Comparative Analysis of Periodontal Parameters and Patient Satisfaction Utilising Different Temporary Crown Fabrication Techniques: A Parallel-Group Randomised Controlled Trial.

Aim The study aims to evaluate the efficacy of different techniques for temporary crown fabrication in maintaining periodontal health and patient satisfaction, addressing a critical gap in the existing literature and informing evidence-based clinical practices. Materials and methods This study, conducted in accordance with CONSORT guidelines, was a parallel-group randomised trial conducted at a dental institute in India. In total, 36 participants aged 18-65 requiring anterior tooth region crowns were randomly assigned to three groups: direct (control), indirect (Test Group 1) and direct-indirect (Test Group 2) fabrication techniques. Participants were selected from outpatient departments based on eligibility criteria, and interventions were allocated using randomization tables. Outcome assessments included gingival health metrics and patient satisfaction levels, with statistical analyses performed using the Kruskal-Wallis test. Results Significant differences were observed in the pink esthetic score (PES) and patient satisfaction (P=0.029) among the three groups, with the direct-indirect technique group demonstrating the highest median PES (9 out of 10). However, no significant disparities were noted in the plaque index (PI) or probing depth (PD) among the groups. Conclusion The direct-indirect technique demonstrated superior PES and patient satisfaction, indicating potential benefits for periodontal health and patient experiences. Integration of virtual preparation workflows may optimise outcomes, but further research is needed for validation and guideline development.

Direct and indirect stamp techniques for composite restorations - Sealing the uniqueness of a tooth: A case series.

Composite resin restorations using the incremental technique are time-consuming and technique sensitive requiring excellent hand dexterity of the clinician for achieving good contacts and contours. "Stamp technique" for posterior composite restoration is a novel method for duplicating occlusal anatomy with near perfection. This technique is indicated when the preoperative anatomy of the tooth is intact. An indirect technique can be used in cases where the occlusal surface is cavitated due to caries. The purpose of this article is to demonstrate the direct and indirect technique of stamp fabrication and restoration using different materials, emphasizing the fact that it is reliable and predictable and, when performed correctly, helps the practitioner to a great extent.

Assessment of conduction anesthesia effectiveness using the angulated needle approach for the inferior alveolar nerve block.

BACKGROUND: Ambulatory painless surgery is dependent on local anesthesia effectiveness. AIM: Evaluating the anesthetic efficacy of the angulated needle approach (ANA) for the inferior alveolar nerve block (IANB). MATERIAL AND METHOD: Group I received direct IANB; group II received indirect IANB; group III received the IANB with ANA. The quality of anesthesia score (QAS), numerical pain intensity score (NRS), onset time of full anesthesia (OT), and perianesthetic complications were measured. RESULTS: Ninety patients (mean age: 37.47 ± 18.90, p = 0.027) of both sexes were split into three equal groups. Group III had the lowest QAS value with the success rate of 93.3%, compared to the statistically significantly worse QAS values of group II, with the success rate of 80% (p = 0.016). Group II had the statistically significant highest NRS values relative to group I (p = 0.002) and group III (p = 0.000001). The shortest OT occurred in group I, when compared to group II (p = 0.000484) and group III (p = 0.000498). The transient syncope and positive aspiration occurred in single cases. CONCLUSION: The ANA for the IANB could successfully serve as a "first choice", or as an "addendum technique" in the cases of multiple failed attempts for direct and indirect IANB techniques.

