0000000000014652
AUTHOR
Antonio Fons-font
Assessment of the capacity of a pyrophosphate-based mouth rinse to inhibit the formation of supragingival dental calculus. a randomized double-blind placebo-controlled clinical trial
Background This study aimed to analyze the efficacy of an anti-calculus mouth rinse and its possible adverse effects on the mucosa and teeth. Material and Methods This randomized double-blind placebo-controlled clinical trial included 40 patients with treated and managed periodontal disease, all with a history of rapid calculus formation. Patients used a pyrophosphate-based test mouth rinse (B) or a placebo (A). A range of parameters were measured for: saliva (saliva flow, pH and chemical composition); calculus (Volpe-Manhold [V-M] index, weight, and volume); adverse effects on mucosa and teeth; and the patients’ subjective perceptive of mouth rinse efficacy. Results The test mouth rinse B …
Shear bond strength of debonded ceramic restorations re-cemented by means of a cleaning and retreatment protocol
Background As there is no standard method for re-cementing debonded partial ceramic restorations, the aim of this study was to evaluate the use of a non-invasive thermal protocol for cleaning and retreatment, and to study its influence on shear bond strength. Material and methods Twenty ceramic samples (IPS e.max CAD®) were bonded to composite cement cylinders and underwent a shear bond strength test (G1, n=20). A second group was created (G2, n=20), representing debonded restorations. To simulate debonding, the samples were artificially contaminated with composite cement. After debonding, these underwent a thermal protocol to remove remaining adhesive. After rebonding to the composite ceme…
Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part II: Soft Tissues
Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (group GS); cemented crown without finishing line (biologically oriented preparation technique) (group GBOPT); and conventional cemented crown with finishing line (group GCC). After three years in function, clinical parameters (presence of keratinized mucosa, probing depths, bleeding on probing, and radio…
Zirconia in fixed prosthesis. A literature review
Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that …
Full maxillary rehabilitation with an all-ceramic system
With the appearance of all-ceramic systems, providing a choice of framework porcelains and allowing the same material to be used for the veneer, it is now possible to select the ideal structure in terms of both function and esthetics. Silicate ceramics allow porcelain laminate veneers and crowns to be used in the anterior region, providing excellent esthetics; while for the posterior area, where function takes precedence, oxide ceramics, specifically zirconium oxide, are preferred. The IPS e.max ceramic system, heir apparent to the IPS Empress 2 system, combines the advantages of zirconium oxide ceramics (IPS e.max Zircad) with the excellent esthetic qualities of silicate ceramics (IPS e.ma…
Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part I: Hard Tissues
Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years functional loading. Materials and Methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (Group GS); cemented crown without finishing line (biologically oriented preparation technique) (Group GBOPT); and conventional cemented crown with finishing line (Group GCC). The clinical behavior of each restoration type was analyzed after 3 years functional loading by analyzing radiographic peri-implant b…
Fracture Resistance of Partial Indirect Restorations Made With CAD/CAM Technology. A Systematic Review and Meta-analysis
Background: The aim of this systematic review and meta-analysis was to determine the fracture resistance and survival rate of partial indirect restorations inlays, onlays, and overlays fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology from ceramics, composite resin, resin nanoceramic, or hybrid ceramic and to analyze the influence of proximal box elevation on fracture resistance. Materials and methods: This systematic review was based on guidelines proposed by the preferred reporting items for systematic reviews and meta-analyses (PRISMA). An electronic search was conducted in databases US National Library of Medicine National Institutes of Health …
Histological study of human periodontal tissue following biologically oriented preparation technique (BOPT)
Background The aim of this study was to conduct histological analysis of a human tooth resected with the periodontal insertion apparatus intact following treatment using biologically oriented preparation technique (BOPT). Material and methods This descriptive histological dento-periodontal study used an anterior tooth extracted with the surrounding periodontal tissues intact, following prosthetic restoration with BOPT. The sample patient was recruited from among those attending the Department of Dental Medicine at the Faculty of Medicine and Dentistry, University of Valencia (Spain). Eight serial sections of the restored tooth were processed. The relative location and histological character…
In vitro experimental study of bonding between aluminium oxide ceramics and resin cements
To evaluate bond strengths of different resin cements to two aluminum oxide-based ceramics. Methods: One hundred ten ceramic cylinders were produced and given four different surface treatments. Resin cement cylinders were then bonded to the ceramic cylinders using different resin cements and the bond strength was determined by shear testing to the breaking point. We were thus able to obtain results for the different combinations of porcelain, surface treatments and cements. All data was analyzed using the Kruskal-Wallis test for more than two independent samples and the Bonferroni correction applied (a=0.01). An optical microscopy study was carried out to analyze the type of failure, and an…
In vivo evaluation of three-dimensional of volumetric changes using a CAD/CAM chair-side system : technical procedure
An intraoral digital scanner in combination with specialized three-dimensional surface analysis software monitors volumetric changes to soft tissues or dental restorations. This technology can evaluate the success of a specific technique or medium- or long-term clinical outcomes in both clinical and research situations. This article describes how this technology was used to provide immediate chair-side data analysis without the help of specialized laboratory support. Key words:Intraoral scanner, CAD-CAM, best fit-method, surface tessellation language.
