-
British Dental Journal Jun 2021Bonded retainers may play an important role in reducing unwanted tooth movements following orthodontic treatment, with an open-ended perspective on retention now...
Bonded retainers may play an important role in reducing unwanted tooth movements following orthodontic treatment, with an open-ended perspective on retention now established. The importance of planning for bonded retention is emphasised, with key principles in minimising failure rates as well as wire and adhesive options discussed. Approaches to preparation of the wire and the teeth, the bonding process, as well as variations in retainer design, and means of preventing problems and undertaking repairs in order to achieve predictable fixed retention in the long term are also outlined.
Topics: Dental Bonding; Orthodontic Appliance Design; Orthodontic Appliances, Fixed; Orthodontic Retainers
PubMed: 34117425
DOI: 10.1038/s41415-021-2936-9 -
Primary Dental Journal Dec 2021The guidelines regarding balancing and compensating extractions, published by the Royal College of Surgeons of England, are based on relatively low-level evidence and it...
The guidelines regarding balancing and compensating extractions, published by the Royal College of Surgeons of England, are based on relatively low-level evidence and it is highlighted in the guidance that further research into these areas is required. This paper aims to appraise the current evidence base regarding balancing and compensating extractions, to aid general dental practitioners in their decision making. General and clinical factors that should be considered in the treatment planning process are discussed throughout.
Topics: Child; Dental Care for Children; Dentists; Humans; Orthodontics; Pediatric Dentistry; Professional Role; Tooth Extraction
PubMed: 35088642
DOI: 10.1177/20501684211066512 -
BioMed Research International 2022Prevalently, there is a primary strategy to cure caries using restorative materials notably bioceramics. Existing synthetic materials stimulate natural tooth structure... (Review)
Review
Prevalently, there is a primary strategy to cure caries using restorative materials notably bioceramics. Existing synthetic materials stimulate natural tooth structure with acceptable interfacial bonding and esthetic and biomechanical qualities with better durability. Several bioceramics have been introduced and investigated for their potentialities as restorative materials. Biomineralization of tooth initiates repair and regeneration of natural dental tissue and reinstating the integrity of periodontium. In the evolution of bioceramics in the aspects of different essential composition for dental application, recent technology and modern strategies revolutionize the restorative dentistry. Bioglass is one among the important bioceramics as a restorative material, and by regulating the properties of the material, it is possible to construct improved formulation towards restoration. This article reviews the current revolution of endodontics, existing restorative materials, and technologies to be achieve for engineering materials with the better design.
Topics: Dental Restoration, Permanent; Dentistry; Endodontics
PubMed: 35941984
DOI: 10.1155/2022/2530156 -
Journal of the American Dental... May 2015Errors are commonplace in health care, including dentistry. It is imperative for dental professionals to intercept errors before they lead to an adverse event and to... (Review)
Review
BACKGROUND
Errors are commonplace in health care, including dentistry. It is imperative for dental professionals to intercept errors before they lead to an adverse event and to mitigate their effects when an adverse event occurs. This requires a systematic approach at both the profession level, encapsulated in the Agency for Healthcare Research and Quality's patient safety initiative framework, as well as at the practice level, in which crew resource management is a tested paradigm. Supporting patient safety at both the profession and dental practice levels relies on understanding the types and causes of errors, which have not been well studied.
METHODS
The authors performed a retrospective review of dental adverse events reported in the literature. Electronic bibliographic databases were searched, and data were extracted on background characteristics, incident description, case characteristics, clinic setting where adverse event originated, phase of patient care that adverse event was detected, proximal cause, type of patient harm, degree of harm, and recovery actions.
RESULTS
The authors identified 182 publications (containing 270 cases) through their search. Delayed treatment, unnecessary treatment, or disease progression after misdiagnosis was the largest type of harm reported. Of the reviewed cases, 24.4% of those patients involved in an adverse event experienced permanent harm. One of every 10 case reports reviewed (11.1%) reported that the adverse event resulted in the death of the affected patient.
CONCLUSIONS
Published case reports provide a window into understanding the nature and extent of dental adverse events; however, the overall dearth of publications on adverse events in the dental literature points to the need for more study.
