Sleep-Disordered Breathing and Its Potential Impact on Restorative Dentistry: A 14-Year Case Study.

Understanding the effects sleep-disordered breathing can have on dentitions may be critical to the long-term success of restorative treatment. In the current case, a patient presented with a large diastema that was successfully closed using porcelain veneers only to have an unexpected unesthetic consequence occur years later. The case demonstrates that if the clinical focus is solely on reparatory modalities or clinical management, without recognition of possible airway issues, unintended restorative consequences may surface in the future. Studying and understanding the origin of the signs and symptoms of sleep-disordered breathing can be crucial for the prevention of future problems and optimization of a patient's overall health.

Evaluation of Sealant Penetration in Relation to Fissure Morphology, Enamel Surface Preparation Protocol and Sealing Material.

PURPOSE: The objective was to assess the effect of fissure depth and enamel surface preparation protocols on penetration of resin-based, giomer and glass-ionomer fissure sealants. MATERIALS AND METHODS: Ninety extracted third molars were assigned into three groups according to the material used. All three groups were subsequently divided depending on tooth preparation: no pretreatment or surface preparation with 10% polyacrylic acid, 37% phosphoric acid, or self-etching adhesive. In addition, Er,Cr:YSGG laser or air abrasion were employed in all subgroups. The penetration was evaluated using scanning electron microscopy. RESULTS: The groups that were pretreated with an appropriate acid resulted in superior penetration of glass-ionomer and resin-based sealants when compared with other surface preparation protocols (p < 0.05). The exception was teeth treated with both air abrasion and acid etching. Both preparation protocol and fissure depth significantly affected the sealant penetration (p < 0.05), but fissure depth had a greater impact on fissure penetration than did enamel surface pretreatment. CONCLUSION: All investigated materials exhibit similar properties regarding sealant penetration. Penetration of a fissure sealant is significantly influenced by the fissure depth. In regard to enamel surface preparation protocol, a pretreatment with phosphoric acid in resin-based and polyacrylic acid in glass-ionomers appears to be essential in obtaining the adequate penetration of a sealing material.

Merging orthodontics and restorative dentistry: an integral part of esthetic dentistry.

UNLABELLED: This article discusses the different approaches in treatment planning of patients who desire an esthetic and functional improvement of their dentition but are hesitant to sacrifice healthy tooth structure. Preservation of tooth structure, whenever possible, should be paramount to any practicing dentist. The importance of such an approach, as taught for so many years, appears to be fading away lately under the pressure of advertisements full of promises for quick esthetic solutions. Exploration of the link between orthodontic and conservative restoration, along with minor use of periodontal procedures, will give another perspective in solving the esthetic dilemma. CLINICAL SIGNIFICANCE: Often underutilized, the combination of procedures such as orthodontics and composite bonding gives practicing clinicians conservative, predictable, esthetic, and functional results.