Modified PEEK Resin Bonded Fixed Dental Prosthesis for a Young Cleft Lip and Palate Patient.

OBJECTIVE: This clinical report presents the use of a modified poly ether-ether ketone material as an alternative material for the fabrication of resin-bonded fixed dental prosthesis (RBFDP) framework. This new material can be used for patients allergic to metals, maintaining the same high esthetic demand of ceramics, presenting light weightness and a flexibility similar to bone as a distinct advantage over ceramic materials. CONCLUSIONS: The use of a BioHPP RBFDP framework could be considered as an alternative restoration for the replacement of missing lateral incisors in young patients with cleft palate defects. CLINICAL SIGNIFICANCE: This modified PEEK material known as BioHPP, is a biocompatible, non allergic, rigid material with good mechanical properties, wear resistance, chemical stability, high polishing and low absorption properties. BioHPP frameworks can be manufactured either via CAD/CAM or via the conventional lost wax technique. The low modulus of elasticity, combined with the use of indirect composite resin as a veneering material, provide a distinct advantage over ceramics or metal ceramics on dampening the occlusal forces, reducing the risk of debonding. (J Esthet Restor Dent 28:201-207, 2016).

Accuracy of implant impressions for partially and completely edentulous patients: a systematic review.

PURPOSE: To compare the accuracy of digital and conventional impression techniques for partially and completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. MATERIALS AND METHODS: An electronic and manual search was conducted to identify studies reporting on the accuracy of implant impressions. Pooled data were descriptively analyzed. Factors affecting the accuracy were identified, and their impact on accuracy outcomes was assessed. RESULTS: The 76 studies that fulfilled the inclusion criteria featured 4 clinical studies and 72 in vitro studies. Studies were grouped according to edentulism; 41 reported on completely edentulous and 35 on partially edentulous patients. For completely edentulous patients, most in vitro studies and all three clinical studies demonstrated better accuracy with the splinted vs the nonsplinted technique (15 studies, splint; 1, nonsplint; 9, no difference). One clinical study and half of the in vitro studies reported better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 10, no difference). For partially edentulous patients, one clinical study and most in vitro studies showed better accuracy with the splinted vs the nonsplinted technique (8 studies, splint; 2, nonsplint; 3, no difference). The majority of in vitro studies showed better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 7, no difference), but the only clinical study reported no difference. CONCLUSION: The splinted impression technique is more accurate for both partially and completely edentulous patients. The open-tray technique is more accurate than the closed-tray for completely edentulous patients, but for partially edentulous patients there seems to be no difference. The impression material (polyether or polyvinylsiloxane) has no effect on the accuracy. The implant angulation affects the accuracy of implant impressions, while there are insufficient studies for the effect of implant connection type. Further accuracy studies are needed regarding digital implant impressions.

Design of removable partial dentures: a survey of dental laboratories in Greece.

The aim of this study was to compare data on design and fabrication methods of removable partial dentures (RPDs) in two major cities in Greece. A questionnaire was sent to 150 randomly selected dental technicians. The participation rate was 79.3%. The anterior palatal strap, the lingual bar, and the Roach-type clasp arm designs were preferred. Half of the RPDs fabricated were retained using precision attachments. Differences between the two cities were observed in types of major maxillary connectors used, types of attachments and impression materials used, as well as the design of distal-extension RPDs. Postdoctoral education was found to have an impact on RPD fabrication. Despite the differences observed, design and fabrication of RPDs followed commonly used principles.

Root proximity characteristics and type of alveolar bone loss: a case-control study.

OBJECTIVE: This study assessed root proximity (RP) in patients with and without periodontitis in terms of prevalence, distribution, location along the root, width and severity, and explored the role of RP characteristics in the type of alveolar bone loss (horizontal or angular). MATERIALS AND METHODS: Root proximity was studied in the interdental spaces of 250 patients with periodontitis and 80 patients without disease. Linear measurements were performed in digitized radiographs. Root proximity was classified by location along the root, width and severity. Bone defect type (horizontal or angular) at the RP site was recorded. RESULTS: Root proximity prevalence did not differ between periodontitis and non-periodontitis groups. For both groups, most RPs were located at the middle root third. Root proximity width and severity in periodontitis sites were different between horizontal and angular bone loss sites. Root proximity width was greater in horizontal bone loss sites. In periodontitis, a unit (pixel) increase in the RP width decreased the probability to detect an angular bone defect by 20%, while a unit decrease in RP severity increased the possibility to detect angular bone loss by 71%. CONCLUSION: Root proximity prevalence was similar for both patients with and without periodontitis. The RP location along the root was not related to the existence of periodontitis. Root proximity width and severity differed between horizontal and angular bone loss sites. Root proximities had greater width in horizontal than angular bone loss sites.

