Evaluation and comparison of the accuracy of three intraoral scanners for replicating a complete denture.

STATEMENT OF PROBLEM: Technological advances in digital acquisition tools have increased the scope of intraoral scanners (IOSs), including scanning a removable complete denture (RCD) to replicate it. However, studies assessing the accuracy of IOSs for replicating a maxillary or mandibular RCD are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the accuracy (trueness and precision) of 3 IOSs while replicating a maxillary and mandibular RCD. MATERIAL AND METHODS: One maxillary and 1 mandibular RCD were scanned with a desktop scanner (D2000) to obtain the reference model. Two operators scanned each RCD 5 times with 3 different IOSs (TRIOS 4, Primescan, and IS3800), following a predefined acquisition protocol. The 60 study models obtained were compared with the reference model using the Geomagic software program. For each comparison, the mean and standard deviation of discrepancy were calculated. Distances were measured on both the reference and the study model, and differences were calculated to assess whether sagittal or transverse deformations were present. The tolerance percentage of the volume of the digital model compared with the volume of the reference model was determined (difference tolerance was set at 0.1 mm). A univariate analysis of variance followed by a post hoc analysis using the Student-Newman-Keuls (α=.05) test was performed to determine the truest and the most precise IOS. RESULTS: The TRIOS 4 and Primescan IOSs had comparable trueness, with mean dimensional variations of 47 ±27 µm and 57 ±8 µm respectively compared with the reference model. The IS3800 had a lower trueness (98 ±35 µm). Primescan was significantly more precise with a mean standard deviation of 64 ±15 µm (P<.05). The TRIOS 4 (141 ±48 µm) and IS3800 (129 ±24 µm) had comparable precision. Primescan showed the least sagittal and transverse deformation. CONCLUSIONS: This study determined that an RCD can be replicated using an IOS, although all IOSs did not have equal accuracy. An in vivo study needs to assess whether this procedure is clinically acceptable.

Evaluation of the design-driven prediction of removable partial denture retention.

STATEMENT OF PROBLEM: Removable partial dentures (RPDs) are a cost-effective treatment designed to replace missing teeth for partially edentulous patients. However, RPDs often have insufficient retention, which results in treatment failure and patient dissatisfaction. PURPOSE: The purpose of this clinical study was to investigate the factors related to RPD retention that affect patient satisfaction, to clinically validate a newly published model for predicting RPD retention based on the number and position of missing teeth and clasps, and to identify the predictions of patient satisfaction to improve the guidelines for RPD design. MATERIAL AND METHODS: Seventy-five patients treated with 107 RPDs delivered at the McGill University Dental Clinic (Montreal, Canada) and Estaing University Hospital (Clermont-Ferrand, France) participated in this study. Data on the RPD design were collected from the clinical records, and the retention of each RPD was tested with the mathematical model designed for predicting RPD retention. Data on patient satisfaction with their RPDs were collected by using a standardized questionnaire (McGill Denture Satisfaction Instrument). Statistical analysis of factors related to RPD retention and patient satisfaction was performed by using the chi-square test and Mann-Whitney test, while the developed model for predicting RPD retention was evaluated by using sensitivity and specificity analysis. RESULTS: The average satisfaction score for all RPDs was 8.2 ±1.7 out of 10. Patients were more satisfied with RPDs in the maxillary arch, tooth-supported, or retained by ≥3 clasps than with RPDs in the mandibular arch, with distal extension bases, or retained by <3 clasps. The materials used for RPD fabrication (metal-based or acrylic resin-based), the number of missing teeth, and the presence of indirect retention were not associated with patient satisfaction. Participants were significantly more satisfied with RPD designs predicted by the developed mathematical model to have enough retention than with RPD designs predicted to have insufficient retention. The mathematical model for predicting the RPD retention showed a clinical specificity of 83% in predicting patient satisfaction. CONCLUSIONS: RPD retention predicted from the number and position of clasps and missing teeth might help to determine patient satisfaction. In addition, patient satisfaction with RPDs was influenced by the arch type, the presence of a distal extension base, and the number of clasps.

Démographie des chirurgiens-dentistes en région Centre-Val de Loire : opportunités et perspectives.

The Center Val de Loire region is particularly affected by the shortage of health professionals. The demographics of dentists are not immune to this situation and the retirement of a practitioner has become a real public health issue. For this purpose, bridges were created between the faculties of odontology of Nantes, Clermont-Ferrand and the Faculty of Medicine of Tours, to welcome short cycle students in Center Val de Loire region, to create a link with the liberal practitioners and to allow the students to confront the health issues of this territory.

