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1.
Compend Contin Educ Dent ; 41(7): 368-376; quiz 377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687381

RESUMEN

Dental implant therapies must be planned and executed to meet both the immediate and longer-term expectations of patients. The early developmental success of dental implants was dependent on the quality and quantity of a patient's bone. Implants were commonly placed into the parasymphyseal mandibular and anterior maxillary bone. Building on this success, bone grafting allowed patients lacking sufficient bone to obtain implant-supported prosthetic solutions for treatment of partial or complete edentulism. More recently, several nongrafting solutions for implant therapy, including pterygoid implants, zygomatic implants, tilted implants, and short implants, have reported success. This article will consider the rationale for graftless solutions in implant therapy as well as the data supporting the use of various graftless protocols as alternatives to grafting and conventional dental implant therapy. It will discuss factors concerning graftless versus grafted approaches to treatment of patients with limited bone volume and will describe the use of short dental implants as a graftless solution in the edentulous maxilla.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
2.
Int J Prosthodont ; 33(4): 429-440, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32639703

RESUMEN

PURPOSE: To systematically review the current evidence on clinical and patient-reported outcomes of implant-supported palatal obturator prostheses. MATERIALS AND METHODS: An electronic search of the PubMed, Web of Science, and Cochrane databases was carried out in June 2019. The titles and abstracts of all articles were screened by two independent reviewers. The references of the subsequently selected studies were further screened for potential articles. Assessment of the selected full texts was performed independently according to established inclusion and exclusion criteria. The quality of the selected studies was determined using the Newcastle-Ottawa scale. Interrater agreement on study selection was calculated using Cohen kappa statistic. RESULTS: The search yielded a total of 2,797 records. Ten studies were selected for data extraction, with a Cohen kappa value of 0.856. Five studies were prospective, and five were retrospective. The survival rates for conventional implants ranged from 21.42% to 100%, whereas for zygomatic implants, the survival rates varied from 30% to 100%. Four studies reported prosthodontic complications, with screw loosening being the most common. Patient quality of life (QoL) was analyzed in six studies. CONCLUSION: In spite of the limitations of the present review, it can be concluded that the clinical outcomes are acceptable in terms of survival rates, implant and prosthodontic complications, and QoL associated with implant-supported maxillary obturator prostheses. QoL of implant-supported prostheses in these patients are acceptable. The general study design was not homogenous between studies.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Estudios Prospectivos , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento
3.
Pediatr Dent ; 42(3): 187-192, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32522320

RESUMEN

Purposes: The purposes of this prospective trial were to: (1) compare the clinical and radiographic outcomes of three restorative methods -modified atraumatic restorative treatment (mART), the Hall technique (HT), and stainless steel crown (SSC)-in primary molars with multi-surface carious lesions; and (2) assess child behavior throughout these treatments. Methods: In this randomized controlled trial (RCT), 123 primary molars in four- to nine-year-old children were randomly divided into treatment groups (HT, mART, and SSC). Variables, including signs of failure, treatment time, child's discomfort, child's behavior, and canine overbite relationship in HT, were recorded immediately after the treatment and at six- and 12-month recalls. Results: Failures occurred most significantly for mART at all recalls (P=0.001). The treatment time was significantly higher in SSC. There was no significant difference in the child-assessment of discomfort (P=0.814). The child's behavior, as evaluated by the dentist, however, was significantly better for the SSC group. Alterations to the canine overbite relationship of HT decreased significantly during recalls (P<0.001). Conclusions: The high success and shorter treatment time of the Hall technique support its consideration as an alternative to the conventional technique for the treatment of carious primary teeth with multisurface lesions. The results for modified atraumatic restorative treatment were not as satisfying.


