A novel technique for the direct fabrication of fixed interim restorations.

This article describes an alternative technique for the fabrication of interim restorations. A thermoplastic, vacuum-formed template and translucent vinyl polysiloxane material are combined in the waxed diagnostic cast to fabricate a matrix in which the interim material can be placed. With this matrix, a variety of materials, such as dual-polymerized or light-polymerized resins, can be used in a predictable way. The major advantage of this technique is that it allows for the fabrication of accurate restorations with excellent reproduction of surface anatomy and for alterations of the tooth shape with light-polymerized materials.

Comparative Effects of 11 Antipsychotics on Weight Gain and Metabolic Function in Patients With Acute Schizophrenia: A Dose-Response Meta-Analysis.

Objective: To investigate the association of metabolic side effects with antipsychotic dose, we conducted a dose-response meta-analysis of randomized controlled trials (RCTs) in which antipsychotics were administered to people with schizophrenia. The primary outcome was mean change in weight. The secondary outcomes were the mean changes in metabolic parameters.Data Sources: MEDLINE, Embase, PubMed, PsyARTICLES, PsycINFO, Cochrane Database of Systematic Reviews, and different trial registries were searched for articles published in English until February 2021.Study Selection: We identified fixed-dose RCTs with first- or second-generation antipsychotics. The quality of RCTs was measured with Cochrane's Risk of Bias tool.Data Extraction: We performed a dose-response meta-analysis.Results: We retained 52 RCTs including 22,588 participants. With the exception of aripiprazole long-acting injectable (LAI), all investigated antipsychotics presented significant dose-response associations with weight, from lurasidone with a quasi-parabolic shaped curve (9 studies, estimation of 95% effective dose [ED95; 59.93 mg/d] = 0.53 kg/6 wk) to olanzapine LAI with a curve that continued to increase with the dose (1 study, ED95 [15.05 mg/d] = 4.29 kg/8 wk). All curves could be ordered in 3 different classes of shapes-quasi-parabolic, plateau, and ascending.Conclusions: We found significant dose-response associations for weight and metabolic variables, with a unique signature for each antipsychotic. Weight gain can occur at a relatively low median effective dose, and increasing doses can be associated with greater weight gain for some drugs. Despite several limitations, including the limited number of available studies, our results may provide useful information for preventing weight gain and metabolic disturbance by adapting antipsychotic doses.Registration: PROSPERO ID number CRD42021176569.

Fracture resistance of three all-ceramic restorative systems for posterior applications.

STATEMENT OF PROBLEM: The failure loads of all-ceramic crowns are influenced not only by the fracture resistance of the component materials but also by prosthesis geometry and size and location of flaws, thus there is a need for a study that compares the fracture resistance of all-ceramic systems using a simple and reproducible specimen geometry that includes flaws occurring at material interfaces. PURPOSE: The research aim was to compare the in vitro fracture resistance and origin of failure of simulated first molar crowns fabricated using 3 all-ceramic systems, IPS Empress 2, Procera AllCeram, and In-Ceram Zirconia. MATERIAL AND METHODS: Twenty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a universal testing machine, and the maximum load (N) was recorded. Fractured surfaces were examined using optical and electron microscopy to determine the most prevalent origin of failure in each ceramic system. Five crowns per system were sectioned, and thickness of the luting agent, core material, and veneer porcelain layers were measured. The 95% confidence intervals of the Weibull modulus and characteristic failure load were compared between the 3 systems. Two-way multivariate analysis of variance was used to analyze the thickness of the luting agent, ceramic core, and veneer porcelain layers (alpha=.05). RESULTS: The 95% confidence intervals for Weibull modulus were 1.8 to 2.3 (IPS Empress 2), 2.8 to 3.6 (Procera AllCeram), and 3.9 to 4.9 (In-Ceram Zirconia). The 95% confidence intervals for characteristic failure load were 771 to 1115 N (IPS Empress 2), 859 to 1086 N (Procera AllCeram), and 998 to 1183 (In-Ceram Zirconia). The origin of failure was most commonly found at the interface between the ceramic core and veneer porcelain for IPS Empress 2 and between the ceramic core and luting agent layer for the other systems. CONCLUSIONS: There was no significant difference in fracture resistance; however, there was a significant difference in failure origin between the all-ceramic systems studied.