Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Influencia de la Morfología Externa de la Raíz de Primeros Premolares Superiores en la Sobreestimación del Espesor Radiográfico Radicular Durante la Preparación para Poste, Evaluados Mediante Tomografía Computarizada Cone Beam / Influence of the External Morphology of the Root of Upper First Premolars on the Overestimation of Radiographic Root Thickness During Post Preparation, Evaluated by Cone Beam Computed Tomography

La investigación tuvo como objetivo determinar la influencia de la morfología externa de la raíz de primeros premolares superiores en la existencia de sobreestimación radiográfica durante la preparación para poste. Con este fin se realizó un estudio transversal in vitro, donde 60 premolares superiores uniradiculares fueron instrumentadas con fresas Gates Glidden y Pesso de calibre 1, 2 y 3. Seguidamente se obtuvieron imágenes radiográficas digitales de cada pieza dentaria mediante un aparato posicionador a una distancia constante en sentido vestíbulo lingual, asimismo se realizaron imágenes tomográficas volumétricas de las muestras. En ambas técnicas imagenológicas se midió el espesor a mesial y distal de las piezas. La sobreestimación fue calculada mediante la diferencia de la medida tomográfica menos la radiográfica. Los resultados indicaron que en ambas paredes radiculares hubo diferencia significativa entre las medidas radiográficas y tomográficas (p<0,05), encontrándose en la pared distal diferencias altamente significativas (p<0,001); además se evidenció que la sobreestimación radiográfica fue mayor en la pared distal. El estudio concluyó que existe sobreestimación radiográfica en premolares superiores durante la preparación para poste de un 20,42 % en promedio, siendo la pared distal la estructura que presenta mayor sobreestimación.

SUMMARY: he investigation´s objective was to determine the influence of external morphology of the root of upper first premolars in the existence of radiographic overestimation during preparation for post. An in vitro cross-sectional study was carried out, where 60 single-rooted upper premolars were instrumented with burs. Gates Glidden and Pesso of caliber 1, 2 and 3, then, digital radiographic images of each dental piece were obtained by means of a positioning device at a constant distance in the buccolingual direction; volumetric tomographic images of the samples were also performed. In both imaging techniques, the mesial and distal thickness of the pieces was measured. The overestimation was calculated by the difference of the tomographic measurement minus the radiographic one. The results indicated that in both root walls there was a significant difference between the radiographic and tomographic measurements (p<0.05), with highly significant differences being found in the distal wall (p<0.001); In addition, it was evidenced that the radiographic overestimation was greater in the distal wall. The study concluded that there is radiographic overestimation in upper premolars during post preparation of 20.42% on average, with the distal wall being the structure that presents the greatest overestimation.

Simultaneous implantation and tooth preparation technology guided by 3D-printed guide / 华西口腔医学杂志

Using digital technologies in concurrently performing missing tooth implantation and preparation of remaining teeth is a solution to reduce the number of visits and improve efficiency. This paper proposes a digital process for simultaneously implanting and preparing teeth. It integrates implant surgical guide and 3D-printed tooth preparation guide into a single guide and completes guided implant placement and precise tooth preparation. Based on "repair-oriented" virtual implant planning, the implant surgical guide can improve the efficiency and predictability of implant placement, and its linear accuracy is about 1 mm. The tooth preparation guide precisely guides tooth preparation and restoration space visualization, ensuring the quality of the tooth preparation. The two guides have different design accuracy requirements, and thus their combination improves the overall guiding accuracy requirements. The concurrent application of the two guides minimizes the clinical operation time, number of visits, and economic burden of patients.

