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Odontology Apr 2024A total of 20 lithium disilicate glass-ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20... (Randomized Controlled Trial)
Randomized Controlled Trial
A total of 20 lithium disilicate glass-ceramics (IPS e.max CAD, Ivoclar Vivadent) and 20 resin nano-ceramic (Voco Grandio Blocks) onlay restorations were performed in 20 patients using a split-mouth design to compare the two-year clinical performance of lithium disilicate and resin nano-ceramic onlay restorations. Both restorations were evaluated at baseline, one-year, and two-year clinical follow-ups based on the modified United States Public Health Service (USPHS) criteria. Chi-square and Fisher's exact tests showed no statistically significant difference between Voco Grandio and IPS e.max ceramic restorations for all evaluated parameters during the different follow-up periods (p > 0.05). Cochrane's and MC-Nemar's tests indicated statistically significant differences regarding color match within the Voco Grandio group. They also indicated statistically significant differences in marginal discoloration, marginal adaptation, surface texture, and postoperative hypersensitivity within both ceramic material groups (p < 0.05). Kaplan-Meier curve indicated that the survival rate of both ceramic materials was 90%. After two years of clinical service, IPS e.max CAD and Voco Grandio onlay restorations exhibited similar clinical performance.
Topics: Humans; Dental Porcelain; Ceramics; Inlays; Mouth; Computer-Aided Design; Materials Testing
PubMed: 37542639
DOI: 10.1007/s10266-023-00841-w -
Cureus Jun 2023Introduction Tooth loss significantly impacts individuals' functional capabilities and quality of life. Fixed partial dentures have been a reliable treatment method for...
Introduction Tooth loss significantly impacts individuals' functional capabilities and quality of life. Fixed partial dentures have been a reliable treatment method for tooth replacement, with their fabrication often involving waxes. Waxes play a crucial role in creating a wax pattern in dental restoration; in particular, inlay waxes play a role in the shape, size, and contour of the restorations. However, these waxes have inherent disadvantages, including a high thermal expansion coefficient and propensity to warp or distort over time. This study aimed to compare wax patterns derived from two heat sources, an electric heat source and a conventional flame, to enhance their marginal accuracy and dimensional stability. Methods This study used an abutment resembling a prepared maxillary right central incisor designed via computer-aided design software and milled from zirconia. Inlay wax was melted using either an electrically heated spatula or a conventional flame, poured into a metal sleeve or a cuboidal mold, and allowed to cool to room temperature. The wax patterns were stored at room temperature for one hour and 24 hours. Subsequently, linear and volumetric measurements were taken to assess the shrinkage of the wax patterns. Results Patterns fabricated using the electric heat source showed less shrinkage at both time points for linear shrinkage and at one hour for volumetric shrinkage than those made using the conventional flame. However, by the 24th hour, patterns made with the electric heat source showed more volumetric shrinkage than those made with the conventional heat source. Significant shrinkage was observed between one hour and 24 hours for both heat sources, suggesting that wax patterns should be invested immediately after fabrication for maximum precision. Conclusions The results suggest that electric heating may be a viable alternative to conventional flame for minimizing discrepancies in wax patterns, particularly in the initial stages of wax pattern fabrication. However, prolonged use may lead to greater volumetric shrinkage with electric heating. These findings point to the potential of electric heating as an alternative to conventional flame in dental restorations, although further research is needed to validate and expand upon these findings.
PubMed: 37529510
DOI: 10.7759/cureus.41235 -
International Journal of Clinical... 2023The success of endodontic treatment in open apex teeth depends on the establishment of an ideal apical barrier so that apical canal space between the periodontium and...
AIMS AND BACKGROUND
The success of endodontic treatment in open apex teeth depends on the establishment of an ideal apical barrier so that apical canal space between the periodontium and the root canal system is filled. Biodentine is a calcium silicate-based cement having several advantages over mineral trioxide aggregate (MTA), glass ionomer cement (GIC), and calcium hydroxide in the treatment of teeth with open apices. Orthograde delivery of biodentine is technique-sensitive and requires multiple radiographs for verification, as well as retrograde placement of biodentine requires surgical intervention. To use the advantages of biodentine and to overcome the disadvantages of placement techniques, an innovative technique was done to obturate the tooth with an open apex using a custom-fit prefabricated BioRoot inlay in this case report.
