Resistance to abrasion of extrinsic porcelain esthetic characterization techniques.

STATEMENT OF PROBLEM: A novel esthetic porcelain characterization technique involves mixing an appropriate amount of ceramic colorants with clear, low-fusing porcelain (LFP), applying the mixture on the external surfaces, and firing the combined components onto the surface of restorations in a porcelain oven. This method may provide better esthetic qualities and toothbrush abrasion resistance compared to the conventional techniques of applying color-corrective porcelain colorants alone, or applying a clear glaze layer over the colorants. However, there is no scientific literature to support this claim. PURPOSE: This research evaluated toothbrush abrasion resistance of a novel porcelain esthetic characterization technique by subjecting specimens to various durations of simulated toothbrush abrasion. The results were compared to those obtained using the conventional characterization techniques of colorant application only or colorant followed by placement of a clear over-glaze. METHOD AND MATERIALS: Four experimental groups, all of which were a leucite reinforced ceramic of E TC1 (Vita A1) shade, were prepared and fired in a porcelain oven according to the manufacturer's instructions. Group S (stain only) was characterized by application of surface colorants to provide a definitive shade of Vita A3.5. Group GS (glaze over stain) was characterized by application of a layer of glaze over the existing colorant layer as used for Group S. Group SL (stain+LFP) was characterized by application of a mixture of colorants and clear low-fusing add-on porcelain to provide a definitive shade of Vita A3.5. Group C (Control) was used as a control without any surface characterization. The 4 groups were subjected to mechanical toothbrushing using a 1:1 water-to-toothpaste solution for a simulated duration of 32 years of clinical use. The amount of wear was measured at time intervals simulating every 4 years of toothbrushing. These parameters were evaluated longitudinally for all groups as well as compared at similar time points among groups. RESULTS: In this study, the novel external characterization technique (stain+LFP: Group SL) did not significantly enhance the wear resistance against toothbrush abrasion. Instead, the average wear of the applied extrinsic porcelain was 2 to 3 times more than Group S (stain only) and Group GS (glaze over stain). Application of a glaze layer over the colorants (Group GS) showed a significant improvement on wear resistance. Despite its superior physical properties, the leucite reinforced ceramic core (Group C) showed 2 to 4 times more wear when compared with other test groups. CONCLUSION: A conventional external esthetic characterization technique of applying a glaze layer over the colorants (Group GS) significantly enhanced the surface wear resistance to toothbrush abrasion when compared with other techniques involving application of colorants only (Group S) or mixture of colorant and LFP (Group SL). The underlying core ceramic had significantly less wear resistance compared with all externally characterized specimens. The novel esthetic characterization technique showed more wear and less color stability, and is thus not advocated as the "best" method for surface characterization. CLINICAL IMPLICATIONS: Application of a glaze layer provides a more wear-resistant surface from toothbrush abrasion when adjusting or extrinsically characterizing leucite reinforced ceramic restorations. Without the glaze layer, the restoration is subjected to a 2 to 4 times faster rate and amount of wear leading to possible shade mismatch.

An implant versus a conventional fixed prosthesis: a case report.

The success of endosseous implant dentistry is widely acknowledged. Clinical research and subsequent innovations with both surgical and restorative techniques--as well as improved surface features and restorative components--have made endosseous dental implants a routinely accepted dental treatment modality. Patients and referring clinicians often specifically request dental implant therapy. This article presents an example of such a patient; however, in this case, a surgical ridge augmentation and fabrication of a conventional fixed prosthesis was selected as the treatment modality. The authors believe that all therapeutic modalities should be considered when adapting appropriate treatment plans for individual patients.

Fabrication and use of a simple implant placement guide.

Proper placement and orientation of dental implants is a requirement for optimum function and esthetics to be obtained with the definitive restoration. This article describes an acrylic resin implant placement guide which is simple to fabricate and easy to use. This device guides the surgeon in the precise position and angulation planned for the implant, yet allows for some flexibility in the event slight adjustments are necessary during surgery.