Aesthetic Dentistry - What You Decided and What I Want: Shade Selection

ABSTRACT Objective: To assess the relationship between patients' and dentists' perceptions of shade selection and its impact on satisfaction with the prosthesis. Material and Methods: A single group pre-post study was conducted at the Prosthodontics department of a teaching hospital in India. One hundred ten participants were selected through a systematic random sampling technique with inclusion and exclusion criteria. Patients' attitudes regarding the aesthetics of their maxillary anterior teeth were recorded using a validated questionnaire. Shades for the intended prosthetic crown selected by the dentist and chosen by the patient were recorded separately, and patient satisfaction with the appearance of the final prosthesis was recorded. We used descriptive statistics followed by Pearson's Chi-square test and a binomial logistic regression model for inferential statistics. Results: 109 participant's data were available for final analysis. Patients choose lighter shades than the dentist's selection, which is statistically significant (p=0.000). 73.4% were satisfied with the final prosthesis, and the binomial logistic regression model identified using patient-selected shade for the final prosthesis was significantly associated with patients' satisfaction with the final prosthesis (OR=3.3, p=0.001). Conclusion: The patient's preference should be considered with the dentist's option when selecting a shade to create good esthetics.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Application of socket-shield technique for immediate implant placement and provisionalization in esthetic zone: a case report and literature review / 口腔疾病防治

Objective@#To investigate the effect of the socket-shield technique (SST) concurrent with immediate implant placement and provisionalization (IIPP) in the aesthetic restoration of anterior teeth.@*Methods@#A case of maxillary anterior tooth stumps with a thin labial bone wall was treated with SST for preservation of labial soft and hard tissue fullness, combined with an immediate implant placement and immediate provisional crown for restoring the shape of the tooth and gingival molding@*Results@#Immediate implant placement and provisionalization restored the morphology and function of the affected tooth in the shortest possible time. The patient's labial soft and hard tissue contours in the affected tooth area were well preserved in the 18-month follow-up after the application of the SST, which presented a better aesthetic result. The literature review indicates that the indications for SST are unrestorable maxillary anterior teeth, whose dental, periodontal and periapical tissues are healthy and intact. In the esthetic zone, root shielding is effective in maintaining the soft and hard tissue contour on the labial side of the implant. However, there is no consensus on the technical details of SST, such as the ideal coronal height and thickness of the shield, and the management of the gap between the shield and the implant. Thus, more clinical studies and histologic evidence are needed to provide a reference for clinical decision-making. In addition, digital technology can improve the accuracy of implant placement and shield preparation.@*Conclusion@#The correct application of SST combined with IIPP in the esthetic zone can ensure esthetic results. However, more high-quality evidence-based medical evidence is needed for its long-term efficacy, and indications should be strictly controlled during clinical application.

Reposicionamiento Labial. Caso Clínico

El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.

SUMMARY: Lip repositioning is a minimally invasive surgical procedure used to treat a gummy smile, which is a condition in which a significant amount of the gum is exposed when a person smiles and may be due to a variety of factors, such as excess gum tissue, a short upper lip or overactive muscles of the upper lip, among others. Clinical crown lengthening, on the other hand, involves removing excess gingival tissue and, if necessary, bone tissue to expose more of the natural crown of the tooth. Clinical case: A clinical case of a 31-year-old female patient who presented a gummy smile caused by hypermobility of the upper lip and an excess of localized gingival tissue is reported. The treatment plan involved a combination of lip repositioning and crown lengthening. The aesthetic results were significant, with the patient's smile more balanced and displayed. The amount of the patient's exposed gum tissue when smiled was reduced and the length of the teeth was more visible, resulting in a more natural-looking smile, as well as increasing their acceptance of smiling.

Adaptación marginal e interna de cofias fabricadas por métodos convencionales, CAD/CAM de fresado y sinterizado por láser / Marginal and internal adaptation of copings manufactured by conventional methods, CAD/CAM milling and laser sintering

