Progress in restorative treatments of primary incisor defects / 口腔疾病防治

@#Dental caries and trauma are the most common oral diseases in children, which could result in defects of the teeth or detention. Maintenance of the primary dentition in a nonpathologic condition is important for oral health, craniofacial development, and the overall well-being of the children. In contemporary dentistry, primary anterior teeth defects are mainly treated with drugs, restorative treatments, or both. Restorative treatment is the most preferred method and includes direct restoration, full coronal restoration, post-and-core crowns, etc. This article reviews the available information regarding a variety of restorative treatments for primary incisor defects, including their backgrounds, clinical indications, clinical pathways, and related studies. The literature review shows that intraconal direct restoration is widely used on single surfaces. There are many kinds of full coronal restorations, and each has its own advantages. Pediatric resin-bonded strip crowns and zirconia crowns are the most popular and have excellent aesthetics. The use of post-and-core crowns for primary incisors is controversial. The absorbable post may be the next research hotspot. Therefore, treatment of severely destroyed primary incisors poses a challenge for pediatric dentists, as three important considerations must be kept in mind: children′s behavioral management, preservation of the tooth structure and parental satisfaction.

Evaluation of resin inlay restoration after root canal therapy for deciduous molars / 口腔疾病防治

Objective @#To explore the clinical effect of composite resin inlays in repairing large areas of primary molar defects after root canal treatment to provide a reference for the restoration of carious primary molars.@*Methods@#Thirty-eight primary molars of 32 children were selected as the research objects. Indirect restoration with composite resin inlays was performed after root canal therapy. The clinical efficacy was evaluated in terms of five indices, including restoration retention, marginal integrity, gingival status, anatomical morphology and secondary caries, according to the modified USHPS evaluation criteria, at 6, 12 and 18 months after restoration.@*Results @#During the 18-month follow-up period, 36 of the 38 teeth were successfully restored, and all the evaluated items reached grade A or B. Six months after the repair, one prosthesis had fallen off, resulting in a success rate of 97.37% (37/38). The success rate remained 97.37% (37/38) 12 months after the repair; 18 months after the repair, another prosthesis had failed(Marginal integrity and anatomical morphology were grade C), reducing the success rate to 94.74% (36/38). There was no significant difference in the success rate of resin inlay repair at 6, 12 or 18 months (χ2=0.518, p=0.772).@*Conclusion@#Composite resin inlay restoration is an alternative method for repairing primary molars with large defects after root canal treatment.

Effect analysis of ceramic onlay to repair serious dental defects in young permanent molars / 华西口腔医学杂志

OBJECTIVE@#To analyze the effect of ceramic onlay to repair serious defects in young permanent molars.@*METHODS@#Sixty patients with defects in young permanent molars were selected. The patients were randomly divided into two groups. One group was restored with ceramic onlay, and the other used resin composite to direct filling. Follow-up visit was conducted at 3, 6, 12, and 24 months after treatment. Modified USPHS/Ryge criteria were used to evaluate the effect of restoration. The occlusal courses were recorded by the T-Scan Ⅲ system in intercuspal position. Gingival and food impaction were recorded. The effect of the two restorative methods, the recovery of occlusal function, and the gingival and approximal conditions were analyzed.@*RESULTS@#At 12 months after restoration, the marginal fitness in the onlay group was significantly better than that in the resin group (P0.05). The gingival and approximal conditions also demon-strated no stati-stical differences (P>0.05).@*CONCLUSIONS@#The ceramic onlay repair method is better than resin composite filling in marginal fitness, surface smoothness, and recovery of the occlusal function when restoring young permanent molars with serious defects.

