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Journal of Clinical Periodontology Nov 2022To test whether the emergence profile (CONVEX or CONCAVE) of implant-supported crowns influences the mucosal margin stability up to 12 months after insertion of the... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To test whether the emergence profile (CONVEX or CONCAVE) of implant-supported crowns influences the mucosal margin stability up to 12 months after insertion of the final restoration.
MATERIALS AND METHODS
Forty-seven patients with a single implant in the anterior region were randomly allocated to one of three groups: (1) CONVEX (n = 15), implant provisional and an implant-supported crown both with a convex profile; (2) CONCAVE (n = 16), implant provisional and an implant-supported crown both with a concave profile; (3) CONTROL (n = 16), no provisional (healing abutment only) and an implant-supported crown. All patients were recalled at baseline, 6, and 12 months. The stability of mucosal margin along with clinical, aesthetic, and profilometric outcomes as well as time and costs were evaluated. To predict the presence of recession, multivariable logistic regressions were performed and linear models using generalized estimation equations were conducted for the different outcomes.
RESULTS
Forty-four patients were available at 12 months post-loading. The frequency of mucosal recession amounted to 64.3% in group CONVEX, 14.3% in group CONCAVE, and 31.4% in group CONTROL. Regression models revealed that a CONVEX profile was significantly associated with the presence of recessions (odds ratio: 12.6, 95% confidence interval: 1.82-88.48, p = .01) compared with the CONCAVE profile. Pink aesthetic scores amounted to 5.9 in group CONVEX, 6.2 in group CONCAVE, and 5.4 in group CONTROL, with no significant differences between the groups (p = .735). Groups CONVEX and CONCAVE increased the appointments and costs compared with the CONTROL group.
CONCLUSIONS
The use of implant-supported provisionals with a CONCAVE emergence profile results in a greater stability of the mucosal margin compared with a CONVEX profile up to 12 months of loading. This is accompanied, however, by increased time and costs compared with the absence of a provisional and may not necessarily enhance the aesthetic outcomes.
TRIAL REGISTRATION
German Clinical Trials Register; DRKS00009420.
Topics: Crowns; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Humans
PubMed: 35817419
DOI: 10.1111/jcpe.13696 -
Clinical Oral Investigations Jun 2023The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use...
OBJECTIVES
The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document.
MATERIALS AND METHODS
An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision.
RESULTS
Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1-4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match).
CONCLUSION
The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling.
CLINICAL RELEVANCE
The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.
Topics: Humans; Dental Restoration, Permanent; Composite Resins; Dentists; Dental Restoration Failure; Esthetics, Dental; Professional Role; Dental Caries; Dental Marginal Adaptation; Follow-Up Studies; Surface Properties; Color
PubMed: 36504246
DOI: 10.1007/s00784-022-04814-1 -
Australian Dental Journal Mar 2018Exodontia is a cardinal skill of all dentists. Patients expect extractions to be skillfully and painlessly accomplished every time. It's not necessarily so simple and...
Exodontia is a cardinal skill of all dentists. Patients expect extractions to be skillfully and painlessly accomplished every time. It's not necessarily so simple and can be challenging. In this paper we explore contemporary issues of the full process of exodontia including diagnosis, technique, complication minimization as well as management of medically compromised patients with appropriate post-operative care, including pharmacotherapy.
Topics: Analgesia; Dentistry; Diabetes Complications; Humans; Osteitis; Periodontal Diseases; Postoperative Period; Steroids; Tooth; Tooth Extraction; Tooth Root
PubMed: 29574811
DOI: 10.1111/adj.12586 -
Medicina (Kaunas, Lithuania) Sep 2022The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. The patient's primary concern...
The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.
Topics: Humans; Female; Crown Lengthening; Dental Porcelain; Gingivectomy; Crowns; Incisor
PubMed: 36295521
DOI: 10.3390/medicina58101360 -
BMC Oral Health Oct 2023Whilst the appropriate assessment criteria for dental biomaterials is debated, there has been an increasing interest in the use of dental biomaterials for oral...
Whilst the appropriate assessment criteria for dental biomaterials is debated, there has been an increasing interest in the use of dental biomaterials for oral rehabilitation. Consequently, a variety of new biomaterials have been introduced in dentistry. To address this issue, BMC Oral Health has launched a Collection on "New biomaterials for modern dentistry".