Protocolo de cementación indirecta de aparatología ortodóncica fija utilizando materiales de uso común / Indirect cementation protocol for fixed orthodontic appliances using commonly used materials

Introducción: La técnica de arco recto es una de las técnicas más utilizadas para la corrección de maloclusiones en ortodoncia; sin embargo, el éxito de la técnica radicará en la exactitud en que se posicionan los brackets. Este artículo presenta un protocolo de cementación indirecta, el cual, adicionalmente, permite una mayor accesibilidad a los materiales requeridos para este procedimiento. Objetivo: Presentar un protocolo efectivo y accesible de cementación indirecta. Material y métodos: Para este protocolo se ha utilizado materiales como resina de cementación de brackets (Transbond XT, 3M Unitek, EEUU), aislante de acrílico para separar los brackets del modelo de yeso y silicona líquida, utilizada habitualmente para autos (Kit Silicona, Johnson, Chile), para separar los brackets del soporte termoplástico, el cual fue realizado con silicona termofusible. Conclusión: El protocolo de cementación indirecta permite un buen posicionamiento de los brackets, reduciendo la posibilidad de reposicionar durante las fases de alineamiento y nivelado (AU)

Introduction: The straight arch technique is one of the most used techniques for the correction of malocclusions in orthodontics; however, the success of the technique will lie in the accuracy in which the brackets are positioned in the correct position. This article presents an indirect cementation protocol which additionally allows greater accessibility to the materials required for this procedure. Objective: Present an effective and accessible indirect cementation protocol. Material and methods: For this protocol, materials such as brace cementation resin (Transbond XT, 3M Unitek, USA), acrylic insulator have been used to separate the brackets from the gypsum and liquid silicone model, usually used for cars (Silicone Kit, Johnson, Chile), to separate the brackets from the thermoplastic support, which was made with hot melt silicone. Conclusion: The indirect cementation protocol allows a good positioning of the brackets, reducing the possibility of repositioning during the alignment and leveling phases (AU)

Digital evaluation of the dimensional accuracy of four different implant impression techniques.

AIMS: The aim of this study was to compare the dimensional accuracy of four different implant impression techniques of a mandibular edentulous model with five parallel implants. MATERIALS AND METHODS: Five dental implants were placed in an edentulous mandibular model in parallel. A total of forty impressions were obtained using four different impression techniques. In Group 1 (G1) and Group 2 (G2), closed tray impressions with and without plastic caps, respectively, were used. In Group 3 (G3) and Group 4 (G4), open tray impressions with a direct splinted technique and an improved direct splinted technique, respectively, were used. All the impressions were poured with Type IV dental stone. Master model and study casts were scanned with a laser optical scanner and aligned by observing the superpositions of the anatomical landmarks using a software program. STATISTICAL ANALYSIS USED: Fifty measurements of the apical, coronal, and angular discrepancies of the master and study casts were obtained (n = 50) and statistically analyzed using a one-way analysis of variance and post hoc (least significant difference ) and Friedman's tests. RESULTS: The lowest accuracy was obtained from G2 when the angular (1.48°), coronal (0.32 µm), and apical (0.14 µm) deviations were tested (P < 0.05), whereas no statistically significant differences were found among the other groups (P < 0.05). CONCLUSIONS: In cases with five parallel mandibular implants, improved accuracy was achieved using the direct splinted technique, the improved direct splinted technique, or the closed tray impression technique with snap on plastic caps.

Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review.

BACKGROUND: Composite resin, serves as esthetic alternative to amalgam and cast restorations. Posterior teeth can be restored using direct or indirect composite restorations. The selection between direct and indirect technique is a clinically challenging decision-making process. Most important influencing factor is the amount of remaining tooth substance. AIM: The aim of this systematic review was to compare the clinical performance of direct versus indirect composite restorations in posterior teeth. MATERIALS AND METHODS: The databases searched included PubMed CENTRAL (until July 2015), Medline, and Cochrane Database of Systematic Reviews. The bibliographies of clinical studies and reviews identified in the electronic search were analyzed to identify studies which were published outside the electronically searched journals. The primary outcome measure was evaluation of the survival of direct and indirect composite restorations in posterior teeth. RESULTS: This review included thirteen studies in which clinical performance of various types of direct and indirect composite restorations in posterior teeth were compared. Out of the thirteen studies which were included seven studies had a high risk of bias and five studies had a moderate risk of bias. One study having a low risk of bias, concluded that there was no significant difference between direct and indirect technique. However, the available evidence revealed inconclusive results. CONCLUSION: Further research should focus on randomized controlled trials with long term follow-up to give concrete evidence on the clinical performce of direct and indirect composite restorations.