The "Plan" phase of a Deming cycle: Measurement of quality and outcome of root canal treatments in a university hospital.

INTRODUCTION: In many countries, dental students are taught in private or university hospitals where they treat patients under the supervision of teachers. Assessing the quality of root canal treatments (RCT) would provide information about the quality of care patients receive when treated by students. METHODS: This study describes the six-step "Plan" phase of a Plan-Do-Check-Act (PDCA) cycle that identifies and analyses clinical practices in endodontics in a university dental hospital service. RESULTS: Step 3 reported that the proportion of RCTs of adequate quality reached 57.1% and this proportion was significantly decreased when specific indicators for treatment difficulties were present. The proportion of successful RCTs after 1 year was 65.6%, and its variation was influenced by the preoperative periapical status rather than the quality of RCTs. The consensual meeting in Step 6 proposed to introduce three new procedures for the further Do, Check and Act phases of the PDCA cycle. CONCLUSION: This study encourages systematic evaluation of RCTs and provides the first step of the methodology that can be reproduced in private and hospital practices where students are asked to treat patients.

[Dentistry demographics of Center Val de Loire region: Opportunities and prospects]. / Démographie des chirurgiens-dentistes en région Centre-Val de Loire : opportunités et perspectives.

The Center Val de Loire region is particularly affected by the shortage of health professionals. The demographics of dentists are not immune to this situation and the retirement of a practitioner has become a real public health issue. For this purpose, bridges were created between the faculties of odontology of Nantes, Clermont-Ferrand and the Faculty of Medicine of Tours, to welcome short cycle students in Center Val de Loire region, to create a link with the liberal practitioners and to allow the students to confront the health issues of this territory.

A new digital denture procedure: a first practitioners appraisal.

BACKGROUND: Historically, the complete removable denture is the last prosthetic procedure to switch to digital techniques whose advantages are mainly observed in the laboratory stages; however, it is not possible to measure the depressibility of the oral mucosa using optical cameras, thus conventional impression techniques are still necessary. This article describes the clinical and laboratory procedure and practitioners appraisal of the first fifteen digitally designed complete removable dental prostheses. METHODS: Several systems are now available including the Wieland® Digital Denture® which offers a complete procedure. This system is composed of a five axis-milling machine combined with a laboratory scanner and a design software application. Fifteen rehabilitations were carried out using the Wieland® system. RESULTS: The practitioner's role is simplified by intraoral recording with a central point and a reduced number of sessions. The prosthesis laboratory requires considerable investment in learning and equipment, making it possible to obtain ideal mounting assemblies in accordance with the occluso-prosthetic concept of bilateral balanced occlusion. The absence of polymerization and therefore of base deformation risks reduce the equilibration step. Finally, the creation of templates as an alternative to the assembly of teeth on wax makes it possible to functionally validate (masticatory and phonatory) the future dentures. However, this procedure still presented some limitations in terms of scanning and software scope of applications. CONCLUSION: Digital denture design software is relatively efficient and helps to standardize clinical results. However, to this date, improvements of the software are still required for a routine use.

Assessment of the oral health knowledge of healthcare providers in geriatric nursing homes: additional training needs required.

OBJECTIVES: This study was aimed at assessing the knowledge of oral health and training needs of health workers in geriatric nursing homes. BACKGROUND: Providing daily oral care to dependent elderly people is the best way to prevent oral disorders. Because there are no dental hygienists in France, health workers play an important role in providing oral care in nursing homes and should have correct and adequate knowledge. MATERIALS AND METHODS: Health workers from 8 geriatric nursing homes in Puy de Dôme (France) completed a 58-item questionnaire. Oral health knowledge regarding dental decay, periodontal diseases, oral hygiene and denture care was assessed. Univariate and bivariate analyses were performed. RESULTS: A total of 99 health workers took part in the study. The total mean score was significantly different if health workers had received training in oral disorders (49.3 ± 11.7 vs. 43.9 ± 10; p < 0.05) or in the maintenance of oral health (50.5 ± 10.5 vs. 42.9 ± 10; p < 0.01). The mean scores obtained in the 'dental decay' subsection and in the 'oral and denture hygiene' subsection were the lowest. CONCLUSION: Geriatric nursing home staff need training in understanding the impact of oral health on general health. Theoretical knowledge of oral diseases has to be improved in order for health workers to understand oral hygiene procedures and to help them identify early oral disorders.