PRACTICAL IMPLICATIONS
Siloed and incomplete contributions to dentistry's understanding of adverse events in the dental office are threats to dental patients' safety. Publishing more, and more comprehensive, case reports on adverse events is recommended for dental practitioners.
Topics: Dental Care; Humans; Medical Errors; Patient Safety; Periodicals as Topic
PubMed: 25925524
DOI: 10.1016/j.adaj.2015.01.003 -
Nederlands Tijdschrift Voor... Feb 2023Deep subgingival margin elevation is a much-debated topic in adhesive and restorative dentistry. The hydrophobic trait of adhesive materials challenges the restorative...
Deep subgingival margin elevation is a much-debated topic in adhesive and restorative dentistry. The hydrophobic trait of adhesive materials challenges the restorative procedure of cavities with deep subgingival margins since bonding and isolation by means of rubber dam is complicated. By relocating the deep subgingival preparation outline to epigingival, or supragingival with a direct composite restoration, the impression procedure and the use of rubber dam is simplified and the bonding of an indirect adhesive restoration can be performed more reliably. In the English-language literature, the term 'Deep Margin Elevation' is reserved for this approach. This article discusses the rationale and clinical implementation of Deep Margin Elevation. The current knowledge about the coronal relocated preparation margin is growing and is tersely summarized in this article with special attention to adhesive bonding between dentine, composites, and ceramic.
Topics: Humans; Dental Restoration, Permanent; Dental Cements; Composite Resins; Dentistry; Dental Marginal Adaptation; Dental Bonding; Dental Cavity Preparation
PubMed: 36748681
DOI: 10.5177/ntvt.2023.02.22097 -
Dental Clinics of North America Oct 2016This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on... (Review)
Review
This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholders; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.
Topics: Dentistry; Environmental Pollution; Humans; Mercury; Policy Making
PubMed: 27671962
DOI: 10.1016/j.cden.2016.05.009 -
Dental Update Dec 2016This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in...
This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.
Topics: Dentistry; Evidence-Based Dentistry
PubMed: 29155534
DOI: 10.12968/denu.2016.43.10.944 -
Journal of Prosthodontics : Official... Jun 2022To evaluate the fracture resistance behaviors of titanium-zirconium, one-piece zirconia, and two-piece zirconia implants restored by zirconia crowns and different...
PURPOSE
To evaluate the fracture resistance behaviors of titanium-zirconium, one-piece zirconia, and two-piece zirconia implants restored by zirconia crowns and different combinations of abutment materials (zirconia and titanium) and retention modes (cement-retained and screw-retained zirconia crowns).
MATERIAL AND METHODS
Three research groups (n=12) were evaluated according to combinations of abutment material, retention mode, and implant type. In the control group (TTC), titanium-zirconium implants (∅ 4.1 mm RN, 12 mm, Roxolid; Straumann USA, Andover, MA) and prefabricated titanium abutments (RN synOcta Cementable Abutment, H 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the second group (ZZC), one-piece zirconia implants (PURE Ceramic Implant Monotype, ∅ 4.1 mm RD, 12 mm, AH 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the third group (ZTS), two-piece zirconia implants (PURE Ceramic Implant, ∅ 4.1 mm RD, 12 mm) and prefabricated titanium abutments (CI RD PUREbase Abutment, H 5.5 mm) were used to support screw-retained zirconia crowns. All zirconia crowns were manufactured in the same anatomic contour with a 5-axis dental mill and blended 3 and 5 mol% yttria-stabilized zirconia (LayZir A2). Implants were inserted into specimen holders made of epoxy resin-glass fiber composite. All specimens were then subject to artificial aging in an incubator at 37°C for 90 days. Fracture resistance of specimen assemblies was tested under static compression load using the universal testing machine based on ISO14801 specification. The peak fracture loads were recorded. All specimens were examined at the end of the test microscopically at 5× and 10× magnification to detect any catastrophic failures. Comparisons between groups for differences in peak fracture load were made using Wilcoxon Rank Sum tests and Weibull and Kaplan-Meier survival analyses (α = 0.05).
