Laser-assisted debonding of ceramic veneers: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The process of removing ceramic veneers is difficult, time consuming, and invasive. However, although lasers should provide a straightforward method for the debonding of ceramic veneers, a systematic review is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to investigate the efficacy of the laser-assisted debonding of ceramic veneers. MATERIAL AND METHODS: A systematic search was conducted in Medline/PubMed, Cochrane, Scopus, and Web of Science databases. Then, an analysis was performed using the meta-analysis approach to investigate the efficacy of the laser-assisted debonding of ceramic veneers. Quality assessment of the included articles was carried out using the Cochrane Collaboration tool. For the meta-analysis, the RevMan 5.4 software program was used to perform a random-effects model of standardized mean differences with 95% confidence intervals. RESULTS: A total of 1108 studies were identified, of which 627 studies were selected for title and abstract analysis. The qualitative analysis included 16 studies, of which 3 studies were used in the quantitative synthesis. In the meta-analysis, the shear bond strength of the laser groups was compared with that of the control group. A substantial level of heterogeneity was noted in the included studies (I2=67%, P<.001). CONCLUSIONS: The findings suggest that erbium lasers have a significant immediate effect in decreasing the shear bond strength of ceramic veneers. Furthermore, with proper laser settings, veneers can be safely removed without damaging the underlying tooth structure.

Temporary fixed prosthesis materials and beverage colorants: an in vitro study.

The esthetic outcome of temporary prostheses, especially those in the anterior area, is of primary importance. The purpose of this in vitro study was therefore to evaluate the color stability of 3 temporary restorative materials: self-curing (SC) acrylic resin (Tempron); heat-curing acrylic resin (SR Ivocron); and polymethyl methacrylate resin blocks (Telio CAD) machined using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The heat-curing material was polymerized with either a pressure-curing technique (PT) or a flasking technique (FT). As a result, there were 4 experimental groups: SC, PT, FT, and CAD/CAM. Sixteen specimens were prepared for each group. After polymerization or milling, all specimens were polished using a diamond polishing paste, and 1 specimen from each group was exposed to Fourier-transform infrared (FTIR) and ultraviolet visible (UV-Vis) spectroscopy before immersion. The specimens were exposed to pigmented beverage agents (coffee, cola, turmeric solution, or tea), and the color change was monitored for 4 weeks using FTIR and UV-Vis spectroscopy as well as by macroscopic observation of the specimens (n = 4 per group per immersion period). The PT specimens showed the most significant color change, followed by the SC specimens. A less significant color variation was noted in the FT specimens, and insignificant change was reported in the CAD/CAM group. The solution that had the most significant staining effect was turmeric, and the CAD/CAM resin showed the greatest color stability of the tested materials. Color stability depends on the material used, the polymerization technique, the polishing steps, the pigmentation agent, and the duration of exposure to the agent.

Replacing Missing Maxillary Lateral Incisors by CAD/CAM PMMA Cantilever Bridges.

Introduction: Management of missing maxillary lateral incisors can be a challenging endeavour for dentists. Whether from agenesis or tooth loss, several treatment modalities are currently present to tackle this task to ensure satisfactory aesthetics. Most patients, especially younger patients are more likely to prefer fixed prosthodontic rehabilitation. Among these options is the computer-aided design and computer-aided manufacturing polymethyl methacrylate (CAD/CAM PMMA) cantilever bridge. Case Descriptions. These two clinical cases describe the management of missing lateral maxillary incisors in two Tunisian female patients with different etiologies, using CAD/CAM PMMA cantilever bridge. Conclusions: CAD/CAM technologies allow for a fairly quick and simple try-in thanks to their high accuracy as well as being predictable, minimally invasive, and affordable treatment options. This type of restoration can be put to use for mid- to long-term solutions to missing maxillary lateral incisors. However, its success depends mainly on patient selection regarding age, general health, occlusal context, and proper indication.

Facial Line Angles: A Key to Tooth-like Rehabilitation.

Recently, improvement of appearance and a quest for beauty have become a primary concern for patients. It is a challenging task for a clinician to achieve esthetic integration of prosthetic pieces for anterior teeth, particularly for highly demanding patients who give attention to particular details. The challenge is harder when only one tooth has to be restored. The objective is to achieve a fully and perfectly integrated rehabilitation with natural dentition. Poorly described, facial line angles are key to the success of achieving the desired tooth shape, especially for the maxillary central incisor. They influence both the shape and color of the tooth through optical illusion. Their misplacement could certainly spoil the esthetic outcome. Thus, it is mandatory to respect and recreate them. The objective of the present study was to define and then to highlight their importance. It also aimed to give some tips on how to perfect the shape of prosthetic teeth through a clinical case of central incisor esthetic rehabilitation.