Fracture Strength of Ceramic Posterior Occlusal Veneers for Functional Rehabilitation of an Abrasive Dentition.

PURPOSE: To evaluate the load at fracture and influence of artificial aging of posterior teeth occlusal veneers ("table tops") made of two different ceramics. MATERIALS AND METHODS: A total of 80 table tops were produced from feldspathic ceramic (VM) and zirconia-reinforced lithium silicate ceramic (CD) using computer-aided design/computer-assisted manufacturing (CAD/CAM). Half of the specimens from each ceramic were aged prior to the load test. RESULTS: Mean ± standard deviation (SD) load at fracture was significantly higher for CD (1,571.1 N ± 297.0 N) than for VM (573.6 N ± 86.4 N) (P < .001). After aging, load at fracture increased significantly to 1,819.0 N (± 310.6 N) for CD and to 745.2 N (± 168.3 N) for VM. CONCLUSION: The use of zirconia-reinforced lithium silicate ceramic for molar nonprep table tops should be uncomplicated according to the high load-at-fracture values. Mechanical stability of either ceramic is not compromised by aging.

[Teeth wedge-shaped defects in adults of different age groups: remark to prevention and treatment]. / Klinovidnye defekty zubov u vzroslykh liudei raznykh vozrastnykh grupp: remarki k profilaktike i lecheniiu.

The aim of the study was to assess the treatment of teeth wedge defects in different age groups. Records of 383 patients (125 males and 258 females aged 22-85 years) treated in outpatient dental facilities with different ownership forms. It is shown that the medical care of patients with wedge-shaped teeth defects routinely consists of remineralization therapy and restoration of anatomical teeth shape regardless of the form of ownership. The extensiveness of dental rehabilitation as well as the use of more modern technologies are typical for private clinics and 96-100% of patients finished their treatment there. In the state and departmental institutions complete rehabilitation of wedge-shaped defects was provided in 45.5-58.0% and 54.3-83.9, respectively. The paper also highlights the drawbacks of primary medical documentation identified in medical institutions of all forms of ownership.

Vertical dimension augmentation with a full digital approach: a multiple chairside sessions case report.

The last few decades have seen an upward trend of the pathologies of abrasion, erosion, and abfraction. These pathologies, especially in combination, can provoke a significant loss of tooth substance. Nowadays, modern digital chairside technologies and new restorative materials allow clinicians to restore the lost tooth structure with a minimally invasive and fully digital approach. This article describes a step-by-step procedure of a full-mouth rehabilitation performed with a total digital chairside approach in several appointments.

Non- and minimally invasive full-mouth rehabilitation of patients with loss of vertical dimension of occlusion using CAD/CAM: an innovative concept demonstrated with a case report.

Abrasion and erosion are two increasingly common indications for dental treatment. Thanks to modern digital technologies and new restorative materials, there are novel therapeutic approaches to restoring such losses of tooth structure in a virtually non-invasive manner. The case study in this article demonstrates one such innovative approach. The patient's severely abraded natural dentition was restored in a defect-driven, minimally invasive manner using high-performance composite materials in the posterior region, and the "sandwich technique" in the anterior region. The restorations were milled on an optimized milling machine with milling cycles adapted for the fabrication of precision-fit restorations with thin edges.

A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: a clinical report.

This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient with a severely worn dentition. The treatment included osteotomy and immediate implant placement and loading in the mandible. The definitive restorations were implant- and tooth-supported metal ceramic restorations. These restorations were fabricated with metal occlusal surfaces at an increased occlusal vertical dimension, which provided acceptable esthetics and function.

CAD/CAM-generated high-density polymer restorations for the pretreatment of complex cases: a case report.

Complex rehabilitations represent a particular challenge for the restorative team, especially if the vertical dimension of occlusion (VDO) needs to be reconstructed or redefined. The use of provisional acrylic or composite materials allows clinicians to evaluate the treatment objective over a certain period of time and therefore generates a high predictability of the definitive rehabilitation in terms of esthetics and function. CAD/CAM technology enables the use of prefabricated polymer materials, which are fabricated under industrial conditions to form a highly homogeneous structure compared with those of direct fabrication. This increases long-term stability, biocompatibility, and resistance to wear. Furthermore, they offer more suitable CAD/CAM processing characteristics and can be used in thinner thicknesses than ceramic restorative materials. Also, based on the improved long-term stability, the transfer into the definitive restoration can be divided into multiple treatment steps. This article presents different clinical cases with minimally invasive indications for CAD/CAM-fabricated temporary restorations for the pretreatment of complex cases.

