Amelogenesis imperfecta: a conservative and progressive adhesive treatment concept.

OBJECTIVE: The aim of this study was to present a case report of a patient affected by amelogenesis imperfecta showing a possible minimal and conservative adhesive treatment approach. CLINICAL PROCEDURE: A treatment philosophy of amelogenesis imperfecta is illustrated by means of a case report of a 14-year-old boy who consulted us for a full mouth rehabilitation. DISCUSSION: This clinical report describes step by step how to manage a case of amelogenesis imperfecta from childhood over time. SIGNIFICANCE: This kind of minimally invasive, progressive approach allows the conservation of maximum tooth substance together with an acceptable esthetic outcome.

Clinical performance of novel-design porcelain veneers for the recovery of coronal volume and length.

The present study evaluated the clinical performance of bonded porcelain veneers (PV) restoring substantial coronal volume and length in the anterior dentition. Forty-eight PVs were placed in 16 patients, with systematic coverage and reconstitution of the incisal edge, including well-defined anterior guidance. A standardized protocol comprising diagnostic steps that integrate additive waxups and acrylic mockups was used. PVs were fabricated using feldspathic and low-fusing porcelains in a refractory die technique. Incisal overlaps featured freestanding porcelain spans ranging from 1.5 to 5.5 mm. After a mean clinical service of 4.5 years, 13 clinical parameters for each tooth and 4 parameters that applied to persons were recorded. Permutation tests evaluated the effects of margin location, incisal edge span of porcelain, overbite, opposing contact location, and restoration age on ceramic failure and clinical marginal adaptation and seal. At recall, 100% of the veneers were satisfactory with minor interventions. The effect of slight marginal defects and porcelain cracking was negligible. Biologic, periodontal, and esthetic parameters showed excellent results, which were supported by 100% patient-reported satisfaction. All patients felt comfortable with the newly defined anterior guidance. Aging was negligible, and there were no significant effects of margin location (P > 0.08), incisal edge span of the ceramic, or overbite (P > 0.22) on ceramic failure and marginal performance. Minor alterations of the palatal margin, however, tended to be more frequent compared to facial locations, and were found especially when the opposing tooth contact in centric occlusion was located on the palatal margin (P = 0.028). Bonded ceramic restorations represent a reliable, effective procedure to restore extensive coronal volume and length in the anterior dentition.

[A microscopic evaluation of the marginal adaptation of onlays in gold]. / Evaluation microscopique de l'adaptation marginale des onlays en or.

The aim of this in vitro trial was to evaluate the marginal seal and adaptation of gold onlays according to the instrumentation used to prepare the bevels, the quality of margins (as cast vs. polished in the laboratory) and two different finishing procedures (burnishing during or after setting of the cement). For that purpose, 25 freshly extracted human molars were restored with onlays using standardized preparation and fabrication methods. The marginal adaptation of the cemented onlays was evaluated using replicas and scanning electron microscopy. The marginal seal was evaluated on sample sections after a dye infiltration test. In order to improve the marginal fit of gold onlay restorations, it can be recommended to: use diamond burs (Intensiv no. 32 and 37) to prepare the bevels finish and polish restorations in the laboratory except for areas with access to clinically burnish, and polish the margins after setting of the cement.