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1.
Anesth Prog ; 68(3): 133-140, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606574

RESUMO

OBJECTIVE: The primary aim of this study was to determine the cardiovascular safety of topical racemic epinephrine pellets by measuring heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure in children receiving dental care under general anesthesia. The secondary aim was to assess clinical efficacy by measuring time to reach adequate hemostasis. METHODS: For this pilot study utilizing a split-mouth randomized design, 13 patients requiring prefabricated zirconia crowns on both primary maxillary first molars were recruited. Patients received continuous infusions of propofol and remifentanil with 50-70% inhaled nitrous oxide and oxygen. After randomization and tooth preparation, either saline pellets (control) or racemic epinephrine pellets (experimental) were applied directly to gingival tissue. Vital signs were recorded for 5 minutes. The procedure was repeated on the contralateral side using the alternative (control or experimental) treatment. RESULTS: Topical racemic epinephrine compared to saline produced a significantly larger decrease in mean diastolic blood pressure (-11.1% vs -3.9%; P < .01) and mean arterial pressure (-8.1% vs -2.1%; P < .01), although all noted decreases in cardiovascular variables were clinically insignificant. All experimental treatment teeth achieved adequate hemostasis after 2.2 minutes. Only 5 of the 13 control treatment teeth achieved adequate hemostasis during the 5-minute observation period (1.6 vs 4.2 minutes; P = .01). CONCLUSION: Overall, we conclude that use of topical racemic epinephrine pellets did not result in adverse cardiovascular effects and hemostasis was reached more quickly and predictably compared to saline pellets.


Assuntos
Hemostáticos , Criança , Coroas , Epinefrina/efeitos adversos , Hemostasia , Hemostáticos/efeitos adversos , Humanos , Projetos Piloto , Zircônio
2.
Clin Oral Implants Res ; 32 Suppl 21: 289-302, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642980

RESUMO

OBJECTIVE: To systematically review the dental literature for clinical studies reporting on production time, effectiveness and/or costs of additive and subtractive computer-aided manufacturing (CAM) of implant prostheses. MATERIALS AND METHODS: A systematic electronic search for clinical studies from 1990 until June 2020 was performed using the online databases Medline, Embase and Cochrane. Time required for the computer-aided design (CAD) process, the CAM process, and the delivery of the CAD-CAM prostheses were extracted. In addition, articles reporting on the effectiveness and the costs of both manufacturing technologies were included. RESULTS: Nine clinical studies were included reporting on subtractive CAM (s-CAM; 8 studies) and additive CAM (a-CAM; 1 study). Eight studies reported on the s-CAM of prosthetic and auxiliary components for single implant crowns. One study applied a-CAM for the fabrication of an implant bar prototype. Time was provided for the CAD process of implant models (range 4.9-11.8 min), abutments (range 19.7-32.7 min) and crowns (range 11.1-37.6 min). The time for s-CAM of single implant crown components (abutment/crown) ranged between 8.2 and 25 min. Post-processing (e.g. sintering) was a time-consuming process (up to 530 min). At delivery, monolithic/veneered CAD-CAM implant crowns resulted in additional adjustments chairside (51%/93%) or labside (11%/19%). CONCLUSIONS: No scientific evidence exists on production time, effectiveness and costs of digital workflows comparing s-CAM and a-CAM. For both technologies, post-processing may substantially contribute to the production time. Considering effectiveness, monolithic CAD-CAM implant crowns may be preferred compared to veneered CAD-CAM crowns.


Assuntos
Desenho Assistido por Computador , Planejamento de Prótese Dentária , Coroas , Fluxo de Trabalho
3.
Clin Oral Implants Res ; 32 Suppl 21: 318-335, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642981

RESUMO

OBJECTIVES: To summarize the existing evidence on patient-reported outcome measures (PROMs) of implant-supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. METHODS: A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant-supported restorations. Only clinical trials assessing conventional versus digital workflows for implant-supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta-analyses, while implant planning/placement was reported descriptively. RESULTS: Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta-analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. CONCLUSION: Most of the studies reporting about PROMs were published during the last ten years and limited to implant-supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.