Management of the severely worn dentition with different prosthetic rehabilitation methods: a case series.

Clinicians are often faced with the challenge of restoring a severely worn dentition. Esthetic and functional rehabilitation of patients in this condition represents a noteworthy clinical challenge. Although treatment options for the severely worn dentition with reduced occlusal vertical dimension can be limited, providing a functional and esthetic restoration in these situations is crucial for restoring the patient's quality of life. Different treatment approaches for the rehabilitation of worn dentition are presented in this case series.

Prosthetic rehabilitation and treatment outcome of partially edentulous patients with severe tooth wear: 3-years results.

OBJECTIVES: The purpose of this study was to report on the management and treatment outcomes of partially edentulous elderly patients with severe tooth wear. METHODS: Partially edentulous patients with severe tooth wear who underwent the same protocols for full prosthodontic rehabilitation were eligible for this observational study. Their clinical diagnoses were based on a complete oral examination, photos, functional and cast analysis, general health conditions and behavioural aspects, such as acidic diets and bruxism. A 6-month preliminary phase with splints and provisional prostheses was maintained prior to the final fabrication of fixed and removable prostheses. All patients completed a follow-up period of ≥3years. The outcomes were technical and biological complications with the prosthesis (wear or fracture of anchorage, abutment, prosthesis core or veneering, and implants, plaque index, caries, endodontic and periodontal lesions, tooth fractures and periimplantitis) and oral health-related quality of life (using the oral health impact profile questionnaire, German version of OHIP G-14). RESULTS: Data from 42 patients (33 men, 9 women) with a mean age of 62±8years were available. The probability that a first, second or third technical complication occurred was 49%, 38% and 21%, respectively. About 50% of the patients remained without any complication. The average OHIP-value was 5±7, which represents high oral health-related quality of life. No statistically significant correlations between the OHIP values and the type of prostheses or the occurrence of complications were observed. CONCLUSIONS: From multiple perspectives, the rehabilitation of partially edentulous patients with severe tooth wear is a complex task, and more information regarding treatment protocols, prosthetic indications and treatment outcome is needed.

Reestablishment of occlusion with prosthesis and composite resin restorations.

Here, we present a case report on prosthetic reconstruction of posterior teeth and composite resin restoration of anterior teeth yielding considerable esthetic improvement, reestablishment of disocclusion guides and function.

Utilização do laser de alta potência [Er: YAG] no tratamento de lesão cervical não-cariosa / Treatment of non carious cervical lesion with power laser [ER: Yag]

Em preparos cavitários conservadores de esmalte e dentina, assim como para remoção final de tecido cariado, os lasers de alta potência vêm demonstrando excelentes resultados. O presente caso clínico ilustra o tratamento de lesão cervical não-cariosa utilizando-se o laser ER: YAG. O passo-a-passo, as vantagens e as desvantagens da utilização do laser são descritos e discutidos. Pode-se concluir que a utilização do laser Er: YAG para a remoção de tecido duro em lesões cervicais não-cariosas é um procedimento seguro, confortável ao paciente e com vantagens em relação ao tratamento convencional.

For conservative cavity preparation in enamel and dentin, as well as for final caries removal, hight power laser has been shown excellent results. This clinical case shows a non carious cervical lesion treated with hight power laser [Er: YAG]. The clinical steps, the vantages and disadvantages of hight power laser are cited and discussed. In can be concluded that the use of Er: YAG for hard tissue removal in non carious lesions in a safe proceeding, comfortable for the patient and with several advantages to conventional treatment.

Complex all-ceramic rehabilitation of a young patient with a severely compromised dentition: a case report.