Asunto(s)
Coronas , Caries Dental , Acero Inoxidable , Niño , Preescolar , Fracaso de la Restauración Dental , Restauración Dental Permanente , Humanos , Diente Molar , Diente Primario , Resultado del Tratamiento
4.
Quintessence Int ; 51(7): 566-576, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32500864

RESUMEN

OBJECTIVES: Long-term retrospective evaluation of the survival rate and the technical and biologic outcomes of all-ceramic inlays and onlays in premolars and molars. METHOD AND MATERIALS: Fifty-four patients treated as part of a prospective clinical trial and having received 157 inlays and 27 onlays made out of a leucite-reinforced glass-ceramic (IPS Empress) in premolars and molars, were invited to the present follow-up examination. The survival of the restorations was evaluated. The biologic outcomes were assessed by measuring the pocket probing depth (PPD), the Plaque Index (PI), and the Sulcus Bleeding Index (SBI). The technical behavior was evaluated using modified US Public Health Service criteria (modUSPHS). Finally, patient satisfaction was recorded with a questionnaire. Data of patients and restored teeth were analyzed descriptively, and continuous variables were given in mean values and standard deviations. For the analysis of the restoration survival over time, the Kaplan-Meier survival estimate was calculated. The level of statistical significance was set at P < .05. RESULTS: Thirty-six patients (20 women, 16 men; mean age 50.9 years) with 132 restorations, 107 inlays and 25 onlays, were examined after a mean observation time of 11.2 ± 4.3 years. The overall 11-year survival rate of the 132 restorations was 80.3%. Inlays exhibited an 11-year survival rate of 80.4% and onlays of 80.0%. Twenty-two technical complications occurred. Ceramic fractures (10.6%) and chipping (2.3%) were the most frequent complications. Six biologic complications occurred (4.5%). CONCLUSION: Glass-ceramic inlays and onlays presented favorable long-term clinical survival and success rates. Technical complications were predominant, and biologic problems remained rare. More clinical long-term data are needed.


Asunto(s)
Porcelana Dental , Incrustaciones , Cerámica , Fracaso de la Restauración Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos
5.
Int J Periodontics Restorative Dent ; 40(4): e157-e162, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32559040

RESUMEN

Placement of short implants is a common approach to rehabilitate edentulous areas. The objective of this study was to evaluate the long-term survival of 7.0- and 8.5-mm implants placed in either a delayed or immediate loading protocol. Life table analysis revealed the implants treated with the delayed loading protocol had a 90.9% survival rate and the implants treated with the immediate loading protocol had a survival rate of 92.0%. The results of this 8-year prospective study demonstrate similar survival rates of short, cylindrical threaded implants placed by either a delayed or immediate loading protocol.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Estudios Prospectivos
6.
J Contemp Dent Pract ; 21(4): 383-389, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32584273

RESUMEN

AIM: This study aimed to investigate the influence of using dual-cure composite core materials for fiber post luting on the fracture resistance of endodontically treated maxillary central incisors. MATERIALS AND METHODS: Fifty sound and recently extracted maxillary central incisors were endodontically treated and distributed into five groups. In the control group, access cavities were restored with the composite resin. Experimental groups had the coronal structure trimmed 2 mm above the cementoenamel junction. Teeth were restored with fiber posts and different combinations of luting and core materials: RelyX Unicem for post luting and MultiCore for core buildup; MultiCore for post luting and core buildup; RelyX Unicem for post luting and LuxaCore for core buildup; or LuxaCore for post luting and core buildup. All teeth were restored with zirconium crowns and subjected to thermocycling (6000 cycles 5/55°C). Loading of the teeth was applied at 135° to the palatal surface, using a universal testing machine at a cross-speed of 0.5 mm/minute until failure. The mode of failure was analyzed under a digital microscope. RESULTS: The fracture resistance of the control group was significantly higher than the experimental groups (p < 0.05). There was no significant difference between the experimental groups (p > 0.05). All teeth demonstrated nonrestorable failures. CONCLUSION: With the presence of the ferrule effect and crown restoration, the selected materials for post luting and core buildup have no significant influence on the fracture resistance of the endodontically treated teeth. CLINICAL SIGNIFICANCE: The use of the same dual-cure composite core materials for fiber post luting and core buildup would simplify the clinical procedure without enhancement of the fracture resistance of the endodontically treated tooth.