Introducción: la adaptación marginal e interna de nuestras restauraciones fabricadas por fundición sistemas de fresado y sinterización láser es uno de los factores clínicos más importantes para el éxito de las prótesis fijas, previniendo el riesgo de microfiltración y enfermedad periodontal. Objetivo: evaluar la adaptación marginal e interna de cofias metálicas en aleación Cr-Co confeccionadas por técnicas convencionales, CAD/ CAM de fresado y sinterizado por láser. Material y métodos: estudio de tipo experimental, comparativo e in vitro. Se imprimió un modelo maestro en Cr-Co, proveniente del escaneo de un premolar preparado para corona completa, sobre el cual se diseñaron 30 cofias divididas en tres grupos: el primero que corresponde al grupo cofias fundidas fresadas en disco de cera A (A = 10), el segundo grupo cofias fresadas en disco de metal presinterizado B (B = 10) y el tercer grupo cofias impresas por sinterización láser C (C = 10). Se empleó la réplica de silicona, colocando silicona al interior de cada cofia, sobre el modelo maestro, simulando al cemento, mediante una máquina de ensayo universal se realizó una compresión de 50 N. Luego de retirar cada cofia se rellenaron con silicona pesada de adición, obteniendo una réplica de silicona. Se efectuaron dos cortes transversales en sentido vestíbulolingual y mesiodistal. Se observó el espesor de silicona VPS (vinil poliéter silicona) mediante un estereomicroscopio (Nikon SMZ745T), obteniendo valores en micrómetros. Para el análisis estadístico se utilizó el software SPSS 25 con el fin de realizar la prueba de normalidad y ANOVA de dos vías bajo un nivel de confianza del 95%. Resultados: el menor gap lo obtuvo el grupo de fresadas, seguido de las impresas y por último las fundidas por métodos convencionales. ANOVA de dos vías reveló diferencias estadísticamente significativas entre los tres grupos (p < 0.0001). Conclusiones: se encontró que el gap varía con cada método de fabricación, la técnica convencional de fundido mostró un mayor gap, ninguna excediendo el rango clínicamente aceptable (AU)

Introduction: the marginal and internal adaptation of our restorations manufactured by casting, milling systems and laser sintering is one of the most important clinical factors for the success of fixed prostheses, preventing the risk of microleakage and periodontal disease. Objective: evaluate the marginal and internal adaptation of metal copings in Cr-Co alloy made by conventional techniques, CAD/CAM milling and laser sintering. Material and methods: an experimental, comparative and in vitro study, a Cr-Co master model was printed from the scan of a premolar prepared for a full crown. An experimental, comparative and in vitro study, a Cr-Co master model was printed from the scan of a premolar prepared for a full crown, on which 30 caps divided into three groups were designed; the first group corresponds to the cast copings milled on a wax disc A (A = 10), the second group milled copings on a presintered metal disc B (B = 10) and the third group printed by laser sintering copings C (C = 10). The silicone replica was used, placing silicone inside each coping, on the master model, simulating cement, using a universal testing machine, a 50 N compression was performed. After removing each coping, they were filled with heavy addition silicone, obtaining a silicone replica. Two cross-sections were made in the buccolingual and mesiodistal direction., observing the thickness of the VPS (vinyl polyeter silicone) silicone using a stereomicroscope (Nikon SMZ745T), obtaining values in micrometers. For the statistical analysis, the SPSS 25 software was used in order to perform the normality and two-way ANOVA tests under a 95% confidence level. Results: the smallest gap was obtained by the milled group, followed by the printed ones and finally those cast by conventional methods. Two-way ANOVA revealed statistically significant differences between the three groups (p < 0.0001). Conclusions: the gap was found to vary with each fabrication method, the conventional casting technique showed a larger gap, none exceeding the clinically acceptable range (AU)

Restauração transcirúrgica: inter-relação periodontia e dentística / Transsurgical restoration: interrelationship between periodontics and dentistry

Tendo em vista a importância da relação Dentística Restauradora e Periodontia na Odontologia atual, o presente estudo demonstrou o relato de um caso clínico realizado no Complexo Odontológico do Centro Universitário da Serra Gaúcha (FSG), retratando um procedimento de restauração transcirúrgica em um paciente cujo elemento 13 estava comprometido com uma cavidade subgengival disto-palatino, sendo a resina composta o material restaurador de escolha. Este estudo teve como objetivo apresentar um caso clínico demonstrando a técnica de restauração transcirúrgica e a integração do planejamento entre Periodontia e Dentística Restauradora realizado na Clínica de Odontologia do Centro Universitário da Serra Gaúcha -FSG. Este trabalho mostrou a importância da realização de uma técnica cirúrgica e restauradora correta por parte dos cirurgiões-dentistas, assim como na verificação de que os tecidos periodontais podem reagir de forma positiva à presença de materiais restauradores adesivos posicionados subgengivalmente(AU)