Fabrication of a fixed provisional implant restoration. A report of three cases.

A clinical problem for patients with posterior partial edentulism who are going to be treated with dental implants is provisionalization during the period of soft and hard tissues preparation, the period of osseointegration and construction of the final restoration. Up to now, the available solutions were either the construction of a removable prosthesis or immediate loading of implants. The purpose of this article is to present an alternative technique for fabricating a fixed provisional restoration in patients with posterior partial edentulism. It is referred to as a teeth-tissue supported restoration which retention and support is provided from prepared or unprepared teeth while support also is gained from the maxillary tubercles or the retromolar pads of the upper and lower jaws.

Provisional restorations for optimizing esthetics in anterior maxillary implants: a case report.

UNLABELLED: The use of implants for the restoration of anterior missing teeth has been established and documented during the past years. However, the use of dental implants in the anterior region is a technique-sensitive procedure. The placement of implants in an ideal position is often not possible because of the lack of sufficient bone. The clinical situation can be further complicated if the teeth were lost as a result of trauma and there is possible damage to the surrounding soft and hard tissues. The restoration of lost anterior teeth and maintenance of the surrounding soft tissues with adequate surgical and prosthetic techniques are a real challenge for the clinician. The aim of this article was to report the laboratory and clinical stages in the restoration of anterior maxillary teeth, which were lost as a result of trauma with implant-supported fixed partial denture. In this case, an intraoperative transfer of the impression posts allowed the construction of provisional restorations, which were inserted at implant uncoverage surgery and contributed significantly to the creation of a better emergence profile and to the final esthetic result. CLINICAL SIGNIFICANCE: Provisional restorations are an important stage in anterior maxillary implants, allowing guided soft tissue management and creating an esthetic emergence profile.

Spectrophotometric evaluation of the influence of different backgrounds on the color of glass-infiltrated ceramic veneers.

The purpose of this spectrophotometric study was to evaluate the influence of different color backgrounds on Vita In-Ceram (Vident) glass-infiltrated ceramic veneers. A total of 50 color background disks were fabricated from Vitadur Alpha 2M2 (n=30) and 5M1 (n=20) dentin porcelain (Vi-dent). Ceramic veneer disks were fabricated from In-Ceram Spinell (n=20) or In-Ceram Alumina (n=20) glass-infiltrated core veneered using Vitadur Alpha 2M2 dentin porcelain. In addition, 10 ceramic veneer disks were fabricated from feldspathic dentin porcelain Vitadur Alpha 2M2. The ceramic veneer specimens were bonded onto the color background specimens using dual-curing luting composite cement, creating the following groups (each n=10): S2M2 (Spinell/2M2), S5M1 (Spinell/5M1), A2M2 (Alumina/2M2), A5M1 (Alumina/5M1), and control (Vitadur Alpha/2M2). L*a*b* color coordinates were measured five times for each specimen using a Vita Easyshade (Vident) spectrophotometer. Mean color differences (deltaE) between each study group and the control group were: 3.79 for S2M2; 7.24 for S5M1; 5.86 for A2M2, and 7.32 for A5M1. Two-way ANOVA showed statistically significant differences in deltaE between all groups. However, a t test revealed that the statistically significant differences only existed between groups S2M2/S5M1, A2M2/A5M1, and S2M2/A2M2. The results suggest that vacuum infiltration with a translucent glass provides the Spinell and Alumina ceramic veneers with increased semi-translucency, which makes them highly influenced by discolored backgrounds. In-Ceram Spinell glass-infiltrated ceramic veneers could be considered as an alternative to conventional feldspathic veneers for the restoration of nondiscolored teeth. Although Spinell and Alumina ceramic veneers could enhance the final color establishment of discolored teeth, the results would not be clinically acceptable.

