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BMC Oral Health May 2024Endocrown in pediatric dentistry was rooted in the fundamental principles of preserving healthy dental tissues, leveraging contemporary adhesive methodologies.
BACKGROUND
Endocrown in pediatric dentistry was rooted in the fundamental principles of preserving healthy dental tissues, leveraging contemporary adhesive methodologies.
AIM
This research aimed on assessing and comparing the fracture resistance of pulpotomized primary molars when rehabilitated with zirconia crowns and two distinct types of endocrowns, namely E-Max and Brilliant Crios.
METHODS
The study involved thirty, anonymized, freshly extracted second primary molars that underwent pulpotomy. These teeth were then evenly divided into three groups, each consisting of ten specimens: the zirconia crown, the E-Max endocrown, and the Brilliant Crios endocrown groups. Post-pulpotomy, the teeth were prepared for their respective restorations. Subsequent to this preparation, the zirconia crowns, E-Max endocrowns, and Brilliant Crios endocrowns were secured. To evaluate the fracture resistance using a computer-controlled testing machine (Instron), a progressively increasing load was applied to each group until fracture occurred. The gathered data were then analyzed for outliers and subjected to normality testing using the Shapiro-Wilk and/or Kolmogorov-Smirnov tests, with a significance threshold set at 0.05.
RESULTS
There was no statistically significant difference in fracture resistance of pulpotomized primary molars among lithium disilicate (E-Max) group (mean=1367.59N), Brilliant Crios group (mean=1349.73N) and zirconia group (mean=1240.82N).
CONCLUSION
Endocrowns can be considered a promising restoration for pulpotomized primary molars.
Topics: Zirconium; Molar; Humans; Tooth, Deciduous; Dental Porcelain; Crowns; Pulpotomy; Tooth Fractures; Dental Stress Analysis; Ceramics; Dental Restoration, Permanent; Materials Testing
PubMed: 38764030
DOI: 10.1186/s12903-024-04332-4 -
Indian Journal of Dental Research :... Oct 2023The need to perform restorations with a natural appearance is one of the most challenging aspects of dentistry, and reproducing the colour of natural teeth in...
INTRODUCTION
The need to perform restorations with a natural appearance is one of the most challenging aspects of dentistry, and reproducing the colour of natural teeth in restorations is a clinical challenge due to the complex optical characteristics of dentition. Various procedures have been advocated in the literature to correct dental anomalies, particularly in the aesthetic region, such as tooth discoloration due to fluorosis or dentition spacing due to changes in tooth shape, such as peg laterals.
CLINICAL APPLICATIONS
Veneer are one of the most commonly used treatment modalities in such cases. As the use of ceramics necessitates the use of more opaque restorative materials or different thickness, obtaining adequate results in terms of the final colour of the restoration becomes increasingly difficult. The purpose of this study is to present a clinical case of smile rehabilitation in the anterior region with facets made of lithium disilicate, with the goal of achieving colour uniformity and demonstrating the benefits and achieving smile aesthetics.
TAKEAWAY LESSONS
Technological advancement such as intraoral scanner for impression making have significant improved the success of prosthesis. This case report presents conservative and aesthetic procedure in the management of closing the space in maxillary anterior region using lithium disilicate laminate veneers with trios software.
Topics: Humans; Dental Veneers; Esthetics, Dental; Dental Porcelain; Smiling; Female; Adult; Dental Prosthesis Design; Computer-Aided Design
PubMed: 38739834
DOI: 10.4103/ijdr.ijdr_430_23 -
Scientific Reports May 2024This study aimed to assess the knowledge regarding impacts, causes and management of black triangles (BT) among participants from different educational backgrounds... (Observational Study)
Observational Study
This study aimed to assess the knowledge regarding impacts, causes and management of black triangles (BT) among participants from different educational backgrounds including dental students, dentists and laypeople. This descriptive cross-sectional observational research included 435 participants who comprised 4 groups: pre-clinical (3rd year) dental students, clinical (4th and 5th year) dental students, dentists, and laypeople. A constructed self-reported questionnaire was utilized to assess participants' demographic data and their knowledge of the impacts, causes and management of BT. The VAS scale was used to assess participants' ratings for the impacts of BT on esthetics, with 0 meaning no impact and 10 meaning very severe negative impacts. The most reported treatments for BT were "cannot be treated" 99.3% and "non-surgical periodontal treatment" 67.1%. Meanwhile, the least reported was "modify the porcelain" 41.8%. The most reported cause of BT was "periodontal disease" 85.1%. However, the least reported were "parafunction" and "deep implants" 33.1% each. Dental professionals had better knowledge of the causes (t = 8.189, P < 0.001) and management (t = 8.289, P < 0.001) of BT than the non-dental participants. The dentists had the best knowledge, while the laypeople had the least knowledge of the causes (F = 62.056, P < 0.001) and treatment (F = 46.120, P < 0.001) of BT. The knowledge of the causes (t = 0.616, P = 0.538) and treatment (t = 1.113, P = 0.266) for BT was not significantly different between males and females. Age was not significantly related to the total knowledge about the causes (r = -0.034, P = 0.475) or treatment (r = -0.034, P = 0.482) for BT. Dental professionals had better knowledge of the impacts, causes and management of BT than the non-dental participants. The dentists were the best, while the laypeople were the worst in this regard. Age and gender had no relationships with the knowledge of causes or management of BT.