A follow-up study of pulpotomies and root canal treatments performed under general anaesthesia.

OBJECTIVES: A previous study considered whether the proportions of clinically satisfactory root canal treatments (RCT) done under general anaesthesia (GA) or under local anaesthesia were equivalent, but the proportion of treatment with long-term satisfactory endodontic outcomes remains unknown. Moreover, no evaluation of pulpotomies performed under GA has been reported. MATERIALS AND METHODS: From 614 endodontic treatments (ETs) performed on permanent teeth under GA, 225 [193 RCT and 32 pulpotomies (P)] were examined after follow-up periods of 1-6 months (71 cases), 6-24 months (77 cases) and over 2 years (77 cases). Changes in the periapical index between the treatment date (T0) and the control time (T1) allowed the treatment to be classified as "success," "uncertain outcome" or "failure." Explicative variables for success of ET were the duration of follow-up and tooth-related criteria expected to affect the outcomes of endodontic treatment. RESULTS: Overall, 87 % of ETs were scored as "success," while 9 % were uncertain and 4 % were failures. There was no difference in the distribution of success in relation with the type of tooth, the pulpal status, the level of endodontic difficulty, the periapical status or the technical quality of RCT. The proportion of endodontic cases with high level of difficulties was higher in the P group than in the RCT group. CONCLUSION: Longer follow-ups and higher numbers of cases are needed to analyse the factors affecting success and failure in endodontic treatments performed under GA. CLINICAL RELEVANCE: The relatively high rates of success of pulpotomies and RCT support undertaking endodontic treatment under GA.

Ceramo-Metal Crown or Cad-Cam Rehabilitation: Patient and Practitioner Appraisal.

Crowns produced using CAD-CAM technology must be evaluated so they can be integrated in the dentist's therapeutic arsenal. To this end, an evaluation tool for the fixed element units was developed and tested in a randomized cross-over pilot study. At a hospital centre, 10 single crowns from the same dental preparation and produced using CEREC technology were compared to Ceramo-Metal Crowns produced using a conventional procedure. Practitioners generally evaluated CEREC crowns more positively, corroborating the subjects' preference for these crowns. The CEREC technology used in a hospital setting meets the requirements of both patients and practitioners.

Accuracy of conventional impressions and digital scans for implant-supported fixed prostheses in maxillary free-ended partial edentulism: An in vitro study.

OBJECTIVES: To evaluate the accuracy of conventional polyether impressions and digital scans produced by five intra-oral scanners (IOSs) in maxillary free-ended partial edentulism for long-span implant-supported prostheses. METHODS: This in vitro study involved the impression of a maxillary model with free-end partial edentulism, in which six implants were placed before digitization using a desktop scanner to generate a digital reference model. Conventional impressions (Impregum Penta Soft, 3M) and digital scans with five IOSs (Trios 3 and 4, 3Shape; Primescan, Dentsply-Sirona; CS 3600, Carestream Dental; and i-500, Medit) were obtained. Conventional impressions were digitized using the same desktop scanner. Each digital STL file of conventional or digital impressions was superimposed over the reference STL file to enable comparison. Trueness was assessed by calculating angles and distance deviations. For precision, dispersions of values around their means were also measured. RESULTS: The mean distance deviation was significantly higher for conventional impressions (454.24 ± 334.70 µm) than for IOSs (ranging from 160.98 ± 204.48 µm to 255.56 ± 395.89 µm) (p < 0.001). The mean angular deviation was high with conventional impressions (1.82 ± 1.51°), intermediate with CS 3600 (1.38 ± 1.42°), Primescan (1.37 ± 2.54°) and Trios 4 (1.30 ± 0.64°) scanners, and lower with I500 (0.97 ± 0.75°) and Trios 3 (1.01 ± 0.85°) scanners (p < 0.001). The dispersion of distance values around their means was lowest with Trios 3 and i-500, followed by CS3600, Primescan, and Trios 4, respectively, and higher for conventional impressions (p < 0.001). The dispersion of angular values was smallest with i-500, Trios 3, and Trios 4 compared with other groups and was highest with Primescan (p < 0.001). CONCLUSIONS: Within the limits of the current study, Trios 3 scanner exhibited the highest accuracy, followed by i-500, Trios 4, CS 3600, Primescan, and conventional impressions respectively. IOSs might be reliable for the fabrication of an implant-supported prosthesis. In vivo studies are required to confirm these findings. CLINICAL SIGNIFICANCE: Passive adaptation of the implant-supported framework is a challenge when rehabilitating patients with maxillary free-end partial edentulism. While Conventional impressions remain a reliable and validated technique, but IOSs demonstrated higher accuracy, suitable for the fabrication of long-span implant-supported prostheses in partially edentulous arch.

