Retrospective Analysis of Lithium Disilicate Laminate Veneers Applied by Experienced Dentists: 10-Year Results.

PURPOSE: To report on the 10-year clinical treatment outcomes for a strictly applied clinical protocol for pressable lithium disilicate glass-ceramic laminate veneers (LDLVs) placed by two experienced dentists. MATERIALS AND METHODS: A 10-year follow-up assessment of 364 LDLVs placed in 41 patients was undertaken with the clinical criteria color/esthetic match of the porcelain surface, chipping and fracture occurrence, marginal discoloration, and integrity, assessed using the modified United States Public Health Service scoring system. RESULTS: After 10 years, the survival rate was 97.4%. Complications occurred in 1.64% of the restorations (fractures and debonding in 0.55% and 1.09%, respectively). CONCLUSION: A strict, repeatable protocol for placing veneers with experienced dentists yielded good results.

Clinical performance of pressable glass-ceramic veneers after 5, 10, 15, and 20 years: A retrospective case series study.

OBJECTIVES: To evaluate the long-term clinical performance and survival rate of pressable lithium-disilicate glass-ceramic veneers (LDSVs). MATERIALS AND METHODS: A total of 413 LDSVs were bonded to anterior and posterior teeth by three experienced clinicians between 1998 and 2012. The LDSVs were examined for color/ esthetic match of the glass-ceramic surface (esthetic evaluation), fracture rate, marginal discoloration (staining of the luting cement), and marginal integrity (including caries, clinical evaluation). For clinical and esthetic evaluations, the modified United States Public Health Services (USPHS) score was used in this study. The success rate was determined with a Kaplan-Meier survival analysis. RESULTS: The mean observation time was 11.33 ± 4.85 years. There was no loss to follow-up, all restorations were accounted for in the final analysis. The probability of survival of the 413 veneers was 98% after 5 years, 95% at 10 years, 91% at 15, and 87% at 20 years, indicating a very low clinical failure rate. Of the 413 restorations, complications were occurred in 15 (3.63%) of all restorations, and fractures and debonding in 6 (1.45%) and 9 (2.18%), respectively. CONCLUSIONS: The LDSVs showed high survival rate and very good results for color match and anatomic form and marginal integrity in the long-term analysis. CLINICAL SIGNIFICANCE: The long-term performance of LDSVs can be considered as highly favorable when carefully planned.

Fracture resistance of manually and CAD/CAM manufactured ceramic onlays.

PURPOSE: This in vitro study aimed to evaluate fracture resistance in lithium disilicate onlays fabricated with IPS e.max Press and IPS e.max CAD systems and luted with different adhesive cements. MATERIAL AND METHODS: Fifty maxillary first molars were prepared using a mesio-occluso-disto-lingual onlay cavity model. Ten onlays from each group were cemented using etch-and-rinse adhesives and high-viscosity composite resin cement, and 10 were cemented with self-adhesive, dual-curing universal resin cement. Fracture resistance was measured. RESULTS: Significant differences were observed between resin cements (p < 0.05) and between materials (p < 0.05), but the interaction of these variables did not produce a significant difference. The fracture resistance of pressable ceramics was significantly higher than that of CAD/CAM onlays (p < 0.05), and Syntac Variolink was significantly higher than that of Multilink Sprint (p < 0.05). CONCLUSION: All groups showed clinically acceptable fracture strength results. According to the study, both the onlay fabrication system and adhesive cements can be a viable treatment option.

Marginal-internal adaptation and fracture resistance of CAD/CAM crown restorations.

This study evaluated the marginal adaptation and fracture resistance of CAD/CAM-fabricated zirconia crowns luted using different luting agents. Twenty crown restorations were produced using IPS ZirCAD zirconium oxide blocks (IZC), and another 20 using Lava zirconium oxide blocks (L). Ten teeth were used as control. Luting agents used were an etch-and-rinse adhesive (Variolink II) and a self-etch adhesive (Multilink Automix). Internal and marginal adaptation was evaluated using silicone replica technique. Fracture resistance was evaluated using a compression test. Marginal discrepancy was 89.26 µm for L crowns and 88.84 µm for IZC crowns, and difference was statistically insignificant. However, L crowns showed significantly larger axial and occlusal gaps than IZC crowns (p<0.05). Fracture resistance of IZC-Multilink was higher than the other groups, although the difference was not significant. Results showed that CAD/CAM-fabricated crowns showed acceptable in vitro marginal discrepancies and fracture strengths.

Effects of thermocycling on the retention of various cements of one-unit and three-unit fixed implant-supported restorations.

