ABSTRACT
In restorative dentistry, the lack of occlusal space may lead to the mutilation of healthy tissue in order to provide sufficient space for the restorative material. Noprep dentistry can be achieved by placing high-bite restorations, followed by Simple Orthodontic Extrusion (SOE) of other teeth to close the created open bite. This rapid, partial orthodontic treatment is well accepted by patients as it can be easily performed using simple buttons, and it takes only a few weeks to reestablish occlusal contacts. The SOE technique is a further development of the Dahl concept. It has the advantages without the disadvantages. Two applications of this technique are presented in this article: the treatment of the severe wear of anterior teeth with no-prep palatal veneers made of Polymer-infiltrated Ceramic Network (PICN, 'hybrid ceramic') material and the realization of no-prep zirconia resin-bonded bridges (RBBs) to replace missing lateral incisors. An original 3D-printed resin guide for correctly positioning RBBs and facilitating the removal of excess composite cement is also presented. This work highlights the considerable advantages of multidisciplinary collaboration in the field of minimally invasive dentistry.
Subject(s)
Dental Veneers , Humans , Female , Incisor , Open Bite/therapy , Denture, Partial, Fixed, Resin-Bonded , Zirconium/chemistry , Tooth Wear/therapyABSTRACT
To assess the variation of thrombopoietin (TPO) responsiveness associated with megakaryocyte (MK) progenitor amplification, TPO dose-response curves were obtained for normal human, single-cell plated CD34(+)CD41(+) cells. The number of MKs per well was determined in situ and expressed as number of doublings (NbD). Dose-response curves of the mean frequency of clones of each size versus log TPO concentration showed highly significant differences in the TPO concentration needed for half-maximum generation of clones of different sizes (TPO(50)): 1.89 +/- 0.51 pg/mL for 1 MK clones; 7.75 +/- 0.81 pg/mL for 2 to 3 MK clones; 38.5 +/- 5.04 pg/mL for 4 to 7 MK clones, and 91.8 +/- 16.0 pg/mL for 8 to 15 MK clones. These results were consistent with a prediction of the generation-age model, because the number of previous doublings in vivo was inversely correlated with the number of residual doublings in vitro. TPO responsiveness decreased in vitro by a factor of 3.5 per doubling, reflecting the recruitment of progressively more ancestral progenitors. In support of this hypothesis, the more mature CD34(+)CD41(+)CD42(+) cell fraction had a lower TPO(50) (P < .001), underwent fewer NbD (P < .001), and expressed a 2.8-fold greater median Mpl receptor density (P < .001) than the CD34(+)CD41(+)CD42(-) fraction. Progenitors that have completed their proliferative program have maximum factor responsiveness and are preferentially induced to terminal differentiation.