Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.

Restoration of a Maxillary Anterior Defect With a Rotational Path Removable Partial Denture: Clinical Report of a Patient With Cleidocranial Dysplasia.

Cleidocranial dysplasia (CCD) is an uncommon genetic condition that affects teeth and bones, potentially leading to delayed ossification, dental abnormalities, and craniofacial changes, which can be treated through a combination of orthodontic and prosthodontic therapies. This case report describes the diagnostic evaluation, laboratory procedures, and prosthodontic treatment for a patient with CCD who had two missing maxillary anterior teeth. Following occlusal device therapy and the achievement of occlusal equilibration, restorative treatment was performed, consisting of a maxillary central incisor survey crown, rest seat preparations, and a lateral rotational path removable partial denture (RPD). The article highlights the value of this type of RPD as an alternative restoration for the replacement of missing anterior teeth.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.

Effects of NanoAg-ACP Microparticles as Bioactive Fillers on the Mechanical and Remineralization Properties of Dental Resin Cement.

PURPOSE: To investigate the potential of adding silver-nanoparticle-containing amorphous calcium phosphate microparticles as bioactive fillers into commercially available nonbioactive dental resin cement. MATERIALS AND METHODS: Experimental cement was formulated by adding 7.5% silver-nanoparticle-containing amorphous calcium phosphate microparticles to Multilink Automix resin cement (Ivoclar Vivadent). The experimental cement was evaluated for shear bond strength (N = 11 per group) and demineralization/remineralization (N = 16 per group), with BioCem® Universal BioActive cement (NuSmile) as the positive control and Multilink Automix cement as the negative control. One-way analysis of variance and post hoc tests were used to assess the significance of differences among or between the groups RESULTS: The addition of silver-nanoparticle-containing amorphous calcium phosphate microparticles at the level of 7.5% by weight into Multilink Automix did not have a statistically significant effect on the shear bond strength (p > 0.05), but statistically significantly increased the depth of remineralization on both dentin and enamel (p = 0.01 and p < 0.001, respectively) when compared to Multilink Automix alone. The experimental cement prepared in the present study was comparable to BioCem® on the depths of remineralization on both dentin and enamel (p = 0.59 and p = 0.99, respectively). CONCLUSION: When incorporated into nonbioactive commercial dental resin cements as bioactive fillers at the level of 7.5% by weight, silver-nanoparticle-containing amorphous calcium phosphate microparticles could provide remineralization potential without affecting the shear bond strength.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.

Surface Roughness of Milled Lithium Disilicate With and Without Reinforcement After Finishing and Polishing: An In Vitro Study.

PURPOSE: To determine the efficacy of various finishing and polishing techniques on the surface roughness of two computer-aided design/computer-aided manufacturing (CAD/CAM) materials, lithium disilicate (IPS e.max), lithium disilicate reinforced with lithium aluminosilicate (Straumann® n!ce™), and a stackable low-fusing nanofluorapatite glass ceramic (Ceram). MATERIALS AND METHODS: Flat specimens (n = 12) per treatment group were fabricated 2 mm thick, 15 mm in length, and 12mm in width. Samples were either glazed or polished. Glazing was accomplished with either Ivoclar IPS e.max CAD crystall glaze spray or IPS e.max Ceram glaze paste, according to manufacturer instructions. Three different polishing systems were tested: Brasseler Dialite HP, Ivoclar OptraFine, and Komet LD/ZR. Polishing was performed using a Kavo adjustable slow speed electric contra-angle handpiece mounted to an oscillating Toothbrush Dentifrice Assessment Instrument. Surface roughness data was collected using a benchtop stylus profilometer and analyzed for statistical significance using two-way ANOVA (α = 0.05). Representative scanning electron micrograph images were generated for all samples. RESULTS: Overall there was no significant difference in Ra when comparing types of ceramic (p = 0.9315, F = 0.071). However, there was a statistically significant difference when comparing groups of finishing treatments (p < 0.001, F = 113.5) and also when comparing finishing treatment with ceramic type (p < 0.001, F = 11.13). No significant difference was found with IPS e.max CAD crystall glaze spray on Straumann® n!ce™ versus IPS e.max Ceram glaze paste on IPS e.max Ceram (p = 0.8745) or IPS e.max CAD crystall glaze spray on IPS e.max versus IPS e.max Ceram glaze paste on IPS e.max Ceram (p = 0.3373). Significant differences in Ra of Straumann® n!ce™ were found when comparing Brasseler with Ivoclar (p = 0.0014) and Ivoclar with Komet (p = 0.047). No significant difference was observed between Brasseler and Komet (p = 0.8099). CONCLUSIONS: It appears that the degree of surface roughness depends upon the specific finishing system and ceramic combination used. Straumann® n!ce™ is more efficiently polished using Brasseler Dialite HP or Komet LD/ZR polishing systems. Ivoclar crystal glaze spray was found to be equally as effective on Straumann® n!ce™ and IPS e.max as IPS e.max Ceram glaze paste on IPS e.max Ceram.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.