Prediction, analysis and application of learning curve of tooth preparation for all ceramic crowns of maxillary central incisors / 北京大学学报(医学版)

OBJECTIVE@#To predict the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training based on the modified Wright learning curve model, then to analyze and applicate the learning curve.@*METHODS@#Twelve graduate students participating in standardized dental resident training were selected to prepare the resin maxillary central incisors on phantom head simulators for all ceramic crowns 4 times. The results of preparation were evaluated by 3 prosthetic experts with at least 10 years' experience focusing on the reduction, contour, taper, shoulder, finish line, margin placement, adjacent tooth injury, and preparation time for tooth preparation. The learning rate of tooth preparation was calculated by scores of tooth preparation of 4 times. The learning curve of tooth preparation was predicted based on the modified Wright learning curve model. According to the criteria of standardized training skill examinations for dental residents in Beijing, 80 was taken as the qualified standard score. The minimum training times for tooth preparation to satisfy the qualified standard score (80) was calculated, to analyze the characteristics of learning curve and evaluate the effectiveness of tooth preparation.@*RESULTS@#The scores of 4 tooth preparation were 64.03±7.80, 71.40±6.13, 74.33±5.96, and 75.98±4.52, respectively. The learning rate was (106±4)%, which showed the learning curve an upward trend. There were no significant differences between the qualified standard score and the predicted scores of tooth preparation from the 5th preparation to the 13th preparation (P > 0.05). The predicted score of the 14th preparation was higher than the qualified standard score (P < 0.05).@*CONCLUSION@#The trend of the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training is upward, which predicts the minimum training times higher than the qualified standard score is 14 times.

Application and research progress of digital virtual simulated design in dental esthetic rehabilitation / 中华口腔医学杂志

In dental esthetic rehabilitation, patients pay great attention to the rehabilitative esthetic effect before teeth preparation, and this is also an important content of doctor-patient communication. Along with the development and combined application of intraoral scan, three-dimensional (3D) face scan, digital design, numerical control machining and 3D printing technology, digital technology is gradually applied to the virtual simulated design before irreversible operation in dental esthetic rehabilitation. Digital technology can be used in dentistry to simulate the esthetic outcome in advance, to assist communication among the dentists, patients and dental technicians, and to realize satisfactory outcome in the final restorations precisely, which, as a result, increases the clinical satisfaction. This review focuses on the application of digital virtual simulated design technology in dental esthetic rehabilitation, analyzes the current research development, deficiency and future prospects, so as to provide guidance for clinical diagnosis and treatment.

Standard operating procedure for microscopic tooth preparation / 中华口腔医学杂志

Tooth preparation is the primary and core operation technique for prosthodontics. Microscopic tooth preparation can improve the accuracy and efficiency of the operation. Experts from Society of Prosthodontics, Chinese Stomatological Association formulated the standard operating procedure for microscopic tooth preparation, so as to standardize its design points and operating procedures, highlight the difference between this novel technique and the traditional naked eye tooth preparation and promote the application of microscopic tooth preparation.

Questions about the numerical value and quantitative data transfer of tooth preparation-from experience guidance to digital guidance / 华西口腔医学杂志

Tooth preparation is a common operation in dental clinical practice. This procedure is irreversible and invasive from the point of view of tooth preservation. Conditions of the abutment tooth, treatment methods, and restoration materials for target restoration affect tooth preparation. To achieve the goals of tooth tissue preservation, dental pulp protection, and periodontal health, dentistry professionals agreed on the importance of minimizing the amount of tooth reduction. The foundations for realizing this consensus are as follows. First, the available restoration materials with improved comprehensive performance need less target restoration space. Next, teeth can be prepared under a digital guide, and the real-time measurement of restoration space can be verified due to the invention of digital technologies for the analysis of the quantity and shape of the prepared tooth and tooth measurement. Moreover, guiding methods for preparation have been developed from freehand operation under the naked eye based on accumulated personal experience to digital-guidance jointing microscope. These innovations indicate the creation of a prototype of guided prosthodontics that is precise and applies real-time measurement throughout the process of tooth preparation. From the perspective of the evolution of digital, guided, and micro prosthodontics, this article raised seven questions about the numerical value and quantitative data transfer of tooth preparation and evaluated the authenticity of existing numerical requirements from the perspective of the four elements of measurement. Identifying unified measuring methods and developing measuring tools with a precision of hundred or ten microns will be the key to solving the problem about the authenticity of numerical measurement. Furthermore, this paper summarizes the methods of how to control tooth reduction and explains in depth why the currently dominant tooth preparation technology, which is based on empiricism, cannot effectively achieve the goals in digital prosthodontics. Therefore, we strongly call for rebuilding the digital foundation of prosthodontic treatment immediately.

