Reabilitação anterior com laminados cerâmicos ­ relato de caso / Previous rehabilitation with ceramic laminates ­ case report

Uma perfeita harmonia do sorriso nos padrões estéticos atuais vai além de dentes em posição, restaurados e íntegros. A busca por dentes brancos tornou-se queixa frequente no consultório dental. Assim, o objetivo do presente trabalho é relatar a resolução estética e funcional de um caso clínico onde a paciente apresentava sorriso desarmonioso, dente desvitalizado escurecido e restaurações anteriores. O tratamento utilizado foi clareamento dental com peróxido de hidrogênio, clareamento com perborato de sódio e laminados cerâmicos de dissilicato de lítio. O resultado estético alcançado mostrou que o clareamento interno do dente desvitalizado foi insatisfatório e evidenciou a necessidade de tratamentos multidisciplinares. (AU)

A perfect smile harmony in today's esthetic standards goes beyond teeth in position, restored and intact, the search for white teeth has become a frequent complaint in the dental office. Thus, the objective of the present study is to report the aesthetic and functional resolution of a clinical case where the patient presented a disharmonious smile, darkened devitalized tooth and previous restorations. The treatment used was dental bleaching with hydrogen peroxide, bleaching with sodium perborate and ceramic laminates of lithium disilicate. The aesthetic results showed that the internal bleaching of the devitalized tooth was unsatisfactory and evidenced the need for multidisciplinary treatments. (AU)

Zirconia-based versus metal-based single crowns veneered with overpressing ceramic for restoration of posterior endodontically treated teeth: 5-year results of a randomized controlled clinical study.

OBJECTIVES: The aim of this 5-year randomized controlled trial was to compare the longevity and clinical behavior of single posterior crowns made with pressable ceramic on zirconia and on metal frameworks, and if failures occur, to delineate the contributing factors. METHODS: 72 patients, who needed the covering of at least a molar and/or premolar, were included in the study. All teeth were endodontically treated, with absence of periapical lesion or active periodontitis. Ninety single crowns were made with zirconia or metal framework and covered with pressable veneering ceramics. Two independent examiners assessed the survival of restorations at 6 months, 1-4 and 5 years after restoration placement including periapical radiographs, intraoral photographs, and USPHS modified criteria. The statistical analyses were performed with the Kaplan-Meier method. RESULTS: One core fracture occurred in Zircad/Zirpress crowns and one metal ceramic crown was lost for root fracture. Chipping fracture of the veneering ceramic was detected in 2 metal-ceramic crowns and in 3 zirconia-based crowns. The Estimate Cumulative Survival (ECS) and the Estimate Cumulative Success (ECSs) with standard deviation (SE) were respectively 97,73±2,19 and 92,64±4,14 for zirconia-based crowns whereas 97,44±2,39 and 91,11±4,27 for porcelain fused to metal crowns. CONCLUSIONS: The present randomized controlled trial shows that the survival of zirconia-based and metal-based single crowns is similar over a follow-up period of 5 years. No significant differences in esthetic, functional and biological outcomes were demonstrated between the two groups. The main failure mode was the chipping fracture of the veneering ceramic in both materials. Study number on ClinicalTrial.gov NCT02758457. CLINICAL SIGNIFICANCE: According to the results of this clinical study, zirconia-based rehabilitations with overpressing veneering technique represent a valid alternative to metal-based for posterior single crown restorations.

Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study.