PURPOSE: To investigate the physical retention of different cements on one-unit and three-unit implant-supported restorations before and after thermocycling. MATERIALS AND METHODS: Twenty acrylic resin maxilla models with a single missing tooth and three missing teeth were fabricated and implants were placed. Cast partial denture copings were cemented to Straumann solid abutments with seven different cements. Specimens were placed in a humidifier at 37°C for 24 hours; half of them were then subjected to thermocycling. The tensile force was measured using a universal testing machine with a crosshead speed of 0.5 mm/min. The retention force required to remove the specimens was recorded and the data were submitted to statistical analyses. RESULTS: The retentive strength of the cements was highest for Multilink Implant, followed in descending order by Kavitan Cem, Adhesor Carbofine, Premier Implant, Adhesor, RelyX Temp, and Cavex before and after thermocycling for both one- and three-unit restorations. The bond strength was statistically significantly higher for three-unit than for one-unit restorations before and after thermocycling, and there were statistically significant differences between cements for all groups before and after thermocycling. Both groups showed a statistically significant decrease in bond strength after thermocycling, and the largest differences were seen for Cavex and RelyX Temp for one-unit restorations and Cavex, RelyX Temp, and Kavitan Cem for three-unit restorations. CONCLUSIONS: The bond strength value was higher for three-unit than for one-unit restorations, and thermocycling reduced the bond strength of cements, especially Cavex, RelyX Temp, and Kavitan Cem.

Internal and marginal adaptation of pressable and computer-aided design/computer-assisted manufacture onlay restorations.

The aim of this research was to evaluate internal and marginal adaptation of lithium disilicate partial crowns fabricated using IPS e.max Press and IPS e.max CAD systems. Forty maxillary first molars were divided into two groups. The margins were located above the cementoenamel junction mesially and below it distally. The adaptation of the restoration was evaluated by means of the silicone replica technique. The lowest marginal discrepancy was measured between the preparation margin on the enamel and the IPS e.max Press specimens; the highest discrepancy was observed on the occlusal surface of the IPS e.max CAD specimens. Both systems tested demonstrated acceptable marginal discrepancies in vitro.

Effects of different acids and etching times on the bond strength of glass fiber-reinforced composite root canal posts to composite core material.

OBJECTIVE: To investigate the effects of different acids and etching times on the bond strength of glass fiber-reinforced composite (FRC) posts to composite core material. METHOD AND MATERIALS: Twenty-six FRC posts (FRC Postec Plus) were randomly divided into 13 groups (each n = 2). One group received no surface treatment (control). The posts in the other groups were acid etched with 35% phosphoric acid and 5% and 9.6% hydrofluoric acid gel for four different etching times (30, 60, 120, and 180 seconds). A cylindric polytetrafluoroethylene mold was placed around the treated posts and filled with dual-cure composite core material (MultiCore Flow). All samples were light cured for 60 seconds. After 24 hours of water storage, the specimens were sectioned perpendicularly to the bonded interface under water cooling to obtain 2-mm post-and-core specimens. Eight specimens were made from each group. Push-out tests were performed at a crosshead speed of 0.5 mm/min using a universal testing machine. Data were analyzed by one-way ANOVA followed by the Tukey honestly significant difference test (alpha = .05). RESULTS: The lowest bond strength was observed in the control group (12.51 megapascal [MPa]). No statistical significant difference was observed among group H5-120 (20.31 MPa), group H9-120 (20.55 MPa), or group P-180 (20.57 MPa) (P > .05). These groups demonstrated the highest bond strength values (P < .05). CONCLUSION: For the FRC posts, all acid-etching procedures tested showed significantly increased bond strength when compared with the control group. Acid-etching with 5% hydrofluoric acid and 9.6% hydrofluoric acid for 2 minutes and with 35% phosphoric acid for 3 minutes (groups H5-120, H9-120, and P-180, respectively) demonstrated the highest bond strength values between the FRC post and composite core material. Although the bond strength was increased by prolonged acid etching, the microstructure of the FRC posts might have been damaged.

Effectiveness of different cleaning agents on the adherence of Candida albicans to acrylic denture base resin.