Effect of Bonding and Rebonding on the Shear Bond Strength of Two-Piece Implant Restorations.

PURPOSE: To evaluate the rebonding strength of ceramics to titanium alloy after disassembling by heat treatment. MATERIALS AND METHODS: A total of 40 titanium alloy (titanium-6 aluminum-4 vanadium) disks (4.0 × 6.6 mm) and 20 zirconia (Lava Plus) disks were manufactured using computer-aided design and computer-aided manufacturing (CAD/CAM) technology. Twenty heat-pressed lithium disilicate glass-ceramic (IPS e.max Press LT) disks were fabricated and used as controls. Bonding protocol for each specimen surface was performed according to manufacturer's instructions. Specimens (n = 10) of zirconia/titanium alloy (ZR) and lithium disilicate/titanium alloy (LD) were bonded using adhesive resin cement (RelyX Ultimate) and then subjected to a heat treatment (HT, 320°C, 2 minutes) to disassemble the bonding complex, cleaned with aluminum oxide airborne-particle abrasion, and rebonded following the initial protocol, group ZRHT and group LDHT, respectively. After 5000 cycles of thermal cycling, a shear bond test was conducted. A universal testing machine was used at a 5 mm/min crosshead speed. Failed specimens were examined with stereomicroscopy at 10× magnification to identify the mode of failure. One-way ANOVA and Tukey HSD tests were applied for statistical analysis of the shear bond strength data, with statistical significance at α = 0.05. RESULTS: The mean ± SD bond strength values ranged from 28.3 ± 7.2 to 45.9 ± 9.7 MPa. Statistically significant lower shear bond strength values were obtained from the LD group (p = 0.002, F = 5.89), while no statistically significant differences in bond strength were observed between the ZR and ZRHT groups (p > 0.05). Failure mode was predominantly mixed-type failure pattern for all specimens. CONCLUSIONS: Heat and abrasion surface treatment increased the bond strength of lithium disilicate glass-ceramics cemented to titanium alloy, but no effect was observed on zirconia/titanium alloy bonding.

Subcrestal Implant Placement and Recontouring Soft Tissue Using the Erbium YAG Laser to Manage Restorative Space in Implant Overdentures.

Subcrestal implant placement helps gain vertical restorative space at the location of the implants; however, this leads to the development of a tall mucosal cuff, necessitating the use of tall abutments. This article describes the technique of gaining restorative space by decreasing the height of the mucosal cuff with an Erbium YAG laser.

A Prosthesis Retention System for Full-Arch, Fixed, Implant-Supported Prosthesis.

Full-arch, fixed, implant-supported prostheses can be designed to be cement- or screw-retained. Both retention mechanisms have a few inherent disadvantages. A fixed attachment system has been introduced to circumvent the disadvantages of both screw and cement retention. This system eliminates the screw access holes and the use of cement. The number of intraoral procedures required is also reduced. The purpose of this article is to report a case using the Locator F-Tx Attachment System to facilitate fabrication of an esthetic, clinician-retrievable, full-arch implant-supported fixed dental prosthesis.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

PROBLEM: There are countless numbers of scientific studies published in countless scientific journals on subjects related to restorative dentistry. PURPOSE: The purpose of this article is to review pertinent scientific studies published in 2017 on topics of interest to restorative dentists. METHODS AND MATERIALS: The authors, considered to be experts in their disciplines searched the scientific literature in 7 different areas (prosthodontics, periodontics, dental materials, occlusion and temporomandibular disorders, sleep-disordered breathing, oral medicine and oral and maxillofacial surgery and dental caries). Pertinent articles were either identified and referenced or reviewed. RESULTS: A total of 437 articles in 7 disciplines were identified or reviewed. CONCLUSIONS: An impressive amount of scientific literature related to restorative dentistry was published in 2017. The evidence presented in this article can assist dentists in the practice of contemporary evidence-based dentistry.

Do denture processing techniques affect the mechanical properties of denture teeth?