Correlation between Polysomnographic Parameters and Tridimensional Changes in the Upper Airway of Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Devices
Background. The effectiveness of mandibular advancement devices has been solidly demonstrated in the past. They are considered a valid alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea. Nevertheless, the relationship between polysomnographic parameters and the increase in the volume of the upper airway in patients with obstructive sleep apnea syndrome has not been clearly established so far. This study aimed to determine the impact of these oral appliances upon the volume of the airway after the device titration phase and correlate it with the degree of mandibular advancement and the improvement of polysomnographic parameters. Methods. Al…
Periodontal outcomes of anterior fixed partial dentures on teeth treated with the biologically oriented preparation technique: A 6-year prospective clinical trial.
Abstract Statement of problem One of the most frequent complications in participants with fixed partial dentures (FPDs) is the apical migration of the gingival margin, which may be associated with factors such as fit, gingival margin location, or tooth preparation type. The prevalence of the complication in participants restored with FPDs prepared by using the biologically oriented preparation technique (BOPT) is unclear. Purpose The purpose of this prospective clinical trial was to evaluate the clinical and biologic outcomes of FPDs on teeth prepared by using the BOPT, over a 6-year follow-up period. Material and methods Tooth-supported zirconia FPDs in the anterior region prepared by usin…
Fracture resistance and the mode of failure produced in metal-free crowns cemented onto zirconia abutments in dental implants.
The purpose of the investigation was to analyze fracture resistance and mode of failure of zirconium oxide (zirconia) abutments placed on dental implants bearing crowns of different esthetic materials: zirconia, lithium disilicate (LDS), and nano-ceramic resin, for replacing single teeth in the anterior sector. Eighty implant-abutment-crown units were divided into four groups: Group T-MC (control): 20 metal-ceramic crowns cemented onto titanium abutments; Group Z-Z: 20 zirconia crowns on zirconia abutments; Group Z-LD: 20 lithium disilicate crowns on zirconia abutments; and Group Z-NCR: 20 nano-ceramic resin crowns on zirconia abutments. Specimens underwent a fatiguing process (dynamic load…
Methodology in specimen fabrication for in vitro dental studies: Standardization of extracted tooth preparation
Background Specimen preparation for in vitro study suffers a general lack of methodological homogeneity, as well as a lack of uniformity in the materials selected for fabricating them. This situation prevents comparisons between studies. When a specimen is not of dental origin it is not possible to study adhesion or bonding techniques realistically. The objective is to design and implement a method of specimen preparation that permits universal standardization for use in in vitro studies. Material and Methods A metal stump of specified dimensions was designed and fabricated by hand. It was scanned, the data digitalized, perfecting and standardizing the dimensions. Ten human molars were adap…
A prospective evaluation of zirconia anterior partial fixed dental prostheses: Clinical results after seven years.
