Search

Background: This study aimed to analyze the effect of 3D printing temporary crowns on the single and continuous loss restoration of posterior teeth during secondary implant surgery., Methods: This study adopted a single-center, randomized, single-blind, parallel-controlled trial design. Thirty patients who were admitted to the Department of Stomatology, Affiliated Hospital of Jiangnan University between January 2020 and February 2023 and who had >2 consecutive missing posterior teeth were implanted with the same implant system. A simple random method was adopted to assign 30 patients to group A (using 3D-printed temporary crowns) and group B (control group) in a 1:1 ratio, with 15 patients in each group. The final prosthesis in Experimental group A was done based on the adjustment of the temporary crown and tooth. Both groups were compared based on total time, accuracy, and patient satisfaction of the final prosthesis. Additionally, 30 patients who had undergone single posterior tooth implantation during the same period were selected as the study objects and divided into 2 groups using the random comparison table method. The patients in the experimental group C (15 cases) were provided with 3D-printed temporary crowns, and the other 15 patients were assigned to the control group D (15 cases)., Results: In the experimental group A, the total time spent on dentures was 10.1 ± 1.3 minutes, which was lesser compared with that spent in the control group B (P < .05). Experimental group A exhibited a significantly higher accuracy of prosthesis (P < .05), as well as significantly higher satisfaction of patients (P < .05). Regarding the food impaction rate, after formal implantation and restoration, the food impaction rate of the experimental group C at 1 month and 6 months was compared with that of the traditional 2-stage surgery group D., Conclusion: Three-dimensional printing temporary crowns exhibited significantly better therapeutic effects for restoration in patients with continuous missing implants in posterior teeth. 3D printing temporary crowns in patients with single posterior tooth implant restoration showed promising results, which improved food immobilization and actively and effectively reduced the complications associated with a single posterior tooth implant., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Computer-aided manufacturing (CAM) technology allows the use of different manufacturing techniques. This in vitro study aimed to evaluate the marginal fit of temporary restorations manufactured using conventional chairside methods, milling, and three-dimensional printing. Fifteen 3-element temporary restorations specimens were produced and categorized into three groups: non-digital, obtained using the conventional chairside method (GC); milled (GM); and three-dimensionally printed (GP). Marginal fit was assessed using scanning electron microscopy (SEM) performed under two conditions: one with only the central screw tightened, and the other with all three screws tightened. Horizontal misfit values were categorized as over-, equal-, and under-extended and qualitatively analyzed. Statistical analysis was performed using the Tukey-Kramer test (α=0.05). In the vertical assessment, three-dimensionally printed restorations demonstrated greater misfit than restorations obtained by milling and the conventional chairside method (P<0.05). In the horizontal assessment, the misfit in the GP group was significantly higher than that in the GM and GC groups. Restorations obtained using the conventional chairside method and milled provisional restorations showed more favorable results than three-dimensionally printed restorations.

The present technical article describes a protocol to digitally reproduce the emergence profile of an interim implant prosthesis (IP) and to transfer its macrogeometry into the definitive restoration. The purpose of this protocol was to minimize alterations in the gingival architecture developed during the interim restorative phase of a single implant that could potentially jeopardize its esthetic outcome. The process included obtaining an intraoral scan with the interim IP in situ, a duplicate of this intraoral scan that was used to capture the exact position of the implant, and an extraoral scan of the prosthesis. These data could then be imported into IOS software to create a model where the patients' soft tissue was incorporated with precision, allowing for the fabrication of a definitive crown with an optimal soft tissue adaptation. As there are few articles in the scientific literature that have reported a consistent method to replicate the emergence profile of an interim IP, the present technical article aims to highlight the potential of utilizing the emergence profile of an interim IP created by IOS software.

Aim: (1) To compare the temperature rise in the pulp chamber with different resin materials used for making provisional fixed partial dentures in anterior and posterior region while using Polyvinylsiloxane impression materials as matrix. (2) To identify a superior provisionalization material based on the amount of heat dissipated suitable for anterior and posterior provisional fixed partial denture fabrication., Settings and Design: Temporary crowns and bridges are integral to Fixed Prosthodontics. It has been observed that conventional fixed prosthesis temporisation materials release heat due to the exothermic polymerisation reaction. When such a provisional material is directly let to set on a vital tooth, the heat transfer causes irreversible changes in the pulp tissue depending of the degree of change. Hence, this study observes amount of heat generation in various materials during temporisation procedure, by simulating similar conditions., Materials and Methods: Two Models were fabricated, one simulating missing lateral incisor (Model A) and another simulating missing first molar (Model B). Intact maxillary central incisors and canine for Model A and intact mandibular Second Premolar and Second Molar were selected to act as abutments. These abutment teeth were fitted with the tip of a K-type Thermocouple inside their pulp chambers and these were connected to a digital thermometer. Five temporisation materials were chosen for fabrication of temporary crowns through Direct technique. (1) polymethy methacrylate (Self Cure acrylic), (2) bisacryl composite (Protemp 4), (3) visible light cure urethane dimethacrylate (Revotec LC), (4) barium glass and fumed silica infused methacrylate (Dentsply Integrity) and (5)nano-hybrid composite (VOCO Structur 3). Ten observations were made for each provisional material on each model. During each observation, temperature rise was recorded at 30s interval from the time of application, through the peak and till a decrease in temperature is observed. Polyvinyl siloxane was used as matrix for all except light cure resin, where polypropylene sheet was used., Statistical Analysis Used: Anova test used for statistical., Results: ANOVA test revealed that there was a significant difference in the temperature changes associated with the provisional restorative materials used. Among the five, polymethy methacrylate (self cure resin) showed the maximum rise in temperature, followed by bisacryl composite (Protemp 4), visible light cure urethane dimethacrylate (Revotec LC), barium glass and fumed silica infused methacrylate (Dentsply Integrity) and nano-hybrid composite (VOCO Structur 3). There was no comparable difference between Model A and B but an overall reduction of temperature rise was observed in model B., Conclusion: VOCO Structur 3 showed the least temperature rise in the pulp chamber, and overall temperature rise was less for model B which can be attributed to the residual dentin thickness., (Copyright © 2024 Copyright: © 2024 The Journal of Indian Prosthodontic Society.)