OBJECTIVE: The purpose of this study was to evaluate the 10-year clinical performance of zirconia-based inlay-retained fixed dental prostheses (IRFDP). METHODS: For replacement of a molar in 27 patients, 30 IRFDP were luted by use of different cements, Panavia F (Kuraray Europe GmbH) or Multilink Automix (Ivoclar Vivadent GmbH), with use of inlay/inlay, inlay/full-crown, or inlay/partial-crown retainers for anchorage. Frameworks were milled from yttria-stabilized zirconia (IPS e.maxZirCAD; Ivoclar Vivadent GmbH) and fully veneered with pressable ceramic (IPS e.max ZirPress; Ivoclar Vivadent GmbH). Before luting, the IRFDP were silica-coated (Rocatec; 3M Espe) and silanized (Monobond S; Ivoclar Vivadent GmbH). Complications (for example, chipping or delamination of the veneering ceramic, debonding, secondary caries, endodontic treatment, and abutment tooth fracture) and failure were reported, by use of standardized report forms, 2 weeks, 6 months, and 1, 2, and 10 years after cementation. Statistical analysis included Kaplan-Meier survival and success (complication-free survival) and Cox regression analysis (α=0.05 for all). RESULTS: During the 10-year observation period, the complications most often observed were chipping of the veneer and debonding. Twenty-five restorations failed and one participant dropped out. Cumulative 10-year survival and success were 12.1% and 0%, respectively. The design of the retainer, use of a dental dam, choice of cement, and location in the dental arch had no statistically significant effect on the occurrence of complications. CONCLUSIONS: Use of fully veneered zirconia-based IRFDP with this technique cannot be recommended. CLINICAL SIGNIFICANCE: A large incidence of complications and poor survival were observed for fully veneered zirconia-based IRFDP, revealing an urgent need for further design improvements for this type of restoration. This, again, emphasizes the need for testing of new restoration designs in clinical trials before implementation in general dental practice.

Efeito de diferentes tratamentos de superfície na resistência de união, ângulo de contato, morfologia e análise da distribuição de tensão de laminados ultrafinos de cerâmica reforçada por dissilicato de lítio / Effect of different surface treatments on bond strength, contact angle, morphology and analysis of stress distribution in ultrathin lithium disilicate ceramic laminate veneers

Laminados cerâmicos são utilizados em tratamentos conservadores para restabelecer estética e função com mínimo desgaste da estrutura dental. O objetivo deste estudo foi avaliar, in vitro, o efeito de dois tratamentos de superfície em espécimes cerâmicos ultrafinos de dissilicato de lítio na resistência de união com o cimento resinoso. Laminas ultrafinas de cerâmica (14 X 12 X 0,3 mm) foram distribuídas aleatoriamente em dois grupos (n=20) de acordo com o tratamento de superfície: ácido hidrofluorídrico 5% durante 20 s e silano (HF) e Monobond Etch & Prime (Ivoclar, Vivadent) por 60 s (MEP). Dois cilindros de cimento resinoso foram confeccionados utilizando matrizes cilíndricas. Após 24 h de armazenamento, os espécimes foram submetidos ao ensaio mecânico de microcisalhamento (1 mm/min) e o modo de falha foi estabelecido. Dados de resistência de união foram analisados pelo teste t de Student (α=0.05). O ângulo de contato foi determinado. Análise morfológica das superfícies cerâmicas por meio de microscopia de força atômica e eletrônica de varredura foi realizada. Através de análise por elementos finitos foi estudada a distribuição de tensão em incisivos centrais superiores restaurados com laminados cerâmicos ultrafinos de dissilicato de lítio (0,3 mm). O modelo tridimensional foi elaborado no software Rhinoceros e exportado para software de análise Ansys. Foram modelados e analisados 04 grupos sob duas condições: desgaste ou não de esmalte e tipo de preparo. Foi aplicada uma carga de 100 N e a tensão gerada analisada pelo critério de Tensão Máxima Principal. Não houve diferença estatística nos valores de resistência de união entre o grupo HF e MEP (p=0,117). O ângulo de contato foi influenciado pelo tratamento de superfície (p=0,001); espécimes sem tratamento de superfície tiveram o maior ângulo de contato (65, 37˚) entanto que o grupo HF exibiu o menor ângulo de contato (33,80˚). A análise morfológica mostrou que o condicionamento da superfície com HF foi mais obvio mostrando poros, irregularidades e maior rugosidade em comparação com o condicionamento com MEP. A análise por elementos finitos mostrou que o grupo com laminado cerâmico cimentado sobre o esmalte sem preparo apresentou as menores concentrações de tensão tanto no esmalte como no laminado. Laminados cimentados sobre esmalte preparado mostraram concentração de tensão na interface dente/laminado. O Monobond Etch & Prime se mostrou estatisticamente equivalente ao ácido fluorídrico e silano em termos de resistência de união. Laminados cerâmicos ultrafinos cimentados sobre esmalte hígido geram menos tensão na superfície do dente e laminado. Laminados cerâmicos cimentados sobre esmalte preparado não provocam concentração de tensão adicional no esmalte(AU)

