterior disc displacement without reduction of temporomandibular joint was diagnosed using magnetic resonance imaging and clinical examination. Pivot splints were used for jaw exercises for five minutes long; five times/day and stabilization splints were used at all other times. The patients were followed for 24 weeks. Lateral and protrusive excursions along with maximum mouth opening and were evaluated at each control. Bilateral palpation of temporal, masseter, sternocleidomastoid muscles and TMJ was assessed for pain perception before and after treatment. Data were statistically analyzed using Paired sample t-test and Independent Samples t-test (p < .05). RESULTS: Mean mandibular range of motion measurements increased from 28.74 mm prior to 49.17 mm on maximum opening; right/left lateral excursion from 7.61 mm to 12.04 mm and 4.09 mm to 7.3 mm on protrusion after treatment. All changes observed before and after treatment were found to be statistically significant. (p < .001) Pain symptoms were eliminated at the end of 24 weeks of treatment in all patients. CONCLUSION: Using pivot splints as an exercise regimen along with a stabilization splint may be a viable treatment option for patients with anterior disc displacement without reduction; as normal mandibular range of motion was established and pain was eliminated.

The effect of dentin desensitizers and Nd:YAG laser pre-treatment on microtensile bond strength of self-adhesive resin cement to dentin.

PURPOSE: The purpose of this study is to evaluate if pre-treatment with desensitizers have a negative effect on microtensile bond strength before cementing a restoration using recently introduced self-adhesive resin cement to dentin. MATERIALS AND METHODS: Thirty-five human molars' occlusal surfaces were ground to expose dentin; and were randomly grouped as (n=5); 1) Gluma-(Glutaraldehyde/HEMA) 2) Aqua-Prep F-(Fluoride), 3) Bisblock-(Oxalate), 4) Cervitec Plus-(Clorhexidine), 5) Smart protect-(Triclosan), 6) Nd:YAG laser, 7) No treatment (control). After applying the selected agent, RelyX U200 self-adhesive resin cement was used to bond composite resin blocks to dentin. All groups were subjected to thermocycling for 1000 cycles between 5-55℃. Each bonded specimen was sectioned to microbars (6 mm × 1 mm × 1 mm) (n=20). Specimens were submitted to microtensile bond strength test at a crosshead speed of 0.5 mm/min. Kolmogorov-Smirnov, Levene's test, Kruskal-Wallis One-way Analysis of Variance, and Conover's nonparametric statistical analysis were used (P<.05). RESULTS: Gluma, Smart Protect and Nd:YAG laser treatments showed comparable microtensile bond strengths compared with the control group (P>.05). The microtensile bond strengths of Aqua-Prep F, and Cervitec Plus were similar to each other but significantly lower than the control group (P<.05). Bisblock showed the lowest microtensile bond strength among all groups (P<.001). Most groups showed adhesive failure. CONCLUSION: Within the limitation of this study, it is not recommended to use Aqua-prep F, Cervitec Plus and Bisblock on dentin when used with a self-adhesive resin cement due to the decrease they cause in bond strength. Beside, pre-treatment of dentin with Gluma, Smart protect, and Nd:YAG laser do not have a negative effect.

Dental anxiety and fear: relationship with oral health behavior in a Turkish population.

The aim of this study was to assess fear and anxiety in dental patients. Five hundred patients were evaluated using the Modified Dental Anxiety Scale and the Dental Fear Scale, along with a questionnaire. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT)/Decayed, Missing, and Filled Surfaces (DMFS) index. Statistic al analysis was performed (P < .05). Sex significantly affected dental anxiety (P < .05), and sex, marital status, having children, and time elapsed since last visit to clinician affected dental fear (P < .05). DMFT/DMFS scores were not related to dental anxiety or fear (P > .05). Female sex alone was a significant predictor of dental anxiety; female sex, adulthood, marriage, having children, and time passed since last visit to a clinician are significant predictors of fear.

Bond strength of veneer ceramic and zirconia cores with different surface modifications after microwave sintering.