Assuntos
Desenho Assistido por Computador , Planejamento de Prótese Dentária , Coroas , Humanos , Medidas de Resultados Relatados pelo Paciente , Fluxo de Trabalho
4.
Clin Oral Implants Res ; 32 Suppl 21: 93-107, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642983

RESUMO

OBJECTIVES: The primary objective was to provide an overview of soft tissue metric parameters, methods, and aesthetic indices in implant dentistry. The secondary objective was to describe reliability and validity of aesthetic indices. MATERIALS AND METHODS: Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase, and Cochrane databases up to October 2020 to identify studies on soft tissue metric parameters, methods, and aesthetic indices. Aesthetic indices were evaluated in terms of reliability and validity. Data extraction was performed by the same reviewers. RESULTS: Five metric parameters (papilla height, linear changes in soft tissue level, color assessment, soft tissue thickness, and profilometric soft tissue changes) registered by means of several methods (intra-oral registrations, radiographic assessments, digital analyses, and ultrasonic assessments), and 15 aesthetic indices (Papilla Index (PI), ad hoc questions scored with Visual Analogue Scales, Pink Esthetic Score (PES), Implant Crown Aesthetic Index (ICAI), Implant Aesthetic Score (IAS), Rompen Index, Subjective Esthetic Score, White Esthetic Score, Copenhagen Index, Complex Esthetic Index, Californian Dental Association Index (CDAI), Peri-Implant, and Crown Index, Functional Implant Prosthodontic Score, Implant Restoration Esthetic Index (IREI), and Mucosal Scarring Index (MSI)) could be identified. With respect to metric parameters and methods, intra-oral registrations were least accurate whereas profilometric soft tissue changes on the basis of digital surface models were most accurate. Six aesthetic indices showed good inter-rater reliability (PI, PES, ICAI, CDAI, IREI, and MSI). Good validity could only be shown for two indices (PES and CEI). Given this and on the basis of ease of use and ease of interpretation, PES qualified best for clinical research on single implants. None of the indices fulfilled the quality criteria for clinical research on multiple implants. CONCLUSION: Many soft tissue assessment methods with varying reliability and validity have been described and used, which hampers uniform reporting in implant dentistry. Clinical investigators are advised to measure linear and profilometric soft tissue changes using digital surface models, and to use a reliable and validated aesthetic index. Currently, PES qualifies best for aesthetic evaluation of single implants. An index is to be developed to assess the aesthetic outcome of rehabilitations on multiple implants.


Assuntos
Prótese Dentária Fixada por Implante , Estética Dentária , Coroas , Satisfação do Paciente , Reprodutibilidade dos Testes
5.
Clin Oral Implants Res ; 32 Suppl 21: 254-288, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642991

RESUMO

OBJECTIVE: To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs). METHODS: Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow-up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all-ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. RESULTS: Forty-nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta-analysis of the included studies indicated an estimated 3-year survival rate of veneered-reinforced glass-ceramic implant-supported SCs of 97.6% (95% CI: 87.0%-99.6%). The estimated 3-year survival rates were 97.0% (95% CI: 94.0%-98.5%) for monolithic-reinforced glass-ceramic implant SCs, 96.9% (95% CI: 93.4%-98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%-97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%-97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%-87.7%) for resin-matrix-ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. CONCLUSIONS: With the exception of RMC SCs, veneered and monolithic implant-supported ceramic SCs showed favorable short-term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.


Assuntos
Implantes Dentários , Falha de Restauração Dentária , Cerâmica , Coroas , Prótese Dentária Fixada por Implante/efeitos adversos , Estudos Prospectivos , Estudos Retrospectivos
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(9): 909-913, 2021 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-34496541