While surgical guides have allowed for more highly accurate immediate implant placement in the esthetic zone, only a few techniques have been described to predictably position an immediate implant provisional. Even fewer techniques have addressed repositioning a patient's extracted tooth for use as the interim implant restoration. This article describes a workflow for the fabrication of a dual-purpose surgical guide that allows for guidance of implant placement as well as repositioning of a decoronated tooth that will serve as a provisional. While other provisional techniques aim to recreate proper gingival contour, the benefit of repositioning of the original tooth is the preservation of the existing gingival margin position and existing critical contour of the emergence profile.

This technical note describes the fabrication and benefits of fiberglass-reinforced hybrid prosthesis veneered with composite resin for 4 implant-supported fixed professional and final restorations. The described prosthesis reduces rehabilitation time, minimizes impression problems, and ensures a passive fit of professional restoration. The prosthesis provides immediate rehabilitation of 4 implants with ease of adjustments and repair during the entire provisional phase. Moreover, it can be easily converted to final restoration with minimal modifications, excellent esthetic results, and reduced costs.

Inserting a presurgically fabricated provisional restoration at the time of implant placement can be problematic if and when the provisional does not fit. The 3-dimensional position of the implant in the mouth typically is not as critical as the long-axis rotational orientation of the implant, which is known as "timing." During implant placement, it is often desirable to have one of the implant's internal hexagon flats in a specific rotational position (ie, timing) that enables the use of orientation-specific hexed abutments. Achieving timing with a high level of accuracy, however, is challenging. This article presents a proposed solution to this dilemma that eliminates any concern for implant timing during surgery by transferring the anti-rotation control from the implant's internal hex to the provisional restoration itself via the use of anti-rotational wing(s).

The aim of this clinical trial was to compare the 5-year cumulative survival of atraumatic restorative treatment restorations using high-viscosity glass-ionomer restorations (ART/HVGIC) and conventional resin composite restorations (CRT) placed in patients with intellectual and/or physical disability. Patients referred for restorative care to a special care service in Córdoba, Argentina, were recruited. Patients and/or caregivers were provided with written and verbal information regarding treatment options and selected the alternative they preferred. The treatment protocols were ART (hand instruments/HVGIC) in the clinic or CRT (rotary instrumentation/resin composite) in the clinic or under general anaesthesia (GA). Two independent, trained and calibrated examiners evaluated restoration survival using established ART codes after 6, 12, 24, 36 and 60 months. The proportional hazard model with frailty corrections provided survival estimates. Jackknife errors were used to test 5-year results. Sixty-six patients (13.6 ± 7.8 years) with 16 different medical conditions participated. CRT in the clinic proved feasible for five patients (13%), and 14 patients received CRT under GA (21%). ART was provided for 47 patients (71.2%). A total number of 298 dentine carious lesions were restored in primary and permanent teeth (182 ART; 116 CRT). Four patients died between the 3 and 5-year follow up. Percentage survival and jackknife standard error were calculated and were significantly higher for all ART/HVGIC restorations (90.2% ± 2.6) than for all CRT restorations (82.8% ± 5.3), 5 years after placement (p=0.044). These 5-year follow-up results confirm that ART/HVGIC is an effective treatment protocol for patients with disability, equal to that of conventional resin composite restoration. The results of this clinical trial support the use of ART as an evidence-based treatment resource contributing to the reduction of inequalities in access to oral health care among people with disability.

Background: Collagen matrices used around immediate implants may reduce morbidity although there is limited evidence on their performance., Purpose: To evaluate soft and hard tissue changes when combining immediate implants, hard and soft tissue grafting, and an immediate provisional restoration., Material and Methods: In 12 patients, immediate implants were placed in the anterior maxillary and first premolar area together with a xenogeneic bone substitute. Then a xenogeneic collagen matrix was placed under the buccal mucosal margin with an immediate provisional restoration. Study casts and clinical measurements were taken before extraction (Baseline/BS) at 6 months (6M) and 12 months (1Y) after implant placement. Files from the scanned casts were matched to calculate the linear and volumetric changes at the buccal tissues. Cone Bean Computed Tomographies (CBCTs) were taken prior to extraction and at 6M. The superimposed DICOM files allowed for assessing hard tissue changes and the superimposition of DICOM and STL files allowed for evaluating of soft tissue thickness at BS and 6M., Results: After 6 months, the horizontal tissue contours decreased 0.66 ± 0.57 mm, concomitant with a horizontal bone loss of 1.31 ± 1.32 mm, measured 1 mm below the most coronal aspect of the ridge. In contrast, the soft tissue thickness, 1 mm below the gingival margin, increased 0.75 ± 1.12 mm. At 1-year, tissue contours had decreased 1.01 ± 0.67 mm compared to BS reaching statistical significance. The mean volume loss after 1Y was 20.43 ± 11.70 mm 3 while the mean mucosal margin recession was 0.86 ± 0.67 mm. These changes had a limited clinical impact as the PES Scores remained stable., Conclusions: The tested protocol resulted in a significant reduction of the tissue contours and osseous ridge dimensions that was partially compensated by a non-significant increase in soft tissue thickness., (© 2018 Wiley Periodicals, Inc.)