In view of the importance of the restorative dentistry and periodontics relationship in current dentistry, the present study demonstrated the report of a clinical case carried out in the Dental Complex of the Centro Universitário da Serra Gaúcha - FSG, portraying a transsurgical restoration procedure in a patient whose element 13 was compromised with a subgingival cavity of this-palatine, the composite resin being the restorative material of choice. This study aimed to present a clinical case demonstrating the technique of transsurgical restoration and the integration of planning between Periodontics and Restorative Dentistry carried out at the Dentistry Clinic of the University Centro Universitário da Serra Gaúcha - FSG. This study showed the importance of performing a correct surgical and restorative technique by dentists, as well as in verifying that periodontal tissues can react positively to the presence of adhesive restorative materials positioned subgingival(AU)

Recontorno de sorriso gengival utilizando piezocirurgia pela técnica flapless ­ relato de caso / Gengival smile contouring using piezosurgery through the flapless technique ­ case report / Contorno de sonrisa gengival mediante piezocirugía a través de la técnica flapless ­ reporte de caso

A cirurgia plástica gengival tem sido cada vez mais procurada por pacientes que se apresentam descontentes com o seu sorriso. O procedimento convencional realizado é feito através de uma elevação de retalho para exposição de tecido ósseo e subsequente a osteotomia ou osteoplastia, o qual leva a necessidade de suturas e uma recuperação mais demorada. Com o avanço da tecnologia, a técnica cirurgia Flapless, conhecida como minimamente invasiva e indolor, onde trás uma recuperação mais favorável e com resultados satisfatórios. Tem como principal indicação para pacientes com biotipo periodontal fino e intermediário, o planejamento cirúrgico deve ser feito com exames complementares, como a tomografia, para poder ser calculado a quantidade de tecido ósseo a ser removido. Após a excisão do tecido gengival sem abertura de retalho, a osteotomia/osteoplastia é feito via sulco gengival com a utilização do ultrassom piezoelétrico. Evidencias clínicas e científicas mostram que a técnica Flapless possui resultados satisfatórios em um menor espaço de tempo, sem necessidade de suturas e melhor pós-operatório.

Gingival plastic surgery has been increasingly sought after by patients who are dissatisfied with their smile. The conventional procedure performed is done through a flap elevation to expose bone tissue and subsequent osteotomy or osteoplasty, which leads to the need for sutures and a longer recovery. With the advancement of technology, the Flapless surgery technique, known as minimally invasive and painless, brings a more favorable recovery and satisfactory results. Its main indication for patients with thin and intermediate periodontal biotype, surgical planning should be done with complementary exams, such as tomography, in order to calculate the amount of bone tissue to be removed. After excision of the gingival tissue without opening a flap, the osteotomy/osteoplasty is performed via the gingival sulcus using piezoelectric ultrasound. Clinical and scientific evidence shows that the Flapless technique has satisfactory results in a shorter period of time, without the need for sutures and better postoperative period.

La cirugía plástica gingival ha sido cada vez más solicitada por pacientes que no están satisfechos con su sonrisa. El procedimiento convencional que se realiza se realiza mediante una elevación del colgajo para exponer el tejido óseo y posterior osteotomía u osteoplastia, lo que conlleva la necesidad de suturas y una recuperación más prolongada. Con el avance de la tecnología, la técnica de cirugía Flapless, conocida como mínimamente invasiva e indolora, trae una recuperación más favorable y resultados satisfactorios. Su principal indicación para pacientes con biotipo periodontal delgado e intermedio, la planificación quirúrgica debe hacerse con exámenes complementarios, como la tomografía, para calcular la cantidad de tejido óseo a remover. Después de la escisión del tejido gingival sin abrir un colgajo, la osteotomía/osteoplastia se realiza a través del surco gingival mediante ultrasonido piezoeléctrico. La evidencia clínica y científica demuestra que la técnica Flapless tiene resultados satisfactorios en menor tiempo, sin necesidad de suturas y con mejor postoperatorio.

Ductus venosus as a marker of fetal growth in first trimester in a population of Colombian pregnant women / Ductus venoso como marcador de crecimiento fetal en primer trimestre en una población de gestantes colombianas

Abstract Objectives: to evaluate the relationship between the ductus venosus (DV) and the variables of fetal growth in the first trimester in a Colombian pregnant population. Methods: a descriptive cross-sectional study was carried out with secondary data obtained from a multicenter study.526 patients were included between weeks 11 and 14 for gestational ultrasound follow-up attended in three health care institutions in Bogotá, Colombia, between May 2014 and October 2018. A bivariate descriptive analysis was carried out where the relationship between the characteristics of the DV in the first trimester and ultrasound findings. Results: the flow wave of the DV in the first trimester was normal in the entire sample, with a pulsatility index of the ductus venosus (DVPI) of 0.96±0.18. In addition, a negative correlation was found between the crown-rump length (CRL) and the DVPI (p<0.05). Conclusion: there is a relationship between the DVPI regarding the CRL, indicating an interest in this early marker in relation to fetal growth alterations; however, more studies are required to determine the usefulness of this variable with respect to fetal growth.