Topics: Humans; Male; Female; Dentists; Adult; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Surveys and Questionnaires; Students, Dental; Young Adult; Middle Aged
PubMed: 38735998
DOI: 10.1038/s41598-024-61356-0 -
BMC Oral Health May 2024This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime...
BACKGROUND
This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components.
METHODS
Five distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed.
RESULTS
All of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones.
CONCLUSIONS
With the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.
Topics: Titanium; Crowns; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Humans; Dental Stress Analysis; Dental Abutments; Benzophenones; Dental Porcelain; Polyethylene Glycols; Dental Materials; Polymers; Ketones; Zirconium; Dental Implants, Single-Tooth; Materials Testing; Dental Implant-Abutment Design; Biomechanical Phenomena
PubMed: 38730391
DOI: 10.1186/s12903-024-04328-0 -
Cureus Apr 2024In order to effectively address challenges related to anterior teeth restoration and achieve natural-looking results, considerations such as shape, size, gingival...
In order to effectively address challenges related to anterior teeth restoration and achieve natural-looking results, considerations such as shape, size, gingival contour, and color are crucial. Due to an increasing desire for visually appealing alternatives that are free of metal, materials such as dental zirconia have become popular because of their superior aesthetics and mechanical characteristics. This case report presents clinical insights into anterior teeth rehabilitation with the use of layered zirconia fixed dental prostheses. It delves into the experiences associated with zirconia dental restorations on both endodontically treated and vital abutments, aiming to discern how various factors influence treatment outcomes. Beginning with the design of the restoration, its intricacies significantly impact its fit, strength, and overall durability. Moreover, the composition of zirconia used plays a pivotal role, as different formulations offer varying degrees of mechanical properties, influencing factors such as resilience and wear resistance. The shade selection is also scrutinized, as it directly affects the restoration's aesthetic integration with surrounding natural teeth, contributing to a more harmonious smile. Furthermore, the layering technique employed, particularly when additional porcelain or ceramic layers are applied, is essential for both cosmetic enhancement and structural integrity. Lastly, considerations of occlusion are paramount, ensuring proper alignment and contact between teeth to prevent premature wear and discomfort. By exploring these facets in zirconia restorations across different abutment types, this inquiry seeks to illuminate best practices for achieving favorable treatment outcomes in dental restoration procedures. The choice of zirconia composition, framework design, and shade must be carefully tailored to suit the characteristics of each individual abutment. This emphasizes the significance of adopting a tailored approach to tackle the distinct challenges posed by every clinical scenario. The manuscript provides detailed observations from a clinical case involving the restoration of anterior teeth utilizing monolithic zirconia-fixed dental prostheses. Through a combination of root canal treatment and composite buildup, successful restoration was achieved, with meticulous attention paid to aesthetic considerations. The utilization of computer-aided designing/computer-aided manufacturing (CAD/CAM) technology in crafting zirconia restorations ensured precise fit and superior biocompatibility, contributing to the overall success of the treatment. The study underscores the importance of personalized treatment strategies in achieving optimal outcomes in anterior teeth restoration, emphasizing the need for careful consideration of various factors such as design, composition, and shade selection. Overall, the findings shed light on the potential of zirconia-based restorations in addressing the unique challenges associated with anterior teeth rehabilitation, offering valuable insights for dental practitioners striving to deliver aesthetically pleasing and functionally sound outcomes for their patients.