Cast accuracy obtained from different impression techniques at different implant angulations (in vitro study).

BACKGROUND: Angulated implants may result in inaccurate impressions, and the impression technique may affect the accuracy of the definitive cast. This study was designed to compare the dimensional accuracy of casts obtained from three impression techniques for three definitive lower casts with implants at different angulations. METHODS: Three Osseolink implants were placed in three reference models with different angles (parallel, 15° and 30°). Impressions of each model were made with three techniques (n = 10 per group): indirect, unsplinted direct, and acrylic resin-splinted direct technique. Impressions were poured with type IV dental stone. Inter-implant distances were measured for casts using a coordinate measuring machine, and the deviations from the reference models (Δr) were calculated. Data were analyzed using one-way ANOVA followed by post hoc tests to detect significance between groups (α = 0.05). RESULTS: This study showed that the deviations in micrometers from the reference model were the least for acrylic resin-splinted direct technique (Δr1 = 49.96, Δr2 = 50.36) versus indirect (Δr1 = 93.8, Δr2 = 90.9) and unsplinted direct techniques ((Δr1 = 67.07, Δr2 = 68.66) in 30° angulated implant situation (p value < 0.0001* for both Δr1 and Δr2). In 15° angulated implants, both the acrylic resin-splinted direct (Δr1 = 44.64, Δr2 = 45.58) and unsplinted direct techniques (Δr1 = 47.39, Δr2 = 55.28) were more accurate than indirect technique (Δr1 = 64.8, Δr2 = 68.3) (p value < 0.0001* for both Δr1 and Δr2). While in parallel condition, no difference was found between all three techniques (p value = 0.085, 0.056 for Δr1 and Δr2, respectively). CONCLUSIONS: The impression technique affected the accuracy of definitive casts. The acrylic resin splinted direct technique produced the most accurate casts, followed by direct unsplinted and indirect techniques. Furthermore, implant angulation affected the impression accuracy. When implant angulation increased from parallel implants to 30°, the forces of deformation increased, which resulted in increased distortion.

Conservative management of a traumatic meniscal injury utilising osteopathy and exercise rehabilitation: A case report.

Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young athletes and an older, degenerative population. Treatment largely depends on the type and extent of the injury with arthroscopic repair or meniscectomy being mainstays. Although non-surgical approaches have been described, there is no published literature regarding a combination of indirect osteopathic techniques and rehabilitation in the management of these injuries. The current case report follows a 20-year-old male presenting with a 5-day history of acute knee pain, following trauma during an Australian Rules Football (AFL) match. An 8-week management plan of indirect osteopathic techniques and a tailored rehabilitation program was implemented. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lower Extremity Functional Scale (LEFS) questionnaires were utilised to measure outcomes. After the 8-week treatment and rehabilitation program, the patient had exceeded the minimum detectable change score for all outcome measures. This case report suggests that osteopathic manipulative treatment and rehabilitation may be an alternative, non-surgical approach in the management of post-traumatic meniscal injuries.

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia.

BACKGROUND: In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years. METHODS: The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia. RESULTS: From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia. CONCLUSION: From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time.

Indirect Bonding Revisited.

In recent years, the popularity of indirect bonding increased due to advantages such as reduction of chair time and enhancement of patient comfort. Although the indirect bonding technique has improved over the years, the literature has shown different techniques of bracket placement; furthermore, new materials were specially developed for this technique. The aim of this article is to provide a review of the literature, advantages, disadvantages, and laboratory and clinical stages of the indirect bonding technique.

Digital evaluation of the accuracy of impression techniques and materials in angulated implants.