Fracture resistance and strain analysis of zirconia copings with vertical knife edge and three horizontal finish line designs; chamfer, deep chamfer and shoulder with two cementation techniques / Resistência à fratura e análise de deformação de copings de zircônia com término cervical em lâmina de faca e três términos horizontais; chanfro, chanfro largo e ombro com duas técnicas de cimentação

Objective: The purpose of this in vitro study is to evaluate the effect of four finish line configurations and two cement types on the fracture resistance of zirconia copings. Material and Methods: Forty yttrium tetragonal zirconia polycrystals copings were manufactured on epoxy resin dies with four preparation designs: knife edge, chamfer, deep chamfer 0.5, 1 mm and shoulder 1 mm. The copings were cemented with two cement types (glass ionomer and resin cement); (n = 5). Two strain gauges were attached on each coping before they were vertically loaded till fracture with a universal testing machine. Data were analyzed by 2-way analysis of variance ANOVA (p < .05). Fractured specimens were examined for mode of failure with digital microscope. Results: Knife edge showed the highest mean fracture resistance (987.04 ± 94.18) followed by Chamfer (883.28 ± 205.42) followed by Shoulder (828.64 ± 227.79) and finally Deep chamfer finish line (767.66 ± 207.09) with no statistically significant difference. Resin cemented copings had higher mean Fracture resistance (911.76 ± 167.95) than glass ionomer cemented copings (821.55 ± 224.24) with no statistically significant difference. Knife edge had the highest strain mean values on the buccal (374.04 ± 195.43) and lingual (235.80 ± 103.46) surface. Shoulder finish line showed the lowest mean strain values on the buccal (127.47 ± 40.32) and lingual (68.35 ± 80.68) with no statistically significant difference. Resin cemented copings had higher buccal (295.05 ± 167.92) and lingual (197.38 ± 99.85) mean strain values than glass ionomer copings (149.14 ± 60.94) and (90.27 ± 55.62) with no statistically significant difference. Conclusion: Vertical knife edge finish line is a promising alternative and either adhesive or conventional cementation can be used with zirconia copings (AU)

Objetivo: O objetivo deste estudo in vitro é avaliar o efeito de quatro configurações de términos cervicais e dois tipos de cimentos na resistência à fratura de copings de zircônia. Material e Métodos: Quarenta copings de zircônia tetragonal policristalina estabilizada por ítrio foram confeccionados em matrizes de resina epóxi com quatro tipos de términos cervicais: lâmina de faca, chanfro, chanfro largo 0,5, 1 mm e ombro 1 mm. Os copings foram cimentados com dois tipos de cimento (ionômero de vidro e cimento resinoso); (n = 5). Dois extensômetros foram fixados em cada coping antes de serem carregados verticalmente até a fratura com uma máquina de teste universal. Os dados foram analisados por análise de variância ANOVA 2 fatores (p < 0,05). Os espécimes fraturados foram examinados quanto ao modo de falha com microscópio digital. Resultados: A Lâmina de faca apresentou a maior média de resistência à fratura (987,04 ± 94,18) seguida pelo Chanfro (883,28 ± 205,42), pelo Ombro (828,64 ± 227,79) e finalmente o Chanfro largo (767,66 ± 207,09), sem diferença estatisticamente significativa. Os copings cimentados com cimento resinoso apresentaram maior média de resistência à fratura (911,76 ± 167,95) em relação aos copings cimentados com ionômero de vidro (821,55 ± 224,24), sem diferença estatisticamente significativa. A lâmina de faca apresentou os maiores valores médios de deformação na superfície vestibular (374,04 ± 195,43) e lingual (235,80 ± 103,46). O término em ombro apresentou os menores valores médios de deformação na superfície vestibular (127,47 ± 40,32) e lingual (68,35 ± 80,68), sem diferença estatisticamente significativa. Os copings cimentados com resina apresentaram maiores valores médios de deformação na superfície vestibular (295,05 ± 167,92) e lingual (197,38 ± 99,85) do que os copings cimentados com ionômero de vidro (149,14 ± 60,94) e (90,27 ± 55,62), sem diferença estatisticamente significativa. Conclusão: O término cervical em lâmina de faca é uma alternativa promissora e a cimentação adesiva ou convencional pode ser usada na cimentação de copings de zircônia. (AU)