Statement of Problem: Cement-retained implant-supported prostheses eliminate screw loosening and enhance esthetics. However, retrievability and the possibility of removing extruded excess cement (EEC) have been problematic., Purpose: The purpose of this systematic review was to analyze the effects of modifying the screw access channel (SAC) on the amount of EEC and the retention of cement-retained implant-supported prostheses., Material and Methods: PubMed, Web of Science, Scopus, and Google Scholar databases were searched with appropriate key words. Related titles and abstracts published up to June 2017 were screened and selected on the basis of defined inclusion criteria. Full texts of all studies were read and subjected to quality assessments. After the initial search, 1521 articles were included in the study. Of these, 11 studies were subjected to critical appraisal, and 10 of them were reliable enough in methodology to be systemically reviewed., Results: All the studies were in vitro and described a total of 260 specimens. According to the interpreted results, closed SACs caused lower retention with a higher amount of EEC, whereas open SACs caused the reverse. Also, as the abutment height decreased, retention decreased., Conclusions: Extending the crown's margin into the SAC, leaving the SAC open, and using internal vents in the SAC space are possible methods of modifying the SAC to gain higher retentive values. Also, the use of internal vents in the SAC system and open or partially filled SAC space reduce the amount of EEC., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: This study investigated the physical and mechanical properties, antibacterial effect and biocompatibility of novel elastomeric temporary resin-based filling materials (TFMs) containing zinc methacrylate (ZM)., Material and Methods: Experimental TFMs were prepared by mixing the zinc methacrylate with monomer, co-monomer, photoinitiator and fillers. A ZM concentration of 0 (control), 0.5% (Z0.5); 1% (Z1), 2% (Z2), or 5% (ZM5) wt% was added to the TFMs. Fermit-N (F) was used for comparison with the experimental material. Microleakage, water sorption/solubility, degree of conversion, depth of cure, ultimate tensile strength, and hardness were determined and compared. A modified direct contact test (DCT) with Enterococcus faecalis and a Streptococcus mutans' biofilm accumulation assay was carried out to evaluate the antimicrobial effect and cytotoxicity of the assay. Statistical comparisons were performed (α=5%)., Results: The results showed that the physical and mechanical properties of the experimental TFMs with ZM are comparable with the properties of the commercial reference and some properties were improved, such as lower microleakage and water sorption, and higher ultimate tensile strength values. TFMs with ZM killed E. faecalis only after 1 h. Biofilm development of S. mutans was not affected by the inclusion of ZM in the experimental TFMs., Conclusions: The present findings suggest that the physical, mechanical and biological properties of the experimental TFMs with ZM are comparable with the properties of the commercial reference. However, some properties were improved, such as lower microleakage and water sorption, and higher ultimate tensile strength values.

Background: Resorption of hard and soft tissues following immediate implant insertion is frequently reported. Data regarding the influencing factors on facial tissue thickness are rare., Purpose: This retrospective study investigated the impact of connective tissue grafting, the orofacial angulation and position of immediately inserted and provisionalized implants on the facial hard and soft tissue thickness in the anterior maxilla within a 1- to 5-year follow-up., Material and Methods: Implants with the prerequisite of having preoperative and postoperative cone beam computed tomography (CBCT) and a follow-up of 1 to 5 years were included. Facial bone deficiencies were grafted flaplessly with autogenous bone in all sites. In a subgroup of implants additional connective tissue grafting was performed, whereas the remaining implants were not grafted with soft tissue. The orofacial tooth and implant angulation, the change of horizontal position and the facial bone thickness were measured by CBCT, the facial mucosa thickness by an ultrasonic device., Results: In total, 76 implants were placed in 55 patients. Sixty-nine sites showed a facial bone defect. Thirty-eight received a connective tissue graft additionally. All implants were still in function after a mean follow-up of 36 months. The mean thickness of the facial mucosa was 1.72 mm at 1 mm, 1.63 mm at 4 mm, 1.52 mm at 6 mm, and 1.66 mm at 9 mm apically to mucosal margin. The bone thickness was 0.02, 0.25, and 0.36 mm initially and 1.32, 1.26, and 1.11 mm finally at 1, 3, and 6 mm apically to implant shoulder level. Mixed model analysis revealed an impact of the preoperative bone status on the facial bone increase. The facial soft tissue thickness was significantly influenced by the gingival biotype., Conclusions: The results indicate that an initial severe hard tissue defect allows for significant bone regeneration. The facial soft tissue thickness is primarily influenced by the gingival biotype., (© 2018 Wiley Periodicals, Inc.)

Transferring the soft tissue around an interim implant-supported fixed partial denture to the definitive cast is difficult. A technique that can accurately record the soft tissue configuration when making an impression for an implant-supported fixed partial denture is described., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Immediate implant placement and provisional restoration has become a popular and well-supported method of tooth replacement in the maxillary anterior dentition. Aside from achieving osseointegration, esthetic demands have grown with better understanding of the behavior of hard and soft tissues following this mode to therapy. Stability of gingival contours, texture of the surrounding tissues, and blending of prosthetic components with the natural dentition are critical for successful outcomes to be maintained long-term. Increasing soft tissue thickness at the time of therapy plays an important role in this regard. A technique combining the proven principles of immediate implant placement and provisional restoration with hard and soft tissue augmentation using nonautogenous materials is demonstrated with comparisons to nongrafted, temporized historical controls.