Asunto(s)
Técnica de Perno Muñón , Fracturas de los Dientes , Diente no Vital , Resinas Compuestas , Coronas , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Humanos , Incisivo
7.
Quintessence Int ; 51(7): 578-584, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32500865

RESUMEN

An edentulous posterior maxilla can present a challenge for placement of dental implants due to the proximity of the maxillary sinus. Sinus augmentation is a surgical bone grafting procedure aimed to increase the bone height for implant support. A number of sinus augmentation techniques have been presented and the outcomes show good implant success rates. In order to achieve the desirable outcomes, it is important to gain knowledge of the maxillary sinus anatomy and complete a thorough preoperative evaluation. Being aware of the location of vasculature, nerves, and the presence of septa will help reduce the risk of intraoperative and postoperative complications. This review provides a narrative clinical overview related to the anatomy, preoperative evaluation, contraindications, techniques, postoperative care, outcome measures, and complications of sinus augmentation procedures.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Maxilar , Seno Maxilar , Resultado del Tratamiento
8.
J Oral Implantol ; 46(3): 235-243, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32582920

RESUMEN

No previously published studies have reported on the placement and restoration of dental implants in a patient diagnosed with sarcoidosis. Patients with sarcoidosis may develop periodontitis as a manifestation of systemic disease and are therefore at increased risk of tooth loss. These patients are likely to want fixed dental prostheses, which may need to be supported by dental implants. The case presented is that of a 31-year-old female patient presenting with a missing maxillary central incisor and a sarcoidal process affecting the anterior maxilla, which had severely compromised the periodontium of the adjacent lateral incisor. The patient was successfully rehabilitated with an implant-retained prosthesis following a staged horizontal and vertical bone augmentation procedure. At the 4-year review, the implant restoration performed well with stable peri-implant bone levels. We conclude that dental implant rehabilitation in patients with sarcoidosis may be a predictable treatment option, depending on disease stability and concurrent systemic therapy, but these patients will require additional maintenance because of the possibility of an increased risk of peri-implantitis. The effects of sarcoidosis and its management on the success of dental implants are discussed to aid treatment planning for such patients.


Asunto(s)
Implantes Dentales , Sarcoidosis , Adulto , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Humanos , Maxilar/cirugía , Resultado del Tratamiento
9.
J Evid Based Dent Pract ; 20(1): 101410, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32381412

RESUMEN

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Implants in the Posterior Maxilla: Open Sinus Lift Versus Conventional Implant Placement. A Systematic Review. Romero-Millán J, Alzcorbe-Vicente J, Peñarrocha-Diago M, Galindo-Moreno P, Canullo L, Peñarrocha-Oltra D. Int J Oral Maxillofac Implants 2019; 34(4):e65-e76. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Systematic review.


Asunto(s)
Implantes Dentales , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía
10.
J Esthet Restor Dent ; 32(5): 487-495, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32452164

RESUMEN

PURPOSE: A retrospective evaluation of extended anterior ceramic laminate veneers (EACVs) after a mean observational period of 10 years. METHODS: Thirty-one patients (20 females/11 males) underwent restoration with 101 adhesively luted, heat-pressed EACVs (maxilla, n = 65; mandible, n = 36). RESULTS: The 10 year survival rate was 91.8% (95% confidence interval [95%-CI]: 0.87;0.97). Eight ceramic fractures, one biological failure, and one change in treatment plan caused the observed failures. Seventy-seven of the 101 restorations remained intervention-free in service (success rate: 78.6% [95%-CI: 0.70;0.88]). Fourteen interventions were needed (nine recementations, two endodontic treatments, two composite fillings, and one fracture polishing). The jaw position (maxilla/mandible, survival P = .578/success P = .056) had no influence on the clinical performance. EACVs covering large areas of exposed dentin (>50%) were associated with a significantly increased risk (hazard ratio 2.98, P = .019) of needing a clinical intervention (success rate: 68.0% [95%-CI: 0.52; 0.84]). However, the degree of dentin exposure had no effect on the survival rate (P = .761). CONCLUSIONS: After a mean observational period of 10 years, mandibular and maxillary EACVs exhibited survival and success rates that were comparable. Significantly lower success rates were associated with large areas of exposed dentin (>50%). CLINICAL SIGNIFICANCE: Mandibular and maxillary EACV revealed 10-year survival rates comparable to those published for anterior metal-ceramic and glass-ceramic full-coverage crowns. Precaution should be taken not to expose dentin, and when large areas of dentin are exposed, different conditioning/luting strategies should be used.


