Prosthetic and Surgical Reconstruction of the Atrophic Anterior Maxilla with Iliac Bone Grafting and Malo Bridge Design: A Case Report.

Alveolar bone loss subsequent to long-term edentulism and trauma may be severe and treatment plan is always an esthetic and functional challenge. Implant supported hybrid prosthesis is widely regarded as an effective treatment option for patients with excessive and irregular bone loss. However, implant placement is occasionally impossible without surgical procedures in such cases. This case report presents rehabilitation of 19-year-old maxillary anterior edentulous male patient with maxillary anterior bone defect and excessive cross-bite anterior closure with multidisciplinary approach. The patient was rehabilitated with implant supported hybrid prosthesis with Malo Bridge design following autogeneous iliac bone augmentation, teeth leveling with orthodontic treatment, and surgical placement of three implants. Esthetics, pleasing phonetics and function were achieved as desired with this treatment option and no complications were observed.

Rehabilitation of the completely edentulous young patient with the "Malo Bridge": A case report.

It is possible to rehabilitate fully edentulous patients with implantsupported fixed or removable prostheses; however, implantsupported fixed prostheses are the gold standard for patients who not prefer to use removable dentures. This case report, prosthetic rehabilitation of a completely edentulous young patient with an implantsupported fixed hybrid prosthesis using the "Malo Bridge" technique is described. A 18 years old male patient was referred to the clinic with complaints of tooth loss, aesthetics, function, and phonetic. A total of 5 implants were placed in both the jaws. Considering that screw holes may cause aesthetic problems due to the Class III occlusion, these problems have been solved with the implant-supported hybrid prosthesis called Malo bridge. With the Malo Bridge design, the patient's aesthetic, functional and phonetic loss was eliminated, patient comfort and quality of life were improved, and patient expectations were met. It is a viable treatment option to rehabilitate completely edentulous jaws with a cross relationship and increase interarch distance using Malo Bridge to support a fixed prosthesis.

Effect of surface treatments to remove temporary cement remnants on the bond strength between the core composite and resin cement.

BACKGROUND: There was no enough data about the appropriate surface cleaning of core composite material after temporary cementation. AIM: To evaluate the effects of surface cleaning techniques on initial shear bond strength (SBS) between core composite material and resin nanoceramic crown materials after temporary cementation. MATERIAL AND METHODS: Cubic specimens were prepared from prosthetic materials, including Lava Ultimate. Cylinder-shaped composites were cemented to glass slides with eugenol-free temporary cement, resulting in a total of 44 cylinders (n = 11). The surfaces of composite cylinders were then cleaned with an Er, Cr:YSGG laser, 37% orthophosphoric acid, yellow tape diamond bur, or dental explorer. Cleaned cylinders were bonded to cubic specimens with resin cement. Initial SBS tests were performed with a universal testing machine at 0.5 mm/min crosshead speed. One-way ANOVA and post hoc Tukey tests were used to analyze the obtained data (P =0.05). RESULTS: Initial SBS values were significantly affected by the different surface cleaning methods (P <.05). The highest SBS value was obtained with the laser group (SBS = 17.14), while the lowest was obtained with dental explorer group (SBS = 5.95). There was no significant difference between the diamond bur group and the laser group (P =0.982). CONCLUSIONS: Laser irradiation or yellow tape diamond bur cleaning of the core composite surface could be recommended to strengthen bond strength between the resin luting cement and the core composite. Before adhesive or conventional cementation of prosthetic restoration, the core composite surface should be cleaned.

Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders.

AIMS: The aim of this study was to investigate dentist's approaches to the use of splint therapy for myofascial pain, bruxism, and temporomandibular joint (TMJ) disorders and to assessment of treatment modalities. MATERIALS AND METHODS: A 12-item questionnaire was developed to determine dentists' knowledge of TMJ disorders and approaches for occlusal splint treatments. The researchers spoke with each dentist included in the study at his/her clinic or by telephone to assess their immediate knowledge and approach to the TMJ disorders. Chi-squared test was performed to analyze the values. The confidence interval was set as 95%. RESULTS: A total of 370 dentists working in Turkey were participated in this study. The most common splint application reason for occlusal splint treatment was bruxism (77.8%) while TMJ pain was very rare (%1.4). The use of hard splint ratios for 0-5 years of professional experience was 57.0%, 42.4.0%, and 26.8% for the experience of 5-15 years and over 15 years groups, respectively (P < 0.001). While the dentists' with sufficient knowledge soft splint application rates were 11.6%, hard splint application rates were 43.4% for the dentists with sufficient knowledge. Occlusion adjustment rate of dentists who practice in all three groups was under 16.0%. CONCLUSIONS: The knowledge of the dentists about TMJ disorders and occlusal splint therapy were found to be insufficient. Their knowledge decreased with increasing experience.

Effect of dentin desensitizing procedures on methyl methacrylate diffusion through dentin.

BACKGROUND: Acrylic and bisacryl resins are widely used both during the temporization phase as well as for provisional restorations and the effect of external agents on dentin sensitivity can be reduced by the obliteration of the tubules. OBJECTIVE: The purpose of this study was to evaluate diffusion of methyl methacrylate monomer through dentin by high performance liquid chromatography (HPLC) after three different desensitizing procedures during the fabrication of two different provisional crown materials. MATERIALS AND METHODS: Forty extracted restoration and caries free human premolar teeth were used in this study. Thermoplastic vacuum formed material was used as a matrix to fabricate provisional restorations for each tooth before crown preparation. Teeth were prepared for a metal supported ceramic crown with 1 mm shoulder margins and then crown parts were separated from cementoenamel junction with a carborundum disk perpendicular to the long axis of the teeth. To the cementoenamel junction of each tooth a polypropylene chamber was attached that contains 1.5 cm 3 of deionized distilled water. Prepared teeth were divided into four groups ( n = 10) including control, desensitizing agent (DA) application, neodymium-doped yttrium aluminum garnet (Nd: YAG) laser irradiation (LI), and LI after DA application groups. After application of DA (except control) each group were divided into two subgroups for fabrication of provisional restorations ( n = 5). Two autopolymerizing provisional materials (Imident (Imicryl) and Systemp C and B (Ivoclar, vivadent)) were used to fabricate provisional restorations using the strips. Water elutes were analyzed by HPLC at 10 min and 24 h. RESULTS: The monomer diffusion values varied statistically according to desensitizing procedures, provisional resin systems, and the time periods. Monomer diffusion through dentin surfaces desensitized with Nd: YAG LI after DA application was the lowest. CONCLUSIONS: Nd: YAG LI in association with DA application is an effective combination to eliminate monomer diffusion through dentin to pulpal chamber.