RESUMO

Objective: To investigate the changes of occlusal delay time, percentage of occlusal force and patients' subjective satisfaction of masticatory function for single implant crown in one year after the application of space reserved occlusion design. To provide data support and suggestions for clinical occlusion design. Methods: Patients who had received single posterior dental implant restoration in Department of Prosthodontics, Capital Medical University School of Stomatology from January 2019 to December 2019 were selected. At 0.5, 3, 6 and 12 months after restoration, the T-scan Ⅲ occlusal analyzer was used to detect and record the initial occlusal contact time of the natural tooth and implanted single crown, the occlusal force percentage of single implant prosthesis and corresponding tooth on the contralateral side (control teeth) on the contralateral side (control teeth) were also recorded. Subjective satisfaction with the masticatory function of the implants was recorded using visual analogue scale (VAS). The changes of occlusal delay time (the difference of the initial occlusal time between implant restoration and the natural teeth), percentage of occlusal force and patients' subjective feeling with time were analyzed. All data were analyzed by repeated measurement analysis of variance, bilatteral P<0.01 was considered statistically significant. Results: A total of 48 patients aged (36.8±8.4) years (23 males, 25 females, aged 23-50 years) were recruited. The occlusal delay time at 0.5 months was 0.15 (0.08, 0.20) s, at 3 months was 0.11 (0.06, 0.16) s, at 6 months was 0.07 (0.03, 0.13) s and at 12 months was 0.06 (0.03, 0.10) s. The occlusal delay time was shortened at every two time points, and the occlusal force percentage of the implant crown increased significantly. The percentage of occlusal force of implant prosthesis at 0.5 months was (7.7±4.8)%, at 3 months was (10.6±5.9)%, at 6 months was (12.3±6.2)% and at 12 months was (13.2±6.7)%. The most significant change was during the period of 0.5-3 months. At 0.5 months, the occlusal force of implant prosthesis was significantly lower than that of control teeth (14.3±6.5)% (P<0.01). The VAS score at 0.5 months was (7.06±1.64) and was (8.71±0.74) at 12 months. The score was increased and the difference was statistically significant from 3 month to 12 month (P<0.01). Conclusions: The change of occlusal force percentage of single posterior dental implant is most obvious within 3 months after restoration. The occlusal condition should be reexamined and adjust occlusal after 3 months of implant restoration as appropriate.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Força de Mordida , Coroas , Oclusão Dentária , Feminino , Humanos , Masculino
7.
Pediatr Dent ; 43(4): 290-295, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34467846

RESUMO

Purpose: The purpose of this study was to evaluate the treatment outcomes of multisurface caries in primary molars treated with intracoronal restorations versus stainless steel crowns (SSCs) through a retrospective split-mouth study. Methods: Dental records were screened for patients who had treatment of one primary molar with a multisurface restoration and one primary molar with an SSC. Teeth were followed until a loss to follow-up, exfoliation, or failure. Results: A total of 988 primary molars were evaluated, with a mean follow-up time of 22 months. The survival probabilities for: SSCs were 95.5 percent at one year of service and 92.8 percent at two years of service; and for intracoronal restorations were 92.0 percent at one year of service and 80.0 percent at two years of service. Overall survival analysis showed SSCs to be significantly more successful than restorations (P<0.001), particularly in children treated at ages four years and younger (P<0.001). No statistically significant difference (P=0.10) was found for children treated at ages five years and older. Conclusions: Stainless steel crowns have a higher survival probability versus restorations for multisurface caries. In children ages four years and younger, more aggressive treatment of multi-surface caries with SSCs should be considered, as conservative treatment leads to an increased need for retreatment.


Assuntos
Cárie Dentária , Aço Inoxidável , Criança , Pré-Escolar , Coroas , Cárie Dentária/terapia , Falha de Restauração Dentária , Restauração Dentária Permanente , Humanos , Dente Molar , Estudos Retrospectivos , Dente Decíduo
8.
BMC Oral Health ; 21(1): 476, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579694