Full-mouth rehabilitation of a patient with bulimia nervosa. A case report.

Anorexia and bulimia nervosa are eating disorders seen mainly in adolescents or young patients. The dentist should be in the position to recognize early signs of the disorder and alert the patient (and the patient's parents, if necessary) of the possible physical, psychologi cal, and dental consequences. Such dental treatment may help motivate the patient to confront the problem. In this paper the full-mouth rehabilitation, using a combination of galvano- and metal-ceramic restorations, of a young patient suffering from bulimia nervosa is described.

Functional and esthetic rehabilitation in amelogenesis imperfecta with all-ceramic restorations: a case report.

Amelogenesis imperfecta is a hereditary condition resulting in poor tooth development, severe anomalies, or complete absence of enamel. Enamel lesions may be the only characteristic of this condition or may be part of a generalized syndrome. Amelogenesis imperfecta can be characterized by enamel hypoplasia and/or hypomaturation or hypocalcification of the existing teeth. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation and the protection of the existing teeth. This paper presents a description of a patient's oral rehabilitation with all-ceramic veneers and crowns after extensive crown lengthening. The diagnostic procedure is also reported in detail. A microscopic examination was also performed on an extracted third molar under polarized light.

Spectrophotometric evaluation of the optical influence of different metal alloys and porcelains in the metal-ceramic complex.

STATEMENT OF THE PROBLEM: Color matching between natural teeth, shade guides, and metal-ceramic restorations is a common clinical problem. Difficulties related to color matching arise from structural differences that exist between metal-ceramic crowns and natural teeth, the limited range of available ceramic shades, inadequate shade guides, different types of metal alloys, and varying compositions of ceramic materials. PURPOSE: The aim of this study was to investigate the influence of various metal alloys and 2 porcelains on the final color of metal-ceramic complex. Material and methods Four commercial alloys for metal-ceramic restorations, a Ni-Cr (Thermobond), a Co-Cr (Wirobond), a Pd-rich noble (Cerapal-2), and a high noble Au-alloy (V-Delta) were combined with 2 porcelains (Vita Omega and Ceramco Silver) in metal-ceramic specimens with a standardized thickness of layers. Five disc-shaped (10 x 1 mm) specimens were prepared for each alloy/porcelain combination. Only opaque and dentin layers were applied (shade A3). The specimens were analyzed with a spectrophotometer, and data were obtained in the CIE Lab color system. The recorded data were analyzed with a 2-way multiple analysis of variance , a pair-wise comparison of group means (Student's t test), and finally, a categorical regression analysis of variance (CATREG) (alpha=.01). RESULTS: The types of alloy substrate and overlying porcelain significantly affected the color (P < .01). Au and Co-Cr alloys were found to be brighter (higher L* values) than the Ni-Cr and the Pd alloys ( P <.01, SE 0.239). Ceramco porcelain was found to be most red (higher a* values) of all tested alloys ( P <.01). Gold and Pd alloys caused a yellow shift to the metal-ceramic color compared to the Ni-Cr and the Co-Cr alloys with both porcelains ( P < .01, SE 0.165). The detected color differences were visually perceptible for some alloy-porcelain combinations. CONCLUSIONS: The final color of metal ceramic specimens was influenced both from the type of alloy substructure and from the type of overlying porcelain.

4.2 Clinical records and global diagnostic codes.

A clinical record should include the personal demographic details of the patient, health status, diagnostic information and management/treatment options. However, clinical records are of little use without effective filing and retrieving systems. Coding is therefore necessary to deal with large amounts of differing data and a global coding system could be effectively developed through the use of information technology. The aim of this section was to review the main existing vocabularies and coding systems and to examine ways of improving their global application. It was concluded that global diagnostic codes would be beneficial to the patient, to the profession and to those responsible for strategic decisions concerning the delivery of health care. Extant dental clinical codes are not accepted widely or applied universally. There is an urgent need to identify existing coding systems and to assess their utility and potential for global application. Every effort should be made to include existing codes in the development of a global coding system on which all specialist areas would need to agree. This would require the provision of an overarching interdisciplinary focus and funding should be made available for this development and its implementation.