Multifunctional bases and liners.

Three one-minute techniques are presented using anhydrous resin modified glass isonomer, an antibacterial and multifunctional base and liner. The isonomer is placed in deep areas of caries, as insurance, and to desensitize the tooth and fill gaps. The anhydrous glass accepts water from the dentin to fill potential contraction gaps from polymerization shrinkage of the composite fill.

Marginal ridge strength of Class II tunnel restorations.

PURPOSE: To test the strength, at the marginal ridge, of the tunnel preparation vs the Class II traditional box preparation when restored with composite or glass ionomer (GI). MATERIALS AND METHODS: Eighty-four extracted maxillary molars stored in normal saline and thymol were randomly divided into six groups of 14 each (determined by pilot study where alpha = 0.05, beta = 0.2). Group A and C were tunnel preparations. Group B and D were traditional Class II preparations. Group E-whole tooth (negative control), and Group F-tunnel preparation unrestored (positive control). Group A and B were restored with Scotchbond 2/P-50 composite. Group C and D were restored with Ketac Fil-GI. The marginal ridge of each tooth was loaded at 0.5 mm/minute on the Instron. A loading rod produced a contact point of 1.0 mm in diameter. RESULTS: The mean compressive loads (kg) required for fracture were: (A): 42.2 +/- 11.9, (B): 53.1 +/- 10.7, (C): 52.0 +/- 10.9, (D): 23.8 +/- 8.4. (E): 79.1 +/- 16.1, (F): 27.0 +/- 10.6. A significant difference was found between whole teeth (E) and all other groups (P < 0.05). The Newman-Keuls test showed a significant difference between Class II composite (B) and tunnel composite (A) (P < 0.05), between tunnel GI (C) and tunnel composite (A) (P < 0.05) but no difference between tunnel GI (C) and Class II composite (B).

Alternatives to posterior complete crowns: integrating foundations with cuspal protection.

A common approach for restoring compromised posterior teeth is to reconstruct the missing anatomic crown with a dental restorative material and prepare the remaining tooth structure for an artificial veneer. Because this procedure is also compounded by designing subgingival finish lines for tooth preparations, a conservative approach for the fabrication of one-piece castings is suggested that incorporates both foundations and cuspal protection, with finish lines prepared above the gingival crest. Patient selection, advantages, disadvantages, and armamentarium are discussed.

Integrating dental and medical care for the chronic bulimia nervosa patient: a case report.

Excessive tooth erosion and resulting sensitivity and esthetic concerns are well-documented problems in patients with eating disorders. Several techniques for restoring lost tooth structure have been reported in the literature. However, the potential significant role of dental care in the comprehensive treatment of the chronically bulimic patient has received little attention. Integration and coordination of dental treatment with medicopsycho-social therapy of the bulimic patient may enhance the patient's success in combating this complex disorder. The key to proper dental management is a definitive approach to data collection and close coordination among all health care personnel providing primary health care therapy. A specific dental approach model is recommended in this report of a patient with a 15-year history of bulimia.

Patient use of removable partial dentures: two- and four-year telephone interviews.

Two telephone surveys requested patients to report on their use of removable partial dentures that were constructed by undergraduate dental students. In the first survey, of the 431 patients called, 290 were contacted and interviewed 24 to 33 months after their removable partial denture(s) had been inserted. Of these, 258 patients reported using their prostheses and 238 had no apparent problems. In the second survey, the 238 trouble-free removable partial denture wearers from the first survey were called and 169 were contacted and interviewed 48 to 57 months after the removable partial dentures had been inserted. Of these, 156 reported still using their prosthesis and 152 had no apparent problems. These data are provided, along with some interpretive caveats, for dentists to use in discussing treatment options with patients.

Displacement of a root form implant into the mandibular canal.

An unusual complication associated with the placement of osseointegrated root form implants is presented. Discussion of this complication focuses on treatment planning and anatomic considerations in the posterior mandible that impact the viability of implant placement. Vital structures in this location, including the mandibular canal, are often obscured on routine panoramic radiography. Tomograms of the maxilla or mandible can provide data on cortical plate thickness, location of vital structures, and the presence of large medullary spaces, information that will decrease the incidence of implant complications.

A provisional and new crown to fit into a clasp of an existing removable partial denture.

A technique that forms an abutment crown to fit into an existing clasp of a removable partial denture by relining an acrylic resin pattern is described. The outer contour of the pattern is made within an irreversible hydrocolloid impression by use of Duralay autopolymerizing acrylic resin applied with precision dispensers. The pattern is formed before tooth preparation and is made approximately 0.4 mm thick. After tooth preparation, the shell pattern is relined with the same autopolymerizing resin and the existing removable partial denture is fitted over it. The gross pattern is trimmed and the margins refined on a die made from an elastomer impression. The refined pattern is cast and finished, avoiding reduction of the contours established. A second crown is similarly formed in tooth-colored autopolymerizing acrylic resin. It serves as a provisional restoration that allows the patient to wear the removable partial denture while the laboratory procedures are performed.

Predicting esthetics of laminate veneers without tooth preparation.

High expectations may contribute to stress in the patient and dentist during dental treatment. Esthetic and restorative results can be predicted for laminate veneers by using a powder blower and a liquid dispenser preoperatively to form self-cured resin veneers. Trial veneers are formed in a precision "salt and pepper" technique that conserves materials and time. The trial veneers are placed, without tooth preparation, on the treatment site so that the patient can preview the planned treatment and so that the dentist can explain proposed treatment in a reversible procedure. This may circumvent misunderstandings between dentist and patient and allow the consideration of alternate treatment plans.

A provisional restoration technique for laminate veneer preparations.

A direct construction technique for laminate veneer provisional restorations uses autocuring acrylic resin and other available armamentarium to facilitate construction. Only a slight preparation modification of the tooth to be treated is necessary to retain the provisional prosthesis.