Laminate veneers are becoming a technique used in the conservative treatments by the ability to restore aesthetics and function. This study aimed to evaluate, in vitro, the effect of two surface treatments on ultrathin lithium disilicate specimens in bond strength between treated ceramics and resin cement. Ceramic ultrathin laminates (12 X 14 X 0.3 mm) were obtained and randomly distributed into two groups (n=20) according to the surface treatment: 5% hydrofluoric acid for 20 s and silane (HF) and Monobond Etch & Prime (Ivoclar, Vivadent) for 60 s (MEP). Two resin cement cylinders were made using cylindrical matrices. After 24 h storage, microshear bond strength tests were performed in a universal testing machine (1 mm/min) and failure mode was analyzed. Bond strength data were submitted to Student's t-test (α=0.05). The contact angle was measured. Micromorphogical analyses of representatives specimens were also performed (atomic force and scanning electron microscopy). Finite element analysis studied the distribution of stress in maxillary central incisors restored with ultrathin laminate veneers of lithium disilicate (0.3 mm). 3D model was elaborated in CAD Rhinoceros® software and exported to analysis software Ansys®. Four groups were modeled and analyzed under two experimental conditions: wear or non-enamel and type of preparation. A load of 100 N was applied at the palatal face. The stress was analyzed by Maximum Principal Stress criteria. Microshear bond strength values showed that HF group was not statistically different from MEP group (p=0.117). Microshear bond strength values showed that HF group was not statistically different from MEP group (p=0.117). Contact angle was influenced by surface treatments (p=0.001); specimens without surface treatment had the highest contact angle (65.37˚) whereas HF group exhibited the lowest contact angle (33.80˚). Surface morphological evaluation showed that hydrofluoric acid etching promoted a more obvious surface pattern regarding pores and irregularities with higher surface roughness in comparison to self-etching glass ceramic primer. Finite element analysis showed that laminates without enamel prepared generated the lowest stress in the enamel and in the laminate. Laminates with enamel prepared showed the stress concentration in the finishing lines of preparation in the tooth/laminate interface. Monobond Etch & Prime obtained statistically equivalent results in terms of bond strength to hydrofluoric acid and silane. Ultrathin laminate veneer cemented over sound enamel generate less stress on the surface of the tooth and laminate. Laminates veneers on prepared enamel do not cause additional tension in the tooth structure(AU)

Restauração estética de dentes anteriores escurecidos com sistema / Componeer Esthetic restoration of darkened anterior teeth using the Componeer system

Como a Odontologia minimamente invasiva tornou-se mais conhecida, diferentes tratamentos estéticos também foram colocados em prática. Um novo tratamento restaurador estético para dentes anteriores é a técnica semidireta usando facetas pré-fabricadas de resina nano-híbrida. Trata-se de um método restaurador alternativo e minimamente invasivo que apresenta confiabilidade estética e cosmética, além de ser uma solução financeiramente vantajosa graças à diminuição de etapas, como procedimentos de moldagem e trabalho laboratorial. Assim, o objetivo deste artigo é demonstrar a utilização de sistema Componeer para o restabelecimento estético de dentes anteriores escurecidos.

As minimally invasive Dentistry has become more known, new aesthetics treatments are also being used. One new esthetic restorative treatment for anterior teeth is the semi-direct technique using pre-fabricated nanohybrid resin composite veneers. It is a minimally invasive alternative restorative method that presents cosmetic and aesthetic reliability and it is a financially advantageous solution due to reduction of stages such as impression procedures and laboratory work. So the purpose of this article is to demonstrate the use of the Componeer system to reestablish the aesthetics of anterior darkened teeth.

