New adhesive rehabilitation technique with indexed occlusal tabletops made by 3D printing technology.

OBJECTIVE: In oral rehabilitation, a full mouth minimal invasive treatment can represent a major challenge for the patient and the dentist. The purpose of this article is to present a new technique to restore eroded teeth and recover the vertical dimension with a simple and predictable technique. CLINICAL CONSIDERATIONS: Occlusal tabletop restorations are a suitable conservative option to restore anatomy and vertical dimension augmentation but highly sensitive. The cementation of those restorations without stable landmarks, the cement excess removal, the insertion path, or the time needed are some of the difficulties can be faced. Now a days with the new CAD-CAM techniques is possible to develop a new occlusal tabletop manufacturing alternative utilizing 3D-printed technology by unifying the restorations with a customized connector that allows us to print several onlays at same time, as a single object, also being cemented at once. CONCLUSIONS: This protocol reduces the technique sensitivity of a vertical dimension oral rehabilitation process, reduce the chair time, enhancing the patient-comfort and delivers a unique way to restore dental lost anatomy as a definitive or temporary way with printing materials. CLINICAL SIGNIFICANCE: With the advent of new CAD-CAM 3D printing materials, which are increasingly versatile and gaining favor among clinicians, it is now possible to address complex clinical situations with greater predictability. This technology enables the development of treatment solutions that are both effective and efficient, consequently reducing clinical time for the patient.

Clinical Implications of Buccinator Fiber Attachment on Interventions Aiming at Enhancing the Peri-Implant Keratinized Mucosa: An Ex-Vivo Study.

A clinical observation usually encountered after vestibuloplasty or interventions aiming at deepening the vestibule with or without simultaneous free epithelialized grafts in the posterior ridges is that they are subjected to major dimensional changes attributed to the buccinator fibers attachment. Hence, this study aimed at assessing the attachment of the buccinator muscles in relation to other anatomical landmarks. An ex-vivo study was performed in cadaver heads to explore the association of fibers attachment in relation to the distance from the crestal aspect of edentulous alveolar process (CAP) and the vestibular depth (VD), crestal band of keratinized mucosa (KM), and ridge height (RH). Interestingly, VD and KM were found to be strongly correlated. Likewise, VD/KM and CAP-BUC were further noted being correlated. CAP-BUC was negatively correlated with RH. Accordingly, the more atrophic the alveolar ridge (being more noticeable in the mandible) is, the shallower the vestibule, the lesser the crestal band of KM and the more crestal attachment of the buccinator muscular fibers. That might be the reason why whenever performing free epithelized graft in the posterior ridges to enhance the peri-implant soft tissue phenotype and deepening the vestibule, the graft is subjected to major dimensional changes.