PubMed: 38725786
DOI: 10.7759/cureus.57889 -
Journal of Applied Biomaterials &... 2024Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs)... (Review)
Review
Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs) are more appropriate. This study's objective was to analyze the available research on full-ceramic RBFDPs. In this study, Web of Science, MEDLINE/PubMed, Scopus, Embase, Cochrane Library, and Google Scholar databases were searched for articles published in English between 2010 and 2020. A total of 14 studies were reviewed based on the eligibility criteria. The results showed that using a cantilever design with one abutment had an advantage over two abutments. Additionally, it was proposed that preparations designed with retentive aids, such as a proximal box, groove, and pinhole, could improve RBFDP survival rates. IPS e.max ZirCAD, In-Ceram alumina, and zirconia CAD/CAM were the most commonly used framework materials. Most studies used air abrasion, salinization, or hydrofluoric acid for surface treatment. Adhesive resin cements were the most frequently used type of cement. The survival rate of In-Ceram ceramics (85.3%-94.8%) was lower than that of In-Ceram zirconia and IPS e.max ZirCAD. Debonding, followed by framework fracture, was the leading cause of failure. Following 3-10 years follow-up, the survival percentage of all-ceramic RBFDPs ranged from 76% to 100%. Although RBFDPs have demonstrated satisfactory success as a conservative treatment, long-term follow-ups and higher sample sizes in clinical research are required to gain more reliable outcomes on the clinical success rate of various RBFDP designs.
Topics: Humans; Ceramics; Resin Cements; Dental Porcelain; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed, Resin-Bonded; Zirconium
PubMed: 38706266
DOI: 10.1177/22808000241250118 -
Clinical Oral Investigations May 2024To assess the long-term clinical performance of ceramic in-/onlays (CIOs) and cast gold partial crowns (CGPCs) in posterior teeth in terms of success, survival,...
OBJECTIVES
To assess the long-term clinical performance of ceramic in-/onlays (CIOs) and cast gold partial crowns (CGPCs) in posterior teeth in terms of success, survival, complications (biological, technical) and quality.
MATERIAL AND METHODS
In a retrospective study, a total of 325 patients were recorded after up to 24.8 years (mean 13.9 ± 3.8 years) having (pre-)molars restored with CIO (Empress I, Ivoclar Vivadent, n = 161) and CGPC (Degunorm, DeguDent, n = 164) by supervised undergraduate students. A total of 296 restorations were assessed clinically and radiologically in healthy and endodontically treated teeth using modified United States Public Health Service (USPHS) criteria. Cumulative success and survival rates of the restorations were calculated using Kaplan-Meier estimates. Biological and technical complications were recorded. Status of oral health comprising caries risk and localized periodontitis were assessed.
RESULTS
The cumulative success rates of CIOs were 92.1% and of CGPCs 84.2% after mean service times of 14.5 years. The annual failure rates of total service times were 0.5% in teeth restored with CIO (n = 155) and 0.7% in teeth restored with CGPC (n = 163). The cumulative survival rates of CIOs were 93.9% after a mean service time of 15.2 years and decreased to 91.7% after 23.5 years. The cumulative survival rates of CGPCs were 92.6% after a mean service time of 14.9 years and 91.8% after 23.5 years. Complications in CIOs (n = 149) were ceramic fracture (6.7%), secondary caries (4.7%), endodontic complication (2.7%) and tooth fracture (1.3%) compared to CGPCs (n = 147) with endodontic complication (8.8%), secondary caries (4.8%) and decementation (2.0%). Endodontically treated teeth restored with CIO or CGPC revealed significantly less often success compared with corresponding vital teeth (p = .02). CIOs and CGPCs revealed clinically and radiographically good and excellent qualities with 71.8% (107/149) and 68% (100/147) without any significant differences regarding type of restoration.
CONCLUSIONS
Both CIOs and CGPCs achieved high survival rates up to 24.8 years when performed by supervised undergraduate students. The longevity of the restorations may benefit from the intraoral repair of accessible defects and, in case of pulp infection or necrosis, an adequate endodontic management.
CLINICAL RELEVANCE
CIOs and CGPCs made by supervised undergraduate students are proper restoration types in posterior teeth in the long-term. An adequate preparation design, meticulous care in the inserting technique and constant biofilm removal due to proper oral hygiene combined with professional maintenance care are substantial. The clinical long-term performance was mostly limited by ceramic fractures in CIOs and endodontic complications in CGPCs.
Topics: Humans; Retrospective Studies; Crowns; Dental Restoration Failure; Female; Male; Adult; Inlays; Ceramics; Gold Alloys; Dental Caries; Dental Porcelain; Middle Aged; Dental Prosthesis Design; Tooth, Nonvital; Treatment Outcome
PubMed: 38702521
DOI: 10.1007/s00784-024-05682-7 -
BMC Oral Health May 2024This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to...