Tiempo de vida de las restauraciones dentales libres de metal: revisión sistemática / Lifetime of metal-free dental restorations: a systematic review

En la actualidad existen muchos materiales dentales para la restauraciónestética, sin embargo, su tiempo de vida clínico no se conoce ampliamente. Objetivo: Identificar las publicaciones recientes de los materiales de restauración libre de metal que incluyan estudios clínicos. Metodología: La búsqueda sistemática de la literatura se realizó en bases de datos de PubMed y SciELO; se consideraron publicacionesdel 2010-2015 y que fueran investigaciones clínicas exclusivamente.Las palabras clave utilizadas fueron: Veneer crowns, dental restorationsfree metal, metal free crowns, aesthetic crowns y restauraciones libres de metal, coronas de silicato de litio, tipos de cerámicas. Resultados: Se revisaron 40 artículos y 20 cumplieron con los criterios de selección para la revisión bibliográfica. Todas las restauraciones protésicas libres de metal muestran un desempeño clínico muy similar a los tres años. Las restauraciones de zirconia y disilicato de litio por CAD mostraronel mejor éxito clínico. Conclusión: El éxito clínico de las restauracioneslibres de metal de esta revisión de la literatura muestra que van de un92.7 al 100 por ciento a tres o más años de seguimiento...

Reabilitação estética com laminados cerâmicos: relato de caso / Aesthetic rehabilitation with ceramic veneer: case report

A demanda por tratamentos restauradores estéticos tem aumentado consideravelmente nos consultórios odontológicos devido ao maior conhecimento por parte dos pacientes. Os laminados cerâmicos de dissilicato de lítio são excelentes opções de tratamento para realizar reabilitações estéticas devido às propriedades estéticas e de resistência do material. Este relato de caso tem como objetivo descrever as etapas envolvidas no protocolo clínico para realizar um tratamento restaurador com laminados cerâmicos ultrafinos (AU).

The demand for aesthetic restorative treatments has increased considerably in dental offices due to increased knowledge on the part of patients. The lithium disilicate laminated ceramics are excellent options to restore dental aesthetics due to their aesthetic properties combined and resistance. This clinical report aims to describe the steps of the clinical protocol of a restorative treatment with ultra-thin ceramic laminates (AU).

Direct anterior composite veneers in vital and non-vital teeth: a retrospective clinical evaluation.

OBJECTIVES: This retrospective, longitudinal clinical study investigated the performance of direct veneers using different composites (microfilled×universal) in vital or non-vital anterior teeth. METHODS: Records from 86 patients were retrieved from a Dental School clinic, comprising 196 direct veneers to be evaluated. The FDI criteria were used to assess the clinical evaluation. The survival analysis was done using Kaplan-Meier method and Log-Rank test. The multivariate Cox regression with shared frailty was used to investigate the factors associated with failure. RESULTS: A total of 196 veneers were evaluated, with 39 failures. The mean time of service for the veneers was 3.5 years, with a general survival rate of 80.1%. In the qualitative evaluation of the restorations, microfilled composite showed slighty better esthetics. The annual failure rates (AFR) were 4.9% for veneers in vital teeth and 9.8% for non-vital teeth with statistical significance (p=0.009). For microfilled and universal veneers the respective AFRs were 6.0% and 6.2% (p>0.05). Veneers made in non-vital teeth had a higher risk of failure over time compared to those made in vital teeth (HR 2.78; 95% CI 1.02-7.56), but the type of material was not a significant factor (p=0.991). The main reason for failure was fracture of the veneer. CONCLUSION: Direct composite veneers showed a satisfactory clinical performance. Veneers performed in vital teeth showed a better performance than those placed in non-vital teeth. No difference in the survival rate for different composites was found, although microfilled composites showed a slightly better esthetic appearance. CLINICAL SIGNIFICANCE: Direct composite veneers show good results in esthetic dentistry nowadays. Composite veneers in vital teeth have a lower risk of failure than those in non-vital teeth.