Resumen Objetivos: evaluar la relación entre el ductus venoso (DV) y las variables del crecimiento fetal en primer trimestre en una población de gestantes colombianas. Métodos: se realizó un estudio transversal descriptivo con datos secundarios obtenidos de un estudio multicéntrico. Se incluyeron 526 pacientes entre las semanas 11 a 14 para seguimiento ecográfico gestacional atendidas en tres instituciones prestadoras de salud en Bogotá, Colombia, entre mayo del 2014 y octubre del 2018. Se realizó un análisis descriptivo bivariado donde se evaluó la relación entre las características del DV en primer trimestre y los hallazgos ecográficos. Resultados: la onda de flujo del DV en primer trimestre fue normal en la totalidad de la muestra, con un índice medio de pulsatilidad del ductus venoso (IPDV) de 0,96±0.18. Se encontró una correlación negativa entre la longitud cefalocaudal (LCC) y el IPDV (p<0.05). Conclusión: existe una relación entre el IPDV respecto a la LCC, señalando un interés de este marcador temprano en relación con las alteraciones del crecimiento fetal, sin embargo, se requieren más estudios para determinar la utilidad entre esta variable respecto al crecimiento fetal

The infection control of post-and-core crown restoration / 华西口腔医学杂志

Post-and-core crown is one of the most common forms of restoration of tooth after root canal therapy (RCT). Infection control is the core objective of RCT, which is usually well realized by endodontists. However, many prosthodontists often neglect the infection control of the tooth and the maintenance of the curative effect of RCT during the process of post-and-core crown, which may lead to the failure of the final restoration. The concept of integrated crown-root treatment advocated recently requires clinicians to consider the RCT and final restoration as a whole, rather than simply divided into two parts-endodontic treatment and restorative treatment. As the core content of integrated crown-root treatment, infection control should be taken seriously by clinicians and implemented throughout the whole treatment process, especially in the restorative treatment that is easily overlooked after RCT. Therefore, this article describes the infection control of post-and-core crown restoration, classifies the tooth requiring post-and-core crown restoration, and puts forward the measures of infection control before and during post-and-core crown restoration, in order to provide reference and guidance for clinical practice.

Application of interpenetrating polymer network enamel-like teeth in the dental practice teaching of crown preparations / 中华医学教育探索杂志

Objective:To explore a type of teaching teeth that can highly simulate natural teeth, and to investigate its application in the practice teaching of crown preparations.Methods:A total of 44 senior students majoring in stomatology Fourth Military Medical University were selected, and each student received the training of crown preparations using interpenetrating polymer network (IPN) enamel-like teaching teeth, extracted natural teeth, and traditional composite resin teeth. Operation assessment was performed, and the operation time of each crown preparation was recorded. According to the requirements for crown preparations, scores were determined from the five aspects of axial converging, space for repair, line angle, shoulder quality, and posture, with 10 points for each aspect and 50 points in total, and the total score was calculated. A questionnaire survey on IPN enamel-like teeth was performed for each student after assessment, and SPSS 23.0 was used to perform the least significant difference t-test and the Tambane's T2 test. Results:There was no significant difference in total assessment score between the IPN enamel-like teeth group and the natural teeth group (37.15±1.17 vs. 37.20±1.20, P>0.05), and both groups had a significantly higher total score than the resin teeth group (31.53±1.41) ( P<0.05). The IPN enamel-like teeth group and the natural teeth group had significantly higher scores than the traditional composite resin teeth group in terms of axial converging, space for repair, and shoulder quality ( P<0.05). The questionnaire survey of the students showed a relatively high score of 3.7-4.9 for each item. Conclusion:Compared with traditional composite resin teeth, IPN enamel-like teeth can more comprehensively and effectively simulate the operation and experience of natural teeth for crown preparations and thus have potential advantages in the practice teaching of crown preparations.

