Digitally designed reduction guide to correct proclined anterior teeth: An aid before fabricating trial restorations.

Restoring teeth with ceramic laminate veneers is most often an additive procedure. However, when proclined anterior teeth are being treated, a misfitting silicone matrix will lead to inaccurate trial restorations, affecting evaluation of the definitive esthetic result and leading to inaccurate definitive preparations. Using the digital technology, a 3-dimensionally printed reduction guide can be used to remove the proclined areas as the first step before trial restorations. Then, the trial restorations and made and then the definitive preparations made through them.

A new concept in restorative dentistry: LIFEDT-light-induced fluorescence evaluator for diagnosis and treatment: part 2 - treatment of dentinal caries.

AIM: A new and innovative therapeutic concept using a light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT) of dental caries based on the imaging and autofluorescence of dental tissues is proposed. The aims of this series of in vivo experiments are to compare and analyze the brightness variations of sound dentin and active and arrested carious dentin illuminated with an intraoral LED camera and to determine if this new device could be helpful in daily practice to discriminate between caries and sound dentin. METHODS AND MATERIALS: A new intraoral LED camera that emits visible blue light was used in this in vivo study to illuminate and photograph 15 teeth at high magnification. The magnified images were examined using the free Image J V version 1.41 software. Four standardized rectangular areas were drawn on each picture that included both healthy and pathologic areas to analyze variations in brightness using a brightness formula: L = 0.299 Red + 0.587 Green + 0.114 Blue. RESULTS: Statistically significant differences in the brightness were found between active and arrested caries processes in an area of infected dentin designated Z2. Within the limitations of this in vivo study, the images created with the intraoral LED camera revealed significant variations in fluorescence between sound dentin and active and arrested caries processes. CONCLUSIONS: The LIFEDT concept provides a therapeutic concept based on these findings of variations in fluorescence between healthy and pathologic tissue. CLINICAL SIGNIFICANCE: This concept defines a pragmatic clinical and therapeutic approach for treating active and arrested carious lesions based on the interpretation of variations of a fluorescence signal and applying the LIFEDT concept to the treatment of dentin carious lesions.

A new concept in restorative dentistry: light-induced fluorescence evaluator for diagnosis and treatment. Part 1: Diagnosis and treatment of initial occlusal caries.

AIM: The objective of this in vivo experiment is to propose an innovative therapeutic concept using a light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT) that is based on the imaging and autofluorescence of dental tissues. BACKGROUND: Processes with the aim of diagnosing carious lesions in the initial stage with optimum sensitivity and specificity employ a wide variety of technologies, but like the conventional diagnosis tools, they remain either inefficient or too subjective. TECHNIQUE: This experiment evaluated a fluorescence light-induced camera that illuminates tooth surfaces within an excitation radiation band of light with a wavelength of 450 nm and facilitates a high magnification image. CONCLUSION: An analysis of 50 occlusal grooves revealed three clinical forms of enamel caries: (1) enamel caries on the surface, (2) suspicious grooves with a positive autofluorescent red signal, and (3) suspicious grooves with a neutral fluorescent dark signal. Two decision-making diagrams were proposed in accordance with international recommendations for preventive dentistry, but modified as a result of the accurate information obtained with this new LIFEDT device. CLINICAL SIGNIFICANCE: The lighting of suspect occlusal grooves with the SoproLife camera enables observation of any variations in the optical properties to refine a caries diagnosis and facilitates more than a 50x magnification of occlusal groove anatomy to provide additional information on the carious potential of the tooth surface.

Minimally invasive dentistry using sonic and ultra-sonic devices in ultraconservative Class 2 restorations.

AIM: Within the context of minimally invasive dentistry this article describes the sonic and ultrasonic cavity preparation techniques and assesses their advantages and disadvantages, clinical difficulties of their use, and offers a statement about these devices. BACKGROUND: Ultra-conservative Class 2 restorative techniques require the use of devices such as sonic and the new ultrasonic preparation systems. These systems, featuring a series of sonic and new ultra-sonic inserts, allow for the fabrication of preventive preparations on proximal surfaces without injuring the adjacent proximal surface or damaging the marginal ridge. REVIEW: An ultraconservative approach to the restoration of teeth with proximal caries that lack frank occlusal cavitation is facilitated by the use of slot-style cavity preparations created with sonic and ultrasonic instrumentation, and esthetic restorative materials. SUMMARY: New restorative procedures appear suitable for use in ultraconservative restorative dentistry. More frequent use of these procedures by dental practitioners could prevent the traditional breakdown of the marginal ridge when preparing a Class 2 dental restoration. When cautiously used, these two ultraconservative devices provide alternative operative procedures to treat carious lesions without frank occlusal cavitation and to promote another aspect of preventive dentistry. CLINICAL SIGNIFICANCE: New restorative procedures appear suitable for use in ultraconservative restorative dentistry. More frequent use of these procedures by dental practitioners could prevent the traditional breakdown of the marginal ridge when preparing a Class 2 dental restoration.

One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions.

AIM: The aim of this study was to examine clinically relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data. METHODS AND MATERIALS: Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study. A total of 56 restorations (14 with each material) were placed by three experienced, calibrated dental practitioners. Two other experienced and calibrated practitioners, under single-blind conditions, followed up on all restorations for a period of one year. Three materials were randomly placed: a micro-hybrid composite with two polymerization methods (G1 and G2), a flowable micro-hydrid composite (G3), and a resin-modified glass ionomer (G4). Statistical analysis was performed using the Kruskall-Wallis test (p<0.05) and a Mann-Whitney U modified test with a corrected significance level. RESULTS: At the one year evaluation time, there were no restorations with secondary caries and the retention rates in G1 (IntenS with a hard polymerization), G2 (IntenS with a soft polymerization), G3 (Filtek flow), and G4 (Fuji II LC) were 85.7% (two losses), 92.8% (one loss), 100%, and 100%, respectively. The total visual comparison of the results at baseline (15 days later) showed significant differences only with the clinical acceptance criterion: G1 was different from G2, with a soft polymerization device (p<0.05). In terms of surface quality at one year, G1, G2, and G3 exhibited a statistically significant difference from G4, p<0.05. The digital analysis at baseline showed significant differences only with the clinical acceptance criterion: G1=G2 was different from G3=G4, p<0.05. At one year, only the microporosity criterion showed any statistical differences: G1=G2=G3 was different from G4, p<0.05. CONCLUSIONS: The resin-modified glass ionomer was easier to use and had a high retention rate, but it failed in terms of surface quality (visual mode) and porosity (digital mode) criteria compared to the others groups. Overall results showed no difference between groups G1 (hard-polymerized) and G2 (soft-polymerized), and only G1 was affected by the marginal edge (p<0.03) and integrity criteria (p<0.02) at one year.

Use of the ditramax system to communicate esthetic specifications to the laboratory.

Prosthetic restoration of the anterior teeth is a major esthetic challenge. Esthetic treatment consists of creating pleasantly proportioned teeth and integrating them harmoniously into the patient's gingiva, lips, and face. The communication of clinical data to the laboratory is critical to the success of any esthetic treatment. The purpose here is to present a straightforward, efficient, and reproducible means of communicating esthetic specifications to ceramists, allowing them to work as though the patient was actually in front of them, with access to all of the major facial esthetic criteria.