A young patient with dentinogenesisimperfecta and a dentition severely compromised by discolorations,abrasion, and breakage of enamel on several teeth was prosthodontically treated with CAD/CAM-manufactured all-ceramic restorations. To reduce treatment risk, preparations were limited paragingivally. Maxillary anterior teeth and premolars were restored with adhesively luted ceramic crowns. All other teeth were treated with zirconia-based restorations luted with a self-etching resin-based material. Considering the deficient pretreatment situation, the use of tooth-colored restoration and luting materials yielded a satisfying functional and good esthetic result. The patient is highly satisfied, even though 3 minor chippings occurred shortly after the completion of treatment

[Rehabilitation of an abraded occlusion with Procera-ZrO2 all-ceramic crowns. A case report]. / Rehabilitation eines Abrasions-gebisses mit Procera-ZrO2-Vollkeramikkronen. Ein Fallbericht.

The rehabilitation of a patient with advanced tooth wear by means of Procera ZrO2 ceramic crowns is described. A healthy, 60 year old patient complained about front teeth esthetics and impaired function due to reduced tooth height. He was aware of bruxism and wished full mouth rehabilitation. The clinical examination showed that tooth wear was generalized, but most teeth could be maintained in both jaws. A staged procedure was planned, starting with a splint therapy and a provisional fixed prosthesis to reestablish correct vertical dimension of occlusion (VDO) and stable occlusal contacts. The new ZrO2 material with the Procera technique was chosen to restore all teeth in both jaws, except the mandible front teeth. In the second treatment phase, crown lengthening of the maxillary front teeth was performed and one implant placed to replace a maxillary premolar. After final tooth preparation, impression taking and bite registration the ZrO2 crown-copings were scanned, processed and completed by veneering. A flat occlusal scheme with stable front teeth guidance was established. The advantage of the presented treatment is the esthetic result in combination with a material of high mechanical and biological quality.

Three patient reports illustrating the use of dentin adhesives to cement crowns to severely worn teeth.

PURPOSE: Severely worn and broken down teeth present clinical treatment planning dilemmas. Extreme examples of worn teeth present in patients suffering from bulimia nervosa and dentinogenesis imperfecta. Bulimia nervosa typically presents early in adult life with a myriad of clinical features and a most important dental sign of eroded palatal surfaces on the maxillary teeth. Dentinogenesis imperfecta is a relatively uncommon disorder that presents with varying severity of unsupported enamel and results in teeth more susceptible to wear. MATERIALS AND METHODS: Dental treatment for both conditions when wear has resulted in the complete loss of the tooth can either be directed toward restoring remaining tooth tissue or extraction and replacement with implants or dentures. This article presents the clinical management of three case histories, each with one or more severely broken down teeth, which were restored with adhesively retained crowns. RESULTS: Treatment lasted nearly 10 years in one patient and failed after 6 years in another. The third patient was treated more recently. CONCLUSION: All three case histories serve as examples of using adhesive cements to retain indirect restorations as a possible prosthodontic management strategy.

Maxillary and mandibular overlay removable partial dentures for the restoration of worn teeth.

This clinical report describes the fabrication of maxillary and mandibular cast overlay removable partial dentures for the restoration of severely worn teeth with accompanying loss of vertical dimension of occlusion. The frameworks supported porcelain veneers for esthetics and metal occlusal surfaces for strength and durability.

Rehabilitating a patient with bruxism-associated tooth tissue loss: a literature review and case report.

Tooth tissue loss from bruxism has been demonstrated to be associated with various dental problems such as tooth sensitivity, excessive reduction of clinical crown height, and possible changes of occlusal relationship. A literature search revealed a number of treatment modalities, with an emphasis on prevention and rehabilitation with adhesive techniques. Rehabilitating a patient with bruxism-associated tooth tissue loss to an acceptable standard of oral health is clinically demanding and requires careful diagnosis and proper treatment planning. This article describes the management of excessive tooth tissue loss in a 43-year-old woman with a history of bruxism. The occlusal vertical dimension of the patient was re-established with the use of an acrylic maxillary occlusal splint, followed by resin composite build-up. Full-mouth oral rehabilitation ultimately involved constructing multiple porcelain veneers, adhesive gold onlays, ceramo-metal crowns, and fixed partial dentures.

The use of implants in the occlusal rehabilitation of a partially edentulous patient: a clinical report.

This article describes the occlusal rehabilitation of a partially edentulous patient who did not want a removable partial denture. Implants and extensive fixed restorations were used to restore posterior support and treat severely worn dentition, respectively. The treatment offered the patient a functional and esthetic result.