-
Cureus Sep 2022Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and...
Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and gold include ceramic dental restorative materials. The lifespan of ceramic inlay repairs is still up for debate. When it comes to durability, colour matching, and anatomical shape stability, ceramic inlay restorations top the list of options. More predictable long-term performance may be achieved by strategically placing ceramic inlays in teeth that are not subjected to significant occlusal stress. Preparation design for ceramic inlay materials is necessary to avoid flexure. This case report discusses the ceramic inlay practice for functional and aesthetic restoration in a patient.
PubMed: 36237818
DOI: 10.7759/cureus.29043 -
Life (Basel, Switzerland) Jan 2023Presbyopia can be defined as the refractive state of the eye in which, due to a physiological decrease in the ability to accommodate, it is not possible to sustain... (Review)
Review
Presbyopia can be defined as the refractive state of the eye in which, due to a physiological decrease in the ability to accommodate, it is not possible to sustain vision without fatigue in a prolonged manner, along with difficulty focusing near vision. It is estimated that its prevalence in 2030 will be approximately 2.1 billion people. Corneal inlays are an alternative in the correction of presbyopia. They are implanted beneath a laser-assisted in situ keratomileusis (LASIK) flap or in a pocket in the center of the cornea of the non-dominant eye. The purpose of this review is to provide information about intraoperative and postoperative KAMRA inlay complications in the available scientific literature. A search was conducted on PubMed, Web of Science, and Scopus with the following search strategy: ("KAMRA inlay" OR "KAMRA" OR "corneal inlay pinhole" OR "pinhole effect intracorneal" OR "SAICI" OR "small aperture intracorneal inlay") AND ("complication" OR "explantation" OR "explanted" OR "retired"). The bibliography consulted shows that the insertion of a KAMRA inlay is an effective procedure that improves near vision with a slight decrease in distance vision. However, postoperative complications such as corneal fibrosis, epithelial iron deposits, and stromal haze are described.
PubMed: 36836669
DOI: 10.3390/life13020312 -
Cureus Jan 2022Alveolar ridge defects are commonly seen in partially dentate patients, and they jeopardize speech, appearance, and oral hygiene maintenance. These defects affect both... (Review)
Review
Alveolar ridge defects are commonly seen in partially dentate patients, and they jeopardize speech, appearance, and oral hygiene maintenance. These defects affect both soft tissues and bone and are mainly caused by trauma. These defects are more prevalent in middle-aged male patients and it is imperative that the defective ridge is augmented before receiving an implant or a fixed partial denture. This review focuses on the different types of ridge defects and their treatment options.
PubMed: 35145779
DOI: 10.7759/cureus.20872 -
Burns : Journal of the International... Jun 2023Hypertrophic scarring is a deviate occurrence after wound closure and is a common burn sequela. The mainstay of scar treatment consists of a trifold approach: hydration,... (Review)
Review
BACKGROUND
Hypertrophic scarring is a deviate occurrence after wound closure and is a common burn sequela. The mainstay of scar treatment consists of a trifold approach: hydration, UV-protection and the use of pressure garments with or without extra paddings or inlays to provide additional pressure. Pressure therapy has been reported to induce a state of hypoxia and to reduce the expression pattern of transforming growth factor-β1 (TGF-β1), therefore limiting the activity of fibroblasts. However, pressure therapy is said to be largely based on empirical evidence and a lot of controversy concerning the effectiveness still prevails. Many variables influencing its effectivity, such as adherence to treatment, wear time, wash frequency, number of available pressure garment sets and amount of pressure remain only partially understood. This systematic review aims to give a complete and comprehensive overview of the currently available clinical evidence of pressure therapy.
METHODS
A systematic search for articles concerning the use of pressure therapy in the treatment and prevention of scars was performed in 3 different databases (Pubmed, Embase, and Cochrane library) according to the PRISMA statement. Only case series, case-control studies, cohort studies, and RCTs were included. The qualitative assessment was done by 2 separate reviewers with the appropriate quality assessment tools.
RESULTS
The search yielded 1458 articles. After deduplication and removal of ineligible records, 1280 records were screened on title and abstract. Full text screening was done for 23 articles and ultimately 17 articles were included. Comparisons between pressure or no pressure, low vs high pressure, short vs long duration and early vs late start of treatment were investigated.
CONCLUSION
There is sufficient evidence that indicates the value of prophylactic and curative use of pressure therapy for scar management. The evidence suggests that pressure therapy is capable of improving scar color, thickness, pain, and scar quality in general. Evidence also recommends commencing pressure therapy prior to 2 months after injury, and using a minimal pressure of 20-25 mmHg. To be effective, treatment duration should be at least 12 months and even preferably up to 18-24 months. These findings were in line with the best evidence statement by Sharp et al. (2016).
Topics: Humans; Burns; Cicatrix, Hypertrophic; Treatment Outcome; Cohort Studies; Time Factors
PubMed: 36941176
DOI: 10.1016/j.burns.2023.03.007 -
British Dental Journal Jul 2022
Topics: Composite Resins; Dental Cavity Preparation; Inlays
PubMed: 35869187
DOI: 10.1038/s41415-022-4522-1 -
Journal of the Mechanical Behavior of... Oct 2023The objective of this study was to determine the influence of different preparation designs on the fracture strength, failure type, repairability, formation of...