This article describes a simplified technique for relining provisional prostheses on natural abutments that can be applied to this specific type of tooth preparation with feather-edge finish line. Starting from a diagnostic wax-up, a provisional fixed restoration is constructed, containing all the correct structural information. This includes the controlled depth of the prosthetic margin into the gingival sulcus, the emergence profile, and the area from the emergence profile to the gingival third. Chair time is saved during the clinical procedures because the finishing and polishing steps are shortened, and the resulting provisional restoration is precise and highly biocompatible. This technique allows for a simple and quick relining and finishing procedure and for the delivery of an esthetic and biocompatible provisional restoration.

The objective of this study was to compare selective physical-mechanical properties, antibacterial effects and cytotoxicity of seven temporary restorative materials (TRM): five resin-based materials [Bioplic (B), Fill Magic Tempo (FM), Fermit inlay (F), Luxatemp LC (L) and Revotek LC (R)], and zinc oxide-eugenol cement (IRM) and glass ionomer cement (GIC) as the controls. Material and methods The physical-mechanical properties were evaluated by determining microleakage (ML), ultimate tensile strength (UTS) and Shore D hardness (SDH). In addition, the polymerization rate (Pr-1), depth of cure (DC), water sorption and solubility (WS/SL) were evaluated. The antimicrobial effects of the materials were assessed by biofilm accumulation of Streptococcus mutans (BT) and the direct contact test (DCT) by exposure to Enterococcus faecalis for 1 and 24 h, and cytotoxicity by MTT assay. The data were analyzed by ANOVA or Kruskall-Wallis tests, and a complementary post-hoc method (p<0.05). Results Group B, followed by FM and GIC had significantly lower percentages of microleakage in comparison with the other groups; Groups FM and L showed the highest WS, while Groups R and FM showed the significantly lowest SL values (p<0.05). Group R showed the statistically highest UTS mean and the lowest DC mean among all groups. Group F showed the lowest S. mutans biofilm accumulation (p=0.023). Only the Group L showed continued effect against E. faecalis after 1 h and 24 h in DCT. The L showed statistically lower viability cell when compared to the other groups. Conclusions These findings suggest the antibacterial effect of the temporary materials Fill Magic and Bioplic against S. mutans, while Luxatemp showed in vitro inhibition of S. mutans biofilm accumulation and E. faecalis growth. Regarding the cell viability test, Luxatemp was the most cytotoxic and Fill Magic was shown to be the least cytotoxic.

A digital technique is presented that records peri-implant soft tissue contours and the emergence profile. The architecture of interim restorations and adjacent teeth, the position of the implant, and the emergence profile of interim prostheses are scanned and registered to design a zirconia frame and to form a digital cast., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Dental implants have become a popular treatment modality for replacing missing teeth. In this regard, the importance of restoring patients with function during the implant healing period has grown in recent decades. Esthetic concerns, especially in the anterior region of the maxilla, should also be considered until the definitive restoration is delivered. Another indication for such restorations is maintenance of the space required for esthetic and functional definitive restorations in cases where the implant site is surrounded by natural teeth. Numerous articles have described different types of interim prostheses and their fabrication techniques. This article aims to briefly discuss all types of implant-related interim prostheses by different classification including provisional timing (before implant placement, after implant placement in unloading and loading periods), materials, and techniques used for making the restorations, the type of interim prosthesis retention, and definitive restoration. Furthermore, the abutment torque for such restorations and methods for transferring the soft tissue from interim to definitive prostheses are addressed., (© 2015 by the American College of Prosthodontists.)

Purpose and Objective: The aim of this in vitro study was to investigate the ability of epithelial cells to attach to or proliferate on various mechanical or chemical surface treatments of an implant provisional material., Materials and Methods: Polyethyl methacrylate discs 10 mm in diameter and ∼0.2 to 0.75 mm in width were used in the study. Experimental discs were treated with either a mechanical (pumice, varnish for shine, or high polishing) or a chemical agent (alcohol, chlorhexidine, or steam) to provide cleaning and/or polishing. Using primary human epidermal keratinocytes, experiments were performed to test the adhesion or proliferation of cells on the discs with various surface treatments., Results: Scanning electron microscope analysis, rhodamine staining, and cell counting using a hemocytometer corroborated all findings and illustrated that the highest cell adhesion was found to be in the smooth surface treatment groups and the poorest adhesion was found to be in the rough surface groups and chemical treatment group., Conclusion: Within the limitations of this study, the following clinical protocol is recommended for finishing, polishing, and disinfecting implant provisional restorations: coarse, medium, fine pumice → high polishing (if desired) → steam. It is recommended to avoid applying varnish in the perimucosal area near the epithelium. This study could establish the most appropriate way to handle provisional restorations in the peri-implant sulcus for improved soft tissue health, esthetics, and long-term stability.

This article presents the results of a scanning electron microscope (SEM) analysis of the surface of an acrylic custom provisional abutment following first disconnection from a post-extraction immediate implant placement. An implant was placed immediately after extraction, the site was grafted, and a barrier membrane was adapted for graft containment. A custom acrylic shell was then relined, polished, and steam-cleaned prior to being screwed onto the implant. After 5 months of undisturbed healing, the custom provisional abutment was disconnected for the first time and processed for SEM examination. The surface of the custom acrylic abutment revealed well-spread fibroblast-like cells with filopodia inserting into the porous surface. These observations suggest that the surface topography of the acrylic provisional restoration/ abutment can function as a substratum for cellular adhesion and may serve an important role in supporting peri-implant mucosa at the time of immediate implant placement.