RESUMO

BACKGROUND: Restoration with locking-taper implants is a widely used methodology. However, conical connection systems such as locking-taper implant systems have rarely been examined. This study provides a retrospective investigation of locking-taper fixed restorations, mainly focusing on prosthetic complications. METHODS: Patients undergo treatment with conical connected implants from 2008 to 2010 were examined. Preparation of the implant sites was performed according to the standard procedures for the Bicon system. Bone healing took over 6 months, and the prosthetic procedure was initiated thereafter. Integrated abutment crowns or gold porcelain crowns were used, and the prosthesis type was a single crown or a fixed dental prosthesis. Once the crown was in place, its occlusion was thoroughly checked and adjusted, and then the crown was glazed or finely polished. The Kaplan-Meier method was used to calculate the cumulative complication-free rates for 5 and 10 years. Additionally, a Cox regression model was used to identify the factors that independently influenced the results. Implant survival and marginal bone loss were also investigated. RESULTS: A total of 392 patients who underwent 541 implants and 434 locking taper implant-based restorations from 2008 to 2010 were examined. The overall 5-year cumulative complication-free rate was 83.34%. The most common prosthetic complication was veneer chipping, with a frequency of 67.53%. According to the Cox regression model, the complication-free rate of integrated abutment crowns was significantly higher than that of gold porcelain crowns, that of molar regions was significantly higher than that of premolar regions, and that of females was significantly higher than that of males. Only three implant failures happened, and the mean marginal bone loss values at 1- year, 5-years and 10- years were 0.25 mm (95% CI ± 0.12), 0.40 mm (95% CI ± 0.03) and 0.51 mm (95% CI ± 0.05), respectively. CONCLUSION: Veneer chipping was the most common complication with locking-taper implant-supported fixed restorations. The incidence of complications for IACs is significantly higher than that for GPCs. Age, location, and prosthesis type are not determinants of prosthetic complications. Besides, the long-term clinical effect of locking-taper implant can meet the clinical needs. The bone tissue level around the implant can maintain long-term stability.


Assuntos
Implantes Dentários , Falha de Restauração Dentária , Coroas , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos
9.
Evid Based Dent ; 22(3): 100-101, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-34561659

RESUMO

Data sources Data was collected from six databases (Medline, Embase, Web of Science, The Cochrane Central Register of Controlled Trials [CENTRAL], China National Knowledge Infrastructure [CNKI] and Chinese Biomedical Literature Database). Studies published in English and Chinese languages comparing ceramic and metal-ceramic implant-supported fixed dental prostheses (FDPs) were searched. The literature search was performed on studies published until 2018. Manual search of the reference lists of the identified articles was also performed to find related review articles and studies.Study selection Randomised controlled trials (RCTs), prospective and retrospective cohort studies involving the comparison of ceramic and metal-ceramic implant-supported FDPs were selected using the PICOS model for the meta-analysis. For ceramic and metal-ceramic single crowns, the survival rate, marginal adaptation, marginal bone loss, pocket probing depth, crown colour match and mucosal discolouration were assessed. The authors also included studies on survival rate of implant-supported fixed partial dental prostheses (FPDPs) in this meta-analysis.Data extraction and synthesis Two investigators independently screened the articles from the literature search and extracted and analysed data from the included studies. The quality of the included RCTs were assessed using the Cochrane collaboration tool for assessment of risk of bias. For the selected non-randomised studies, the quality and risk of bias were assessed using the Newcastle-Ottawa scale. Twenty studies were included in data synthesis.Results Of the selected 20 studies, ten were RCTs and ten were prospective or retrospective cohort studies.Conclusions The results of this study can be useful to clinicians in making decisions between ceramic and metal-ceramic implant-supported single crowns. This study concluded that the ceramic implant-supported single crown has better crown colour match over a metal-ceramic single crown, but poorer marginal adaptation, and there was no difference observed in other parameters studied (survival rate, marginal bone loss, pocket probing depth and mucosal discolouration). The conclusions on survival rate of implant-supported FPDPs needs to be further evaluated with RCTs with larger samples.


Assuntos
Implantes Dentários , Falha de Restauração Dentária , Cerâmica , Coroas , Prótese Dentária Fixada por Implante , Humanos , Estudos Prospectivos , Estudos Retrospectivos
10.
Evid Based Dent ; 22(3): 106-107, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-34561662

RESUMO

Data sources The review searched for articles via Medline up to March 2019 for English language papers only.Study selection Two authors screened the reviews initially against the inclusion and exclusion criteria. Discrepancies were discussed with all authors for the final decision. Due to a low number of higher-level studies on non-operative caries management (NOCM; excluding silver diamine fluoride [SDF]), studies other than randomised controlled trials, systematic reviews and meta-analyses were included to allow some collation of evidence for an overview to be gained.Data extraction and synthesis Data extracted included setting, participants, focused question, search results, comparators, main outcomes and conclusion. Data for SDF was collated separately to other NOCM due to the higher level of evidence and its use in cavitated lesions as well as non-cavitated carious lesions.Results Five systematic reviews investigated SDF use. All the reviews demonstrated SDF to be an effective management tool for arresting early caries. Ten studies looked at NOCM, which showed fluoride varnish has a moderate effect on arresting carious lesions, but the evidence was of low level. For restorative approaches, a low level of evidence showed resin restorations to have a higher failure rate than composite strip crowns, regardless of general anaesthesia, and more so than stainless steel or zirconia crowns.Conclusions SDF is an effective tool in the management of early childhood caries.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Pré-Escolar , Coroas , Assistência Odontológica , Cárie Dentária/prevenção & controle , Fluoretos , Fluoretos Tópicos/uso terapêutico , Humanos
11.
BMC Oral Health ; 21(1): 433, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488727