OBJECTIVES: The aim of this study was to investigate the accuracy of 2 different impression techniques and 3 different impression materials in models simulating parallel and angulated implants. METHODS: Three master models simulating partial edentulous mandible with 2 implants at the sites of second premolars (parallel) and second molars with different angulations (parallel, 10° or 20° angulated) were fabricated. Two different impression techniques [splinted direct (D), indirect (I)] and 3 different monophase impression materials [polyether (PE), vinyl polysiloxane (VPS), vinyl polyether silicone (VPES)] were used for each master model and a total of 180 impressions were made (n=10). Master model and casts were scanned by a modified laser scanner and data were transferred to VRMesh software. Master model and duplicate cast scans were digitally aligned observing the superposition of anatomic markers. Angular and coronal deviations between master and duplicated copings were calculated and data were statistically analyzed. RESULTS: Mean angular and coronal deviations were in a range of 0.205-0.359° and 22.56-33.33µm, respectively. Statistical analysis revealed that the angulation of implant affected both coronal and angular deviations of the impression copings (P<0.05). According to statistical analyses, for parallel implants, the accuracy of impression materials and techniques were ranging as VPS-D=PE-D>VPS-I=PE-I>VPES-D>VPES-I from most accurate to the least. For 10° and 20° angulated implants the most accurate material and technique was VPS-D whereas the least accurate combination was VPES-I (P<0.05). CONCLUSION: Angulation, impression technique and material were found to be effective on the accuracy of implant impressions. CLINICAL SIGNIFICANCE: Clinicians may prefer VPS impression material and splinted direct technique for impressions of both parallel and up to 20° angulated implants.

Reattachment of a fractured fragment with relined fiber post using indirect technique: a case report.

Although fiber-reinforced posts have been widely used, they sometimes fail to obtain sufficient retention because of an extremely large canal space. To address this, several techniques have been introduced including relining of the fiber-reinforced posts. Here, we used a relined glass-fiber post to increase retention and fitness to the root canal in a crown reattachment case. The relining procedure was performed by using an indirect method on the working cast. This case also highlights the esthetic concerns regarding dehydration of the attached crown fragment.

Reattachment of a fractured fragment with relined fiber post using indirect technique: a case report

Although fiber-reinforced posts have been widely used, they sometimes fail to obtain sufficient retention because of an extremely large canal space. To address this, several techniques have been introduced including relining of the fiber-reinforced posts. Here, we used a relined glass-fiber post to increase retention and fitness to the root canal in a crown reattachment case. The relining procedure was performed by using an indirect method on the working cast. This case also highlights the esthetic concerns regarding dehydration of the attached crown fragment.

An indirect technique for assuring simplicity and marginal integrity of provisional restorations during full mouth rehabilitation.

Full mouth rehabilitation with fixed prosthodontics can be a time- and labor-intensive process. The use of provisional restorations allows the treating clinician to determine the functional and esthetic requirements of the definitive prostheses. However, in the case of full mouth rehabilitation, the individual preparation of provisional restorations for multiple teeth may complicate the provisional phase and increase the treatment time. This article describes a method to simplify the indirect fabrication of provisional restorations for full mouth reconstruction. Provisional restorations may be easily achieved by splinting the provisional restorations in sextants, trimming them according to red pencil marks around the prepared margins as guidelines, and fitting them in the laboratory, utilizing a second set of solid casts for the prepared teeth.

Restoration of anterior teeth using an indirect composite technique. Case report.

OBJECTIVE: This article presents a case report of restoration of anterior teeth using an indirect technique with composite veneers in order to restore the dental anatomy and to provide aesthetic and function of anterior teeth. MATERIALS AND METHODS: A treatment of upper anterior teeth with indirect micro-hybrid composite restoration was proposed to a 40-year-old woman with old discolored and fractured ceramic veneers. Upper six anterior teeth were prepared and, after impressions with VPS of maxillary arche, the composite veneers were placed. DISCUSSION AND RESULTS: There are several advantages offered by indirect techniques compared to direct techniques. The increased practice of veneering technique with indirect composites is due to improvement in the properties of composite materials in the last years. The results are very favourable and the patient is satisfied. CONCLUSIONS: The restorations with composite veneers have proved durable and aesthetic, protect tooth structure and aesthetic and function is predictably re-established.

Marginal adaptation and microleakeage of directly and indirectly made fiber reinforced composite inlays.