Study on clinical efficacy of a 3D model based on crown-root integration in clear aligners / 口腔医学

Objective@#To evaluate the clinical effect of clear aligners in the anterior region in non-extraction cases by establishing a three-dimensional model of crown-root fusion to guide clinical application.@*Methods@#Eleven patients visiting the orthodontic department of Xuzhou Stomatological Hospital from December 2020 to December 2021 were collected, and the orthodontic plan was designed using Maestro 3D Dental Studio scheduling software to obtain the expected three-dimensional model of the patient's orthodontic treatment result. CBCT, intraoral scan, and 3D reconstruction software were used to create a postoperative model of the patient. The crown and root data were aligned in Geomagic Studio 2014, and differences in torque and axial inclination between the actual model after treatment and the predicted model of the anterior teeth before treatment were compared in 3-matic.@*Results@#The actual torque angles of the anterior teeth were all smaller than the predicted angles before treatment, with the highest realization rate of 77.55% for lateral incisors and the lowest of 60.70% for central incisors; the actual axial inclination angles of the anterior teeth were also smaller than the predicted angles before treatment, with the highest realization rate of 81.49% for central incisors and the lowest of 74.95% for cuspids. @*Conclusion@# A digital model of crown-root integration based on a combination of 3D reconstruction and intraoral scanning techniques is advantageous in assessing the efficacy of clear aligners. In non-extraction cases with clear aligner, the efficiency of movement is higher for small areas of the anterior region.

Clinical effect of a door shaped individualized dental archwire on the treatment of maxillary transposed canines / 口腔疾病防治

Objective @#To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians.@*Methods@#Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. @*Results@# All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P<0.05). The mean angulation changes of the long axes of the canines were 17.5°. There was no significant difference in the depth of periodontal measurement and buccal crown height measurement between T1 and T3 (P>0.05). @*Conclusion @# The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.

Three-dimensional finite element analysis of cement flow in abutment margin-crown platform switching / 北京大学学报(医学版)

OBJECTIVE@#To analyze the cement flow in the abutment margin-crown platform switching structure by using the three-dimensional finite element analysis, in order to prove that whether the abutment margin-crown platform switching structure can reduce the inflow depth of cement in the implantation adhesive retention.@*METHODS@#By using ANSYS 19.0 software, two models were created, including the one with regular margin and crown (Model one, the traditional group), and the other one with abutment margin-crown platform switching structure (Model two, the platform switching group). Both abutments of the two models were wrapped by gingiva, and the depth of the abutment margins was 1.5 mm submucosal. Two-way fluid structure coupling calculations were produced in two models by using ANSYS 19.0 software. In the two models, the same amount of cement were put between the inner side of the crowns and the abutments. The process of cementing the crown to the abutment was simulated when the crown was 0.6 mm above the abutment. The crown was falling at a constant speed in the whole process spending 0.1 s. Then we observed the cement flow outside the crowns at the time of 0.025 s, 0.05 s, 0.075 s, 0.1 s, and measured the depth of cement over the margins at the time of 0.1 s.@*RESULTS@#At the time of 0 s, 0.025 s, 0.05 s, the cements in the two models were all above the abutment margins. At the time of 0.075 s, in Model one, the gingiva was squeezed by the cement and became deformed, and then a gap was formed between the gingiva and the abutment into which the cement started to flow. In Model two, because of the narrow neck of the crown, the cement flowed out from the gingival as it was pressed by the upward counterforce from the gingival and the abutment margin. At the time of 0.1 s, in Model one, the cement continued to flow deep inside with the gravity force and pressure, and the depth of the cement over the margin was 1 mm. In Model two, the cement continued to flow out from the gingival at the time of 0.075 s, and the depth of the cement over the margin was 0 mm.@*CONCLUSION@#When the abutment was wrapped by the gingiva, the inflow depth of cement in the implantation adhesive retention can be reduced in the abutment margin-crown platform switching structure.

Técnicas para prática de escultura dental / Techniques for the practice of dental sculpture / Técnicas para la práctica de la escultura dental

Objetivo: Caracterizar e diferenciar as técnicas de escultura dental, bem como descrever as etapas da ceroplastia de dentes. Revisão Bibliográfica: As principais técnicas encontradas foram: Técnica de escultura regressiva de dentes isolados em cera; técnica progressiva; técnica de ceroplastia em dentes articulados no manequim; enceramento progressivo em molde de gesso; enceramento progressivo com a oclusão dente-a-dente, cúspide-fossa; técnica de escultura de dentes articulados (restaurações unitárias); técnica de escultura de dentes articulados (restaurações múltiplas). No geral, o material e instrumental utilizados nas práticas de escultura são definidos pelo corpo docente do componente curricular Escultura Dental, e alguns desses diferem de uma universidade para outra, assim como o passo a passo seguido. Para o alcance da completa e correta escultura, faz-se necessário seguir a sequência evitando ultrapassar uma etapa sem antes haver cumprido com plena observância dos detalhes o passo imediatamente anterior. Considerações finais: Não houve uma técnica de escultura dental padrão a ser aplicada, entretanto acredita-se que a técnica de ceroplastia em dentes articulados no manequim destaca-se na prática laboratorial, pois os dentes a serem esculpidos precisaram respeitar o tamanho, a relação de oclusão, a relação interdental e o alinhamento, de forma a simular um procedimento clínico.