The impact of implant treatment on oral health related quality of life in a private dental practice: a prospective cohort study.

BACKGROUND: Very few studies on the impact of implant therapy on Oral Health Related Quality of Life (OHRQoL) in partially edentulous patients have been published. AIM: This study aimed at analysing the improvement of OHRQoL of patients who underwent dental implant treatment using the "functional", "psychosocial" and "pain and discomfort" categories of the Geriatric Oral Health Assessment Index (GOHAI). METHODS: Within a prospective cohort of patients rehabilitated with Straumann dental implants, the OHRQoL of 176 patients (104 women and 72 men) was assessed using the GOHAI questionnaire, at two different times, before and after implant placement. The degree of oral treatment was categorised into three classes: "Single Tooth Implant" (n = 77), "Fixed Partial Denture" (n = 75), "Fixed or Retained Full Prostheses" (n = 24). The participants' characteristics (gender, age, tobacco habits, periodontal treatment, time between both evaluations) were assessed. RESULTS: Before treatment, the GOHAI score was lower for participants with fewer teeth (F = 19, P < 0.001). After treatment, no difference was observed between participants; significant improvements were observed in the GOHAI scores obtained (repeated measures, analysis, (F = 177, P < 0.001)) for each of the GOHAI fields studied (functional, psychosocial and pain & discomfort), regardless of the degree of treatment. The best improvement was observed in patients who needed complete treatment (P < 0.001). The presence of preliminary periodontal treatment, tobacco habits, age and gender of the participants did not have a significant impact on OHRQoL. Changing the time between the two evaluations (before and after treatment) had no impact on the changes in the GOHAI score. CONCLUSIONS: Implants enhanced the OHRQoL of participants that needed oral treatment.

Comparison of the sliding resistance between three models of self-ligating ceramic brackets: An in vitro and micro-morphological study.

OBJECTIVE: The main objective of our study was to compare a new model of self-ligating ceramic bracket (Clarity™ Ultra by 3M™), to its competitors by evaluating their resistance to sliding during an in vitro simulation of canine retraction. MATERIAL AND METHODS: The sample consisted of 120 brackets (30 brackets in each group: Victory Twin Series LP™, Clarity Ultra™ by 3M™, Damon Clear 2™ by Ormco™ and Empower™ 2 Clear by American Orthodontics™). Canine retraction was simulated using a universal testing machine connected to a software that measured the average sliding resistance (ASR) for each group. Five brackets from each group were randomly selected and observed under a digital optical microscope at ×50 magnification. ANOVA test and Tukey's analysis were carried to detect statistically significant differences between the groups' sliding resistance values, at the risk of α=0.05. RESULTS: Measured ASR values of control group (metallic Victory Twin) were the highest ones (70.55g), followed by 3M™ (33.22g) then Damon™ (6.72g) and AO™ (5.49g) (P-value<0.0001). Through microscopic observations, we found that the 3M™ bracket has the lowest percentage of slot chamfering (8%) compared to the other brackets (12%). The 3M™ bracket also has the widest slot followed by AO, and then Damon™. All three bracket types have oversized slots compared to the manufacturer's description, the least oversized being the 3M™ bracket, followed by AO™ and then Damon™. 3M™ and Damon™ brackets have covers that concealed the entire wire in the vertical dimension whereas the AO™ bracket has a curvilinear cover that only shields the gingival part of its slot. Wire-play is zero for the 3M™ group, and 0.1mm for the other two groups. CONCLUSION: Clarity Ultra™ ceramic bracket produced by 3M™ does not perform well against friction forces compared to its competitors and that is due to its micro-morphological characteristics.

In Vitro Resistance of Natural Molars vs. Additive-Manufactured Simulators Treated with Pulpotomy and Endocrown.