Influencia del tallado en la lisura superficial del esmalte / The influence of carving on surface smoothness of enamel

Al momento de realizar una preparación dental existen diferentes alternativas. Dentro del instrumental rotatorio hay dos opciones: la turbina dental (ultra-velocidad) y el micromotor acoplado a un contra-ángulo multiplicador (alta velocidad). El propósito de este estudio fue evaluar cualitativamente la diferencia en la lisura superficial sobre esmalte, que se genera al desgastarlo, utilizando para esto, una turbina dental y un micromotor eléctrico acoplado a un contra-ángulo multiplicador 1:5 (anillo rojo). Se realizó un análisis cualitativo sobre una muestra de 24 superficies de esmalte obtenidas de 12 premolares extraídos por indicación ortodóntica, los cuales fueron preparados y observados al microscopio óptico. Luego de observar las 24 superficies al microscopio se pudo constatar una mayor lisura superficial sobre el esmalte al utilizar micromotor eléctrico acoplado a contraángulo multiplicador en comparación con turbina (AU)

Clinical pathway and preparation method of high-precision tooth shoulder platform / 华西口腔医学杂志

A clear shoulder platform that can be easily identified by doctors and technicians or machines (mouth scan and warehouse scan) is important to obtaining a good long-term and stable fixed prosthesis treatment effect. At present, the pre-paration of the shoulder platform is usually based on free hands, and the practical operation is mainly guided by experience. Moreover, no comprehensive and objective preoperative design, intraoperative verification, and final test are available. Thus, the accuracy of shoulder platform preparation needs to be improved. In this study, the clinical pathway of "three determination, three selection, and three steps" with high accuracy of preparation and the precise shoulder preparation method of "bur-tip guidance" are proposed in detail.

Precise tooth preparation technique guided by 3D printing guide plate with quantitative hole / 华西口腔医学杂志

The minimum amount of tooth preparation that can be fully controlled is crucial in achieving long-term, stable, and effective aesthetic restoration, which is also a major difficulty in aesthetic restoration. The tooth preparation can be imple-mented efficiently and accurately through digital technology based on the fixed-deep hole guiding technology. Prior the actual tooth preparation, the technology first designs the virtual contour, layering, and virtual occlusion of the prosthesis on the computer. Then, virtual tooth preparation is carried out by cutting back according to the virtual prosthesis. Next, the virtual drilling operation plan is designed according to the shape of the virtual tooth preparation and the contour of the abutment tooth. Finally, the tooth preparation guide plate is designed and printed in 3D. It realizes the whole process of quantitative and precise guidance of dental preparation, visualizes the restoration space, reduces the clinical operation time, and guarantees the quality of dental preparation. It also promotes the improvement of the teaching quality of digital practical exercises.

Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dogs

Abstract Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. Objective The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. Methodology The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. Results At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. Conclusions Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.

Minimal invasive microscopic tooth preparation based on endodontic, periodontal and functional health / 华西口腔医学杂志

Tooth preparation is the primary and core operation technique for dental esthetic restoration treatment, due to its effect of providing restoration space, bonding interfaces and marginal lines for dental rehabilitation after tooth tissue reduction. The concept of microscopic minimal invasive dentistry put forward the issue of conducting high-quality tooth preparation, conserve tooth-structure, protect vital pulp and periodontal tissue simultaneously. This study reviewed the concepts, physiology background, design and minimal invasive microscopic tooth preparation, and in the meantime, individualized strategies and the two core elements of tooth preparation (quantity and shape) are listed.

