Biological Effects of Provisional Resin Materials on Human Dental Pulp Stem Cells.

OBJECTIVES: This study investigated the in vitro cytotoxicity as well as the proinflammatory cytokine expression of provisional resin materials on primary cultured human dental pulp stem cells (hDPSCs). METHODS: Five commercially available provisional resin materials were chosen (SNAP [SN], Luxatemp [LT], Jet [JE], Revotek LC [RL], and Vipi block [VB]). Eluates that were either polymerizing or already set were added to hDPSCs under serially diluted conditions divided into three different setting times (25% set, 50% set, and 100% set) and incubated for 24 hours with 2× concentrated culture media. Cell cytotoxicity tests were performed by LDH assay and live and dead confocal microscope images. The expression of proinflammatory cytokines in SN and VB was measured using cytokine antibody arrays. Data were analyzed using repeated measures analysis of variance (ANOVA) or ANOVA followed by the Tukey post hoc test at a significance level of p<0.05. RESULTS: Cytotoxicity greater than 30% was observed in the 50% diluted culture in SN, LT, and JE in the already set stage (p<0.05), while it was detected in SN and LT in early or intermediate stage samples. The cytotoxicity of SN, JE, and LT was greater with eluates from the polymerizing phase compared to that from already set samples (p<0.05), as observed by live and dead images. On the other hand, RL and VB did not exhibit cytotoxicity greater than 30%. Proinflammatory cytokines were not detected in 12.5% diluted culture with eluates from VB and early set stage SN. CONCLUSIONS: The eluates from chemical-activated provisional resin materials during polymerization (SN, LT, and JE) were cytotoxic to hDPSCs and may adversely affect pulp tissue.

Management of complex implant aesthetics: ensuring restorative design continuity with a comprehensive outcome-based strategy.

Since implant therapy must be dictated by prosthetic requirements, a protocol for the comprehensive and continuous integration of the restorative blueprint through the entire treatment planning and clinical execution phases is mandatory. This article demonstrates a systematic approach where the establishment of a final restorative treatment objective is incorporated into the diagnosis and subsequently integrated through every phase of clinical execution. Design continuity is ensured, and multidisciplinary cohesiveness is enhanced by providing clearly defined treatment objectives to every member of the clinical team.

Achieving aesthetic excellence through an outcome-based restorative treatment rationale.

The conceptual basis of restorative-driven implant dentistry is well established among clinicians. Its implementation includes the development of a prosthetic blue-print that will serve as a guide throughout therapy. While these concepts may be applied to prosthetic dentistry in general, their benefits are most compelling in the treatment of the aesthetic zone. This article demonstrates a systematic multidimensional approach for the establishment and incorporation of definitive aesthetic objectives throughout the diagnostic, adjunctive, and restorative treatment phases.

Shade matching and communication in conjunction with segmental porcelain buildup.

To the majority of patients, the aesthetic appearance of a restoration is often as important as its biological compatibility and function. While technological advancements have significantly improved the procedures and biomaterials utilized to fabricate ceramic restorations, the definitive result must address these increasing aesthetic expectations. A means of properly matching a crown restoration with the surrounding natural dentition is therefore critical. This article discusses shade communication between the members of the restorative team as well as ceramic layering techniques that can be utilized to achieve enhanced aesthetic results.