Abstract Statement of problem Because of the high mechanical strength of zirconium dioxide, the metal in fixed partial prostheses can now be replaced. However, the material is susceptible to aging or hydrothermal degradation and to chipping of the feldspathic veneer. Purpose The purpose of this prospective study was to evaluate the survival (without failure) and success (survival without any complication or failure) rate and clinical efficacy of anterior zirconia partial fixed dental prostheses. Material and methods Twenty-seven anterior partial fixed dental prostheses of 3 to 6 units were fabricated. All participants were examined after 1 month and 6 months, then annually for 7 years. Resu…
Influence of bruxism on survival of porcelain laminate veneers
Objectives: This study aims to determine whether bruxism and the use of occlusal splints affect the survival of porcelain laminate veneers in patients treated with this technique. Material and Methods: Restorations were made in 70 patients, including 30 patients with some type of parafunc - tional habit. A total of 323 veneers were placed, 170 in patients with bruxism activity, and the remaining 153 in patients without it. A clinical examination determined the presence or absence of ceramic failure (cracks, frac - tures and debonding) of the restorations; these incidents were analyzed for association with bruxism and the use of splints. Results: Analysis of the ceramic failures showed that …
Dimensional analysis of the upper airway in obstructive sleep apnoea syndrome patients treated with mandibular advancement device: A bi‐ and three‐dimensional evaluation
BACKGROUND The efficiency of the mandibular advancement device (MAD) in patients with obstructive sleep apnoea syndrome (OSAS) has been demonstrated. Nevertheless, the behaviour of the upper airway once MAD is placed and titrated, and its correlation with the apnoea-hypopnoea index (AHI) is still under discussion. OBJECTIVES To analyse the morphological changes of the upper airway through a bi- and three-dimensional study and correlate it with the polysomnographic variable, AHI. METHODS Patients were recruited from two different hospitals for the treatment of OSAS with a custom-made MAD. A cone-beam computer tomography and a polysomnography were performed at baseline and once the MAD was ti…
Traction test of temporary dental cements
Background Classic self-curing temporary cements obstruct the translucence of provisional restorations. New dual-cure esthetic temporary cements need investigation and comparison with classic cements to ensure that they are equally retentive and provide adequate translucence. The objective is to analyze by means of traction testing in a in vitro study the retention of five temporary cements. Material and methods Ten molars were prepared and ten provisional resin restorations were fabricated using CAD-CAM technology (n=10). Five temporary cements were selected: self-curing temporary cements, Dycal (D), Temp Bond (TB), Temp Bond Non Eugenol (TBNE); dual-curing esthetic cements Temp Bond Clear…
Fracture Resistance of New Metal-Free Materials Used for CAD-CAM Fabrication of Partial Posterior Restorations
Background and Objectives: To evaluate in vitro the fracture resistance and fracture type of computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: Discs were fabricated (10 ×
Analysis of Predisposing Factors for Rapid Dental Calculus Formation.
Background: Calculus accumulation varies widely between individuals. Dental calculus has been associated with the principal periodontal diseases. The aim of this study was to analyze individual characteristics, and salivary and microbiological parameters among patients considered to be rapid calculus formers and patients who form calculus slowly. Methods: Individual characteristics were recorded in a sample of 74 patients (age, sex, smoking, periodontal diagnosis, and dental crowding), as well as salivary parameters (unstimulated saliva flow, pH, and biochemical analysis of saliva) and microbiological parameters (by means of semi-quantitative polymerase chain reaction (PCR) analysis). Resul…
Are Metal-Free Monolithic Crowns the Present of Prosthesis? Study of Mechanical Behaviour
Purpose: To analyze in vitro the mechanical behavior of five types of complete coverage crowns fabricated from different materials. Materials and methods: Seventy-five full coverage crowns were divided into five groups according to material: Group I, metal core with feldspathic ceramic covering (MC- control group)
A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A pilot study
Objective Measuring soft tissue thickness after mucogingival surgery has traditionally been performed by means of a calibrated transgingival probe. The main aim of this study was to apply a non-invasive technique based on digital images formatted as Standard Tessellation Language (STL) files to quantify soft tissue volume after connective tissue grafting. Clinical innovation report Ten patients who presented Cairo Class I gingival recession were selected for connective tissue grafting using the tunnel technique. In all patients, the initial position of the gingiva and quantity of keratinized tissue were recorded, and gingival recession was scanned with an intra-oral scanner. Six months afte…
Fractographic study of the behavior of different ceramic veneers on full coverage crowns in relation to supporting core materials