Asunto(s)
Porcelana Dental , Coronas con Frente Estético , Cerámica , Fracaso de la Restauración Dental , Femenino , Humanos , Masculino , Cementos de Resina , Estudios Retrospectivos
11.
J Esthet Restor Dent ; 32(5): 472-479, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32369271

RESUMEN

OBJECTIVES: The purpose of this in vitro study was to compare the effect of simulated endodontic access preparation on the failure loads of lithium disilicate crowns and resin-matrix ceramic (RMC) crowns. MATERIALS AND METHODS: Eighty maxillary first premolar crowns were manufactured by using four different CAD/CAM blocks (n = 20): lithium disilicate (LD; IPS e.max CAD), resin nanoceramic (RNC; Lava Ultimate), flexible nanaoceramic (FNC; GC Cerasmart), and polymer-infiltrated ceramic (PIC; VITA Enamic). Half of each group was accessed and repaired to simulate endodontic treatment. After cyclic loading, all specimens were loaded to failure. Data were analyzed with two-way ANOVA followed by Tukey-HSD test (α = .05). RESULTS: The load to failure results showed significant differences for material types (P < .001), but not for endodontic access simulation (P = .09). The highest and lowest mean failure loads were obtained for LD (1546 N) and PIC (843 N), respectively. CONCLUSION: The endodontic access preparation was not found to affect the fracture strength of LD and RMC crowns. The LD showed higher fracture strength than RMC crowns. Even though significant differences were noted for failure loads regarding different crown materials, all could reasonably withstand masticatory forces. CLINICAL SIGNIFICANCE: The endodontic access preparation through a restoration is known to be a common challenge in clinical practice. Maintaining a repaired LD or RMC crown is feasible and replacement may not be necessary.


Asunto(s)
Resistencia Flexional , Litio , Cerámica , Resinas Compuestas , Diseño Asistido por Computadora , Coronas , Porcelana Dental , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Ensayo de Materiales
12.
J Esthet Restor Dent ; 32(5): 444-450, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32442351

RESUMEN

OBJECTIVE: Ceramic fracture is an undesirable outcome of the rehabilitation with fixed partial dentures (FPD), mainly because it may involve additional cost and clinical time for intraoral repair or replacement of the restoration. This clinical report describes a 5 years survival intraoral repair of a chipped porcelain veneered zirconia framework restoration using a resin-based composite. CLINICAL CONSIDERATIONS: A FPD of porcelain veneered zirconia was made. After 18 months, the FPD presented a porcelain chip (porcelain fracture without exposure to the zirconia structure) on the buccal side of the pontic. An epoxy resin replica of the fractured surface was obtained and was examined under scanning electron microscopy. Fracture origin was found at the cervical area of the pontic. Intraoral repair by bonding the chipped fragment back in place was performed. After 15 days, the porcelain fragment debonded without patient knowledge and the fragment was lost. Then, intraoral repair using composite resin to restore the fractured area was performed and is still in function to date. CONCLUSIONS: Based on the 5-years survival of the performed intraoral repair, the composite resin reconstruction technique has shown to be an adequate alternative treatment for fractured FPD. CLINICAL SIGNIFICANCE: A resin composite repair of the fracture site can be performed in one clinical session, using much less time and cost than for the replacement of FPD. This clinical case survived 5 years to date.


