Long-term behavior of double crown retained dentures with metal and metal-free secondary crowns and frameworks made of Vectris(©) on all-ceramic primary crowns: a prospective, randomized clinical trial up to 14 years.

OBJECTIVES: This prospective randomized clinical trial aimed to evaluate the long-term behavior of metal-free double crown retained dentures with secondary crowns and dental frameworks made of the fiber-reinforced composite Vectris(©) on all-ceramic primary crowns (IPS Empress 2(©)) over a period of up to 14 years and to subsequently evaluate patient satisfaction. For the control group, electroplated gold copings and metal frameworks were used. MATERIALS AND METHODS: A total of 29 patients were treated with a total of 37 prostheses on 165 primary crowns. Of these 37 prostheses, 27 were allotted to the control group and 10 to the test group. The mean observation time was 91 ± 57 months; patient satisfaction surveys were conducted over 77 ± 59 months. RESULTS: Success rates in both groups were compared using Kaplan-Meier survival curves and log-rank test. Up to about 3 years, both types of prostheses exhibited similar success rates. Afterwards, a massive decrease in the Vectris(©) curve could be noted, whereas the metal curve dropped only slightly. This difference was also statistically significant (p = 0.032361). There was a comparable susceptibility to damages in both groups: 88.9 % (control) and 90 % (test), respectively, of the prostheses had to be repaired within the period of investigation (p = 0,121). Damages of the Vectris(©) secondary crowns could be detected significantly more often compared to the electroformed gold copings (p < 0.00005). Patient satisfaction with the restorations was comparably high in both groups. CONCLUSION: Metal-free secondary crowns and denture frameworks made with the glass fiber-reinforced composite material Vectris(©) showed a lower survival rate than the electroplated gold copings and metal frameworks. Primary crowns made of IPS Empress 2(©) had insufficient stability. Exclusively high-strength zirconia ceramics should be recommended for this indication. CLINICAL RELEVANCE: Both clinical and statistical data indicated the superiority of the restorations made with electroplated secondary crowns and metal framework. Therefore, the use of Vectris(©) cannot be recommended for the fabrication of double crown retained removable dentures as permanent restorations.

Laboratory strength of glass ionomer and zinc phosphate cements.

PURPOSE: The present in vitro study examined 3 mechanical properties, namely compressive, flexural, and diametral tensile strength, of various commercially available cements and core materials as a function of time after mixing. MATERIALS AND METHODS: The examined materials were 2 cermet cements (Ketac Silver [ESPE, Seefeld, Germany] and Chelon Silver [ESPE]), 1 metal-reinforced glass ionomer cement (Miracle Mix [GC Dental Industrial Corp, Tokyo, Japan]), 2 conventional glass ionomer cements (Ketac Bond [ESPE] and Ketac Cem [ESPE]), 1 standard cure zinc phosphate cement (Harvard Cement [Richter and Hoffmann, Berlin, Germany]), and 1 zinc phosphate cement with the addition of 30% silver amalgam alloy powder (Harvard Cement 70% with Dispersalloy 30% [Richter and Hoffmann/Johnson and Johnson, East Windsor, NJ]). Properties were measured using a universal testing machine at 15 minutes, 1 hour, and 24 hours after first mixing. RESULTS: Compressive strengths varied widely between the 3 times of measurement from 5.8 +/- 6.6 MPa for Ketac Cem to 144.3 +/- 10.2 MPa for Ketac Silver. Twenty-four hours after mixing, the Bonferroni test showed significant (p

Advanced biomaterials used for a new telescopic retainer for removable dentures.

Removable dentures supported by cast-metal telescopic crowns often exhibit an unpredictable increase or decrease in retentive force after being in clinical use for some time. The objective of the present in vitro study was to develop a new retainer for removable dentures and to evaluate its tribological properties. The new retainer is based on a tapered crown design and consists of a conical all-ceramic abutment crown and a coping made of electroplated gold. It was compared with conventional telescopic retainers made of cast metal. There were 30 specimens in groups of equal size by material used (abutment crown/coping): Group 1, gold/gold; Group 2, titanium/titanium; Group 3, ceramic/electroplated gold. Each specimen consisted of 2 conical-shaped abutment crowns (alpha =4 degrees; h = 6 mm; O(base) = 4,5 mm); their copings were rigidly connected at 25 mm intervals. Retentive forces were measured with a universal testing machine following axial loading to 5-400 N. Wear was simulated by 500-100, 000 joining and separating cycles in the presence of artificial saliva. Metallographic cross-sections were made to evaluate the specimens' fit and surfaces with an SEM. Retentive forces in Groups 1 and 2 increased with load, exhibiting nondirectional changes after induced wear. Sometimes the alloys' functional surfaces showed considerable tracks of wear. Neither load nor wear had any effect on Group 3 retentive forces (mean(force) = 5.03 N). The functional ceramic and gold surfaces showed no traces of wear and the best fit (median(gap) = 4.9 microm). Replacing cast metals by ceramics and electroplated gold results in retainers with clinically advantageous tribological effects, implying, in particular, high wear resistance.