Endocrowns are designed to restore endodontically treated teeth with root canal treatment (Rct). Recently, endocrowns were proposed for teeth treated with full pulpotomy (FP). No data exist on in vitro evaluations for this combination. This study aimed to evaluate the mechanical behavior of pulpotomy-treated teeth with endocrowns according to different protocols for preparation design and materials and to assess whether 3D-printed resin simulators could be a reliable alternative for human teeth during in vitro strength tests. One hundred and ten extracted natural molars were randomized into 11 groups according to the type of endodontic treatment, the material used, and the design of peripheric preparation. One hundred and ten resin simulators were separated similarly. The samples were embedded in epoxy resin blocks before being subjected to oblique compressive load until failure. For natural teeth, the variance analysis separated two homogeneous groups, one regrouping the endodontically treated or pulpotomy-treated teeth without coronal restoration and the other one regrouping all the other samples, i.e., the untreated teeth (positive controls) and the treated and restored teeth. The strength resistance was lower for the resin simulators than for natural teeth in all groups. Within the limit of this study, strength resistance is not the most important criterion for choosing the type of material, preparation, or endodontic treatment for endocrowns. Resin simulators are not efficient for in vitro strength studies.

Accuracy of Conventional and Digital Impressions for Full-Arch Implant-Supported Prostheses: An In Vitro Study.

Both conventional and digital impressions aim to record the spatial position of implants in the dental arches. However, there is still a lack of data to justify the use of intraoral scanning over conventional impressions for full-arch implant-supported prostheses. The objective of the in vitro study was to compare the trueness and precision of conventional and digital impressions obtained with four intra-oral scanners: Trios 4 from 3Shape®, Primescan from Dentsply Sirona®, CS3600 from Carestream® and i500 from Medit®. This study focused on the impression of an edentulous maxilla in which five implants were placed for implant-supported complete prosthesis. The digital models were superimposed on a digital reference model using dimensional control and metrology software. Angular and distance deviations from the digital reference model were calculated to assess trueness. Dispersion of the values around their mean for each impression was also calculated for precision. The mean distance deviation in absolute value and the direction of the distance deviation were smaller for conventional impressions (p-value < 0.001). The I-500 had the best results regarding angular measurements, followed by Trios 4 and CS3600 (p < 0.001). The conventional and I-500 digital impressions showed the lowest dispersion of values around the mean (p-value < 0.001). Within the limitations of our study, our results revealed that the conventional impression was more accurate than the digital impression, but further clinical studies are needed to confirm these findings.

Is endodontic treatment performed under general anaesthesia technically acceptable?

OBJECTIVES: Undertaking endodontic treatment under general anaesthesia (GA) is often described as difficult and hazardous, but no study reports on safe and efficacious conditions for endodontic treatment under GA. This study aims to evaluate whether compromises made for the endodontic treatment of permanent teeth under GA are acceptable. It describes the quality of endodontic treatment undertaken in two series of consecutive patients treated either under GA or local anaesthesia (LA). MATERIALS AND METHODS: Post-operative data sheets and periapical radiographs were collected for 255 permanent teeth treated under GA during a 4-year period (GA group, 125 patients with special needs) and for 246 permanent teeth treated under local anaesthesia over 7 months (LA group, 180 healthy patients). The radiographic criteria for quality of endodontic treatment (RCQET) were considered satisfactory when (1) the root filling was within 2 mm of the apex; (2) the filling displayed no voids or defects; and (3) all the visible canals had been obturated. The type of tooth, pulpal status and periapical status were considered independent variables for RCQET. RESULTS: The proportion of satisfactory RCQET reached 63% in both groups and differed by type of tooth, being significantly lower for molars than for other teeth. CONCLUSION: From a technical point of view, compromises made for the endodontic treatment of permanent teeth under GA are acceptable. Further studies should be conducted to evaluate the long-term success of endodontic treatment performed under GA. CLINICAL RELEVANCE: This study supports the feasibility of endodontic treatment for patients treated under GA.

A clinical trial of efficacy and safety of inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox™) in general practice.

The current study aimed to verify if the safety and effectiveness of inhalation sedation with 50% nitrous oxide in oxygen (N(2)O/O(2)) is maintained when the premix is administrated by trained general practitioners in their dental surgeries compared to its use in the hospital. Success (completion of planned treatment), cooperation (modified Venham scale), and adverse events were recorded. The acceptability of the technique to the patients, the level of patient cooperation, the ease of use, and the satisfaction of the dentist were also evaluated. Thirty-three general practitioners included 549 patients and recorded 638 sessions of N(2)O/O(2) sedation for dental treatment. Of the sessions, 93.7% were successful in terms of both sedation and treatment. Patient cooperation was seen to improve under N(2)O/O(2) sedation, and for 91% of the sessions, the patients declared that they would like future treatment to be undertaken in the same way. No serious adverse events were recorded. Minor adverse events were noted for 10% of the sessions (behavioural, vagal, and digestive disorders). These results were similar to those found for sessions undertaken in hospital practice. The main difference was in the type of patient treated-more patients received N(2)O/O(2) sedation in general practice for a one-off indication or for dental phobia, and more patients with intellectual disability and more pre-cooperative children were treated in hospital practice. This study gives strong supporting evidence for the safety and effectiveness of inhalation sedation using 50% N(2)O/O(2) in general dental practice for healthy patients.