A randomized controlled clinical trial of 3-unit posterior zirconia-ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results.

OBJECTIVES: The aim of the present pilot study was to test whether or not posterior zirconia-ceramic fixed dental prostheses (FDPs) with pressed veneering ceramic exhibit less chipping than FDPs with layered veneering ceramics. METHODS: Forty patients (13 female, 27 male; mean age 54 years (range 26.1-80.7 years) in need of one maxillary or mandibular three-unit FDP in the second premolar or molar region were recruited and treated at two separate centers at the University of Zurich according to the same study protocol. The frameworks were made out of zirconia using a CAD/CAM system (Cerec Sirona, Bensheim, Germany). The patients were randomly assigned to either the test group (zirconia frameworks veneered with pressed ceramic; IPS e.max ZirPress, Ivoclar Vivadent AG, Schaan, Liechtenstein; n=20) or the control group (layered veneering ceramic; IPS e.max Ceram, Ivoclar Vivadent AG, Schaan, Liechtenstein; n=20). All FDPs were adhesively cemented and evaluated at baseline (i.e., cementation), at 6 months and at 1 and 3 years of clinical service. The survival of the reconstruction was recorded. The technical outcome was assessed using modified United States Public Health Services (USPHS) criteria. The biologic parameters analyzed at abutment teeth and analogous non-restored teeth included probing pocket depth (PPD), plaque control record (PCR), bleeding on probing (BOP), and tooth vitality (CO2). Data was descriptively analyzed and survival was calculated using Kaplan-Meier statistics. RESULTS: 36 patients (25 female, 11 male; mean age 52.3 years) with 18 test and 18 control FDPs were examined after a mean follow-up of 36 months (95% CI: 32.6-39.1 months). Comparison of groups was done by Crosstabulation showing even distribution of the respective restored teeth amidst the groups. Survival rate was 100% for both test and control FDPs. Chipping of the veneering ceramic tended to occur more frequently in test (n=8; 40%) than in control (n=4; 20%) FDPs, albeit not significantly (p=0.3). No further differences of the technical outcomes of test and control FDPs occurred.In both test and control group healthy conditions and no difference of the biologic parameters at the abutment and un-restored teeth was found. CONCLUSION: Zirconia FDPs with pressed and layered veneering ceramics exhibited similar outcomes at 3 years. A trend to more chipping of the pressed veneering ceramic, however, was observed. CLINICAL SIGNIFICANCE: Posterior restorations with zirconia frameworks are a viable treatment method. When restoring posterior teeth with all-ceramic restorations, care providers should be aware of the higher rate of chipping compared to the published data on conventional metal-ceramic restorations.

Nonparametric estimation in an "illness-death" model when all transition times are interval censored.

We develop nonparametric maximum likelihood estimation for the parameters of an irreversible Markov chain on states {0,1,2} from the observations with interval censored times of 0 → 1, 0 → 2 and 1 → 2 transitions. The distinguishing aspect of the data is that, in addition to all transition times being interval censored, the times of two events (0 → 1 and 1 → 2 transitions) can be censored into the same interval. This development was motivated by a common data structure in oral health research, here specifically illustrated by the data from a prospective cohort study on the longevity of dental veneers. Using the self-consistency algorithm we obtain the maximum likelihood estimators of the cumulative incidences of the times to events 1 and 2 and of the intensity of the 1 → 2 transition. This work generalizes previous results on the estimation in an "illness-death" model from interval censored observations.

Oral health status and treatment need among institutionalised hearing-impaired and blind children and young adults in Udaipur, India. A comparative study.