OBJECTIVE: To evaluate the ability of three alkaline peroxide-type (Polident, Efferdent, Fittydent) and two mouth rinse cleaning agents (CloSYSII and Corsodyl) to inhibit Candida albicans on acrylic denture base resin. BACKGROUND: Appropriate routine cleaning of dentures is necessary to prevent denture stomatitis and maintenance of healthy supporting tissues. MATERIALS AND METHODS: A total of 180 acrylic resin specimens (10 × 10 × 2 mm) were prepared and divided into six groups. Candida albicans was incubated on Sabouraud dextrose agar (SDA) at 37°C for 48 h. After dilution, a final yeast suspension of approximately 10(6) C. albicans per millimetre was prepared. Ten acrylic resin specimens for each group were placed in a sterile Petri dish covered with 20 ml of fungal suspension and incubated at 37°C for 90 min. Then, the specimens were immersed in 40 ml of the test solution at 37°C for 15, 30 and 60 min. Fungal cells adhering to acrylic resin surfaces were fixed in formaldehyde and counted microscopically. RESULTS: Mouth rinses showed the highest removal activity for all the treatment times and completely eliminated the adherence of C. albicans. CONCLUSIONS: The use of mouth rinse may be a suitable method for cleaning dentures.

The association between socioeconomic status, oral hygiene practice, denture stomatitis and oral status in elderly people living different residential homes.

Oral hygiene practices and denture status of elderly people living in residential homes are different depending on the type of residential homes. In this study the elderly people living in three different residential homes were investigated for this purpose. A total of 269 subjects, 119 males (mean age 73.9±8.8) and 150 females (mean age 78.5±7.2) were involved in this study. All subjects were interviewed and clinically examined. Age, sex, educational status, financial status, general health, dental visiting, overnight denture wearing, brushing habits and frequency were recorded using a structured questionnaire. The prevalence of edentulism, the presence and type of dental prostheses, denture cleanliness and the presence of denture stomatitis were evaluated. Forty-one percent of subjects were non-educated. Fifty-one percent of subjects had low income. The majority of people (66.6%) were edentulous. Among the edentulous subjects 32% had full denture and 16% had no denture. Forty three percent of the subjects reported cleaning their dentures with water and 40% with a toothbrush only. Denture hygiene was good for 14% of the subjects. Denture stomatitis was observed in 44% of the subjects wearing dentures. There was statistically significant difference between residential homes and educational status, level of income, dental visiting, denture status, brushing methods and brushing frequency (p<0.001). A positive relationship was observed between poor denture hygiene habits and the presence of denture-related stomatitis. The most important need within the residents of the residential home was the enhancement of oral care social insurance.

Oral health status and treatment requirements of different residential homes in Istanbul: a comparative study.

The purpose of this study was to investigate dental/denture status of the elderly people living in different residential homes. In 346 elderly people from different residential homes two belonging to the state (Group 1 and Group 2) and one supported by private foundations (Group 3) were examined. Sixty percent of participants were edentulous and 22.8% of participants had no complete dentures which 9 (7.4%) of them were in Groups 1 and 2. Over 50% of the participants had no or low income and 45% of participants were illiterate. All of the participants who were illiterate and had low income were in Group 1 and Group 2. Oral hygiene was good for 15.4% and only 19.4% of participants removed their dentures overnight. Denture stomatitis was observed in 61.7% of subjects. Significant correlation was found between denture hygiene and age of participant, general health status, denture stomatitis, and overnight denture wear (p=0.001). The decayed, missing and filled teeth (DMFT) scores were 25.52±3.37. There was statistically significant differences between groups for DMFT scores (p=0.016). Dental health education is also needed focusing on the special needs of this neglected and socioeconomically deprived population to improve their quality of life.

Clinical and microbiological efficacy of three different treatment methods in the management of denture stomatitis.

OBJECTIVE: This study evaluated. the effect of mouthrinses and tissue conditioner on the clinical findings and microbial flora of 60 patients with Newton's type II denture stomatitis (N2DS) BACKGROUND: Denture stomatitis is a common problem in complete denture wearers. MATERIALS AND METHODS: Sixty patients with N2DS were included in this study and divided into three groups. Two groups of patients were instructed to rinse their mouth with the designated mouthrinses DioxiDent and Corsodyl twice daily for 1 min and to soak their dentures overnight in these solutions for 15 days. For the third group, tissue conditioner was placed in each of 20 patients' existing maxillary dentures. Patients were evaluated both clinically and microbiologically at baseline and after 15 days. Palatal swabs and smears were taken from each patient before and after treatment and these samples were examined mycologically. The difference between Candida colonisation before and after treatment and the differences between pre-treatment and post-treatment clinical findings were assessed. RESULTS: DioxiDent and Corsodyl showed an improvement in palatal inflammation and a decrease in Candida colonisation compared to Visco-gel. CONCLUSIONS: The effectiveness of topical chlorine dioxide and chlorhexidine gluconate in the management of N2DS was demonstrated.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis.

OBJECTIVE: Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study. MATERIAL AND METHODS: Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically. RESULTS: The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment. CONCLUSIONS: The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

OBJECTIVE: Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study. MATERIAL AND METHODS: Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically. RESULTS: The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment. CONCLUSIONS: The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.