Objective: To present comparative study aims to assist the practitioner to choose between behavior modification (BM) techniques, pharmacologic sedation (N 2 O-O 2 alone or combined with midazolam 0.5 mg/ kg) or routine general anesthesia (GA) for the most successful approach in enabling pediatric dental care., Study Design: Dental records of 56 children treated in a university dental clinic between 2006-2016 were reviewed, and data on age, gender, required treatment (amalgam restorations, composite restorations, pulpotomy, and stainless steel crowns [SSC]), treatment approaches and therapeutic success at final follow-up were retrieved., Results: Treatment under GA had the best success rates compared to both BM and pharmacologic sedation. N 2 O-O 2 alone had a 6.1-fold greater risk of failure compared to N 2 O-O 2 +midazolam (p- <0.008). Amalgam restorations had a 2.61-fold greater risk of failure than SSC (p- <0.008)., Conclusions: The GA mode yielded significantly greater success than the N 2 O-O 2 mode alone. There were no significant differences in success rates between GA and combined midazolam 0.5 mg/kg+N 2 O-O 2 . When choosing restoration material, it is important to remember the high success rate of SSC compared to amalgam restoration.

Objectives: The present preliminary study evaluated the clinical and radiographic performances of heat-cured high viscosity glass ionomer (HCHVGI) in class II restorations of primary molars., Study Design: A retrospective study on a cohort of patients who had dental caries restored at a private practice was conducted. Restorations were evaluated radiographically and photographically by two separate examiners., Results: Ninety-three Class II restorations in 44 patients (average age: 108 months ± 25.3, 24 males, 20 females) were examined. Average recall time was 22.2 months ± 4.2. All but three restorations (96.8%) were present and intact, with no incidents of secondary caries. Three additional restorations had occlusal defects that required retreatment, resulting in an overall success rate of 93.5%. Ninety-seven percent of the restorations were rated optimal for marginal integrity with no staining of the restoration surfaces. No patients complained of post-operative sensitivity. The most common flaw found was a concavity on the proximal wall of the cavity box (27%, mean age 16 months ± 3.9)., Conclusion: The findings in this preliminary study suggest that heat cured high viscosity glass ionomer cement may be an effective restorative material for Class II restorations in primary molars that are a year or two from shedding.

Provisional restorations play an important role when providing indirect restorations. There are a number of materials and techniques available for their construction. Careful planning and construction can protect the prepared tooth surface, improve the periodontal condition and help plan for the definitive restoration. A good provisional restoration can save time, money and effort. Clinical relevance: Provisional restoration construction is an integral part of the indirect restorative process for inlays, onlays, crowns and bridges.

Purpose: The purpose of the presented technique is to enable the clinician to replicate the contours of the interim prosthesis., Materials and Methods: A clinical case report is presented where this novel technique was implemented. A stone base and a silicone index were used to duplicate the contours of an interim prosthesis, so that the definitive restoration can have similar contours., Results: The definitive prosthesis was fabricated based on the acquired soft tissue architecture and the contours of the interim restoration., Conclusion: The presented technique may assist clinicians in replicating the contours of interim restorations into the definitive prosthesis.

Upon the premature loss of permanent anterior teeth from unanticipated trauma or by ongoing patient neglect requiring surgery, patient requisites of functional and esthetic considerations must be addressed. Interim management can be achieved through the use of several diverse fixed and/or removable treatment modalities. The purposes of this report are to provide a review of traditional and unconventional techniques for interim replacement of missing anterior teeth and to present a clinical report demonstrating the fabrication of a removable, thermoplastic (vacuum-formed) EssixTM prosthesis, utilizing composite resin as the surrogate material of choice for the absent teeth. This measure proved to be an immediate, esthetic, and transitional treatment solution prior to a permanent resolution for the patient's long-term dental requirements.

Background: Optimal integration and long-term stability of oral rehabilitations require correct diagnostic approach, appropriate pre-prosthetic treatments and accurate therapeutic protocols. Technology provides devices to optimise therapeutic results, according to biologic constraints and aesthetic parameters., Case Report: The present report describes a multidisciplinary management in a young patient affected by lateral incisor agenesis, including pre-prosthetic orthodontic treatment and restorative and implant-supported prosthetic rehabilitation. Minimally invasive clinical procedures with veneer restorations and flapless implant placement, followed by immediate prosthesis delivery, are carried out. Tridimensional diagnostic data and dedicated software were used for treatment planning, allowing to achieve optimal results.

When patients are constrained financially to receive dental work, a staged approach can be an effective way for enabling treatment to proceed. In this case, a patient who had been in the practice for about 10 years and had a severely worn and eroded dentition finally opted to receive treatment in stages. A systematic approach was used to determine the proper postoperative position of the teeth. The subsequent treatment plan included the use of porcelain onlays and full-coverage crowns in the mandibular posterior along with provisional direct composite restorations in the maxillary dentition; the composites would be transitioned to porcelain crowns as the patient's finances would allow.

Background/aim: Several cytokines and lymphokines (IL1β, ENA78, IL6, TNFα, IL8 and S100A8) are expressed during dental pulp inflammation. Analysis of gingival crevicu-lar fluid (GCF) offers a non-invasive means of studying gen-eral host response in oral cavity. Although GCF levels of various mediators could reflect the state of inflammation both in dental pulp and gingiva adjacent to a tooth, GCF samples of those without significant gingivitis could be inter-preted as reflection of pulpal process. The aim of this study was to investigate IL9 GCF values in patients with dental car-ies and to assess possible influence of various dental fillings materials on local IL9 production., Methods: The study group included 90 patients, aged 18–70, with inclusion and exclusion criteria in the prospective clinical study. Of the 6 types of material used for the restoration of prepared cavities, 3 were intended for temporary and 3 for definitive restora-tion. According to dental fillings weight, all the participants were divided into 3 groups: those with fillings lighter than 0.50 g, those with 0.50–1.00 g, and those with fillings heavier than 1.00 g. Samples were taken from gingival sulcus using the filter paper technique. Clinical parameters were deter-mined by bleeding index, plaque index (Silness-Lou, 0–3), gingival index (0–3), and gingival sulcus depth. Cytokine con-centrations were assessed using commercially available cy-tomix., Results: According to the weight of dental fillings, there was a clear decreament trend of IL9 values meaning that dental defects greater than 1.00 g of dental filling were associated with lower GCF IL9 concentration. The IL9 val-ues correlated with the degree of gingival index and depth of gingival sulcus, being higher with more advanced gingivitis and more pronounced anatomical changes in the tooth edge. Different filling materials exerted various local IL9 responses. Zink polycarbonate cement and amalgam fillings induced a significant and long-lasting local IL9 decrement, while the use of Tetric EvoCeram and GMA-BISK significantly increased IL9 levels., Conclusion: The obtained results indicate that IL9 GCF could be regarded as a measure of odontoblasts’ re-sponse to the extensity of dental caries. The type of material used for dental fillings could profoundly alter biological func-tion of gingival and pulpal cells. Also, the results obtained in this study suggest that some materials could even enhance wound repair by modulating macrophage activation.