Post-endodontic Restoration on Erupting Permanent First Molars Using Endocrown with a Polyglass Composite Resin: Report of Two Cases / 대한소아치과학회지

Post-endodontic restorations are both important and challenging for clinical success in endodontically treated posterior teeth. Several options have been proposed to restore endodontically treated molars.In pediatric dentistry, restoration using conventional single crowns, especially for partially erupted molars with insufficient retentive tooth structure, has proven to be difficult. However, the endocrown presents a conservative and esthetic restorative alternative to conventional crowns with post-and-core, as it acquires additional retention within the pulp chamber. The tooth preparation consists of a circular, equigingival, butt-joint margin and a central retention cavity in the pulp chamber that helps to construct both the crown and core as a single unit.This case report describes the esthetic and conservative endocrown restorations of erupting permanent first molars with extensive coronal destruction.

Effect of cooling water temperature on the temperature changes in pulp chamber and at handpiece head during high-speed tooth preparation

OBJECTIVES: It was the aim of this study to evaluate the effect of cooling water temperature on the temperature changes in the pulp chamber and at the handpiece head during high-speed tooth preparation using an electric handpiece. MATERIALS AND METHODS: Twenty-eight intact human molars received a standardized occlusal preparation for 60 seconds using a diamond bur in an electric handpiece, and one of four treatments were applied that varied in the temperature of cooling water applied (control, with no cooling water, 10°C, 23°C, and 35°C). The temperature changes in the pulp chamber and at the handpiece head were recorded using K-type thermocouples connected to a digital thermometer. RESULTS: The average temperature changes within the pulp chamber and at the handpiece head during preparation increased substantially when no cooling water was applied (6.8°C and 11.0°C, respectively), but decreased significantly when cooling water was added. The most substantial drop in temperature occurred with 10°C water (−16.3°C and −10.2ºC), but reductions were also seen at 23°C (−8.6°C and −4.9°C). With 35°C cooling water, temperatures increased slightly, but still remained lower than the no cooling water group (1.6°C and 6.7ºC). CONCLUSIONS: The temperature changes in the pulp chamber and at the handpiece head were above harmful thresholds when tooth preparation was performed without cooling water. However, cooling water of all temperatures prevented harmful critical temperature changes even though water at 35°C raised temperatures slightly above baseline.

Influence of angulation and height of tooth preparation on the distribution of tensions in prosthetic crowns for upper central incisor: in silico analysis

Aim: it was to use tridimensional finite element analysis (FEA) to analyze the effect of height and angulation of prosthetic preparations on the distribution of stresses for lithium disilicate prosthetic crowns, the underlying resin cement, and the prosthetic preparation of a superior central incisor. Methods: a CAD modeling software, SolidWorks 2013, was used to generate three-dimensional virtual models comprising the dimensions of the preparation parameters. Three angles (6, 12 and 16 degrees) were simulated on the prepared walls and two wall heights were utilized (4 and 5 mm), for a total of six model groups according to the height and angulation of the walls. A vertical line in the Y-axis was used as a reference for determining the degrees of convergence (inclination of the preparations). The chamfer finish and preparation width were standardized for all groups. Results: the 4 mm preparations behaved more appropriately when the axial wall convergence was approximately 6 degrees. The 5 mm preparations required 12 degrees of angulation. In relation to resin cement, there was better stress distribution when the angle of incisal convergence was between 6 and 12 degrees. An increase to 16 degrees led to a considerable increase in peak stress at the preparation margin. Conclusion: it was concluded that the convergence of the axial walls of coronal preparations with 4 and 5 mm heights should be 6 and 12 degrees, respectively, to avoid high tension spikes in the underlying resin cement

Monobond Etch & Prime, primer acondicionador monocomponente que permite el grabado y la silanización de las superficies cerámicas en un solo paso / Monobond Etch & Prime, first single bottle conditioner for one step etching and silanization of ceramic surfaces