Objective: To characterize and differentiate dental carving techniques, as well as describe the stages of wax-up of teeth. Bibliographic Review: The main techniques found were: Technique of regressive sculpture of isolated teeth in wax; progressive technique; wax-up technique on articulated teeth on the dummy; progressive waxing in plaster mold; progressive waxing with tooth-to-tooth, cusp-fossa occlusion; articulated teeth sculpting technique (single restorations); articulated teeth sculpting technique (multiple restorations). In general, the material and instruments used in sculpting practices are defined by the faculty of the Dental Sculpture curricular component, and some of these differ from one university to another, as well as the step by step followed. In order to achieve a complete and correct sculpture, it is necessary to follow the sequence, avoiding going beyond a stage without first having completed the immediately preceding step in full observance of the details. Final considerations: There was no standard dental sculpting technique to be applied, however, it is believed that the wax-up technique on articulated teeth on the dummy stands out in laboratory practice, as the teeth to be sculpted needed to respect the size, the relationship of occlusion, interdental relationship and alignment, in order to simulate a clinical procedure.

Objetivo: Caracterizar y diferenciar las técnicas de tallado dental, así como describir las etapas del encerado de los dientes. Revisión Bibliográfica: Las principales técnicas encontradas fueron: Técnica de escultura regresiva de dientes aislados en cera; técnica progresiva; técnica de encerado en dientes articulados en el maniquí; encerado progresivo en molde de yeso; encerado progresivo con oclusión cúspide-fosa diente a diente; técnica de esculpido de dientes articulados (restauraciones individuales); Técnica de esculpido de dientes articulados (restauraciones múltiples). En general, los materiales e instrumentos utilizados en las prácticas de escultura son definidos por la facultad del componente curricular de Escultura Dental, y algunos de estos difieren de una universidad a otra, así como el paso a paso seguido. Para lograr una escultura completa y correcta, es necesario seguir la secuencia, evitando pasar de una etapa sin haber completado antes el paso inmediatamente anterior con total atención a los detalles. Consideraciones finales: No existía una técnica de esculpido dental estándar a aplicar, sin embargo, se cree que la técnica de encerado sobre dientes articulados sobre el maniquí se destaca en la práctica de laboratorio, ya que los dientes a esculpir debían respetar el tamaño, la relación de oclusión, relación interdental y alineación, con el fin de simular un procedimiento clínico. PALABRAS CLAVE: Corona del Diente; Escultura; Anatomía Artística.

Mechanical behavior of different machinable ceramic crowns using vertical and horizontal preparations: an in-vitro study / Comportamento mecânico de diferentes coroas cerâmicas usináveis usando preparos verticais e horizontais: um estudo in vitro

Objective: the aim of this study was to compare the mechanical behavior of different ceramics when used in thin vertical preparations versus traditional horizontal preparation. Material and Methods: two stainless-steel dies were milled to simulate a minimally invasive vertical preparation (VP) and a traditional horizontal preparation (HP) for an all-ceramic crown of a maxillary first premolar. The stainless-steel dies were duplicated using epoxy resin. Eighty monolithic crowns were milled and divided into 2 groups according to preparation design. Each design group was subdivided into 4 sub-groups according to material (n=10): IPS e.max CAD (lithium disilicate), Bruxzir shaded zirconia (full contour zirconia), CeraSmart (resin nanoceramic) and CEREC Tessera (advanced lithium disilicate). The crowns were cemented on their relevant epoxy resin dies using self-adhesive resin cement. All specimens were subjected to 15,000 thermocycles and then loaded to fracture in a universal testing machine. Data were analyzed using two-way ANOVA and Tukey pair wise comparison test. Results: the fracture resistance mean values of the VP (1344 + 118 N) was significantly lower than the HP design (1646 + 191 N). Ceramic crowns made of full contour zirconia had higher fracture resistance mean values (2842 + 380 N) than advanced lithium disilicate (1272 + 125 N) followed by lithium disilicate crowns (983 + 52 N) and resin nanoceramic (882 + 61 N). Conclusion: both vertical and horizontal preparations, regardless the different ceramic materials, showed clinically acceptable fracture resistance values. (AU)