Topics: Humans; Biocompatible Materials; Dentistry
PubMed: 37899445
DOI: 10.1186/s12903-023-03531-9 -
Indian Journal of Dental Research :... 2017
Topics: Dental Research; Dentistry; Education, Dental; India
PubMed: 28721984
DOI: 10.4103/ijdr.IJDR_357_17 -
Australian Dental Journal Mar 2015Many nations are facing a demographic shift in the age profile of their population, leading the World Health Organization to a 'Call for Public Health Action' on the... (Review)
Review
BACKGROUND
Many nations are facing a demographic shift in the age profile of their population, leading the World Health Organization to a 'Call for Public Health Action' on the oral health of older people.
METHODS
A search of the literature relevant to geriatric dentistry teaching was undertaken using MEDLINE, Web of Science, Eric and Psychlit. A search of dental professional school websites in Australia and policy and international practice documents was undertaken.
RESULTS
The international literature describes requirements for geriatric dentistry courses and various approaches to teaching, including didactic teaching, practical experiences and external placements. Challenges are identified in the area of geriatric dental education. Educational institutions (with others) have an obligation to lead change, yet there appears to be little formal recognition in Australian dental curricula of the need to develop quality education and research programmes in geriatric dentistry.
CONCLUSIONS
Internationally, the inclusion of geriatrics within dental curricula has been the subject of consideration since the 1970s. The current evidence indicates that geriatrics/gerodontology is not a significant component of dental curricula. Given the projected age distribution in many countries, the need for implementation of dental curriculum content in the area of geriatrics/gerodontology is evident.
Topics: Aged, 80 and over; Australia; Curriculum; Dental Care; Education, Dental; Geriatric Dentistry; Health Services Needs and Demand; Humans; Teaching
PubMed: 25762049
DOI: 10.1111/adj.12291 -
The Kaohsiung Journal of Medical... Apr 2018In the last 5 decades, the developments of osseointegrated titanium implants (since 1965) have led to the success of contemporary dentistry. Endosseous implant-supported... (Review)
Review
In the last 5 decades, the developments of osseointegrated titanium implants (since 1965) have led to the success of contemporary dentistry. Endosseous implant-supported restorations delivered in accordance with the traditional Branemark protocol have proven to be highly predictable. Today, implants are becoming increasingly common in dental care and provide more therapeutic options, but treatment planning and the sequencing of therapy are critical in implant-assisted and implant-supported cases. Implant prostheses give patients and dentists more options in treatment planning, but also present challenging decisions regarding implant surgery. In essence, the emerging thought is that teeth are expendable, as we now have implants to solve these problems. The fact that peri-implantitis is no simple problem to treat does not seem to affect many who hold that thought. In this article, the authors explain how to properly apply the periodontal prosthesis philosophy, concepts, principles, and techniques in contemporary dentistry. (This article is an update from the article was published in 2005) [1].
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dentistry; Health Knowledge, Attitudes, Practice; Humans; Patient Care Planning; Peri-Implantitis; Periodontal Prosthesis; Periodontium; Titanium; Tooth Loss
PubMed: 29655407
DOI: 10.1016/j.kjms.2018.01.008 -
La Clinica Terapeutica 2019The aim of the present study was to analyse the clinical potential of radiosurgery applied to modern dentistry through a revision of the indexed literature. Radiosurgery... (Review)
Review
The aim of the present study was to analyse the clinical potential of radiosurgery applied to modern dentistry through a revision of the indexed literature. Radiosurgery represents a recent form of electrosurgery working at a frequency of 3.0-4.0 MHz. The depth of penetration of the waves is inversely proportional to the frequency. Radiowaves working at high frequency express a lower penetration with a consequent lower tissue alteration. The authors analyzed the literature in order to give to the scientific community an overview of the possible applications of radiosurgery in the clinical dental practice and their effectiveness. Radiosurgery can be used in prosthodontics, in periodontal and implant surgery, in the treatment of trigeminal neuralgia, in the treatment of obstructive sleep apnea syndromes (OSAS) and in endodontics. Our analysis shows that although there are few articles in indixed literature on the applications of radiosurgery in dentistry, thanks to the benefits that derive from it, radiosurgery will spread more in the daily clinical practice of the dentists.
Topics: Dentistry; Humans; Periodontics; Prosthodontics; Radiosurgery; Sleep Apnea, Obstructive; Treatment Outcome; Trigeminal Neuralgia
PubMed: 30789197
DOI: 10.7417/CT.2019.2107 -
International Journal of Oral Science Sep 2023The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant... (Review)
Review
The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Topics: Humans; Dentistry, Operative; Consensus; Endodontics; Root Canal Therapy; Dental Care
PubMed: 37723147
DOI: 10.1038/s41368-023-00247-y