PURPOSE: To evaluate the effects of surface treatments on shear bond strength (SBS) between microwave and conventionally sintered zirconia core/veneers. MATERIALS AND METHODS: 96 disc shaped Noritake Alliance zirconia specimens were fabricated using YenaDent CAM unit and were divided in 2 groups with respect to microwave or conventional methods (n=48/group). Surface roughness (Ra) evaluation was made with a profilometer on randomly selected microwave (n=10) and conventionally sintered (n=10) cores. Specimens were then assessed into 4 subgroups according to surface treatments applied (n=12/group). Groups for microwave (M) and conventionally (C) sintered core specimens were as follows; MC,CC: untreated (control group), M1,C1:Al2O3 sandblasting, M2,C2:liner, M3,C3:Al2O3 sandblasting followed by liner. Veneer ceramic was fired on zirconia cores and specimens were thermocycled (6000 cycles between 5°-55℃). All specimens were subjected to SBS test using a universal testing machine at 0.5 mm/min, failure were evaluated under an optical microscope. Data were statistically analyzed using Shapiro Wilk, Levene, Post-hoc Tukey HSD and Student's t tests, Two-Way-Variance-Analysis and One-Way-Variance-Analysis (α=.05). RESULTS: Conventionally sintered specimens (1.06 ± 0.32 µm) showed rougher surfaces compared to microwave sintered ones (0.76 ± 0.32 µm)(P=.046), however, no correlation was found between SBS and surface roughness (r=-0.109, P=.658). The statistical comparison of the shear bond strengths of C3 and C1 group (P=.015); CC and MC group (P=.004) and C3 and M3 group presented statistically higher (P=.005) values. While adhesive failure was not seen in any of the groups, cohesive and combined patterns were seen in all groups. CONCLUSION: Based on the results of this in-vitro study, Al2O3- sandblasting followed by liner application on conventionally sintered zirconia cores may be preferred to enhance bond strength.

Effect of preparation taper and height on strength and retention of zirconia crowns.

This study aimed to determine the effect of the taper and height of tooth preparations on the fracture strength and retention of zirconia crowns. Sixty-four dies were designed to simulate a crown preparation. Dies were machined with a height of either 4 mm (n = 16) or 7 mm (n = 16) and a taper of either 6 degrees (n = 16) or 20 degrees (n = 16). Copings were created from Lava zirconia blanks. Retention tests were performed using a universal testing machine. Copings were recemented on the dies, thermocycled, and tested for fracture strength. Data were analyzed using factorial analysis of variance. Retention was greater in the taller and less-tapered preparation designs. Taller preparations showed superior fracture strength. Preparing posterior teeth with higher axial walls and less taper is recommended to achieve increased retention and strength for zirconia crowns.

Correlation between residual ridge resorption and radiomorphometric indices.

OBJECTIVES: The study evaluated the relationship between residual ridge resorption (RRR) and radiomorphometric indices, including mandibular cortical index (MCI), mandibular cortical width (MCW) and panoramic mandibular index (PMI), along with demographic factors. MATERIAL AND METHODS: Panoramic radiographs of 1863 patients over 20 years of age were assessed. Gender, age and dental status of each patient were recorded. Relationships between RRR and demographic factors and radiomorphometric indices were evaluated using chi-square and Fisher's exact tests with level of significance of p = 0.05. RESULTS: Residual ridge resorption was not affected by gender (p > 0.05), but was more frequently seen in patients over the age of 50 compared with those below 49 years of age (p < 0.001). RRR was significantly associated with edentulism (p < 0.001) and with severe erosions of endosteal margin of mandible (p < 0.05). RRR was more frequently seen in patients with PMI below 0.30 (p < 0.001) and with MCW below 3 mm in 50- to 69-year-old age group (p < 0.001). CONCLUSIONS: Patients younger than 50 years of age who demonstrate severe erosions of endosteal margin of mandible and have MCW < 3 mm and PMI < 0.30 appear to be suitable candidates for early implant placement or for maintaining roots or natural teeth to preserve bone, regardless of gender.

Effect of repeated firings on microtensile bond strength of In-Ceram Alumina with two different veneering ceramics.

Microtensile bond strengths of In-Ceram Alumina cores veneered with two ceramics after different numbers of firing cycles were evaluated. After In-Ceram Alumina cores were fabricated, they were veneered with either Vitadur Alpha or Vita VM7. A control group of each core-veneer combination was fired twice, and a second group was fired five times to induce thermal fatigue. Obtained microbars were subjected to microtensile bond strength tests. Data were analyzed using two-way analysis of variance. Microtensile bond strength values for Vita VM7 specimens were higher than those for Vitadur Alpha (P < .001). Although the number of firing cycles revealed no change in bond strength, the veneering material proved to be an important factor.

Effects of shade tab arrangement on the repeatability and accuracy of shade selection.