AIM: The aim of this study was to assess and compare the oral health status and the treatment needs of the institutionalised hearing-impaired and blind children and young adults in the city of Udaipur, Rajasthan, India. METHODS: A descriptive cross-sectional study was conducted among 498 institutionalised hearing-impaired and blind people, aged 4 to 23 years, in the city of Udaipur, Rajasthan. The World Health Organization oral health assessment basic methods and form (1997) were used for data collection. Clinical examinations were carried out in the institute's medical room or classroom by single examiner with the aid of a mouth mirror, explorer and Community Periodontal Index (CPI) probe under adequate natural light (Type III examination). The resulting data were entered into statistical software and analysed by applying the chi-square test, ANOVA, t-test and stepwise multiple linear regression analysis. RESULTS: The total mean DMFT (decayed-missing-filled teeth) and mean dft scores were 1.77 and 0.27 respectively. The largest component of DMFT was the D, with a mean of 1.49. The F component of 0.08 was very low. Mean DMFT/dft was greater among hearing-impaired than among blind subjects. Overall, 159 (32%) were periodontally healthy (CPI=0), 162 (32%) had shallow pockets (CPI=3) and 36 (7%) had deeper pockets (CPI=4). A higher percentage of the blind (87; 43%) than the hearing-impaired (72; 24%) subjects were periodontally healthy (CPI score=0). One-surface fillings were the most commonly provided form of past treatment. CONCLUSION: The findings in this study highlight the lack of dental treatment for this group. Overall oral health status was poorer in the hearing-impaired than in the blind subjects.

Survival rates for porcelain laminate veneers with special reference to the effect of preparation in dentin: a literature review.

UNLABELLED: The porcelain laminate veneer is an elective restoration, often placed in the absence of disease for purely esthetic reasons. As such, it would appear desirable that the success rate of the technique was 100%. It is therefore the purpose of this paper to review the literature on porcelain laminate veneer survival by searching dental databases containing clinical trials of porcelain veneer restorations. References of selected trials were also screened to identify relevant studies. Each paper that was included was examined to ascertain if preparation into dentin affected survival. A total of 24 papers were included in the review. It was concluded that survival rates of porcelain laminate veneers are rarely 100%, and there is reasonable evidence indicating that a veneer preparation into dentin adversely affects survival. CLINICAL RELEVANCE: A review of the literature has indicated that porcelain laminate veneer survival is rarely 100%. Accordingly, patients should be made aware of this before embarking on this elective restorative technique. Clinicians should also be aware that the ideal preparation for porcelain veneers remains within enamel.

Contemporary dental practice in the UK in 2008: indirect restorations and fixed prosthodontics.

OBJECTIVES: To investigate, by postal questionnaire, various aspects of primary dental care provision in the United Kingdom. Additionally, to compare the results of this survey with a similar survey completed four years previously. METHODS: A questionnaire containing 89 questions was sent to 1,000 general dental practitioners selected at random from databases of practitioners throughout the United Kingdom. Non-responders were sent another questionnaire after a period of four weeks had elapsed. RESULTS: Overall a response rate of 66.2% was achieved. Amalgam was the preferred material for the core build up of vital teeth for 65% of the respondents. Dentine pins were still being used by practitioners, with stainless steel pins being preferred by 34% of respondents. 39.7% of dentists that had graduated between 0-10 years previously reported using no pins. Indirect posts were still used most widely, by 55% of the practitioners in the study, with increasing use of fibre posts noted (34%). Addition cured silicone impression materials were still the most frequently used impression material (71%) with reduced use (10%) of condensation cured silicone impression materials recorded. Glass ionomer luting cements (48%) and zinc phosphate (28%) were the most commonly used luting cements. CONCLUSIONS: Within the limitations of this study, the following conclusions can be drawn: amalgam is still the preferred material for the core build-up of vital teeth; dentine pins are still used widely, but not by younger practitioners; fibre posts are being increasingly used by practitioners; addition cured silicone is still the most widely used impression material; traditional glass ionomer cements are still the most widely used luting cements; veneers are still the preferred indirect restoration for restoring anterior teeth; and CAD/CAM systems are increasingly being used by practitioners.

Clinical long-term evaluation and failure characteristics of 1,335 all-ceramic restorations.