The needs of denture-brushing in geriatrics: clinical aspects and perspectives.

INTRODUCTION: Oral and denture hygiene are often defective in particular with dependent persons such as geriatric subjects. The reasons are the lack of hygiene education of the subjects or those caring for them. Consequently, oral hygiene is often neglected, resulting in poor oral health and an increase in the presence of local or general infections. OBJECTIVE: This paper is a report of brushing effectiveness on microbial biofilm deposits on dentures of subjects participating in a specific oral hygiene programme. MATERIALS AND METHODS: Thirty-nine dentures of 30 subjects were assessed for 2 weeks following an educational brushing programme. Microbial biofilm was recovered using fluoresceine and then scanned and quantified by 'Mesurim' software three times: before study, after 1 and 2 weeks. RESULTS: The repeated measurement procedures showed a decrease in the percentage of biofilm present (F = 15, p < 0.001) whatever the type of denture (partial or complete) and for all biomaterials. CONCLUSION: Regular denture-brushing can improve local hygiene. Consequently, decreasing the biofilm surface can reduce the prevalence of oral pathogens, thereby contributing to the general prevention of the risks of infections such as pneumotisis.

Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers.

BACKGROUND AND OBJECTIVE: The prevalence of malnutrition increases with age because of many factors. Edentulousness leads to the avoidance of many types of foods. The aim of this study was to determine whether elderly complete denture wearers have a higher risk of malnutrition than dentate controls. MATERIAL AND METHODS: A Mini-Nutritional Assessment (MNA) and a 3-day dietary record were compiled for a group of fully dentates (21 women and 29 men; mean age 70.1 ± 6.1) and for a group of complete denture wearers (31 women and 16 men; mean age 70.1 ± 8.1). Socio-demographic data and scores on the General Oral Health Assessment Index (GOHAI) questionnaire were collected. RESULTS: Inter-group comparison of MNA scores showed that more subjects in the edentulous group (21.3%) risked malnutrition than in the dentate group (0%). The variability of the MNA could be explained for 22% by dental status, 7% by loneliness and 4% by the GOHAI score (regression analysis). Both groups had insufficient energy intakes and deficits in vitamins and micronutrients; moreover, edentulous subjects had lower intakes than dentate subjects. CONCLUSION: The use of conventional dentures increases the risk of malnutrition in the elderly.

Comprehensive CAD/CAM Prosthetic Rehabilitation Management in a Young Patient with Agenesis: A Case Report.

With the advancement in ceramic restorations bonded to the tooth structure, the treatment has become a practicable and conservative option to restore teeth with shape alteration owing to the high demand for aesthetics, with minimum tooth preparation. This article describes the case of a 25-year-old man who was dissatisfied with his smile. After an assessment of the clinical situation, a decision was made to place a full-mouth prosthodontic rehabilitation (monolithic lithium disilicate glass-ceramic, IPS E-max CAD) with minimal tooth preparation, which figures as a conservative full-coverage approach. The restoration of an aesthetic smile resulted in the patient's satisfaction. Bonding of all monolithic veenerlay and crowns onto minimally prepared teeth figures as conservative treatment in cases of hypodontia.

Aesthetic and Functional Rehabilitation of Patients with Genetic Microdontia: A Multidisciplinary Approach.

This case report presents the treatment of a 33-year-old patient with a genetic, generalized microdontia of permanent teeth. Microdontia is a developmental dental anomaly of the teeth characterized by a decrease in their size. In the literature, treatment has been multidisciplinary, often utilizing orthodontics and implantology. However, for adult patients with generalized microdontia who do not benefit from these treatments as much, a combination of adhesive dentistry, endodontics and removable prostheses remains a therapeutic alternative to consider. Given the specificities of the patient and the nature of the care, the objective of this treatment option was to manage the patient's comfort while guaranteeing quality of care. A feature of this treatment was the use of general anesthesia for endodontic treatments and exodontia. Chairside CAD/CAM and adhesive dentistry reduced the chairside time and preserved healthy dental tissue.