Asunto(s)
Porcelana Dental , Circonio , Materiales Dentales , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Humanos
13.
Am J Dent ; 33(3): 165-168, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32470244

RESUMEN

PURPOSE: To clinically evaluate the clinical success of a primary zirconia molar crown, compared with stainless steel crowns (SSCs). METHODS: This randomized, controlled clinical trial was designed as a split-mouth study. 50 subjects ranging in age from 3-7 years were recruited to provide a total of 50 paired teeth requiring primary molar crowns, each participant receiving a SSC and zirconia crown. Restorations were evaluated at 6-, 12-, 24-, and 36-month recall appointments examining the following criteria: gingival health, estimate of the degree crown was high in occlusion, surface roughness, staining on crown surface, wear of opposing arch tooth, color match, anatomic form, marginal integrity, marginal discoloration, proximal contact area, secondary caries at crown margin and parent/guardian satisfaction with crown appearance. RESULTS: The 36-month follow up included 23 subjects (46%). 35 crowns (35%) were evaluated; of the 18 zirconia crowns and 17 SSCs, there were no failures at the 36-month evaluation. The only significant differences in the parameters evaluated were parent satisfaction, with the zirconia crown preference (P< 0.05) and gingival health, with the zirconia crowns having healthy adjacent gingiva (P< 0.01). The 36-month results indicated that zirconia primary molar crowns performed similarly to an established SSC for restoration of primary molars. CLINICAL SIGNIFICANCE: The findings from this study indicated that at 36 months, NuSmile ZR zirconia crowns clinically performed as well as stainless steel crowns.


Asunto(s)
Fracaso de la Restauración Dental , Restauración Dental Permanente , Coronas , Humanos , Diente Molar , Estudios Prospectivos , Acero Inoxidable , Diente Primario , Circonio
14.
J Prosthodont ; 29(6): 479-488, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32364656

RESUMEN

PURPOSE: To determine the prevalence and distribution of prosthetic complications affecting implant-supported fixed dental prostheses (ISFDPs). MATERIALS AND METHODS: Subjects previously treated with one or more ISFDP(s) were identified from an electronic health record search and recalled for comprehensive clinical examination. Past prosthesis failures and complications were identified from the patient records while any existing complications, not previously recorded, were assessed during examination. ISFDP survival and failure rates were calculated with Kaplan-Meier curves and life table analysis, while regression Poisson analysis was used to identify associations between outcomes and possible patient- and prosthesis-based risk factors. RESULTS: Seventy-four subjects with 107 ISFDPs were enrolled in the study with a mean time between prosthesis delivery and exam of 3.14 years (range: 1.00-9.00 years). Four prostheses failed, resulting in a cumulative prosthesis survival rate of 96.26%. Prosthetic complications affected 48.59% of ISFDPs, the majority (94.87%) of them minor complications. Only the use of a nightguard was associated with a lower prevalence of prosthetic screw loosening (HR 0.11, 95% CI 0.02-0.59, p = 0.007) while no outcome differences were noted for other variables. Patient satisfaction was high regardless of presence or number of complications. CONCLUSIONS: ISFDPs demonstrated a high survival rate and overall high, patient-reported satisfaction. Minor prosthetic complications were common but were only significantly associated with nightguard use.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Falla de Prótesis , Estudios Retrospectivos , Tasa de Supervivencia
15.
Ned Tijdschr Tandheelkd ; 127(4): 245-253, 2020 Apr.
Artículo en Holandés | MEDLINE | ID: mdl-32459220

RESUMEN

The fracture strength of endodontically treated molars restored by means of various types of direct and indirect materials was studied in vitro. 105 sound molars were endodontically treated and randomly assigned to 1 control group (endodontic access cavity only) and 6 experimental groups (n = 15) with restorations of the following materials: glass fibre reinforced composite (GFRC); microhybrid composite (C); microhybrid composite restoration with glass fiber post (CP); full-contour lithium disilicate crown (LDS); full-contour lithium disilicate crown with glass fiber post (P-LDS); and an endocrown (EC). Specimens were thermo-mechanically aged and axially loaded until failure. Data were analysed using ANOVA and Tukey's post hoc test (α = 0.05). Fracture strength was significantly affected by the type of restoration (p = 0.000). LDS had significantly higher fracture strength than the control group and GFRC, C and CP groups. Groups EC, LDS and P-LDS were not statistically different from each other in fracture strength. This was also the case with EC, P-LDS and all composite groups. The glass fibre strength of composite restoration resulted in significantly fewer fatal fractures.