PURPOSE: The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years. MATERIALS AND METHODS: Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis. RESULTS: The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth. CONCLUSION: All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.

[Correlations complications after cosmetic veneer treatment with initial parameters of oral cavity].

The aim of the study was to define interrelations between complications after veneer treatment with initial parameters of an oral cavity, state of an organism, social and biological factors. 65 patients with veneers treated between 2005 and 2009 at Margvelashvili Dental Clinic (Tbilisi) were investigated. Correlation analysis on Spearmen was spent with application of the package statistical programs SPSS 11.5. Chip of veneers finds out significant positive correlation with the following factors: a crossbite - r=0.2543, p<0.0409; decompensative caries - r=0.3189, p<0.0096; exhibiting of a pathological microflora - r=0.2879, p<0.0163; discoloration - patient with age 41-60 y. - r=0.3877, p<0.0014; focal infection contamination - r=0.2599, p<0.0366; often use of coffee - r=0.2819, p<0.0229; ulitis up to veneer - r=0.2444, p<0.0498; appearance line of demarcation - with the mechanical factor - r=0.3479, p<0.0045; use of synthetic fluids, - r=0.3823, p<0.0017; recurrence caries - with gastro-intestinal pathologies r=0.2924, p<0.0181; of a focal infection contamination - r=0.2756, p<0.0263; by feeding priority by carbohydrates - r=0.2324, p<0.0625; decompensate caries - r=0.2583, p<0.0377; Exhibiting of a pathological microflora - among males - r=0.2772, p<0.0254; by smoking - r=0.3227, p<0.0087; gastro-intestinal pathologies - r=0.2365, p<0.0579; by endocrine diseases - r=0.2546, p<0.0407; by focal infection contamination - r=0.5416, p<0.0000; decompensate caries - r= 0.2530, p<0.0420; by an ulitis - r=0.4551, p<0.0001; by a hygienic index - r=0.4611; p<0.0001; periodontal index - r=0.4611, p<0.0001; PMA index - r=0.3529, p<0.0039. The correlation circuit of the factors of complications after veneers will help the practical stomatologists with realization of purposeful prophylaxis.

[Assessment prevalence and risk factors of aesthetic defects dens and need veneers in a population Georgia].

PURPOSE: definition risk - factors of aesthetic defects of dens and need veneers. The work is fulfilled on the basis of research 330 persons age from 14 till 70 years from a common population of Tbilisi. Phylum of research - case - control of Criterion of incorporation: the patients entered clinic per 2005-2009, Criterion of exception: general diseases, Diabetes, autoimmune diseases, serious forms parodontosis, called by somatopathies. Statistical Analysis spent with the help of the package of statistical programs SPSS 11.5 Is placed, that the relative chance of need veneers is defined by the following factors: smoking - OR=1.82 (95%CI=1.13-12.37); pathologies gastrointestinal of a path - OR=1.94 (95%CI=1.22-14.26); the locuses of a focal infection contamination - OR=65.57 (95%CI=8.80-76.22); the mechanical factor - OR=2.23 (95%CI=1.27-58.95); medicamental treatment - OR=2.14 (95%CI1.34-24.56); feeding mainly by carbohydrates - OR=2.89 (95%C=I.51-13.15); the often use sweet - OR=1.87 (95%CI=1.07-9.85); often use of coffee OR=1.75 (95%CI=1.10-12.51); distal an occlusion - OR =2.26 (95%CI=1.09-18.68); - subcompensated caries - OR=2.04 (95%CI1.28-23.48); a ulitis - OR=1.62 (95%CI1.02-19.20); complications after previous veneer: particulate or complete chip of a seal - OR=34.12 (95%CI7.98-52.11); discoloration a seal - OR=80.67 (95%CI19.15-509.48); appearance line of demarcation - OR=95.23 (95%CI12.86-714.61); recurrent a caries - OR=25.75 (95%CI=7.69-39.87); Ulitis - OR=11.22 (95%CI=3.22-68.99); exhibitings of a pathological microflora - OR=123.16 (95%CI=16.68-726.40).