STATEMENT OF PROBLEM: Appropriate and repeatable shade matching using visual shade selection remains a challenge for the restorative dentist. PURPOSE: The purpose of this study was to evaluate the effect of different arrangements of a shade guide on the repeatability and accuracy of visual shade selection by restorative dentists. MATERIAL AND METHODS: Three Vitapan Classical shade guides were used for shade selection. Seven shade tabs from one shade guide were used as target shades for the testing (A1, A4, B2, B3, C2, C4, and D3); the other 2 guides were used for shade selection by the subjects. One shade guide was arranged according to hue and chroma and the second was arranged according to value. Thirteen male and 22 female restorative dentists were asked to match the target shades using shade guide tabs arranged in the 2 different orders. The sessions were performed twice with each guide in a viewing booth. Collected data were analyzed with Fisher's exact test to compare the accuracy and repeatability of the shade selection (α=.05). RESULTS: There were no significant differences observed in the accuracy or repeatability of the shade selection results obtained with the 2 different arrangements. When the hue/chroma-ordered shade guide was used, 58% of the shade selections were accurate. This ratio was 57.6% when the value-ordered shade guide was used. The observers repeated 55.5% of the selections accurately with the hue/chroma-ordered shade guide and 54.3% with the value-ordered shade guide. CONCLUSIONS: The accuracy and repeatability of shade selections by restorative dentists were similar when different arrangements (hue/chroma-ordered and value-ordered) of the Vitapan Classical shade guide were used.

Validity of conventional surgical treatment methods for mandibular dentigerous cysts. Two case reports.

Dentigerous cysts, which are the most commonly seen odontogenic cysts in the jaws, usually expand asymptomatically and extensively. They are surgically eliminated along with the accompanying impacted tooth, because of their destructive nature to the surrounding vital structures, tissues, bone and teeth. The surgical treatment for removing dentigerous cysts includes decompression, marsupialization, enucleation or curettage of the cyst through an extraoral or intraoral approach. Cysts causing tooth displacement and involving loss of bone are treated by marsupialization or decompression, followed by enucleation. In the cases presented here, both patients had enlarged dentigerous cysts in the left mandibular molar region, with an accompanying impacted tooth. Both cases were treated surgically by the enucleation technique alone, without any need for additional autogenous grafts or alloplastic materials to regain integrity of bone structure. They were rehabilitated with dental implants. The implant-retained fixed prostheses functioned well throughout the 24-month evaluation time; and the functional and psychological needs of the patients were provided successfully.

Effect of bleaching on staining susceptibility of resin composite restorative materials.

STATEMENT OF THE PROBLEM: Effect of bleaching procedures on staining susceptibility of resin restorative materials is still questionable. PURPOSE: The aim of this study was to evaluate the staining susceptibility of restorative materials bleached with 20% carbamide peroxide home bleaching agent and subsequently immersed in coffee and tea. MATERIALS AND METHODS: Forty-two disk-shaped specimens were fabricated for each of the resin composites (Filtek Supreme XT [3M ESPE, St. Paul, MN, USA], Ceram-X Mono [Dentsply, Konstanz, Germany], and Aelite All Purpose Body [BISCO, Inc., Shaumburg, IL, USA]). The baseline color values were measured with a spectrophotometer. The specimens of each restorative material were randomly divided into two groups (N = 21). While the first group specimens were stored in distilled water (nonbleaching group-control), bleaching agent (Opalescence PF 20% [Ultradent Poducts, South Jordan, UT, USA]) was applied on the top surface of each specimen of the second group (bleaching group). After color change values were measured, the specimens were randomly divided into three subgroups (N = 7) according to the staining solutions. The color change values (DeltaE*ab) were calculated and the data were subjected to analysis of variance. Statistical significance was declared if the p value was 0.05 or less. RESULTS: There was no statistically significant difference within each restorative material's DeltaE*ab values after bleaching (p = 0.714). Also, the staining solutions did not cause a statistically significant difference between DeltaE*ab values of bleaching compared with nonbleaching groups (p = 0.146). Significant interaction was found only between restorative materials and staining solutions (p = 0.000). CONCLUSION: Bleaching of the tested resin composites did not increase their susceptibility to extrinsic staining in vitro. CLINICAL SIGNIFICANCE Bleaching did not affect staining susceptibility of the tested resin composite restorative materials. (J Esthet Restor Dent 21:407-415, 2009).

Surface roughness and bond strengths of glass-infiltrated alumina-ceramics prepared using various surface treatments.

OBJECTIVES: To compare and evaluate effects of CO(2) laser and conventional surface treatments on surface roughness and shear bond strengths of glass-infiltrated alumina-ceramics to dentin. METHODS: One hundred fifty ceramic discs of In-Ceram Spinell, In-Ceram Alumina and In-Ceram Zirconia (n=50) were prepared. Specimens which were divided into 5 groups (n=10) were untreated (control group), sandblasted, airborne particle abraded, etched with 9.6% hydrofluoric acid or irradiated with CO(2) laser. Scanning electron microscope was used at 1000x magnification for qualitative examination. Following surface roughness (Ra) determination by profilometry, discs were cemented on extracted-human-molar teeth. Cemented specimens were stored in distilled water at 37 degrees C for 1 week. Shear bond strength (MPa) test was performed using a universal testing machine at a crosshead speed of 1mm/min. Statistical comparisons were made with Wilcoxon signed ranked test, Kruskall Wallis test and Spearman's correlation coefficient. RESULTS: All surface treatments produced rougher surfaces than the untreated groups of all ceramics (P<.05). Sandblasting demonstrated a rougher surface on In-Ceram Spinell than In-Ceram Alumina and In-Ceram Zirconia (P<.05). While CO(2) laser irradiation showed significantly higher bond strength for In-Ceram Spinell (P<.05), both airborne particle abrasion and CO(2) laser irradiation showed higher bond strengths for In-Ceram Zirconia (P<.05). Airborne particle abrasion demonstrated higher bond strength for In-Ceram Alumina and In-Ceram Zirconia (P<.05). No significant relationship was determined between surface roughness (Ra) and shear bond strength values (MPa) among ceramic groups. CONCLUSIONS: Sandblasting is an effective surface treatment for roughening surfaces of In-Ceram Spinell. Although CO(2) laser irradiation does not increase surface roughness, it reveals the highest bond strength.