STATEMENT OF PROBLEM: Denture tooth fracture may limit the longevity of dental prostheses. Whether the strength of the denture tooth material is affected by the denture processing technique is unclear. PURPOSE: The purpose of this in vitro study was to investigate whether the denture processing technique affects the mechanical properties of denture tooth materials. MATERIAL AND METHODS: Two denture processing techniques, injection and compression molding, were tested for 3 types of denture teeth: nanohybrid composite (NHC), interpenetrating network (IPN), and microfiller-reinforced polyacrylic (MRP). Denture teeth were processed by using an injection-molded resin or a compression-molded resin. Unprocessed denture teeth served as the control. After teeth were processed, they were sectioned into rectangular beams for 3-point bend testing (n=20 to 24). Elastic moduli were determined from load deflection and maximum stress from maximum bending load. The results were statistically analyzed by using 2-way ANOVA and multiple comparisons (α=.05). RESULTS: The processing technique and the type of denture tooth affected both the elastic modulus and the maximum stress. The injection-molded technique resulted in significantly higher (24% to 26%) elastic modulus for NHC and IPN (12% higher in MRP, but not statistically significant) and higher (12% to 17%) maximum stresses for IPN and MRP (3% lower in NHC, but not statistically significant). Compression-molded technique increased the elastic modulus of IPN and NHC by 10% to 17% (3% lower in MRP but not statistically significant), but maximum stresses were not statistically significantly different in any of the tested teeth. Regardless of processing, MRP teeth had the highest elastic modulus (8.0 to 9.2 GPa) but the lowest maximum stresses (97 to 124 MPa), whereas IPN teeth had the lowest elastic modulus (5.5 GPa) but high or highest maximum stress (171 to 192 MPa). CONCLUSIONS: The injection-molded technique significantly increased the elastic modulus of NHC and IPN teeth and significantly increased the maximum stress of IPN teeth. The compression-molded technique did not significantly affect mechanical properties of denture teeth.

Comparison of digital surface displacements of maxillary dentures based on noninvasive anatomic landmarks.

STATEMENT OF PROBLEM: Artificial markers called fiducials are commonly used to orient digitized surfaces for analysis. However, when these markers are tangible and placed in the region of interest, they may alter surface topography and influence data analysis. PURPOSE: The purpose of this in vitro study was to apply a modified digital surface fitting method based on anatomic landmarks to evaluate denture accuracy and to use 2 different denture processing techniques to evaluate the method. The goal was to noninvasively measure and describe any surface differences in denture processing techniques at the intaglio and denture tooth levels. MATERIAL AND METHODS: Twenty standardized maxillary complete dentures were waxed on standardized edentulous casts and processed by using acrylic resin compression (COM, n=10) and injection molding (INJ, n=10) methods. Digital scans were recorded of the anatomic surface of the cast, the intaglio and cameo surfaces of the acrylic resin dentures, and the cameo surface of the wax dentures. Three anatomic fiducials were identified on denture intaglio and cast scans and 4 on the cameo surfaces of waxed and acrylic resin denture scans. These fiducials were then used to digitally align the anatomic with the processed intaglio surfaces and the waxed with the processed cameo surfaces. Surface displacements were compared among processed dentures expressed at specific points (9 tissue landmarks and 8 tooth landmarks). The accuracy of surface displacements was assessed by changes in the number and location of anatomic fiducials. The scanning precision and the intraobserver repeatability in the selection of dental landmarks were also determined. For each landmark, the spatial (x, y, and z) mean differences between the 2 processing techniques were calculated for the intaglio and the cameo surfaces and presented on each orthogonal plane. Statistical nonparametric comparison of these means was analyzed with the Mann-Whitney U test (α=.05). Benjamini-Hochberg corrections for multiple comparisons were used. RESULTS: Changing the number and the location of anatomic landmarks had a small effect on the precision of the surface fitting. Repeated scans yielded high precision levels. In contrast, intraobserver repeatability had a larger error. In general, injection-molded dentures showed less displacement after polymerization than did the compression-molded ones. These differences were more substantial at the denture tooth level than on the intaglio surfaces. CONCLUSIONS: Anatomic noninvasive fiducials chosen at distinct locations of maxillary edentulous areas seem to be reliable markers for the superposition of corresponding digital surface scans. Maxillary dentures processed with the injection molding technique have minimal deformation. Posterior denture teeth displace in 3 dimensions with the compression molding technique.

Influence of remaining coronal tooth structure on fracture resistance and failure mode of restored endodontically treated maxillary incisors.