Objetivo: o objetivo deste estudo foi comparar o comportamento mecânico de diferentes cerâmicas quando utilizadas em preparos verticais finos ou preparos horizontais tradicionais. Material e Métodos: dois modelos de aço inoxidável foram fresados para simular um preparo vertical minimamente invasivo (PV) e um preparo horizontal tradicional (PH) para uma coroa totalmente em cerâmica de um primeiro pré-molar superior. As matrizes de aço inoxidável foram duplicadas usando resina epóxi. Oitenta coroas monolíticas foram fresadas e divididas em 2 grupos de acordo com o desenho do preparo. Cada grupo foi subdividido em 4 subgrupos de acordo com o material (n=10): IPS e.max CAD (dissilicato de lítio), zircônia Bruxzir (zircônia de contorno total), CeraSmart (resina nanocerâmica) e CEREC Tessera (dissilicato de lítio avançado). As coroas foram cimentadas em suas respectivas matrizes de resina epóxi usando cimento resinoso autoadesivo. Todos os espécimes foram submetidos a 15.000 ciclos térmicos e então carregados até a fratura em uma máquina de teste universal. Os dados foram analisados usando ANOVA com dois fatores e teste de comparação por pares de Tukey. Resultados: os valores médios de resistência à fratura do PV (1344 + 118 N) foram significativamente menores do que PH (1646 + 191 N). As coroas de cerâmica feitas de zircônia de contorno total apresentaram maiores valores médios de resistência à fratura (2842 + 380 N) do que dissilicato de lítio avançado (1272 + 125 N), seguido por coroas de dissilicato de lítio (983 + 52 N) e resina nanocerâmica (882 + 61 N). Conclusão: preparos verticais e horizontais, independentemente dos diferentes materiais cerâmicos, apresentaram valores de resistência à fratura clinicamente aceitáveis. (AU)

Terapia Pulpar Vital en Diente con Fractura Coronaria Complicada

La fractura coronaria es el traumatismo dentoalveolar (TDA) más frecuente en la dentición permanente. Cuando existe exposición pulpar, se conoce como fractura coronaria complicada (FCC). Actualmente, en estos casos, se recomienda realizar terapias que permitan preservar la vitalidad del tejido pulpar, tanto en dientes maduros como inmaduros. El presente reporte describe el caso de un paciente de 9 años con FCC en diente 2.1, donde se realizó tratamiento con terapia pulpar vital (pulpotomía de Cvek), y adhesión de fragmento dentario. En los controles posteriores al TDA (1 semana, 4 meses, 1 y 2 años) el diente estaba asintomático, se observó formación de puente dentinario y continuación de desarrollo radicular con cierre apical, indicios de que el tejido pulpar se mantuvo vital. En este caso se destaca la importancia del diagnóstico, tratamiento adecuado, junto al seguimiento de un diente con desarrollo radicular incompleto.

Crown fracture is the most frequent dental traumatic injury (DTI) in permanent dentition. When there is pulp exposure, it is known as a complicated crown fracture. Currently, in these cases, it is recommended to carry out therapies that allow preserving the vitality of the pulp tissue, both in mature and immature teeth. This report describes the case of a 9-year-old patient with a complicated crown fracture in tooth 2.1, who underwent treatment with vital pulp therapy (Cvek pulpotomy), and adhesion of the dental fragment. In follow-up sessions (after 1 week, 4 months, 1 and 2 years), the tooth was asymptomatic. It was observed dentin bridge formation and the continuation of root development with apical closure, indications that the pulp tissue has remained vital. In this case, the importance of proper diagnosis and treatment is highlighted, together with the follow-up of a tooth with incomplete root development.

Ectodermal Dysplasia in Primary Dentition – A Rare Case Report

Development of the primary and permanent dentition is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. A cascade of signaling pathways occur in a spatio-temporal manner resulting in the development and eruption of the human dentition. Any developmental aberrations in shape, size, number, and position can lead to deviations from normal development of teeth. In this book, dental anomalies including gemination, fusion, concrescence, dilaceration, dens invaginatus, DE, taurodontism, enamel pearls, fluorosis, peg?shaped laterals, dentinal dysplasia, regional odontodysplasia and hypodontia etc. are discussed. Diagnosing dental abnormality needs a thorough evaluation of the patient and careful clinical and radiographical examination is required. Furthermore, more complex cases need multidisciplinary planning and treatment.