Objectives: To observe porcelain veneer behavior of zirconia and metal-ceramic full coverage crowns when subjected to compression testing, comparing zirconia cores to metal cores. Study Design: The porcelain fracture surfaces of 120 full coverage crowns (60 with a metal core and 60 with a zirconia core) subjected to static load (compression) testing were analyzed. Image analysis was performed using macroscopic processing with 8x and 12x enlargement. Five samples from each group were prepared and underwent scanning electron microscope (SEM) analysis in order to make a fractographic study of fracture propagation in the contact area and composition analysis in the most significant areas of the…
Retrospective study of a series of 850 patients with temporomandibular dysfunction (TMD). Clinical and radiological findings
Objective: To define the clinical and radiological characteristics of the four most common presentations of temporomandibular dysfunction-myofascial pain (MFP), disc displacement with reduction (DDWR), disc displacement without reduction (DDWoR), and osteoarthrosis (OR)-and to identify the differences among them. Material and methods: The study comprised a series of 850 patients (121 males and 729 females) seen between May 2003 and December 2006 in Valencia University General Hospital (Spain) for temporomandibular joint disease (TMJD). An analysis was made of the possible etiological factors (stress, traumatisms, sleep disturbances, parafunctional habits, reason for consultation), possible …
A clinical longitudinal study 323 porcelain laminate veneers. Period of study from 3 to 11 years
Objective: The objective of this study was to evaluate the clinical results of 323 porcelain laminate veneers over a period of 3 to 11 years. Material and Methods: This study included 70 patients, aged between 18 and 74 years. Of the 323 total veneers, 124 were of a simple design and 199 were of a functional design. The condition of the soft tissues and hygiene, in addition to the condition of the abutment teeth, the restorations and patient satisfaction were all clinically examined. In carrying out the statistical analysis, a descriptive approach was taken in analyzing the data. The Kaplan Meier method was used for statistically analyzing the survival rates of the porcelain laminate veneer…
Mechanical behavior of provisional implant prosthetic abutments
Introduction: Implant-supported prostheses have to overcome a major difficulty presented by the morphology and esthetics of peri-implant tissues in the anterior sector. Diverse therapeutic techniques are used for managing the mucosa adjacent to the implant and the most noteworthy is immediate/deferred fixed provisionalization. Objectives: In vitro testing of strength and deformation of implant prosthetic abutments made from different materials (Titanium/PEEK/methacrylate). Material and Methods: Forty Sweden&Martina® implant prosthetic abutments (n=40) were divided into five groups: Group MP: methacrylate provisional abutments with machined titanium base; Group PP: Poly ether ether ketone (P…
An implant-supported overdenture design with a horizontal path of insertion
The rehabilitation of the atrophic maxilla by means of implant-supported prostheses cannot always be achieved with fixed prostheses because of anatomic, esthetic, or economic issues, so for some patients the treatment of choice is a removable prosthesis. This article analyzes a new design for implant-supported overdentures with horizontal or faciolingual insertion. Its retention system is based on frictional forces or stepped interlocking horizontal surfaces and is appropriate for patients with skeletal Class II or III relationships with severe maxillary atrophies. The design facilitates implant-prosthetic hygiene and improved esthetics in patients with nonparallel implants by hiding abutme…
Survival rates of a lithium disilicate-based core ceramic for three-unit esthetic fixed partial dentures: a 10-year prospective study.
Purpose The aim of this prospective study was to evaluate the clinical efficacy and long-term survival rate of three-unit fixed partial dentures (FPDs) made from lithium disilicate-based core ceramic. Materials and methods Twenty-one three-unit FPDs were placed in 19 patients to replace single lost teeth in the esthetic area, following a study protocol that took clinical, esthetic, and radiologic aspects into consideration. Each case was reviewed at 1 week following placement, at 6 months, and then annually for 10 years. Statistical analysis was performed using Kaplan-Meier survival analysis. Results Out of the 19 patients, 14.3% presented reversible postoperative sensitivity. Recession was…
Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study
bjectives. The aim of this study was to analyze the behavior of the periodontal tissues around teeth in the anterior region when restored with zirconia single crowns, using a biologically oriented preparation technique (BOPT), over a 6-year follow-up. Methods. The study investigated tooth-supported single crowns in the anterior region that were fabricated with a zirconia core and feldspathic ceramic covering, in 34 patients. Follow-up analysis took place annually for 6 years, assessing periodontal responses by evaluating the following variables: plaque index (PI)
Bonding to silicate ceramics : conventional technique compared with a simplified technique