STATEMENT OF PROBLEM: Limited information is available on the effect of an incomplete ferrule because of the varying residual axial wall heights and the volume of residual tooth structure on the fracture resistance of endodontically treated and restored maxillary incisors. PURPOSE: The purpose of this in vitro investigation was to examine the effect of varying residual axial wall heights, residual coronal tooth structure, and the absence of 1 proximal axial wall on the fracture resistance and failure mode of endodontically treated teeth restored with metal posts. MATERIAL AND METHODS: Sixty intact human maxillary central incisors were divided into 6 groups (n=10): no ferrule (NF), 2-mm complete ferrule (CF2), 2-mm (IF2), 3-mm (IF3), and 4-mm (IF4) incomplete ferrules missing a single interproximal wall, and a control group that had a 6-mm incomplete ferrule (IF6). Cast metal post-and-cores were placed in all experimental specimens except for controls. Control specimens received 1 interproximal cavity preparation extending to the root canal access and a composite resin restoration. Complete metal crowns were then cemented on all specimens. Completed specimens were subjected to thermocycling (6000 cycles, 5°C/55°C) followed by the immediate testing of fracture resistance. Failed specimens were sectioned buccolingually and evaluated to identify the failure mode. The data were analyzed with an analysis of variance (ANOVA) and the Student-Newman-Keuls multiple comparison test (α=.05). RESULTS: An incomplete ferrule (IF2) with 1 interproximal wall missing had significantly reduced fracture resistance (697 N) compared with a complete ferrule (932 N). An increase of 3 to 4 mm of remaining wall height improved fracture resistance, from 844 N (IF3) to 853 N (IF4). Partial decementation was noticed in 8 NF and 5 IF2 specimens. IF3 and IF4 had no decementations. Radicular fractures and cracks (catastrophic failure) were observed in all IF2, IF3, and IF4, 9 CF2, and 6 NF specimens. In 7 specimens without posts (IF6, control), composite resin foundation and/or coronal dentin fracture were observed and the failure was considered repairable. CONCLUSIONS: The results of this in vitro study indicated that specimens with a 2-mm ferrule of uniform height were more resistant to fracture than specimens with a 2-mm ferrule and 1 missing interproximal wall. An increased wall height of 3 or 4 mm was associated with a significant increase in fracture resistance and can compensate for the missing interproximal wall.

Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry.

This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature in their discipline published in 2016 and review the articles for important information that may affect treatment decisions. Comments on experimental methodology, statistical evaluation, and the overall validity of conclusions are included with many of the reviews. The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source, if they want more detail.

Implant-assisted removable partial dentures: practical considerations.

At the heart of prosthodontic treatment planning must be a sound understanding of the quality and reliability of the prosthodontic foundation. Implant prosthodontics relies almost entirely on the biological and mechanical properties of an osseous foundation. Initiation of therapy in the absence of a healthy and stable prosthodontic foundation risks unintended and suboptimal treatment outcomes. For conventional removable partial denture (RPD) therapy, consideration must be given to interactions between the soft and hard tissues available to support and stabilize planned prostheses. The strategic addition of implants to the partially edentulous foundation can improve the support, comfort, and esthetics of an RPD, resulting in elevated patient satisfaction and greater therapeutic success. This article discusses aspects of diagnosis, treatment planning, clinical management, laboratory execution, and maintenance that must be considered in order to obtain optimal results with implant-assisted RPDs.

Failure strengths of denture teeth fabricated on injection molded or compression molded denture base resins.

STATEMENT OF PROBLEM: Denture tooth fracture or debonding remains a common problem in removable prosthodontics. PURPOSE: The purpose of this in vitro study was to explore factors determining failure strengths for combinations of different denture tooth designs (shape, materials) and injection or compression molded denture base resins. MATERIAL AND METHODS: Three central incisor denture tooth designs were tested: nanohybrid composite (NHC; Ivoclar Phonares II), interpenetrating network (IPN; Dentsply Portrait), and microfiller reinforced polyacrylic (MRP; VITA Physiodens). Denture teeth of each type were processed on an injection molded resin (IvoBase HI; Ivoclar Vivadent AG) or a compression molded resin (Lucitone 199; Dentsply Intl) (n=11 or 12). The denture teeth were loaded at 45 degrees on the incisal edge. The failure load was recorded and analyzed with 2-way ANOVA (α=.05), and the fracture mode was categorized from observed fracture surfaces as cohesive, adhesive, or mixed failure. RESULTS: The following failure loads (mean ±SD) were recorded: NHC/injection molded 280 ±52 N; IPN/injection molded 331 ±41 N; MRP/injection molded 247 ±23 N; NHC/compression molded 204 ±31 N; IPN/compression molded 184 ±17 N; MRP/compression molded 201 ±16 N. Injection molded resin yielded significantly higher failure strength for all denture teeth (P<.001), among which IPN had the highest strength. Failure was predominantly cohesive in the teeth, with the exception of mixed mode for the IPN/compression group. CONCLUSIONS: When good bonding was achieved, the strength of the structure (denture tooth/base resin combination) was determined by the strength of the denture teeth, which may be affected by the processing technique.