Asunto(s)
Técnica de Perno Muñón , Fracturas de los Dientes , Diente no Vital , Resinas Compuestas , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Resistencia Flexional , Humanos , Ensayo de Materiales , Diente Molar
16.
Ned Tijdschr Tandheelkd ; 127(4): 254-261, 2020 Apr.
Artículo en Holandés | MEDLINE | ID: mdl-32459221

RESUMEN

The aim of this practice-based cohort study was to determine the performance and influence of possible variables in class II restorations related to practice, patient, tooth, and restoration. To do this, electronic patient files from 11 general practices in the Netherlands were collected, and 31,472 restorations placed between January 2015 and October 2017 were analysed. The observation time of restorations varied from 0 to 2.7 years, resulting in a mean annual failure rate (AFR) of 7.8% at 2 years. However, wide variation in AFRs existed among the operators, varying between 3.6% and 11.4%. An excess of patient-related variables, such as age, general health, periodontal status, caries risk and the presence of parafunctional habits and tooth or restoration-related factors, increases the risk of reintervention. Restorations placed due to fracture were more prone to fail than restorations placed due to caries. This study demonstrated that a wide variety of risk factors on the practice, patient, and tooth levels influences the survival of class II restorations.


Asunto(s)
Caries Dental , Restauración Dental Permanente , Estudios de Cohortes , Resinas Compuestas , Fracaso de la Restauración Dental , Humanos , Países Bajos , Estudios Retrospectivos , Factores de Riesgo
17.
J Esthet Restor Dent ; 32(4): 424-432, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32270920

RESUMEN

OBJECTIVE: This in vitro study aims to evaluate load-to-failure of ceramic veneers with butt joint (BJ) and feathered edge (FE) incisal preparation designs, and to correlate these results to the failure mode of the restorations. MATERIALS AND METHODS: One hundred and forty-eight typodont teeth (customized Nissin A25A-UL19B) were divided into two different preparation configurations BJ and FE and two different loading angulations, 0° and 20°. Lithium disilicate ceramic veneers (IPS e.max CAD, Ivoclar Vivadent) were milled using computer-aided-design-and-computer-aided-manufacturing (CAD/CAM) techniques. Veneers were bonded to typodont teeth with resin cement (IPS Variolink Esthetic, Ivoclar Vivadent). Each group was loaded at the incisal edge using an Instron Universal Testing Machine at a crosshead speed of 0.01 mm/s till failure. RESULTS: Pairwise comparison showed veneers from the BJ groups had a significantly higher load-to-failure value compared to the FE groups. Veneers with a FE preparation design loaded at 20° angulation had the lowest load-to-failure value. CONCLUSIONS: Within the limitations of the present study, both incisal preparation designs and loading angulations have significant effects on the load-to-failure values of ceramic veneers. BJ group exhibits a significantly higher load-to-failure value compared to the FE group. CLINICAL SIGNIFICANCE: BJ incisal preparation is preferred over FE preparation design.


Asunto(s)
Porcelana Dental , Coronas con Frente Estético , Cerámica , Diseño Asistido por Computadora , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Ensayo de Materiales , Cementos de Resina
18.
Dent Mater ; 36(5): 617-625, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32299664