Background Silicate ceramic bonding is carried out by acid-etching with hydrofluoric acid (HF) followed by an application of silane. By replacing HF with ammonium polyfluoride, contained in the same flask as the silane, the number of steps in this clinical procedure, can be reduced, while maintaining bond strength values, and reducing toxicity. A shear bond test was performed to compare the conventional and the simplified surface treatment techniques. Material and methods Twenty ceramic samples were fabricated from IPS emax CAD® ceramic (Ivoclar Vivadent) and divided into two groups (G1 and G2) (n=10). The conventional technique was applied to G1 samples, and the simplified technique to G2 …
Bond strength of selected composite resin-cements to zirconium-oxide ceramic
Objectives: The aim of this study was to evaluate bond strengths of zirconium-oxide (zirconia) ceramic and a selection of different composite resin cements. Study Design: 130 Lava TM cylinders were fabricated. The cylinders were sandblasted with 80 μm aluminium oxide or silica coated with CoJet Sand. Silane, and bonding agent and/or Clearfil Ceramic Primer were applied. One hundred thirty composite cement cylinders, comprising two dual-polymerizing (Variolink II and Panavia F) and two autopolymerizing (Rely X and Multilink) resins were bonded to the ceramic samples. A shear test was conducted, followed by an optical microscopy study to identify the location and type of failure, an elec…
Cleaning and retreatment protocol for a debonded ceramic restoration
Objectives: The aim of this article is to propose a resin cement cleaning protocol for use before recementing a debonded restoration. Study Design: Ceramic samples were fabricated from IPS d.sign® and IPS e.max Press® and were treated with hydrofluoric acid etching (HF), or HF+silane (S), or HF+S+adhesive or HF+S+A+resin cement. All samples were placed in a furnace at 650º for one minute in order to attempt to pyrolyze the composite. Each step was examined under scanning electron microscopy (SEM). Results: When the cleaning protocol had been performed, it left a clean and retentive surface. Conclusions: If the restoration is placed in a furnace at 650º for one minute, the composite cement w…
Influence of surface preparation on fracture load of resin composite-based repairs
The purpose of the present study is to evaluate the fracture load of composite-based repairs to fractured zirconium oxide (Z) crowns and to ceramic-fused-to-metal (CM) crowns, comparing different mechanical surface preparation methods. A total of 75 crowns were repaired; samples then underwent dynamic loading and thermocycling. Final fracture load values for failure of the repaired crowns were measured and the type of fracture registered. Group I: CM: Surface preparation with a diamond bur + 9.5% Hydrofluoric Acid (HF) etching; Group II): CM: air-particle (Al 2 O 3 ) + 9.5% HF; Group III: CM: Silica coating (SiO 2 ); Group IV): Z: air-particle (Al 2 O 3 ) + HF 9.5%; Group V) Z: Silica coati…
Shear bond strength of partial coverage restorations to dentin
BACKGROUND: When partial coverage restorations (veneers, inlays, onlays…) must be cemented to dentin, bond strength may not reach the same predictable values as to enamel. The purpose of this study was: 1. To compare, with a shear bond test, the bond strength to dentin of a total-etch and a self-etching bonding agent. 2. To determine whether creating microretention improves the bond strength to dentin. MATERIAL AND METHODS: Two bonding agents were assayed, Optibond FL® (Kerr), two-bottle adhesive requiring acid etching, and Clearfil SE Bond® (Kuraray), two-bottle self-etching adhesive. The vestibular, lingual, distal and mesial surfaces of ten molars (n=10) were ground to remove all enamel …
Systematic review of chewing simulators : reality and reproducibility of in vitro studies
Background The aim of this systematic review was to analyze the types of human chewing simulator described in scientific literature. Material and Methods An electronic search was conducted in the databases PubMed, Embase and Scopus. The search strategy included 10 search terms: “in vitro”; “dental materials”; “shear strength”; “fatigue fracture”; “bite force”; “prosthetic materials”; “chewing simulator”; “chewing machine”; “simulated mastication”; and “dental wear simulator.” Two researchers worked independently to assess the titles and abstracts of the articles. The quality of the in vitro trials selected was evaluated by means of the Consolidated Standards of Reporting Trials scale. Resul…
Immediate placement of single implant simultaneously with immediate loading in a fresh socket associated to periapical infection: a clinical case report
Early restoration of the masticatory function, phonatory and aesthetics is some of the current goals of the therapy based on endosseous implants. Facing the classic protocols of implant insertion, which recommend a period of several months between extraction and implant placement, alternatives have been developed that demonstrate that immediate implant placement after tooth extraction permits adequate osseointegration, even in those cases where there is a periapical disease. The immediate restoration of implants after placement is a possibility where aesthetic requirements are high. This article presents a case with immediate implant placement and immediate loading of a first upper premolar…