BACKGROUND
This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material.
METHODS
eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 μm AlO, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05).
RESULTS
The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK.
CONCLUSION
The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.
Topics: Benzophenones; Ketones; Dental Porcelain; Polyethylene Glycols; Resin Cements; Polymers; Dental Bonding; Surface Properties; Shear Strength; Materials Testing; Dental Stress Analysis; Acid Etching, Dental; Sulfuric Acids; Ceramics; Air Abrasion, Dental; Aluminum Oxide; Dental Veneers; Dental Etching; Humans
PubMed: 38698366
DOI: 10.1186/s12903-024-04269-8 -
Heliyon Apr 2024Environmental consciousness motivates scientists to devise an alternative method for producing natural fiber composite materials in order to decrease the demand for...
Environmental consciousness motivates scientists to devise an alternative method for producing natural fiber composite materials in order to decrease the demand for synthetic fibers. This study explores the potential of a novel composite material derived from madar fiber-reinforced epoxy with porcelain filler particulates, designed specifically for biomedical instrumentation applications. The primary focus is to assess the material's structural, mechanical, and antibacterial properties. X-ray Diffraction analysis was employed to discern the crystalline nature of the composite, revealing enhanced crystallinity due to the inclusion of porcelain particulates. Fourier-Transform Infrared Spectroscopy confirmed the chemical interactions and bonding mechanisms between madar fiber, epoxy matrix, and porcelain filler. Mechanically, the composite exhibited superior properties when addition of porcelain fillers, maximum results obtain in tensile strength of 51.28 MPa, flexural strength of 54.21 MPa, and impact strength of 0.0155 kJ/m2, making it ideal for robust biomedical applications. Scanning Electron Microscopy provided detailed insights into the morphology and distribution of the reinforcing agents within the epoxy matrix, emphasizing the fibrillated structure of madar fiber and the uniform dispersion of porcelain particulates. Importantly, antibacterial assays demonstrated the composite's potential resistance against common pathogenic bacteria, which is crucial for biomedical instrumentation. Collectively, this research underscores the promising attributes of the madar fiber reinforced epoxy composite with porcelain particulates, suggesting its suitability for advanced biomedical applications.
PubMed: 38681603
DOI: 10.1016/j.heliyon.2024.e29818 -
Journal of the Mechanical Behavior of... Jul 2024The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative...
The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative materials on the marginal/internal fit and fatigue behavior of endocrowns produced by CAD-CAM. Eight groups (n= 10) were considered through the combination of TRIOS 3 (TR) or Primescan (PS) IOS; 4-axes (CR; CEREC MC XL) or 5-axes (PM; PrograMill PM7) milling machines; and lithium disilicate (LD; IPS e.max CAD) or resin composite (RC; Tetric CAD) restorative materials. Specific surface treatments were applied to each material, and the bonding to its corresponding Endocrown-shaped fiberglass-reinforced epoxy resin preparations was performed (Variolink Esthetic DC). Computed microtomography (μCT) was performed to assess the marginal/internal fit, as well as a mechanical fatigue test (20 Hz, initial load = 100 N/5000 cycles; step-size = 50 N/10,000 cycles until a threshold of 1500 N, then, the step-size was increased if needed to 100 N/10,000 cycles until failure or a threshold of 2800 N) to evaluate the restorations long-term behavior. Complementary analysis of the fracture features and surface topography in scanning electron microscopy was performed. Three-way ANOVA and Kaplan-Meier test (α = 0.05) were performed for marginal/internal fit, and fatigue behavior data, respectively. PS scanner, CR milling machine, and RC endocrowns resulted in a better marginal fit compared to their counterparts. Still, the PM machine resulted in a better pulpal space fit compared to the CR milling machine. Regardless of the scanner and milling machine, RC endocrowns exhibited superior fatigue behavior than LD ones. LD endocrowns presented margin chipping regardless of the milling machine used. Despite minor differences in terms of fit, the 'IOS' and 'milling machine' factors did not impair the fatigue behavior of endocrowns. Resin-composite restorations resulted in a higher survival rate compared to glass-ceramic ones, independently of the digital devices used in the workflow.
Topics: Materials Testing; Composite Resins; Dental Porcelain; Computer-Aided Design; Mechanical Phenomena; Surface Properties; Mechanical Tests; Stress, Mechanical
PubMed: 38657286
DOI: 10.1016/j.jmbbm.2024.106557