RESUMO

BACKGROUND: When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area. METHODS: Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon. RESULTS: Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD - 1434. CONCLUSION: The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.


Assuntos
Implantes Dentários , Análise Custo-Benefício , Coroas , Prótese Dentária Fixada por Implante , Prótese Parcial Fixa , Humanos , Dente Molar
12.
Int J Comput Dent ; 24(3): 263-273, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34553891

RESUMO

AIM: One-piece ceramic implants (O-PCIs) have proven to be clinically useful, with high survival rates. The biocompatibility and bio-inert characteristics of ceramics in addition to the fact that minimal plaque deposits occur on these materials provide esthetic advantages and justification for their use in the anterior maxilla. The objective of the present study was to investigate the suitability of O-PCI use in the anterior maxilla. MATERIALS AND METHODS: The data of patients who had received conventional two-piece titanium implants were analyzed. Virtual planning was performed to determine whether O-PCIs could have been used. Three groups were formed: single-tooth gap (group A); multiple-tooth gap treated with two implants (group B); and complex treatments with at least three implants (group C). In addition to assessing the feasibility of O-PCIs, their usefulness as well as additional procedures such as augmentation and a change in the implant quantity or position were evaluated. Values of the location of the virtual cementation line were summarized for all cases. RESULTS: Without additional procedures, O-PCIs could be used in 97.9% of group A, 77.3% of group B, and 59.1% of group C. For group B, 18.2% of the cases could have been managed with additional augmentation. For the complex cases (group C), 18.2% of the patients would have been treatable if the planning had been altered, augmentation had been performed or implants with an inclined abutment had been available. The mean value of the lowest point of the cementation line was 2.9 mm (standard deviation 1.23; 0.0 to 7.2 mm). CONCLUSION: O-PCIs can be used in the anterior maxilla with planning. The esthetic advantages of ceramics can be leveraged for this part of the mouth, especially for single-tooth gaps.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Intervenção Coronária Percutânea , Cerâmica , Coroas , Estudos de Viabilidade , Humanos , Maxila/cirurgia , Zircônio
13.
Compend Contin Educ Dent ; 42(9): 512-515, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34555912

RESUMO

Despite it being an older, conventional production method, the cast metal post and core is still often considered the best option for the restoration of severely damaged teeth. The direct technique for fabrication of cast post-and-core patterns, however, can pose challenges due to the inefficiencies and guesswork involved in creating an appropriate form and dimension for the core segment. This article presents an enhanced technique for cast post-and-core fabrication in reference to the desired dimensions of the final restoration. As the authors demonstrate, the procedure involves creation of an accurate and passive pattern of each post space. Bis-acrylic composite resin is then injected into a putty impression of the idealized wax-up and seated on the prepared post patterns. A preparation of the abutments is then performed by creating the cores according to the desired dimensions of the final restoration. The major advantages of this technique include a more efficient workflow and a reduction in the number of adjustments needed after insertion.


Assuntos
Técnica para Retentor Intrarradicular , Resinas Acrílicas , Resinas Compostas , Coroas
14.
Eur J Paediatr Dent ; 22(3): 204-206, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34544248

RESUMO

AIM: The purpose of this clinical case is to present the Kids Digital Crown Technique (KDCT), an innovative technique to restore primary teeth with customised prosthetic crowns. METHODS: A six-year-old patient presented to our clinic with an extensive carious process affecting tooth 8.4. After assessing the patient’s conditions, a digital intraoral impression was taken and digitally sent to the dental lab to realise a customised prosthetic crown of the tooth. After the endodontic treatment and a minimal tooth preparation the crown was cemented using a dual resin-based cement. RESULTS: The procedure permitted to realise a customised prosthetic crown ready to be applied immediately after the endodontic therapy. The crown was the correct size, easy to adapt and of the correct colour. The protocol follows an easy, kid-friendly workflow, reducing the operative time and maintaining the advantages of other procedures. CONCLUSION: Kids Digital Crown Technique is a valid procedure to restore primary teeth with prosthetic crowns. Future prospective studies will be necessary to confirm the efficacy of this technique.