Transitioning a patient with partial edentulism through hard and soft tissue grafting to an implant restoration with an interim removable dental prosthesis (IRDP) presents a challenge to the restorative dentist. The management of grafted sites requires care, and without the appropriate design, an IRDP may impede surgical outcomes and place the graft at risk for displacement or necrosis. A site development IRDP (SDIRDP) for a grafted site must fulfill restorative goals and promote the surgical objectives for site development. A technique is described for fabricating an SDIRDP that facilitates surgical procedures and maintains prosthetic goals., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

According to evolving computer-aided design/computer-aided manufacturing (CAD/CAM) technology, ceramic materials such as zirconia can be used to create fixed dental prostheses for partial removable dental prostheses. Since 3D printing technology was introduced a few years ago, dental applications of this technique have gradually increased. This clinical report presents a complete-mouth rehabilitation using 3D printing and the CAD/CAM double-scanning method., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The application of 3-dimensional printing technology is emerging in dentistry and is being increasingly used to fabricate dental restorations. To date, scientific evidence is lacking regarding the effect of different factors on the mechanical properties of the printed restorations with the additive manufacturing technique., Purpose: The purpose of this in vitro study was to evaluate the effect of build direction (layer orientation) on the mechanical properties of a novel 3-dimensionally (3D)-printed dental restorative material., Material and Methods: Based on the printing direction, 2 groups were tested. In the first group (n=20), the specimens were vertically printed with the layers oriented perpendicular to the load direction. In the second group (n=20), the specimens were horizontally printed with the layers oriented parallel to the load direction. All specimens were fabricated using the DW028D 3D-printer. The specimens were loaded with a universal testing machine at a crosshead speed of 1 mm/min with a 10-kN load cell. The test was performed at room temperature (22°C) under dry testing conditions. The compressive strength was calculated for both groups, and the results were compared using the unpaired t test (α=.05)., Results: The mean ±SD compressive strength for the vertically printed specimens was 297 MPa (±34) compared with 257 MPa (±41) for the horizontally printed specimens (P=.002)., Conclusions: Within the limitations of this study, the layer orientation was found to influence the compressive strength of the material. Vertically printed specimens with the layers oriented perpendicular to load direction have improved mechanical properties more than horizontally printed specimens with the layers oriented parallel to load direction., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The accuracy of interim crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems has not been well investigated., Purpose: The purpose of this in vitro study was to evaluate the marginal integrity of interim crowns made by CAD/CAM compared with that of conventional polymethylmethacrylate (PMMA) crowns., Material and Methods: A dentoform mandibular left second premolar was prepared for a ceramic crown and scanned for the fabrication of 60 stereolithical resin dies, half of which were scanned to fabricate 15 Telio CAD-CEREC and 15 Paradigm MZ100-E4D-E4D crowns. Fifteen Caulk and 15 Jet interim crowns were made on the remaining resin dies. All crowns were cemented with Tempgrip under a 17.8-N load, thermocycled for 1000 cycles, placed in 0.5% acid fuschin for 24 hours, and embedded in epoxy resin before sectioning from the mid-buccal to mid-lingual surface. The marginal discrepancy was measured using a traveling microscope, and dye penetration was measured as a percentage of the overall length under the crown., Results: The mean vertical marginal discrepancy of the conventionally made interim crowns was greater than for the CAD/CAM crowns (P=.006), while no difference was found for the horizontal component (P=.276). The mean vertical marginal discrepancy at the facial surface of the Caulk crowns was significantly greater than that of the other 3 types of interim crowns (P<.001). At the facial margin, the mean horizontal component of the Telio crowns was significantly larger than that of the other 3 types, with no difference at the lingual margins (P=.150). The mean percentage dye penetration for the Paradigm MZ100-E4D crowns was significantly greater and for Jet crowns significantly smaller than for the other 3 crowns (P<.001). However, the mean percentage dye penetration was significantly correlated with the vertical and horizontal marginal discrepancies of the Jet interim crowns at the facial surface and with the horizontal marginal discrepancies of the Caulk interim crowns at the lingual surface (P<.01 in each instance)., Conclusions: A significantly smaller vertical marginal discrepancy was found with the interim crowns fabricated by CAD/CAM as compared with PMMA crowns; however, this difference was not observed for the horizontal component. The percentage dye penetration was correlated with vertical and horizontal discrepancies at the facial surface for the Jet interim crowns and with horizontal discrepancies at the lingual surface for the Caulk interim crowns., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The esthetic outcome of an implant-supported restoration is greatly influenced by the relationship between the contours of the definitive prosthesis and the periimplant tissues. In this clinical technique, an implant analog holder and autopolymerizing acrylic resin were used to accurately register the soft-tissue transition zone created by the interim restoration and transfer it to the impression post during the definitive impression., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: To make use of fiber-reinforced composite and the patient's own extracted teeth in fabricating a provisional restoration following immediate implant placement., Background: Fiber-reinforced composites offer various possibilities in temporization of osseointegrating implants in the esthetic zone., Technique: In this chairside technique, the patient's own extracted teeth with fiber-reinforced composite were used to fabricate a provisional restoration after immediate implant placement., Conclusion: A putty index was made before extracting the teeth and placing the implants as planned. The index and crowns of the extracted teeth were used to make a nonloading, esthetic, chair-side provisional restoration after immediate implant placement., Clinical Significance: By using the patient's own teeth for pro-visionalization immediately after implant placement, acceptance is greatly enhanced.

