RESUMO
Vertical ridge augmentation is a demanding and technique-sensitive surgical procedure. In the present case series, cone beam CT (CBCT) scans from the clinical routine of patients treated using a novel approach for vertical bone augmentation were assessed. All patients showed a single-tooth class 5 defect and were treated using a modification of the original shell technique. Cortical bone plates were replaced with a lamina composed of a partially demineralized porcine xenograft. CBCT scans of six consecutive patients were treated with the lamina and particulate bone from the mandibular ramus prior to a single tooth implant in the anterior maxilla were included. Pre- and postsurgical CBCT data sets were superimposed and analyzed digitally using surface matching and Boolean subtraction. The volume of the grafted area was calculated with and without the xenograft. The vertical gain of the ridge height measured in this case series varied from 7 to 11.3 mm. The mean vertical gain was 8.97 mm. The mean volume including the xenograft was 382.59 mm3 (SD 73.39) and 250.84 mm3 (SD 53.67) without the lamina. The modified shell technique used in this case series for the vertical augmentation of single-tooth class 5 defects provided sufficient bone for single implant restorations.
RESUMO
OBJECTIVE: To show the benefit of a minor orthodontic pretreatment prior to fixed restorations in the esthetic zone in challenging situations. OVERVIEW: Esthetic rehabilitations in complex situations need careful treatment planning and comprehensive interdisciplinary approach. Minor orthodontic pretreatments may transfer complex situations into straight forward situations. Typical indications are space opening in order to provide space for a restoration with anatomic proportion or corrections of the tooth axis. CONCLUSION: This article presents three clinical cases that show how decision making can be facilitated by a functional and esthetic wax-up/mock-up workflow and how orthodontic pretreatment can contribute to a more functional, less invasive, and more esthetic outcome of restorative treatments in the esthetic zone. CLINICAL SIGNIFICANCE: Some complex cases in restorative dentistry can be transformed to straight forward cases with the help of minor orthodontic tooth movements.
Assuntos
Estética Dentária , Dente , Odontologia , Planejamento de Assistência ao Paciente , Técnicas de Movimentação DentáriaRESUMO
PURPOSE: To test the bond strength of one-piece zirconia implants with either standard or reduced height using different luting agents and pretreatments of the ceramic crowns' inner surfaces. MATERIALS AND METHODS: Twenty monolithic CAD/CAM-fabricated zirconia single crowns were cemented onto 10 one-piece zirconia implants with either 5-mm or 4-mm abutment height (Z-Look3 Evo SLM, Z-Systems) using 13 different luting agents. After water storage, the crowns were removed using a specially developed test fixture in a universal testing machine (Z010, Zwick/Roell). The maximum force was recorded (N), and the force per area was calculated (MPa). The statistical evaluation was performed using univariate analysis of variance (SPSS version 25.0, IBM). RESULTS: A mean of 4.19 MPa (SD 2.90) at 5 mm and 3.89 MPa (SD 2.85) at 4 mm was obtained for all luting agents. The highest values were achieved for a resinmodified glass-ionomer cement, with 12.37 MPa (4 mm)/12.00 MPa (5mm). The lowest values were shown for a long-term temporary material, with 0.73 MPa (4 mm)/1.07 MPa (5 mm). Only a polycarboxylate cement (P < .001) and a glass-ionomer cement (P = .006) showed statistically significant differences, in favor of the reduced abutment height. The latter did not significantly reduce bond strength for any of the materials examined. CONCLUSION: Implants with a reduced abutment height are clinically suitable. Pretreatment of the crowns' inner surfaces with ceramic primer showed to be advantageous.
RESUMO
OBJECTIVE: The insertion of implants through template-guided surgery is an established method. At the present time, the static navigation is based on sleeves integrated into the guides, through which drill bits of the corresponding size are passed. The present clinical trial is designed to test a new sleeveless system to determine the precision of implant insertion for one-piece ceramic implants. MATERIALS AND METHODS: For 12 patients, implant bed preparation and the insertion of the implants were done using a sleeveless implant guide. Twenty implants were inserted in this way and checked for precision. The check was done using a noninvasive method, which permitted comparison of the planning data with the actually realized positions after superimposition. RESULTS: The mean deviations were 0.52 mm (95% CI: 0.37 to 0.67 mm) at the crestal position of the implant, and 0.82 mm (95% CI: 0.56 to 1.08 mm) at the apical tip of the implant. The height deviation was 0.35 mm (95% CI: 0.01 to 0.68 mm). The mean angular deviation was measured as 2.85 degrees (95% CI: 2.18 to 3.51 degrees). CONCLUSION: The values showed good precision in all the parameters measured. The results were thus in a range equal to or better than the mean precision found in numerous clinical trials described in the literature. In particular, the method showed little deviation, as illustrated by the confidence interval (CI), but also by the clinically critical maximum deviations.