Assuntos
Coroas , Dente Decíduo , Dente Pré-Molar , Criança , Humanos , Estudos Prospectivos , Cimentos de Resina
15.
J Clin Pediatr Dent ; 45(4): 259-264, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34534309

RESUMO

OBJECTIVE: To determine the retentive force of three glass-ionomer luting cements used with prefabricated primary zirconium crowns (PPZCs) and to assess whether the retentive force was dependent on cementation material or different PPZCs brands. STUDY DESIGN: Four mandibular right second molar PPZCs were selected, one each from four manufacturers-NuSmile®ZR, Sprig Crowns, Cheng Crowns and Kinder Krowns. Silicone impressions of the outer surface of crowns were taken; stone dies prepared and reduced to fit the corresponding brand. 24 alginate impressions of each die obtained and filled with core buildup flowable composite. 96 composite tooth-replicas thus achieved were divided into four groups and further categorized into three subgroups of eight samples based on luting cements used - BioCem, FujiCEM®2 and KetacCem. Samples were thermocycled, placed in artificial saliva for one week followed by assessment of retentive force for crown dislodgment and failure mode. RESULTS: Data was statistically evaluated using two-way ANOVA, HSD (P <0.05). KetacCem had the lowest retentive force while BioCem showed comparatively higher value to FujiCEM®2. Adhesive failure modes were predominant with cement mainly adhering to crown's internal surface. CONCLUSIONS: Resin-based GI cements offered superior retention than conventional GI cements for PPZCs and retentive force was dependent on cement type.


Assuntos
Retenção em Prótese Dentária , Zircônio , Resinas Acrílicas , Cimentação , Coroas , Cimentos Dentários , Cimentos de Ionômeros de Vidro , Humanos , Teste de Materiais , Cimentos de Resina , Dióxido de Silício
16.
Artigo em Inglês | MEDLINE | ID: mdl-34547064

RESUMO

This study involves a group of 168 teeth in 126 patients treated with crown lengthening and tooth reconstruction (experimental group), and a group of 75 teeth from 62 patients that were judged irrational to treat, extracted, and replaced (control group). In the control group, 13 teeth in 12 patients were not replaced; 37 were replaced with an implant-supported crown, 14 with a tooth-supported partial denture, 2 with a Maryland partial denture; and 9 patients requested a removable prosthesis. In the experimental group, 44 teeth in 37 patients received a conservative restoration (24 direct and 20 indirect), while 124 teeth in 94 patients received a full crown. All 168 teeth were surgically treated with minimally invasive crown lengthening. Endodontic treatment and orthodontic extrusion were applied when necessary. Treatment resulted in healthy periodontal and dental/implant conditions at the 1-year follow-up in both groups. Function and esthetics were described from satisfactory to extremely satisfactory by patients of both groups, with the exception of three patients in the control group who received a mobile prosthesis restoration and reported some difficulties in chewing. When comparing treatment cost and duration of the reconstructed teeth (experimental group) to the treatment cost and duration of extracted and replaced teeth (control group), the difference is significantly in favor of the preservation of natural teeth, both monetarily and in terms treatment time. Saving a tooth with a compromised crown is more favorable for the patient than extraction and replacement. This conservative approach is advisable to clinicians whenever the clinical conditions enable treatment.