Objective: To compare mean micro-leakage around 3 types of temporary restorative materials in-vitro, when placed adjacent to permanent restorations (amalgam) in complex endodontic access cavities., Study Design: Randomized controlled trial., Place and Duration of Study: Dental Clinics, Dental Laboratory and Research Laboratory at The Aga Khan University Hospital, Karachi, from January to June 2014., Methodology: After random allocation of 60 teeth into 3 experimental groups, each group had conventional class II cavities prepared and amalgam placed. After 14 days, endodontic access cavities were made in these teeth, followed by placement of Cavit, IRM and CLIP(depth of 4 mm each). After thermo-cycling and immersion in 0.5% methylene blue dye, the teeth were sectioned mesio-distally and observed under stereoscopic microscope (magnification x4) along 2 interfaces 'a' and 'b' (tooth-temporary restoration and temporary restoration-primary restoration), respectively. Depth of dye penetration was measured in millimeters., Results: IRM was leakiest at interface 'a', cavit had highest dye penetration at interface 'b', while CLIP exhibited least micro-leakage at 'a' and 'b'. The mean dye penetration for Cavit was 0.80 ± 0.23 mm at 'a', and 2.24 ± 0.48 mm at 'b'. For IRM, it was 1.82 ± 0.09 mm at 'a', and 0.44 ± 0.13 mm at 'b'. For CLIP, the mean dye penetration was 0.43 ± 0.05 mm at 'a', and 0.32 ± 0.12 mm at 'b'. The difference in dye penetration observed between the 3 groups at both interfaces was statistically significant., Conclusion: In a complex access cavity made adjacent to a pre-existing amalgam restoration, CLIP exhibits the least micro-leakage, followed by IRM and Cavit.

The use of an immediately placed provisional restoration that mirrors the cervical contours of the extracted tooth at the time of implant placement may provide a platform to promote peri-implant soft tissue healing. This study examined the association of sulcular bleeding at the time of initial disconnection of the provisional restoration with stability of the buccolingual ridge dimension following immediate implant placement. Eighteen immediate implants grafted with particulate bone were restored with a screw-retained, single-unit, provisional restoration and abutment. The presence of sulcular bleeding was recorded after 5 to 7 months of healing. Stability of the buccolingual ridge dimension at the level of the free marginal gingiva and 1, 2, 3, 5, 7, and 9 mm apical was estimated using the contralateral tooth as a control. Gingival bleeding was associated with the disconnection of the provisional restoration in 11 (61.1%) of the grafted implant sites. Bleeding upon initial disconnection of the provisional restoration was significantly correlated with smaller changes, or greater stability, in the buccolingual ridge dimension at each reference point from 0 to 3 mm apical to the free gingival margin. The use of anatomically contoured provisional restorations may provide a platform to promote peri-implant soft tissue healing and minimize remodeling of the buccolingual ridge dimension.

The tooth is an ectodermal organ that arises from a tooth germ under the regulation of reciprocal epithelial-mesenchymal interactions. Tooth morphogenesis occurs in the tooth-forming field as a result of reaction-diffusion waves of specific gene expression patterns. Here, we developed a novel mechanical ligation method for splitting tooth germs to artificially regulate the molecules that control tooth morphology. The split tooth germs successfully developed into multiple correct teeth through the re-regionalisation of the tooth-forming field, which is regulated by reaction-diffusion waves in response to mechanical force. Furthermore, split teeth erupted into the oral cavity and restored physiological tooth function, including mastication, periodontal ligament function and responsiveness to noxious stimuli. Thus, this study presents a novel tooth regenerative technology based on split tooth germs and the re-regionalisation of the tooth-forming field by artificial mechanical force.

A cosmetic smile makeover has become a sought after procedure in our esthetically driven society. To promote patient satisfaction with treatment outcomes, all parties involved, including the patient, must be aware of the results that can be achieved and what it will require to achieve them. Although treatment can be redone, it cannot be undone. Therefore, much patient input must be solicited and considered before beginning treatment and before the final restorations are cemented. This article provides a treatment sequence that minimizes the possibility of an unhappy patient., (Copyright © 2015 Elsevier Inc. All rights reserved.)

This article demonstrates the use of a smile evaluation form as an adjunct in arriving at diagnosis and developing a treatment plan for a patient desiring Diastema closure. It also shows the importance of the diagnostic wax-up for temporization and visualization of case outcome. The case also demonstrates the use of soft tissue lasers to create a gingival harmony that enhanced the resulting esthetics. Feldspathic porcelain was used for the final restorations because they provide optimal esthetics and translucency., (Copyright © 2015 Elsevier Inc. All rights reserved.)

