Preparing and Restoring Composite Resin Restorations. The Advantage of High Magnification Loupes or the Dental Surgical Operating Microscope.

Use of magnification, such as 6x to 8x binocular surgical loupes or the surgical operating microscope, combined with co-axial illumination, may facilitate the creation of stable composite resin restorations that are less likely to develop caries, cracks or margin stains over years of service. Microscopes facilitate observation of clinically relevant microscopic visual details, such as microscopic amounts of demineralization or caries at preparation margins; microscopic areas of soft, decayed tooth structure; microscopic amounts of moisture contamination of the preparation during bonding; or microscopic marginal gaps in the composite. Preventing microscope-level errors in composite fabrication can result in a composite restoration that, at initial placement, appears perfect when viewed under 6x to 8x magnification and which also is free of secondary caries, marginal staining or cracks at multi-year follow-up visits.

Reliable and repeatable centric relation adjustment of the maxillary occlusal device.

This technique article describes a quantifiable, repeatable, and reliable method for occlusal device adjustment in centric relation using a leaf gauge. In addition, specific suggestions for occlusal device design are provided to enhance patient comfort with the prosthesis in place.

[Intruding upper incisors using mini-screw anchorage in patients with gummy smile].

OBJECTIVE: To evaluate the effectiveness of mini-screw anchorage on intruding upper incisors in patients with gummy smile. METHODS: Sixteen female patients (mean age: 23.8 years) were involved in this study. The mini-screws were placed between upper lateral incisors and canines on both sides for intruding upper incisors together with fixed appliance. The cephalometric analysis was carried out. RESULTS: Totally 63 teeth in 16 patients were intruded successfully and the deep overbite was decreased by (2.74 +/- 2.00) mm (P < 0.001). The distance from the edge of the upper incisor to palatal plane was reduced by (5.00 +/- 2.76) mm (P < 0.001), and the incisors were proclined by (9.34 +/- 10.06) degrees (P < 0.01). The duration for intrusion was 10.8 months on average. CONCLUSIONS: It was practicable and effective to improve gummy smile by intruding upper incisors with mini-screw implant.

Effect of lateral excursive movements on the progression of abfraction lesions.

The theory of abfraction suggests that tooth flexure arising from occlusal loads causes the formation and progression of abfraction lesions. The current study investigated whether reducing occlusal loading by adjusting the occlusion on a tooth during lateral excursive movements had any effect on the rate of progression of existing abfraction lesions. Recruited were 39 subjects who had two non-carious cervical lesions in the maxillary arch that did not need restoration and were in group function during lateral excursive movements of the mandible. One of the teeth was randomly selected to have the excursive occlusal contacts reduced by using a fine grain diamond bur. Centric occlusal contacts were not reduced. Impressions of the lesion were taken over a 30-month period to enable monitoring of the wear rate, and duplicate dies were poured into epoxy resin to allow for sectioning. The size of the lesions was measured using stereomicroscopic analysis of the sectioned epoxy resin dies, and the results were analyzed using an Independent t-test. No statistically significant difference in wear rates between the adjusted and non-adjusted teeth was found (p > 0.05). Within the limitations of the current study, it was concluded that occlusal adjustment does not appear to halt the progression of non-carious cervical lesions; consequently, this procedure cannot be recommended.

Computerized occlusal management of a fixed/detachable implant prosthesis.

The long-term success of an implant-supported prosthesis is related to the management of occlusal forces upon the restoration. Since implants are not anchored in bone with periodontal ligament proprioceptors, subjective confirmation by the patient is not always an accurate means of determining occlusion. A computerized occlusal analysis system has been developed to determine the timing and nature of the occlusal forces on tooth contacts. This article details the implementation of this system as an aid in the occlusal adjustment procedure of an implant-supported fixed/detachable prosthesis.

O uso da aleta unilateral nos tratamentos das mordidas cruzadas posteriores unilaterais / The use of unilateral wing in the treatment of unilateral posterior cross-bites

Os autores propöem um novo método de tratamento para as mordidas cruzadas posteriores unilaterais através de aparatologia própria

Polyvinyl siloxane template aids in recontouring natural teeth opposing single dentures.

This article describes a procedure that provides proper reduction of natural teeth opposing complete dentures. By use of a polyvinyl siloxane prosthetic template, natural dentition can be reduced to a more favorable plane, which will facilitate denture construction. This procedure will eliminate the risk of arbitrary grinding and will minimize guesswork through guided intraoral reduction.