RESUMO
Reconstructing severely damaged teeth has always presented a challenge when the remaining crown structure is limited, often requiring retention from the root canal using intracanal posts. However, the real challenge is when the root canal walls are also weak, and there is a high risk of vertical root fracture due to the wedging forces of a rigid post. This case report presents a tooth with extremely flared (0.3mm) root canal walls, successfully restored with a newly introduced polymer made of polyether ether ketone (PEEK), with one-year follow-up. Due to its close elastic modulus to dentin, capacity to bond effectively to tooth structure, shock-absorbing properties, and thereby facilitating favorable stress distribution, utilizing this material for an intracanal post has the potential to mitigate the risk of fractures often associated with cast metal posts. It combines the good fitness of cast posts with the low modulus of elasticity and optical properties of prefabricated fiber posts.
RESUMO
Objective: This study evaluated the influence of various gingival displays on the esthetic perception in the presence of upper dental midline discrepancy. Methods: A smiling image of a male subject was altered digitally to produce five image series: normal smile (series A), decreased tooth show (series B), increased gingival show (series C), maxillary cant (series D), and asymmetric upper lip elevation (series E). In each image series, the midline was deviated to the right and left incrementally. A total of 210 raters (four professional groups and laypersons, n = 42 in each group) determined the midline deviation threshold and the attractiveness of midline position in each series. Results: The right and left thresholds were statistically similar for the symmetrical series (A, B, and C), while for series D, the right threshold was significantly lower. In most rater groups, the mean threshold order was: B > A > E > C > D. In all the series, the raters selected the coincident midline as the most attractive series except for series D, for which 1-2-mm deviations to the left were selected as the most attractive by almost all the groups. Conclusions: It is crucial to establish the coincident midline position in a symmetrical smile, especially when a gummy smile exists. In the asymmetrical gingival show, a coincident midline might not be the most esthetic midline position.
RESUMO
Objective: This study aimed to compare the effect of Er,Cr:YSGG laser with a tungsten carbide bur in orthodontic finishing on the enamel surface roughness and the heat generated in the pulp chamber. Methods: Before bonding, of 125 intact extracted premolar teeth, 15 teeth were randomly assigned to the control group. Of the remaining 110 bonded teeth, 50 were used to determine the laser parameters, and 60 were included in the main in vitro study. After debonding, the teeth were randomly distributed among four study groups (n = 15) for finishing with laser beams (Er,Cr:YSGG, Waterlase) with and without polishing with Sof-Lex discs, and finishing with a bur (tungsten carbide, Reliance) with and without polishing with Sof-Lex discs. The thermal changes were measured during finishing using a thermo-controller-coupled thermocouple placed in the pulp chamber. Enamel surface roughness was evaluated qualitatively under a scanning electron microscope (SEM) and quantitatively under an atomic force microscope (AFM). Results: The thermal changes of the bur group were significantly higher than those in the laser group (p = 0.0001). Quantitatively, the surface roughness values of all the study groups were significantly higher than those of the control group (p < 0.05), with no significant difference between the study groups (p > 0.05). SEM analysis confirmed the AFM measurements. Conclusions: Er,Cr:YSGG can be recommended as an alternative for a carbide bur for adhesive agent removal after orthodontic debonding, considering its mild thermal effect on the pulp. Polishing with Sof-Lex discs did not significantly reduce the surface roughness, regardless of the finishing procedure.