AIM: This study evaluated in vitro microleakage of inlays made by direct or indirect techique with or without fiber reinforced composite (FRC) substructure. MATERIALS AND METHODS: Standardized mesio-occlusal cavities were prepared and restored using direct-technique with composite resin only or FRC-composite resin, and indirect technique with laboratory composite only or FRC-laboratory composite resin. After thermocycling, teeth were immersed in basic fuchsin dye, sectioned and examined under a stereo-microscope (x40). RESULTS: No differences of cement thickness and dye penetration were found in gingival area (p>0.05), whereas microleakage revealed statistical differences between groups (p=0.02) in occlusal area, where FRC-groups had lower microleakage than composite restorations. Thickness of cement layer did not show significant difference between groups with indirect technique (p>0.05). CONCLUSION: The present study suggests that insertion of FRC substructure to the inlay cavity by direct composite filling technique does not increase the marginal leakage compared to that of cementing indirectly made restotorations by composite resin luting cement. CLINICAL SIGNIFICANCE: On the basis of the results of this in vitro study, the use of direct FRC technique might be an effective way to decrease the marginal leakage.

Evaluación clínica de restauraciones indirectas con resinas / Clinical evaluation of indirect restorations with resin

Evaluar el comportamiento clínico de las restauraciones con resinas fotocuradas a través de la técnica indirecta como alternativa para el tratamiento de cavidades complejas en dientes primarios y/o permanentes posteriores jóvenes. Ocho niños que asistieron al Servicio de Odontopediatría "Santa Elena", en Mérida, Venezuela, fueron incluidos en este estudio, reacondicionando un total de ocho dientes, para posteriormente evaluar el comportamiento clínico: estado periodontal, estado pulpar, restauración presente, satisfacción estética del paciente y estado y adaptación marginal de la restauración. Todas las restauraciones fueron evaluadas a los 8 días y a los 3 meses de realizados los tratamientos. Los datos fueron analizados utilizando el paquete estadístico SPSS versión 13.0 (SPSS INC, Chicago, IL, Estados Unidos de América). Se realizó un análisis estadístico descriptivo de todas las variables estudiadas y un análisis cualitativo no paramétrico aplicando el Test Chi-cuadrado y Exacto de Fisher. Al tercer mes del tratamiento se observa que el comportamiento clínico es exitoso en un 100%, excepto la presencia de placa bacteriana (62,5%) y la satisfacción estética del paciente (87,5%). Sin embargo, al aplicar el Test Chi-Cuadrado y Exacto de Fisher no existen diferencias estadísticamente significativas (p=0,302, 0,606 y 0,304). Las restauraciones indirectas con resinas compuestas constituyen una alternativa de tratamiento para dientes primarios o permanentes posteriores jóvenes con cavidades complejas

The aim of this study was to evaluate the clinical behavior of the restorations with resins light cure through the indirect technique like alternative for the treatment of complex cavities in primary and/or permanent posterior young teeth. Eight children who attended the Service of Pediatric Dentistry "Santa Elena", in Mérida, Venezuela, were including in this clinical test, recovering a total of eight teeth, later to evaluate the periodontal state and pulp , is present at or not of biofilm, state and marginal adaptation of the restoration and esthetic satisfaction of the patient. All the restorations were evaluated to the 8 days and the 3 months. The data were analyzed using statistical package SPSS version 13.0 (INC. SPSS, Chicago, IL, United States of America). It was made a descriptive statistical analysis of all the studied variables and a non-parametric qualitative analysis having applied to the Test Chi-square and Exact of Fisher. The third month of the treatment it is observed that the clinical behavior is successful in 100% a, except the presence of biofilm (62.5%) and the esthetic satisfaction of the patient (87.5%). Nevertheless, when applying the Test Chi-Square and Exact de Fisher does not exist statistically significant differences (p=0,302, 0.606 and 0.304). The indirect restorations with compound resins constitute an alternative of treatment for primary or permanent posterior young teeth with complex cavities