RESUMO
The digital smile design is a practical diagnosis method that can assist the clinician to visualize and measure dentogingival discrepancies. This clinical report aims to present the associated steps, from the diagnosis of the alterations diagnosis through to the final aesthetic result. A 37-years-old female patient presented as her main complaint the tooth form and colour discrepancies. Applying the digital smile design principle, the necessary measures for a harmonic smile correction could be accurately determined. The initial diagnosis led to a wax up of the master cast that was duplicated in acrylic resin directly in the mouth. This temporary restoration guided the periodontal surgery and the final pressed ceramic crown restoration. We conclude that the digital smile design concept seems to be a useful tool to achieve a satisfactory aesthetic result.
RESUMO
Restauração de dentes tratados endodonticamente constituidesafio permanente na odontologia, uma vez que aspectos biomecânicos,estéticos e complexidade de execução técnica podemresultar em insucesso com consequente perda do elemento dentário.Geralmente dentes tratados endodonticamente se encontramenfraquecidos devido à perda de estrutura dentária o queresulta em redução de resistência mecânica da dentina. Estesfatores resultando em maiores riscos de falhas biomecânicasquando comparados aos dentes com vitalidade pulpar. Este trabalhotem por objetivo apresentar procedimentos clínicos reabilitadorespara devolução de harmonia estética com ênfase emprocedimentos realizados em incisivo central superior com extensaperda de estrutura coronária e restauração em resina compostainsatisfatória. Foi empregada a associação de pino de fibrade vidro (Exacto, Ângelus) e resina composta para reconstruçãointerna seguido de coroa em cerâmica pura (In Ceram Alumina,Vita). São destacados os passos clínicos e breve revisão de aspectosbiomecânicos e estéticos desta alternativa reabilitadora.
Restoration of endodontically treated teeth is a challenge inoperative dentistry, since the biomechanical, aesthetic and complexityof the technique can result in failure with subsequenttooth loss. Generally endodontically treated teeth are weakeneddue to loss of tooth structure and reduce the mechanicalstrength of dentin. These factors result in a higher risk of biomechanicalfailure when compared to teeth with pulp vitality.This paper aims to present clinical rehabilitation procedures torecover the smile harmony with an emphasis on aesthetic proceduresperformed in the maxillary central incisor with extensiveloss of coronal tooth tissue and unsatisfactory compositeresin restoration. It was employed the combination of fiberglasspost (Exacto, Angelus) and coronal reconstruction with compositeresin followed by all ceramic alumina crown (In CeramAlumina, Vita). Highlights the clinical steps and brief review ofbiomechanical and aesthetic rehabilitation of this alternative aredescribed.
RESUMO
OBJECTIVE: This study investigated the durability of repaired all-ceramic crowns after cyclic loading. MATERIAL AND METHODS: Eighty In-ceram zirconia crowns were fabricated to restore prepared maxillary premolars. Resin cement was used for cementation of crowns. Palatal cusps were removed to simulate fracture of veneering porcelain and divided into 4 groups (n = 20). Fracture site was treated before repair as follows: roughening with diamond bur, (DB); air abrasion using 50 µm Al2O3, (AA) and silica coating using Cojet system followed by silane application, (SC). Control group (CG) 20 specimens were left without fracture. Palatal cusps were repaired using composite resin. Specimens were stored in water bath at 37ºC for one week. Ten specimens of each group were subjected to cyclic loading. Fracture load (N) was recorded for each specimen using a universal testing machine. Two-way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) test (a=.05) were used for statistical analysis. RESULTS: There was statistically significant difference between control and tested groups, (p<0.001). Post Hoc analysis with the Tukey HSD test showed that cyclic loading fatigue significantly decreased means fracture load of control and test groups as follows (CG, 950.4±62.6 / 872.3±87.4, P = 0.0004), (DB, 624.2 ±38 / 425.5± 31.7, P <.001), (AA, 711.5 ±15.5 / 490 ± 25.2, p <0.001) and (SC, 788.7 ± 18.1 / 610.2 ± 25.2, P <.001), while silica coating and silane application significantly increased fracture load of repaired crowns (p<0.05). CONCLUSION: Repair of fractured In-ceram zirconia crowns after chairside treatment of the fracture site by silica coating and silane application could improve longevity of repaired In-ceram zirconia crowns.