Metal-ceramic dowel crown restorations for severely damaged teeth: a clinical report.

This clinical report describes an alternative prosthodontic treatment of a patient who had severely damaged endodontically-treated first molar teeth in all quadrants of her mouth. The young patient's severely damaged permanent molar teeth were treated with a restoration combining the advantage of the esthetics of dental porcelain, reinforced with the underlying cast gold dowel crown. Using this technique, the remaining sound tooth structure was preserved with function and esthetics accomplished. The described metal-ceramic one piece dowel crown restoration seemed to perform without any problems for the 12 month evaluation time.

Radiomorphometric indices and their relation to alveolar bone loss in completely edentulous Turkish patients: a retrospective study.

STATEMENT OF PROBLEM: In edentulous patients, alveolar bone loss is a critical factor that affects denture retention, stability, and masticatory function. In addition to their use for the assessment of bone quality, panoramic radiomorphometric indices have been used to observe signs of bone resorption. Currently, there is no published data on the possible relationships between bone loss, radiomorphometric indices, and edentulism. PURPOSE: The purpose of this study was to investigate the influence of age and gender on the mandibular cortical index, panoramic mandibular index, and mandibular cortical width, as well as alveolar bone loss and bone height, using panoramic radiographs of patients having been edentulous for more than 2 years. MATERIAL AND METHODS: Panoramic radiographs of 94 edentulous patients (41.5% men and 58.5% women) were assessed. In addition to gender and age, the mandibular cortical index (normal cortex, mild or severe erosions on endosteal margin of the mandible), panoramic mandibular index, mandibular cortical width at the mental foramen region, alveolar bone loss, and bone heights of the premolar and molar regions of the mandible were recorded. Statistical comparisons were performed using chi-square, Mann-Whitney U, Kruskal-Wallis, and 2-way ANOVA tests (alpha=.05). RESULTS: Mild erosions on the endosteal margin of the mandible were more frequently seen in age groups of 60 in women (P<.001). While the mean values of the mandibular cortical width were stable as age increased in men, the mean mandibular cortical width values decreased significantly with age in women (P<.01). The panoramic mandibular index, alveolar bone loss, and bone heights were not affected by age or gender. CONCLUSIONS: Severe erosions on the endosteal margin of the mandible are seen more frequently in women over 60 years in age. While mean mandibular cortical width values are stable in men over 60 years, mean mandibular cortical width values decrease significantly in women of the same age group.

The effects of extraoral porcelain polishing sequences on surface roughness and color of feldspathic porcelain.

The aim of this study was to evaluate the surface properties and color of porcelain modified by extraoral polishing sequences. Six different surface treatment regimens (diamond burs, self-glaze, overglaze, reglaze, Pearl Surface polishing system, and Diamond Twist SCL) were applied to 60 porcelain disks (n = 10 per group). Profilometry and atomic force microscopy (AFM) were used for the determination of surface roughness (Ra); color changes (deltaE*) were investigated by spectrophotometry. Statistical comparisons were made using analysis of variance, the Kruskal-Wallis test, and the Pearson correlation coefficient test. Surface treatments significantly affected Ra values (P < .001) but had no effect on color (P > .05). AFM findings were consistent with Ra values. Color did not appear to be correlated with surface roughness (P > .05). The findings concluded that the Pearl Surface system helps to decrease chairside time and may be used as an alternative to overglazing.

Multidisciplinary approach to traumatized teeth: a case report.

Treatment of crown fractures often requires a multidisciplinary approach. In the anterior teeth, reestablishment of proper esthetics and function is quite important for the patient. However, crown-root fractures with fracture line below the gingival attachment or alveolar bone crest presents restorative difficulties. This case report presents a cervical tooth fracture that had been treated with minimal invasive approach with different disciplines. The tooth had endodontic treatment and a glass-fiber post, and a composite core was accomplished. Then, the tooth was extruded to the desired level with orthodontic forced eruption before definitive restoration.