PURPOSE
The objective of this study was to determine the influence of different preparation designs on the fracture strength, failure type, repairability, formation of polymerization-induced cracks, and tooth deformation of structurally compromised molars restored with lithium disilicate inlays and overlays in combination with Immediate Dentin Sealing (IDS).
MATERIAL AND METHODS
Human molars (N = 64) were randomly assigned to four different preparation designs: Undermined Inlay (UI), Extended Inlay (EI), Restricted Overlay (RO), and Extended Overlay (EO). The teeth were restored using lithium disilicate partial restorations and subjected to thermomechanical fatigue in a chewing simulator (1,2 × 10 (Mondelli et al., 2007) cycles on 50 N, 8000x 5-55 °C), followed by load to failure testing. In silico finite element analysis was conducted to assess tooth deformation. Polymerization-induced cracks were evaluated using optical microscopy and transillumination. Fracture strengths were statistically analyzed using a Kruskal-Wallis test, while the failure mode, repairability, and polymerization cracks were analyzed using Fisher exact test.
RESULTS
The propagation of polymerization-induced cracks did not significantly differ among preparation designs. All specimens withstood chewing simulator fatigue, with no visible cracks in teeth or restorations. Fracture strength was significantly influenced by preparation design, with restricted overlay (RO) showing higher fracture strength compared to extended inlay (EI) (p = .042). Tooth deformation and fracture resistance correlated between in vitro and in silico analyses). UI exhibited a statistically less destructive failure pattern than EO (p < .01) and RO (p = .036). No statistically significant influence of the preparation design on repairability was observed. Groups with higher repairability rates experienced increased tooth deformation, leading to less catastrophic failures.
CONCLUSIONS
The preparation design affected the fracture strength of compromised molars restored with lithium disilicate inlays and overlays, with significantly lower fracture strength for an extended inlay. The failure pattern of lithium disilicate overlays is significantly more destructive than that of undermined and extended inlays. The finite element analysis showed more tooth deformation in the inlay restorations, with lower forces in the roots, leading to less destructive fractures. Since cusp coverage restorations fracture in a more destructive manner, this study suggests the undermined inlay preparation design as a viable option for restoring weakened cusps.
Topics: Humans; Flexural Strength; Molar; Dental Porcelain; Fatigue; Fractures, Bone
PubMed: 37659167
DOI: 10.1016/j.jmbbm.2023.106096 -
The Journal of Prosthetic Dentistry Sep 2023A consensus on whether a fully digital workflow can replace conventional methods of manufacturing partial-coverage restorations is lacking. (Review)
Review
STATEMENT OF PROBLEM
A consensus on whether a fully digital workflow can replace conventional methods of manufacturing partial-coverage restorations is lacking.
PURPOSE
The purpose of this systematic review was to evaluate the accuracy, fit, and clinical outcomes of inlay, onlay, overlay, and endocrown restorations obtained with both digital and conventional workflows.
MATERIAL AND METHODS
This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Register of Systematic Reviews database (CRD42021258696). Studies evaluating the accuracy, fit, and clinical outcomes of inlay, onlay, overlay, and endocrown restorations obtained with digital and conventional workflows were included from 5 databases searched in November 2022. The Checklist for Reporting Randomized Clinical Studies (ROB 2) and the Checklist for Reporting In vitro Studies (CRIS guidelines) were used to assess the risk of bias.
RESULTS
Twenty-three studies were included in this review. Sixteen studies evaluated marginal and internal fit, 5 evaluated accuracy, 3 evaluated fracture resistance, and 1 evaluated long-term clinical performance. Although most studies reported acceptable clinical outcomes for both workflows, 11 studies showed better results with the conventional workflow, 10 with the digital workflow, and 2 reported that the outcomes of the workflows were similar.
CONCLUSIONS
Clinically acceptable values have been reported for the parameters evaluated in both digital and conventional workflows, and no consensus has been reached regarding the more efficient method.
PubMed: 37716898
DOI: 10.1016/j.prosdent.2023.08.005 -
International Journal of Computerized... Sep 2022With the development of new materials, 3D printing has had an immense impact on dentistry. The latest innovations are the direct manufacturing of temporary and permanent...
AIM
With the development of new materials, 3D printing has had an immense impact on dentistry. The latest innovations are the direct manufacturing of temporary and permanent crown and bridge restorations, inlays, onlays, and veneers. In the present case report, 3D-printing technology was used to control and adjust the occlusal rehabilitation with 3D-printed crowns.
MATERIALS AND METHODS
A 44-year-old male patient with pathologic dental attrition visited the Department of Restorative Dentistry at the University of Würzburg (Würzburg, Germany). The attrition process was far advanced, and no conventional conservative therapy was indicated. For the rehabilitation of the tooth substance loss, dental height, and appearance, a permanent solution with dental crowns was elected. After the preparation, the restorations were constructed digitally. For the control of the occlusal height, appearance, and color, the restorations were fabricated with a 3D printer and temporarily cemented. The crowns showed a high precision, and only minimal occlusal corrections were needed. After a trial period of 2 weeks and another fine occlusal adjustment, the temporary crowns were removed and scanned. The data were matched to the original construction file, which could be used to optimize the final rehabilitation. The final restorations were made of monolithic zirconia, with only minimal occlusal corrections required.
