Prosthetic rehabilitation for a patient treated for embryonal rhabdomyosarcoma.

A female patient, now aged 17 years, was diagnosed with rhabdomyosarcoma (RMS) in the right pterygopalatine fossa when she was 3 years old. The RMS was successfully treated by excision, but the subsequent radiation and polychemotherapy resulted in the complete anesthesia of the distribution area of the right trigeminal nerve and loss of vision in the right eye. The patient also experienced pain in the mandibular joints and masticatory muscles. Panoramic radiographs displayed a multiple agenesia of the permanent teeth and underdeveloped apices. Treatment involved the fabrication of a complete maxillary denture. A removable device was fabricated to evaluate her response to an occlusal vertical dimension increase of 6 mm and provide a stable intercuspal position. After wearing the prosthesis for 6 months, the patient reported that she was completely free of symptoms.

Evaluation of hypersensitivity after the placement of metal-ceramic crowns cemented with two luting agents: Long-term results of a prospective clinical study.

STATEMENT OF PROBLEM: Different luting materials are available for the cementation of fixed dental prostheses. Postcementation hypersensitivity is an occasional complication in the definitive delivery. How the choice of luting agent affects long-term postcementation sensitivity is unknown. PURPOSE: The purpose of this prospective, randomized, controlled, split-mouth clinical trial was to compare the hypersensitivity of 2 cementation methods for metal-ceramic crowns. The primary endpoint was the evaluation of differences in hypersensitivity between the study groups over a study period of 5 years. MATERIAL AND METHODS: The study investigated 20 participants with 40 metal-ceramic crowns cemented with either zinc phosphate cement or a self-adhesive resin cement, each in nonantagonistic contralateral quadrants (observation period of 5 years). The data regarding postcementation hypersensitivity included continuous patient-related outcome variables assessed using a visual analog scale (sign test; primary endpoint, level of significance α/3=.0167; secondary endpoint, level of significance, α=.05) and categorical variables represented by yes/no replies (absolute and relative frequencies). The sensitivity of teeth was controlled in relation to mastication, air streams, and hot and cold temperatures. RESULTS: The observation period was 5 years, with a dropout rate of 12.5% in the last 2 years. The results indicated no significant differences between the cement groups for patient- and clinical-related outcomes at any of the observed time points. CONCLUSIONS: As no differences were found between the 2 different cementation modes with respect to developing hypersensitivity after 5 years, the choice of a luting agent remains an individual practitioner decision.

Relative Clinical Success of Bis-Acryl Composite Provisional Crowns.

The high demands on the clinical performance of a single-tooth provisional restoration necessitate that said performance be examined. The authors evaluated 24 teeth evaluated. Two test groups received bis-acrylic composite for provisional crowns (n = 12) and a single-unit, self-supporting, malleable, light-curing composite crown (n = 12). Final crowns (n = 24) served as paired controls. Evaluation of clinical success was measured using previously selected subcategories of FDI criteria. Statistical analysis was performed using McNemar's Test (α = 0.05). The null hypothesis of no improvement of the definitive crown relative to the provisionals was rejected at the 5% significance level (McNemar's P value <.001, Bonferroni corrected). Of the provisional crowns, 75% received a clinically insufficient valuation, while only 8% of the definitive crowns did. The authors concluded that, independent of the manufacturing process, a bis-acrylic composite provisional crown cannot serve as a replacement for a conventionally manufactured definitive crown.

Polishing of Monolithic Zirconia Crowns-Results of Different Dental Practitioner Groups.

This pilot study evaluates the surface roughness of monolithic zirconia crowns after chairside polishing by different dental practitioner groups. Four practitioner groups (group I: dental clinical students (n = 6); group II: dentists < 2 years post-qualification experience (n = 6); group III: dentists > 2 years post-qualification experience (n = 6) and group IV: dental technicians (n = 6)) were asked to polish two CAD/CAM-fabricated full-contour zirconia crowns (48 in total). A two-step zirconia polishing kit was used in both trials. The first trial (T1) was conducted without a time limitation. In the second trial (T2), the polish was restricted to 15 seconds for each polisher. Two blinded investigators (I1 and I2) analyzed the surface roughness (Ra) before and after polishing (Alicona measuring system). No statistically significant difference in surface roughness was found between the polishing results of the dental practitioner groups. Major difference in surface finish was achieved by dental technicians, with a median value of 25.4 nm (interquartile range 10.15-35.26 nm) for I1 in T1. The lowest difference was achieved by dental students, with a median value of Ra = 6.72 nm (interquartile range 4.7-17.9 nm) in T1. In T2, experienced dentists showed the highest difference in surface finish, with a median value of 41.35 nm (interquartile range 7.77-54.11). No significant correlation was found between polishing time and polishing results. The polishing of monolithic zirconium dioxide crowns can be performed with the present polishing set directly chairside after occlusal adjustment, regardless of the practitioner's experience level.