Las propiedades mecánicas de los materiales, han hecho que la técnica de cementación de las carillas sea tan cambiante y tan estudiada. Esta técnica ha sido modifi cada basados en investigaciones de diversos estudios clínicos. Lo cambiante de la técnica, no solamente es para el substrato del órgano dental, sino también para el material de la cerámica elegida. Esto confunde al clínico al estar modifi cando los procedimientos de cementación. En años recientes, como resultado del rápido progreso en la tecnología CAD/CAM, existe una gran cantidad de nuevas cerámicas y materiales híbridos en el mercado odontológico, esto se refl eja en benefi cios para los pacientes, al poder seleccionar distintas clases de materiales restaurativos. A su vez, las indicaciones se han expandido, esto hace que se incremente la difi cultad para los clínicos y ceramistas para mantenerse actualizados en la selección del material, lo que es más importante en los protocolos correctos de adhesión para el tratamiento en distintas superfi cies. En este artículo, se presenta el reporte de un caso clínico a nueve meses de seguimiento con la fi nalidad de evaluar la efi cacia del nuevo acondicionador monocomponente, para grabar y silanizar en un solo paso para Disilicato de Litio (DL), el nuevo Monobond Etch & Prime (MBEP) en el mismo frasco contiene la cantidad sufi ciente de ácido acondicionador y silano. Esto simplifi ca los procedimientos de adhesión, reduciendo no sólo el número de pasos, sino también el tiempo de trabajo (AU)

The mechanical properties of the materials have made the technique of veneer cementation, so changing and so studied. This technique has been modifi ed due to several clinical studies; especially in investigations that have been carried out in this respect. The changes made in the cementation technique, have not been only for the substrate of the dental organ, but also for the chosen ceramic material. This confuses the clinician by modifying the cementing procedures. In recent years, as a result of the rapid progress in CAD/CAM technology, a large number of new ceramics and hybrid materials, have been introduced into the dental market. This is refl ected in benefi t to the patients, because we have more opportunities to off er diff erent kinds of restorative materials; and at the same time, their indications have expanded, but this, increases the diffi culty for clinicians and ceramists to stay up-to-date on material selection, and the most important in the correct adhesion protocols for the treatment of diff erent surfaces. This paper presents, a nine months clinical case report to evaluate the effi cacy of the new monocomponent conditioner, for etching and silanizing in a single step the Lithium Disilicate (LD), the new Monobond Etch & Prime (MBEP), contains in the same bottle suffi cient amount of conditioning acid and silane. This simplifi es the adhesion procedures by reducing, not only the number of steps but also the working time (AU)

Diferencia entre las medidas radiográficas y anatómicas de conductos, posterior a la preparación para la colocación de postes / Difference between radiographic and anatomical measurements of canals, after preparation for the placement of a post

Antecedentes: Las radiografías periapicales presentan distorsiones que podrían conducir a un mayor desgaste de la estructura dental aumentando el riesgo de debilitamiento y de perforación o fractura vertical cuando se realiza la preparación del conducto radicular para la colocación de postes. Objetivo: El objetivo de la presente investigación es determinar la diferencia entre las medidas del espesor radiográfi co y el espesor anatómico mediante un calibrador de la dentina residual, luego de la preparación para poste en conductos ovales de premolares. Material y métodos: 50 premolares fueron tratados endodóncicamente y posteriormente fueron desobturados con fresas Pesso #1 y 2 dejando 4 mm de sellado apical, se realizó la toma radiográfi ca y se comparó con medidas realizadas con un calibrador digital. Las medidas fueron comparadas con una t de Student. Resultados: Las medidas radiográfi cas fueron 24.63% más grandes en comparación con las medidas del calibrador. Las medidas radiográfi cas no fueron signifi cativamente mayores en comparación con las del calibrador digital. Conclusiones: La radiografía periapical presenta una sobrestimación de la medida de la dentina residual, por lo tanto se debe escoger el protocolo más conservador para obtener resultados predecibles y exitosos (AU)

