Injectable Flowable Resin-based Composite Veneers Prior to Ceramic Veneers.

OBJECTIVES: This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. CLINICAL CONSIDERATION: The patient's primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. CONCLUSIONS: Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.

Effectiveness of Different Polishing Kits for Chairside CAD/CAM Provisional Restorative Materials.

OBJECTIVE: To investigate the efficacy of three specially designed polishing kits for provisional restorations made from three chairside computer-aided design and computer-aided manufacturing (CAD/CAM) provisional resin blocks. METHOD: Ninety-six chairside CAD/CAM provisional restorations were milled out of three chairside CAD/CAM provisional resin blocks: (1) ArtBloc Temp (Merz Dental); (2) Telio CAD (Ivoclar Vivadent); and (3) Vita CAD-Temp (VITA Zahnfabrik). The provisional restorations for each material were allocated into the following groups: (1) milled restorations (no polish); (2) polished with CADMaster CAD/CAM Adjustment & Polishing Kit (CM, Shofu); (3) polished with KUT Ultimate Bisacryl (Temporaries) Polishing Kit (KU, Dental Savings Club); and (4) polished with K0330 PMMA Adjusting, Finishing & Polishing (KP, Brasseler USA). Optical profilometry and atomic force microscopy (AFM) were used to assess the surface roughness (Ra) of each provisional restoration at the microscale and nanoscale, respectively, and obtain topographical images. In addition, the milled and polished restorations were visually evaluated by 16 dentists. RESULTS: There was a strong positive correlation with Ra values between optical profilometry and AFM. Only KP significantly improved the surface roughness of CAD/CAM provisional restorations compared to the milled equivalent, regardless of material type or measurement modality (ie, lateral length scale). Although surface topography imaging with AFM revealed some shallow scratches, even for KP polished specimens, all KP polished restorations were categorized as clinically acceptable for provisional restorations in visual inspections from dentists. CONCLUSION: Specially designed polishing kits for provisional restorations did not all improve the surface roughness of chairside CAD/CAM provisional restorations, regardless of the measurement method. KP was more consistently effective in polishing milled chairside CAD/CAM provisional restorations than CM and KU.

Evaluation of the Efficacy of Two Fibre-Reinforced Post Removal Techniques.

OBJECTIVE: The aim of this in-vitro study was to compare the amount of material (post and luting agent) and root dentine removed using two methods for removal of endodontic posts. METHODS: Human premolar teeth (n=20) were sectioned at the CEJ and fibre reinforced posts were cemented at a length of 10mm following root canal therapy. Teeth were randomly assigned to two study groups. The methods of removal compared were: the use of RTD re-access kit (Composipost, RTD, France, St Egreve) in a conventional hand-piece driven by an electric motor (Group A); or a long tapered diamond bur (FG Diamond grit bur, Dentsply Ltd, UK) in an air-driven high speed turbine (Group B). Using micro- CT the volume of material and root dentine removed for each sample was calculated. RESULTS: Both the volume of material removed and the volume of root dentine removed were significantly greater when using diamond burs. (p⟨0.001). The volume of dentine removed using the diamond bur method (mean 22.64mm³) was greater than the volume removed using the reaccess kit (mean 11.71mm³). SIGNIFICANCE: Use of a diamond bur to remove fibre reinforced endodontic post removal poses higher risk for root perforation compared to the reaccess kit.