RESUMEN

OBJECTIVES: (1) To investigate the properties of acoustic emission (AE) signals from fracture of dental materials and endocrown restorations during quasi-static compression using the continuous wavelet transform analysis. (2) To determine by the parameters of AE signals in which structural element of tooth-endocrown system the fracture starts. METHODS: Five restorative materials (zirconium dioxide (Prettau zirconia), ceramics (IPS e.max Press), metal ceramics (GC Initial MC+Nicrallium N2 BCS), composite resin (Nano Q), luting cement (Relyx™ U200)) were manufactured into discs, 13mm diameter, 5mm thick, which were divided into 5 groups (Group B, C, D, E, F, respectively) and included into Type 1. Twenty-five extracted human molars were divided into 5 groups and included into Type 2: Group A (control, no restoration); BE (tooth restored by zirconium dioxide endocrowns); CE (restored by ceramic endocrowns); DE (restored by metal ceramic endocrowns); EE (restored by composite resin endocrowns). An increasing load was applied to the center of the samples with a hard steel ball until a fracture occurred. The loading rate was 0.12mm/min. Two-channel AE detection system was used to record the AE activity during testing. The parameters including the peak frequency, bandwidth, duration time and energy of AE signals were analyzed. RESULTS: The restorative materials (Type 1) differ from each other by acoustic properties such as the peak frequency main bands and energy of AE signals. The detected AE signals correspond to the different fracture types. The dominant fracture mechanism of Group C, E and F specimens was the macrocracking (brittle fracture), and of Group D specimens was the microcracking, which alternated with the plastic deformation and macrocracking. For the number of events corresponding to the brittle fracture, statistically significant differences (p<0.05) were found between all group pairs. AE signals were not released during compression test of the zirconium dioxide samples, thus the fracture was not detected. All the AE signals detected during compression test of the different endocrown systems (Type 2) had two peak frequency bands. The fracture of Groups A, BE, CE and DE samples characterized by alternating the micro- and macrocracking with plastic deformation, and the brittle fracture was the dominant fracture mechanism. The restorations of Group EE fractured without plastic deformation. For the number of events corresponding to the brittle fracture, statistically insignificant differences (p>0.05) were found between Groups A vs CE and A vs EE, and statistically significant differences (p<0.05) were found between Groups A vs BE and A vs DE. SIGNIFICANCE: The initiation of fracture in the restorations with endocrowns made from different materials begins with the tooth damage. The metal ceramic endocrown restoration showed the highest fracture resistance, what is especially important for clinical use.


Asunto(s)
Coronas , Porcelana Dental , Acústica , Cerámica , Resinas Compuestas , Materiales Dentales , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Humanos , Ensayo de Materiales
19.
Clin Oral Implants Res ; 31(7): 634-645, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32249972

RESUMEN

OBJECTIVE: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants. MATERIAL AND METHODS: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used. RESULTS: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276). CONCLUSIONS: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Masculino , Estudios Retrospectivos
20.
Pediatr Dent ; 42(2): 141-145, 2020 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-32276682

RESUMEN

Purpose: To compare fracture strength, failure mode, and chairside time of Class IV fractures restored with CEREC (Chairside Economic Restorations of Esthetic Ceramics) technology or direct composite. Methods: Forty-eight fractured anterior bovine teeth were randomly assigned to three experimental groups (indirect restoration) with margin designs including: A) butt joint, B) short chamfer (one mm), and C) long chamfer (two mm) and a control group (direct composite). Preparations were scanned; restorations were milled from zirconia-reinforced lithium-silicate blocks and cemented. Fracture load (N) and failure mode were analyzed. Techniques were timed from start of margin preparation through finishing. Results were analyzed using one-way analysis of variance or the Kruskal-Wallis test (significance level: P=0.05). Results: Fracture loads (mean±standard deviation) for groups A, B, and C and control group were 2,177±644 N, 2,183±507 N, 2,666±609 N, and 2,358±886 N, respectively (not significantly different; P=0.26). The direct composite was significantly different from all indirect groups (P<0.01) for failure mode. Chairside time was longer for direct restoration. Conclusions: Fracture strength is similar for directly and indirectly fabricated Class IV restorations, with margin design not affecting strength or failure mode. Practitioner's chairside time, but not total time, is reduced when using indirect methods.


Asunto(s)
Estética Dental , Fracturas de los Dientes , Animales , Bovinos , Resinas Compuestas , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Ensayo de Materiales
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