RESULTS
The TTC group (942 ± 241 N) showed significantly higher peak fracture loads than the ZZC (645 ± 165 N) and ZTS (650 ± 124 N) groups (p < 0.001), while there was no significant difference between ZZC and ZTS groups (p = 0.940). The survival probability based on the Weibull and Kaplan-Meier models demonstrated different failure molds between titanium-zirconium and zirconia implants, in which the TTC group remained in the plastic strain zone for a longer period before fracture when compared to ZZC and ZTS groups. Catastrophic failures, with implant fractures at the embedding level or slightly below, were only observed in the ZZC and ZTS groups.
CONCLUSIONS
Cement-retained zirconia crowns supported by titanium-zirconium implants and prefabricated titanium abutments showed superior peak fracture loads and better survival probability behavior. One-piece zirconia implants with cement-retained zirconia crowns and two-piece zirconia implants with screw-retained zirconia crowns on prefabricated titanium abutment showed similar peak fracture loads and survival probability behavior. Titanium-zirconium and zirconia implants could withstand average intraoral mastication loads in the incisor region. This study was conducted under static load, room temperature (21.7°C), and dry condition, and full impacts of intraoral hydrothermal aging and dynamic loading conditions on the zirconia implants should be considered and studied further.
Topics: Crowns; Dental Abutments; Dental Implant-Abutment Design; Dental Implants; Dental Materials; Dental Restoration Failure; Dental Stress Analysis; Materials Testing; Titanium; Zirconium
PubMed: 34632673
DOI: 10.1111/jopr.13440 -
The Journal of Prosthetic Dentistry Sep 2021Digital and conventional options for definitive impressions and for the fabrication of fixed dental prostheses (FDPs) have been compared in previous studies. However, a... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Digital and conventional options for definitive impressions and for the fabrication of fixed dental prostheses (FDPs) have been compared in previous studies. However, a comprehensive review with concluding data that determined which method provided the minimal internal and marginal adaptation is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis of in vivo and in vitro studies was to compare the marginal and internal adaptation of complete-coverage single-unit crowns and multiunit FDPs resulting from digital and conventional impression and fabrication methods.
MATERIAL AND METHODS
The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Cochrane Trials, Scopus, and Open Grey databases were used to identify relevant articles. Based on fixed prostheses impression and fabrication methods, groups from each study were categorized into 4 groups: conventional impression and fabrication (CC), conventional impression and digital fabrication (CD), digital scanning and conventional fabrication (DC), and digital scanning and fabrication (DD). The risk of bias was assessed by using the Cochrane Collaboration tool for clinical trials and the modified Methodological Index for Non-Randomized Studies (MINORS) for in vitro studies. Heterogeneity was evaluated among studies, and meta-analysis was performed with random-effect models (α=.05). Subgroup analysis was conducted when possible.
RESULTS
Eight clinical trials and 21 in vitro studies were eligible for analysis. There was no significant difference between the CD and DD clinical groups for marginal adaptation (P=.149); However, the DD group had significantly less internal discrepancy than the CD group (P=.009). The in vitro studies found no significant difference in marginal adaptation among the CC-CD, CC-DC, and CC-DD pairs (P=.437, P=.387, P=.587), but in the comparison CD versus DD group, a significantly better marginal adaptation was observed for the DD group (P=.001). All the compared in vitro groups were similar in terms of internal adaptation.
CONCLUSIONS
Impression and fabrication techniques may affect the accuracy of fit of complete-coverage fixed restorations. A completely digital workflow yielded restorations with comparable or better marginal adaptation than the other methods.
Topics: Computer-Aided Design; Crowns; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Workflow
PubMed: 32928518
DOI: 10.1016/j.prosdent.2020.07.007 -
Dental Clinics of North America Jul 2020Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not... (Review)
Review
Dentistry is in a unique position among the health care professions to assess and manage the patient with controlled substance risk. The concern over opioid risk is not new, and historically dentists have had to balance the critical need for adequate pain care with the importance of recognizing the consequences of using controlled substances for their patients. Barriers for providing adequate patient assessment and management may be greater in dentistry than other health care fields, although these barriers can be recognized and overcome. Collaboration with cotreating providers will improve patient outcomes and reduce patient risk.
Topics: Analgesics, Opioid; Controlled Substances; Dentistry; Humans; Pain
PubMed: 32448453
DOI: 10.1016/j.cden.2020.02.002