When patients seek cosmetic dentistry, their main concern is how their new smile is going to appear. In trying to achieve a patient's desire for a more beautiful smile, a careful and comprehensive analysis must be completed to insure the desired outcome is achievable and will function for many years to come. The clinician's primary goal is to restore the patient's dentition to ideal form and function. Full mouth rehabilitations need to be done in a systematic way to ensure all the parameters of an esthetic and functional outcome are achieved., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this paper was to systematically review the quality of evidence related to self-applied and professionally applied fluorides, antimicrobial agents, fissure sealants, temporary restorations, and restorative care for the prevention and management of early childhood caries (ECC)., Methods: Relevant papers were selected after an electronic search for literature published in English between 2000 and April 2014. From 877 reports, 33 were included for full review. The quality of evidence was expressed according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system., Results: There was moderate and limited quality of evidence in support of fluoride toothpaste and fluoride varnish for ECC prevention, while the evidence for fluoride tablets/drops was insufficient. The support for the use of silver diamine fluoride, xylitol, chlorhexidine varnish/gel, povidone iodine, probiotic bacteria, and remineralizing agents (casein phosphopeptide-amorphous calcium phosphate) was insufficient. There was also insufficient quality of evidence for the use of sealants, temporary restorations, and traditional restorative care to reduce incidence of ECC., Conclusion: The results reinforce the need for high quality clinical research and point out the knowledge gaps to be addressed in future studies.

Pre-eruptive intracoronal resorption (PEIR) are lesions that are often located in the occlusal portion of the crown in unerupted teeth. The etiology and pathology of these lesions remain unclear and most go undetected until later stages of development. Prognosis is dependent on early detection, and conservative treatment is recommended. This report reviews the etiology, prevalence, diagnosis and treatment of PEIR and describes a case of a permanent second molar with PEIR diagnosed in an 11-year-old patient.

Unlabelled: Interface integrity can be maintained by setting the composite in a layering technique and using liners., Objective: The aim of this in vitro study was to verify the effect of resin-modified glass-ionomer cement (RMGIC) lining and composite layering technique on the bond strength of the dentin/resin adhesive interface of lateral walls of occlusal restorations., Material and Methods: Occlusal cavities were prepared in 52 extracted sound human molars, randomly assigned into 4 groups: Group 2H (control) - no lining + two horizontal layers; Group 4O: no lining + four oblique layers; Group V-2H: RMGIC lining (Vitrebond) + two horizontal layers; and Group V-4O: RMGIC lining (Vitrebond) + four oblique layers. Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper™ Single Bond 2, 3M ESPE) dyed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. The teeth were stored in deionized water at 37oC for 24 hours before being sectioned into 0.8 mm slices. One slice of each tooth was randomly selected for Confocal Laser Scanning Microscopy (CLSM) analysis. The other slices were sectioned into 0.8 mm x 0.8 mm sticks to microtensile bond strength test (MPa). Data were analyzed by two-way ANOVA and Fisher's test. Results There was no statistical difference on bond strength among groups (p>0.05). CLSM analysis showed no significant statistical difference regarding the presence of gap at the interface dentin/resin among groups., Conclusions: RMGIC lining and composite layering techniques showed no effect on the microtensile bond strength and gap formation at the adhesive interface of lateral walls of high C-factor occlusal restorations.

Wear, extraction, or fracture of all or part of a mandibular first molar can lead to the supraeruption of the opposing maxillary molar, resulting in occlusal interference and lack of restoration space. This report describes a method to gain sufficient vertical space for permanent restoration. A direct composite resin restoration was placed on the occlusal surface of a lower molar, intentionally making the interim restoration high and intruding the maxillary molar. After 6 weeks, the extruded tooth returned to the desired position, and functional occlusion was restored, enabling a ceramic restoration on the mandibular molar. No marked adverse sensory reaction was reported in this therapeutic process, and no deleterious signs were detected in the teeth, periodontium, or temporomandibular joints. The simple treatment type was effective, noninvasive, and time saving, while also preserving maximum tooth structures., (© 2014 by the American College of Prosthodontists.)

When considering endodontically treated teeth, the quality of the restoration is important from the outset. It sheds light into possible causes of pulp necrosis or failure of endodontic treatment and influences the outcome of future endodontic treatment. A tooth undergoing endodontic treatment requires an effective coronal seal during and following completion of endodontic treatment. This paper discusses, using the available literature, the maintenance of optimal coronal seal and coronal integrity during and after root canal treatment.

Purpose: Delayed placement of implant abutments has been associated with peri-implant marginal bone loss; however, long-term results obtained by modifying surgical and prosthetic techniques after implant placement are still lacking. This study aimed to evaluate the marginal bone loss around titanium implants placed in fresh extraction sockets using two loading protocols after a 5-year follow-up period., Material and Methods: A total of 36 patients received 40 titanium implants (Astra Tech) intended for single-tooth replacement. Implants were immediately placed into fresh extraction sockets using either a one-stage (immediate loading by placing an interim prosthesis into functional occlusion) or a two-stage prosthetic loading protocol (insertion of abutments after 8 weeks of healing time). Marginal bone levels relative to the implant reference point were evaluated at four time intervals using intraoral radiographs: at time of implant placement, and 1, 3, and 5 years after implant placement. Measurements were obtained from mesial and distal surfaces of each implant (α = 0.05)., Results: One-stage immediate implant placement into fresh extraction sockets resulted in a significant reduction in marginal bone loss (p < 0.002) compared to the traditional two-stage technique. Whereas mesial surfaces remained stable for the 5-year observation period, significant marginal bone loss was observed on distal surfaces of implants after cementation of interim prostheses (p < 0.007) and after 12 months (p < 0.034)., Conclusions: Within the limitations of this study, immediate loading of implants placed into fresh extraction sockets reduced marginal bone loss and did not compromise the success rate of the restorations., (© 2014 by the American College of Prosthodontists.)