Quantification of the esthetics of dentists' before and after photographs.

PURPOSE: The purpose of this study was to measure dentists' before and after restorative treatment photographs to identify four metrics to describe the esthetic improvement: (a) central incisor width-to-height ratio; (b) central-to-lateral incisor width ratio; (c) lateral incisor-to-canine width ratio; and (d) lateral incisor percentage offset. MATERIALS AND METHODS: Internet searches for "before after" and "veneers" and "prosthodontic" were used to obtain 198 before and after photographs of patient treatments showing the restoration of the six maxillary anterior teeth with porcelain veneers, crowns or a combination. The four metrics were measured using Adobe Photoshop. Groups were compared with repeated measures ANOVA followed by a post hoc Tukey-Kramer test with the variables of "Before or After Treatment"; "Treatment Type" (veneers, crowns or a combination) and "General Dentist or Prosthodontist". RESULTS: Mean central incisor width-to-height ratio was 91.7% before treatment, 80.8% after; mean central-to-lateral incisor width ratios were 69.9% and 64.7%; mean lateral incisor-to-canine width ratios were 85.3% and 81.4% and lateral incisor percentage offsets were 9.6% and 8.7%. There were significant (p<0.05) differences for before and after treatment for all variables except central-to-lateral incisor width ratio. Differences between specialist and general dentist were not statistically significant. CONCLUSIONS: On average, esthetic prosthetic treatment resulted in reduced central incisor width-to-height ratio, increased proportional width of the mesially positioned tooth of adjacent anterior teeth and reduced lateral incisor offset. The mean values of treatments by GPs and prosthodontists were not statistically significantly different. CLINICAL IMPLICATIONS: Knowledge of dentists' optimal restorative treatments provides insight on the esthetic outcome of extensive prosthodontic therapy.

Ten-year outcome of porcelain laminate veneers placed within the general dental services in England and Wales.

AIM: It is the aim of this paper to consider the factors associated with the need for re-intervention on teeth restored with porcelain veneers. METHODS: A data set was established consisting of adult patients (18 years or older) whose restoration records contained the placement of one or more porcelain laminate veneers. For each tooth treated with a porcelain veneer, the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the extended data set, was obtained. Thus a data set was created of porcelain veneers which have been placed, with their dates of placement and their dates, if any, of re-intervention. RESULTS: Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 2562 porcelain veneer restoration occasions in 1177 patients were obtained from the data over a period of 11 years. Factors which were found to influence the survival of porcelain veneers include patient gender, patient age, changing dentist, patient's treatment need, patient charge-paying status and geographical area. CONCLUSIONS: While dentist factors do not appear to play a part, a variety of patient factors have been found to influence veneer survival to re-intervention. Overall, 53% of porcelain veneers in the study survived without re-intervention at 10 years.

Analysis of an administrative database of indirect restorations over 11 years.

AIM: This paper describes the database used to assess the survival of indirect restorations and presents general data on survival of these restorations. METHODS: Data, based on the complete attendance and treatment history, over the 11 years from 1991 to 2001, of a statistically representative sample of 23,165 General Dental Services' (GDS) patients in England and Wales, all of whom received at least one indirect restoration during the observation period, have been analysed. The patients on the database received a total of 36,397 courses of treatment, and there were 52,481 indirect restorations placed. The method of analysis involved the estimation of the probability that the patient will eventually return, given an interval without attending, by analysing the observed patterns of re-attendance. This estimated probability of re-attendance was then used to modify the standard Kaplan-Meier procedure to produce realistic estimates of the hazard of re-intervention. RESULTS: Overall, 75% of indirect restorations remained without re-intervention after 5 years, and 61% after 10. Crowns outperformed other types of indirect restoration. Multi-surface metal inlays, by contrast, had a median interval to re-intervention of less than 8 years. CONCLUSIONS: The times to re-intervention for different types of indirect restoration have been successfully estimated and crowns shown to outperform veneers and inlays.