CONCLUSION
At the present time, dentistry is experiencing a great shift toward new and interesting production solutions with 3D-printing technologies. Such technologies give dentists the ability to create more predictable and cost-effective treatments. 3D printing is already being used to create temporary and definitive dental crowns as well as complex treatments, as is shown in the present case report. (Int J Comput Dent 2022;25(3):325-332; doi: 10.3290/j.ijcd.b3380909).
Topics: Adult; Computer-Aided Design; Crowns; Dental Prosthesis Design; Humans; Male; Occlusal Adjustment; Printing, Three-Dimensional; Stereolithography
PubMed: 36125805
DOI: 10.3290/j.ijcd.b3380909 -
Evidence-based Dentistry Dec 2022Data sources Electronic search through PubMed (Medline), CENTRAL (Cochrane) and Embase databases in November 2021. Grey literature searches (OpenGrey, Pro-Quest,... (Meta-Analysis)
Meta-Analysis Review
Data sources Electronic search through PubMed (Medline), CENTRAL (Cochrane) and Embase databases in November 2021. Grey literature searches (OpenGrey, Pro-Quest, National research register and the register of clinical studies hosted by the US National Institute of Health).Study selection Randomised in vivo clinical trials (RCTs) with at least two-year follow-ups, that compared the longevity of adhesively luted indirect ceramic restorations against conventionally cemented indirect metal restorations. The teeth studies had to be about single tooth restorations, on premolars or molars, with sufficient information available for extraction; eg outcome assessment, reason for failure. No language or time restrictions were applied.Data extraction and synthesis Two authors performed study selection, data extraction and quality assessment independently and in duplicate. The following clinical data was extracted: number of participants and dental health status, location of the cavosurface margin, cavity type, reason for intervention, methods and materials for treatment, follow-up, lesion activity at moment of restoration placed, lesion extension (surfaces of restoration), lesion margin (enamel or dentine). It was decided if the restoration was renewed, repaired or re-cemented, then this was classed as outcome failure. Grading of evidence was performed according to the GRADE network.Results After duplicates were removed, 2,667 underwent title screening, 389 abstract screening, and 186 went on to have full text screening with 72 being excluded. In total, 110 eligible articles were then excluded from the 114 that were assessed leaving four RCTs meeting the eligibility criteria and being included in the synthesis, published between 2000 and 2013. Two studies were parallel-arm, the other two, split-mouth design. Overall, 443 restorations had been placed, 212 were adhesively luted ceramic, and 213 conventionally cemented metal restorations; these were all gold. The follow-up periods ranged from 5-7 years. Two studies compared inlays only, one looked at partial crowns only, and the fourth full crowns. The lowest failure rates were found for metal restorations, ranging from 0-11%. The failure rates for ceramic inlays and partial crowns were 5-9% over the same observation period. The failure rates for ceramic full crowns were 36% after five years. The most common failure for ceramic was found to be fracture of the restoration, whereas caries was the most frequent cause of failure for the gold restorations.Conclusions The risk of bias was high for all four studies and the grading of evidence showed a low level of evidence. Only one meta-analysis could be performed comparing conventionally cemented metal vs adhesively luted ceramic restorations, showing the relative risk to fail for conventionally cemented metal indirect restorations is significantly lower than adhesively luted ceramic indirect restorations.
Topics: Humans; Dental Restoration, Permanent; Crowns; Gold; Inlays; Ceramics; Dental Caries; Dental Restoration Failure
PubMed: 36526847
DOI: 10.1038/s41432-022-0837-7 -
Compendium of Continuing Education in... Oct 2023Surgical crown lengthening (SCL) is the treatment of choice to ensure healthy tissues when subgingival tooth defects encroach on the biologic width.1 However,...
Surgical crown lengthening (SCL) is the treatment of choice to ensure healthy tissues when subgingival tooth defects encroach on the biologic width.1 However, restorative techniques employing adhesive dentistry may provide viable alternatives to or complement SCL in select cases without the repercussions of surgical bone removal and open interproximal spaces. One such clinical technique, deep margin elevation (DME), employs a direct restoration to relocate the cervical margin of small subgingival defects of posterior teeth supragingivally. The "elevated" margin simplifies impression-making and bonding of indirect restorations, especially inlays and onlays. Recent scientific systematic literature reviews indicate favorable clinical outcomes and suggest that DME restorations made with scrupulous care have high success rates and are compatible with periodontal health. Optimal working field isolation, meticulous placement of matrices, proper bonding and buildup procedure, as well as regular maintenance and follow-up are essential for success. This article provides an overview of this approach.
Topics: Dental Restoration, Permanent; Crown Lengthening; Dental Cements; Inlays; Crowns
PubMed: 37850958
DOI: No ID Found