Advanced biomaterials used for a new telescopic retainer for removable dentures.

Telescopic retainers with conical ceramic abutment crowns and electroplated gold copings define a new retainer for removable dentures exhibiting favorable tribological properties that could offer clinical advantages. The objective of this study was to evaluate the clinical effects of this retainer. To do so, a novel treatment modality was developed based on intraoral bonding of the copings to the framework in order to be able to realize, in a clinical setting, the retainer function based on a precision fit. A total of 32 patients wearing 33 dentures (16 mandibular, 17 maxillary; period of risk [months]: minimum = 3; maximum = 58; mean = 27.6), supported by 147 abutments (83 natural teeth, 64 implants) with ceramic abutment crowns (IPS Empress 1, IPS Empress 2, InCeram, Procera, CerAdapt; CeraBase) were followed at 6-month intervals. The ceramic abutment crowns showed low plaque accumulation (mean PI = 17.3%). The gingival tissues around natural abutments were generally free of inflammation; so was the mucosa around the implants (mean SBI = 4.9%). Denture adhesion and occlusion did not change, and there were no rocking movements. The mobility (as determined by Periotest) of 29 teeth was reduced in a highly significant manner within 6 months (t test, p < 0.001). Osseointegration was preserved for all implants. One abutment loosened. Six Empress 1 ceramic copings failed (94.6% Kaplan-Meier survival rate), and one abutment tooth was lost (99.2% survival rate). All patients reported problem-free handling, no rocking movements, and constant adhesion. The adhesive strength of one denture was too low at insertion. 94% of the patients experienced no problems with oral hygiene. The retainer examined has relevant clinical advantages and meets geriatric requirements for removable dentures.

The Procera AllCeram system.

The Procera AllCeram system is indicated for manufacturing all-ceramic crowns for single-tooth restorations in the anterior and posterior regions. In addition, it is possible to create metal-free superstructures on CeraOne abutments from the Brånemark implant system or crowns on individually prepared aluminum oxide abutments (CerAdapt). The Procera copings, which are manufactured using computer-aided design/manufacturing technology, are characterized by very good mechanical properties. Ceramic veneers tailored to the copings offer excellent esthetics, favorable abrasion behavior, and an ideal surface structure for non-inflammatory apposition of the periodontal or periimplant tissues. The present article offers an overview of previous scientific studies, describes clinical and laboratory procedures, and presents case reports.

Success rates for two different types of post-and-cores.

The objective of our follow-up study was to evaluate the success of two different types of partially prefabricated post-and-core systems following crown placement. Two hundred and thirty-seven Permador posts and 49 Radix posts were evaluated clinically. Radiological follow-up was performed for 230 Permador posts and 47 Radix posts. The restorations had been in situ for an average of 3.9 years (Permador posts) and 2.3 years (Radix posts), respectively. Root canal fillings were evaluated as to their length, their homogeneity and their flushness with the walls of the root canal. The post-and-cores were evaluated for their orientation in the root canal and for the length of the inserted post relative to the length of the root. The position of the post was classified as centric in 78.0% of the restorations followed, and eccentric in 19.5%, while 2.5% showed a root perforation. The minimal requirement that the length of the post-and-core should at least be equal to the length of the clinical crown was met in 85% of the cases. Eighteen (6.3%) of the 286 teeth examined had to be extracted. There were significant correlations between insertion periods, horizontal bone loss, length of the root canal filling, and position of the post on one hand and tooth loss on the other.

Temperature response in the pulpal chamber during ultrahigh-speed tooth preparation with diamond burs of different grit.