Three-year retrospective clinical evaluation of pulp-less molars with defects of varying degree repaired by cast ceramic onlays of three marginal types / 华西口腔医学杂志

OBJECTIVE@#This study aimed to evaluate the clinical effect of pulp-less molars with defects of different degrees repaired by cast ceramic onlays of three marginal types.@*METHODS@#A total of 165 endodontically treated molars of 105 patients were included in this study and were divided into three kinds of defect (mild, moderate, severe) according to the number of remaining axial walls. Each defect was divided into three groups according to the shape of edge to edge, bevel edge, and concave shoulder. After tooth preparation, the casting of ceramic onlays was performed. Treatment follow-up was done for the evaluation of the success and survival rates of three groups under the same defect.@*RESULTS@#The average follow-up was 925.44 days. Under the mild defect, the success and survival rates of the edge to edge onlays were respectively 100% and 100%; bevel edge onlays, 100% and 100%; and concave shoulder onlays, 94.4% and 100%. Under the moderate defect, the success and survival rates of the edge to edge onlays were respectively 96.0% and 100%; bevel edge onlays, 80.0% and 93.3%; and concave shoulder onlays, 95.2% and 95.2%. Under the severe defect, the success and survival rates of the edge to edge onlays were respectively 95.2% and 100%; bevel edge onlays, 73.7% and 89.5%; and concave shoulder onlays, 73.3% and 80.0%. Under different defects, the success or survival rates of the three kinds of onlays had no significant difference (P>0.05).@*CONCLUSIONS@#The edge to edge type is the most preferable way of onlay tooth preparation and can achieve good clinical results in the mild, middle, and severe tooth defection with root canal treatment.

Clinical observations of all-ceramic restorations of children’s first permanent molars with severe defects / 口腔疾病防治

Objective @#To explore the therapeutic efficacy of chairside CEREC all-ceramic restorations in children with first permanent molars with severe defects and to summarize the clinical methods and procedures.@*Methods@# Forty teeth of 7-15 years old thirty-four children with first permanent molars with severe defects were selected. After careful tooth preparation, a total of 40 all-ceramic restorations (8 inlays, 32 onlays) were designed and manufactured using the CEREC 3D system, and all prostheses were bonded with composite resin cement. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was assessed. The clinical efficacy was analyzed using modified USPHS criteria at 12 months and 24 months. Evaluations included secondary caries, marginal adaptation, surface texture, color matching, fracture, anatomical form, adjacency relationship and gingival health.@*Results @# For the 40 all-ceramic restorations of the first permanent molars, after 24 months, 100% of the teeth were grade A for secondary caries, surface texture and fracture of the prosthesis, and 85% of the teeth were up to grade A for the other indexes at 12 and 24 months. There were no significant differences (P > 0.05) between 12 months and 24 months. Immediately after treatment and after 24 months, the subjective satisfaction of the patients was greater than 94%. @*Conclusion @#Application of the CEREC 3D system had a clear curative effect and resulted in high satisfaction in the repair of permanent molars with severe defects in children.

Application of three-dimensional finite element method in different dental restorations / 口腔疾病防治

@#Three-dimensional finite elemennt method (3-D FEM) is an approach to simulate the intraoral environment by fabricating virtual model in computer software, to provide various options of restorations according to the requirements of study, and finally to give relevant mechanic data for clinical reference by stress analysis. 3-D FEM has been applied in stomatological research more and more widely in recent years. This review has summarized the applications of 3-D FEM in various kinds of dental restorations.

Esthetical effects of crown lengthening surgery on teeth with subgingival defect / 中华医学美学美容杂志

Objective To observe the results of crown lengthening surgery on the teeth with subgingival defect.Methods Crown lengthening surgery was performed on 54 terior teeth,which were divided into two groups based on probing depth of pre-operation:group A (<3 mm) and group B (3-4 mm).All teeth were restored 8 weeks after operation and followed-up to 1 year.The parameters of plaque index (PLI),suleus bleeding index (SBI),maximal defect probing depth (PD) and mobility degree (MD) at different times were measured,respectively.Results PLI,BI and PD were significantly improved during the follow-up period (P<0.01).The success rates of both groups were 96.8% and 69.6%, respectively (P<0.01).No significant difference about MD in the group A one year after restoration (P>0.05),but a significant improvement in the group B (P<0.01).Conclusion Crown lengthening surgery is a good method on the teeth with subgingival defect,but one must select the right indication.