Background: Periapical radiographs have distortions that lead to greater wear of the dental structure, increasing the risk of weakening, perforation or vertical fracture when the root canal is preparation for post placement. Objective: The investigation is to determine the diff erence between the measurements of the radiographic thickness and the anatomical thickness by means of a calibrator of the residual dentine after the preparation for post placement. Material and methods: Root canal treatment was performed in 50 premolars and was unsealed with Pesso #1 and 2 leaving 4 mm of the apical seal, the radiographic was made and compared with measurements made with a digital calibrator. The measurements were compared with a Student t. Results: The radiographic measurements were 24.63% larger than the caliper measurements. The radiographic measurements were signifi cantly higher in comparison with the digital calibrators. Conclusions: The periapical radiography presents an overestimation residual dentin measurement, therefore the most conservative protocol should be chosen to obtain predictable and successful results (AU)

In-vitro performance and fracture strength of thin monolithic zirconia crowns

PURPOSE: All-ceramic restorations required extensive tooth preparation. The purpose of this in vitro study was to investigate a minimally invasive preparation and thickness of monolithic zirconia crowns, which would provide sufficient mechanical endurance and strength. MATERIALS AND METHODS: Crowns with thickness of 0.2 mm (group 0.2, n=32) or of 0.5 mm (group 0.5, n=32) were milled from zirconia and fixed with resin-based adhesives (groups 0.2A, 0.5A) or zinc phosphate cements (groups 0.2C, 0.5C). Half of the samples in each subgroup (n=8) underwent thermal cycling and mechanical loading (TCML)(TC: 5℃ and 55℃, 2×3,000 cycles, 2 min/cycle; ML: 50 N, 1.2×106 cycles), while the other samples were stored in water (37℃/24 h). Survival rates were compared (Kaplan-Maier). The specimens surviving TCML were loaded to fracture and the maximal fracture force was determined (ANOVA; Bonferroni; α=.05). The fracture mode was analyzed. RESULTS: In both 0.5 groups, all crowns survived TCML, and the comparison of fracture strength among crowns with and without TCML showed no significant difference (P=.628). Four crowns in group 0.2A and all of the crowns in group 0.2C failed during TCML. The fracture strength after 24 hours of the cemented 0.2 mm-thick crowns was significantly lower than that of adhesive bonded crowns. All cemented crowns provided fracture in the crown, while about 80% of the adhesively bonded crowns fractured through crown and die. CONCLUSION: 0.5 mm thick monolithic crowns possessed sufficient strength to endure physiologic performance, regardless of the type of cementation. Fracture strength of the 0.2 mm cemented crowns was too low for clinical application.

What is the changing frequency of diamond burs?

PURPOSE: The purpose of this study was to determine the changing frequency of a diamond bur after multiple usages on 3 different surfaces. MATERIALS AND METHODS: Human premolar teeth (N = 26), disc shaped direct metal laser sintered CoCr (N = 3) and zirconia specimens (N = 3) were used in this study. Groups named basically as Group T for teeth, Group M for CoCr, and Group Z for zirconia. Round tapered black-band diamond bur was used. The specimens were randomly divided into three groups and placed with a special assembly onto the surveyor. 1, 5, and 10 preparation protocols were performed to the first, second, and third sub-groups, respectively. The subgroups were named according to preparation numbers (1, 5, 10). The mentioned bur of each group was then used at another horizontal preparation on a new tooth sample. The same procedure was used for CoCr and zirconia disc specimens. All of the bur surfaces were evaluated using roughness analysis. Then, horizontal tooth preparation surfaces were examined under both stereomicroscope and SEM. The depth maps of tooth surfaces were also obtained from digital stereomicroscopic images. The results were statistically analyzed using One-Way ANOVA, and the Tukey HSD post-hoc tests (α=.05). RESULTS: All of the groups were significantly different from the control group (P < .001). There was no significant difference between groups Z5 and Z10 (P=.928). Significant differences were found among groups T5, M5, and Z5 (P < .001). CONCLUSION: Diamond burs wear after multiple use and they should be changed after 5 teeth preparations at most. A diamond bur should not be used for teeth preparation after try-in procedures of metal or zirconia substructures.