The outcome of partial pulpotomy in traumatized permanent anterior teeth – A systematic review and meta-analysis

Background: Partial pulpotomy is a procedural intervention that can maintain the vitality of pulp during the management of traumatized permanent teeth with pulpal involvement. Aim: To evaluate whether partial pulpotomy can be considered a reliable conservative treatment option for treating traumatized permanent anterior teeth with pulpal involvement. Methodology: A computerized systematic search was performed in PubMed, Science Direct, Cochrane, and LILACS databases from 1980 to May 2021. Five studies were included in the final analysis. Quality assessment, Meta?analysis, and Publication bias of the studies were evaluated. This systematic review was registered in PROSPERO (ID – CRD42021262031). Result: The comprehensive Meta?Analysis Software was used. The test of the heterogeneity was analysed using Cochran’s Q statistics. The Q value was 7.186 (df = 6) with a P value of 0.3 and I2 as 16.5%. The studies were considered homogenous, and the fixed?effect model showed an overall point estimate of 0.89 with a 95% confidence interval (0.86–0.91). The Begg and Egger funnel plot indicated that there was no publication bias in the included studies. Conclusion: Evidence indicates that partial pulpotomy may be considered a reliable definitive treatment option in asymptomatic traumatized permanent anterior teeth with exposed pulp rather than total pulpotomy.

THE POST TRANSFIXED IN THE CORONAL CAVITY INCREASES THE FRACTURE RESISTANCE OF WEAKENED AND DIRECTLY RESTORED TEETH? A SYSTEMATIC REVIEW

Introduction: The objective of this systematic review was to answer the question: Does the intraradicular post transfixed in the dental crown increases the fracture resistance of weakened and directly restored teeth? Methods: Electronic databases (MEDLINE/PubMed, LILACS, SCOPUS, EMBASE, Scientific Electronic Library Online - SCIELO, and Central Register of Controlled Trials - CENTRAL) were searched until March 2021, without language or year restriction. Grey literature was also searched through Google scholar and OpenGrey repository. Only in vitro stud-ies were included that evaluated the influence of the use of intraradicular post trans-fixed in the crown in the buccopalatal/lingual direction in the fracture resistance of the dental crown. Relevant results were summarized and evaluated. The risk of bias was also assessed in the studies. Results: Initial screening of databases resulted in 249 studies, of which 109 were excluded for being duplicates. Of 140 eligible pa-pers, fourteen studies met the inclusion criteria and were selected for full-text read-ing. Of these, two studies were excluded for not having access to the full article. All selected articles were classified as low risk of bias. Conclusion: Based on the studies, it is possible to conclude that the use of a transfixed post in the crown increases the fracture resistance of weakened and directly restored teeth.

Retrospective analysis of adverse reactions and related factors of resin cement dentin adhesive / 口腔疾病防治

Objective@# To investigate the adverse reactions of resin cement used for dentin bonding and its influencing factors.@*Methods@# Patients with dental defects treated with resin cement dentin adhesive for direct composite resin repair or full crown indirect repair were selected as the research objects. The occurrence and causes of adverse reactions, such as dental pulp lesions, soft tissue adverse reactions, and restoration loosening and falling off 7 days, 1 month, 3 months, 6 months, and 1 year after treatment, were analyzed retrospectively.@*Results @# Among the 14 776 teeth of 5 971 patients who used resin cement dentin adhesive, 580 cases (3.93%) had adverse reactions. Univariate analysis showed that the incidence of adverse events was highest in teeth with the "full crowns (fixed partial dentures)" restoration type at 7 days, 1 month, and 12 months after treatment. At 7 days after treatment, the incidence of adverse events was the highest in teeth with a preparation depth of "near pulp after preparation". At 7 days and 3 months after treatment, the incidence of adverse events was the highest in teeth with " dentin conditioner-adhesive-resin" treatment of the bonding surface. Multivariate analysis indicated that pulp perforation and pulp capping after tooth preparation were risk factors for adverse events 7 days after treatment (OR=2.610), and the “dentin primer-adhesive-resin” bonding surface treatment method was a protective factor for adverse events 7 days and 3 months after treatment (OR<1). @*Conclusion@#affect the occurrence of adverse events. pulp perforation, and pulp capping after tooth preparation, and self-etching bonding may contribute to adverse reactions.