STATEMENT OF PROBLEM: Ultrahigh-speed tooth preparation can traumatize the hard dental tissues and the dental pulp. PURPOSE: This in vitro study examined the relationship between different grits of diamond burs on the temperature response within a pulpal chamber during tooth preparation with a turbine. MATERIAL AND METHODS: Newly extracted, undamaged third molars were secured by a rapid-tensioning device mounted on an air-supported slide. NiCrNi thermocouples were inserted apically and used to determine the temperature within a pulpal chamber. The grinding tests used cylindrical fine, coarse, and ultracoarse diamond burs. RESULTS: The maximal temperature elevation within the pulp was 3.2 degrees C, and the most pronounced rise in temperature occurred with ultracoarse burs. Temperature increases in the pulpal chambers and grinding times or temperatures of the cooling water were approximately proportional. Residual dentinal thickness was inversely proportional to temperature elevation within the pulpal chamber. CONCLUSIONS: This study demonstrated that coarse diamond burs resulted in more pronounced temperature increases within the pulpal chamber during tooth preparation. In addition, the benefit of short intervals between grinding steps and a cooling water temperature between 30 degrees C and 32 degrees C was confirmed. A cooling temperature of 38 degrees C to 43 degrees C did not afford actual cooling.

[Comparative material studies on dental stones in accordance with DIN 13911]. / Vergleichende werkstoffkindliche Untersuchungen an zahnärztlichen Hartgipsen nach DIN 13911.

It was the object of this investigation to compare nine high-strength stone plasters in terms of visual appearance, pouring time, setting time, setting expansion, compressive strength and detail reproduction in accordance with DIN 13911 and ISO 6873 using both standard consistency as indicated in the industrial standard and the water-to-powder ratio as indicated by the manufacturer. None of the tested stones met the visual requirements in all points. Regarding their physical properties, six tested stones were up to standard. Three stones failed to meet the DIN and ISO requirements. Following the manufacturer's mixing instructions resulted in a significant improvement in material properties as against standard consistency. Disregarding some minor improvements required, DIN 13911 and ISO 6873 are useful standards for a standardized comparison of dental plasters.

[Effects of porcelain fused to metal on the accuracy of fit of various alloys]. / Einfluss der Aufbrennkeramik auf die Passgenauigkeit unterschiedlicher Legierungen.

One high gold and five low gold porcelain bonding alloys were examined for dimensional changes after fusion of the porcelain. With the same processing techniques applied, the individual firings resulted in varying changes in the accuracy of fit of the tested alloys. Averaging at -0.09 mm Bond-on 4 showed the greatest marginal discrepancies and this was the only alloy that displayed a statistically significant difference to Degudent U.

[Comparative material testing of dental impression and articulation plasters according to German Industrial Standard DIN 13911]. / Vergleichende Untersuchungen an zahnarztlichen Abdruck- und Artikulationsgipsen nach DIN 13911.

The purpose of the present investigation was a comparison of three special articulation plasters and three impression plasters. As DIN 13911 does not refer to articulation plasters, the inspection as well as the testing of pouring time, setting time, setting expansion and compressive strength using standard and manufacturer's consistence as carried out conforming to the guidelines for impression plasters. None of the tested plasters could meet the requirements of inspection in all points. Considering the physical parameters all plasters are up to standard, while Alpa quickstone and Arti-Plaster exhibited very low expansion and high compressive strength values. Although the compressive strength standard needs redefining, the value of a standardized testing technique for dental plasters is evident.

Effects of the temperature of cooling water during high-speed and ultrahigh-speed tooth preparation.

In vitro measurements of heat production in the pulp chamber during tooth preparation were performed on intact third molars. The experiments were designed to simulate physiologic temperature conditions in the tooth and oral cavity and to standardize parameters of tooth preparation. Two drive systems, the turbine and the high-speed angle, were compared by using two ranges of cooling water temperature. The critical temperature of 41 degrees C to 42 degrees C that is irreversibly harmful to pulpal tissue was not reached with a cooling water temperature of 30 degrees C to 34 degrees C. Because the temperature elevation during turbine preparation was dependent on the diminishing thickness of remaining dentin, in preparing teeth close to the pulp, a high-speed angle was advantageous.

Protein content in rabbit periodontal ligament fibroblasts during growth in culture.

The protein content of an individual periodontal ligament fibroblast decreases with increasing cell density during growth in culture. A mean total protein concentration of 3.3 +/- 0.4 micrograms per 10(3) cells was calculated. This reference value can be used in studies evaluating enzyme activities, transport rates or metabolic functions.