Assuntos
Boca Edêntula , Dente , Coroas , Prótese Dentária Fixada por Implante , Seguimentos , Custos de Cuidados de Saúde , Humanos , Coroa do Dente
17.
Artigo em Inglês | MEDLINE | ID: mdl-34547074

RESUMO

This article evaluated the sealing capacity of single crowns made of a new zirconia (Katana STML, Kuraray Noritake) when cemented with two different cement types and two different marginal preparation types. Forty intact human anterior teeth, extracted for periodontal reasons, were used. Each sample was prepared with two margin preparations: knife-edge (KE) on one half of the tooth and chamfer (CH) on the other half. Based on the type of cement used, abutments were randomly distributed into one of two groups: Group 1 used resin cement (Panavia V5, Kuraray Noritake), and Group 2 used reinforced glass-ionomer cement (FujiCEM 2, GC). A digital workflow was utilized for crown fabrication. After the cementing procedures, samples were processed, and microleakage and scanning electron microscopic observations were made. Microleakage varied significantly depending on the type of cement combination used. Group 1 samples showed less microleakage (medians: 0.76 for CH and 0.51 for KE in Group 1, and 4.1 and 3.45 for Group 2, respectively) than Group 2 specimens; the difference was statistically significant (P < .000). KE preparation showed less microleakage than CH, although no statistically significant differences were found (P < .0558). Under microscopic observations, some samples showed internal fractures within the zirconia material. KE and CH seal the margin of zirconia crowns similarly. The resin cement system ensured better adhesion than reinforced glass-ionomer cement.


Assuntos
Infiltração Dentária , Cimentação , Coroas , Cimentos Dentários , Cimentos de Ionômeros de Vidro , Humanos , Teste de Materiais , Cimentos de Resina , Fluxo de Trabalho , Zircônio
18.
Artigo em Inglês | MEDLINE | ID: mdl-34547080

RESUMO

The morphology and histology of the soft tissue around the implant are different from the periodontal tissue, but the difference in the regulation of blood flow is not known. The aim of the study was to compare the resting blood flow and the vasodilatation capacity of the gingiva between implants and teeth. Twenty-six healthy volunteers with single-tooth implants were involved. The implant-borne crown was retained on either a zirconia or titanium abutment. The vasodilatation capacity of the gingiva was assessed by a postocclusive reactive hyperemia test. Blood flow was measured by a laser speckle contrast imager at the buccal gingiva of the implant-borne crown and an analog natural tooth. No significant differences in baseline gingival blood flow were observed between the different abutments and the teeth in either region. The hyperemia after compression was significantly attenuated at the zirconia abutments in all regions during the entire investigation period (20 minutes) compared to the titanium abutments and the teeth. No differences were observed between titanium abutments and the teeth. The resting microcirculation seems to be the same at implants and teeth. However, the vascular reactivity might be disturbed at the zirconia, but not at the titanium, abutment.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Coroas , Dente Suporte , Humanos , Membrana Mucosa , Titânio , Zircônio
20.
J Indian Soc Pedod Prev Dent ; 39(2): 178-182, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34341238

RESUMO

Introduction: The primary function of corono-radicular post is to provide retention for the core and to reinforce and to replace the remaining coronal tooth structure. There is considerable controversy regarding optimal choice of the material. An ideal post system should exhibit fracture resistance higher than the average masticatory forces. Finite elemental analysis (FEA) method facilitates precise analysis of the distribution and magnitude of stresses at any point of complex and irregular structures. Thus, this FEA study has been undertaken to evaluate the fracture stress distribution patterns in three fiber posts, viz., carbon, glass fiber, and everStick with an FEA. Materials and Methods: The FE stress analysis was performed with the FE software program (CATIA). Three two-dimensional FEA models of central incisor were simulated, and elastic moduli and Poisson's ratio of all the materials were fed to the software. For all the models, a 200 N vertical force was applied on the lingual surface of the tooth at an angle of 45°. Stress concentration and distribution were evaluated and noted down for all the models. To evaluate the stresses within the restored tooth, the modified von Mises failure criterion was used. The equivalent stresses found in the tested models were compared with the tensile strength of the respective materials. Contact stresses in the luting cement-dentin interface were calculated. Results: Finite element method revealed that maximum stress concentration was at the point of stress application. The stress value was highest in carbon fiber post followed by glass fiber post and least stresses found in everStick post. Maximum stress was observed at the labial surfaces of crown. However, the stress values and distribution were more homogenous in everStick post. Conclusion: The present findings suggest that everStick post has uniform stress distribution within tooth structure.


Assuntos
Técnica para Retentor Intrarradicular , Resinas Compostas , Coroas , Materiais Dentários , Análise do Estresse Dentário , Dentina , Análise de Elementos Finitos , Vidro , Humanos , Estresse Mecânico
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