CASE DESCRIPTION
In the present case, biodentine has been used as a BioRoot inlay to overcome the disadvantages of various management options of open apex with parallel dentinal walls. BioRoot inlay is an intraradicular custom-made prefabricated restoration which provides the three-dimensional seal of the root canal space and promotes an apical barrier formation in a wide-open apex. This BioRoot inlay, placed passively in the canal, had a good seal laterally and apically along with the Biodentine as sealer forming a monoblock. This sealer helps in sealing milder discrepancies between the plug and the root, providing a three-dimensional seal which had resulted in good healing of periradicular bone.
CONCLUSION
Biodentine, when used as BioRoot inlay, has been shown to induce faster periapical healing. It provides promising results when used in open apices with parallel walls. It establishes three-dimensional obturation and proper apical seal, which promotes effective root-end induction.
CLINICAL SIGNIFICANCE
It can be considered as the effective and definitive alternative for nonsurgical and surgical approaches to treating open apex.
HOW TO CITE THIS ARTICLE
Thiyagarajan G, Manoharan M, Veerabadhran MM, Biodentine as BioRoot Inlay: A Case Report. Int J Clin Pediatr Dent 2023;16(2):400-404.
PubMed: 37519983
DOI: 10.5005/jp-journals-10005-2580 -
Journal of Esthetic and Restorative... Feb 2024Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior... (Review)
Review
OBJECTIVE
Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior teeth at risk. Onlays are often more conservative of tooth structure which may be an advantage for teeth with large MOD preparations. It remains uncertain how onlays and crowns compare for posterior teeth with MOD tooth structure loss. The purpose of this systematic review was to compare the resistance to fracture, success rate, survival rate, and failure rate of teeth with MOD preparations restored with onlays or crowns.
MATERIALS AND METHODS
An electronic search queried Medline (PubMed), Embase (Ovid), Scopus, the Cochrane Library, and grey literature (OpenGrey) from database inception through April 29, 2023.
RESULTS
After eliminating duplicates and irrelevant records, 32 manuscripts were assessed. Only three publications met the criteria for inclusion. Most exclusions were due to poor reporting of restorative design and the amount of tooth structure remaining, or due to combining various restorative designs. Due to the limited sample size and high heterogeneity, no meta-analysis was conducted. One study observed a better outcome for onlays and two observed no difference. All three studies reported the mode of failure for crowns as more catastrophic whereas teeth with onlays could be salvaged.
CONCLUSIONS
Onlays may be an advantageous alternative to crowns for teeth with MOD preparations, but the level of evidence is insufficient to draw meaningful conclusions.
CLINICAL SIGNIFICANCE
Current evidence is insufficient to determine whether onlays or crowns are providing a different outcome when used to restore posterior teeth with MOD tooth structure loss. However, the fracture of teeth with MOD tooth structure loss restored with onlays appears to be less catastrophic than when restored with crowns.
Topics: Humans; Crowns; Inlays; Tooth
PubMed: 37497796
DOI: 10.1111/jerd.13114 -
Journal of Clinical Periodontology Nov 2023To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment-based ranking on the incidence of... (Meta-Analysis)
Meta-Analysis Review
Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta-analysis.
AIM
To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment-based ranking on the incidence of complications as well as their clinical effectiveness.
MATERIALS AND METHODS
Searches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra-operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient-reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair-wise and network meta-analysis (NMA) models.
RESULTS
Thirty-two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense-polytetrafluoroethylene, expanded-polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92-29.14). The latter group, however, ranked last in clinical VBG.
CONCLUSIONS
VRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non-resorbable membranes yield the most favourable results in relation to VBG and complications.
Topics: Humans; Dental Implantation, Endosseous; Bayes Theorem; Network Meta-Analysis; Alveolar Ridge Augmentation; Alveolar Process; Bone Regeneration; Polytetrafluoroethylene; Bone Transplantation; Membranes, Artificial; Dental Implants; Guided Tissue Regeneration, Periodontal
PubMed: 37495541
DOI: 10.1111/jcpe.13850 -
BMC Oral Health Jul 2023The accuracy of intraoral scanning plays a crucial role in the workflow of computer-assisted design/computer-assisted manufacturing. However, data regarding scanning...
BACKGROUND
The accuracy of intraoral scanning plays a crucial role in the workflow of computer-assisted design/computer-assisted manufacturing. However, data regarding scanning accuracy for inlay preparation designs are lacking. The purpose of this in vitro study was to evaluate the influence of the depth of the occlusal cavity and width of the gingival floor of the proximal box on the trueness and precision of intraoral scans for inlay restoration.
METHODS
Artificial teeth were used in this study. Four types of preparations for mesio-occlusal inlay were performed on each #36 artificial tooth depending on two different depths of the occlusal cavity (1 mm and 2 mm) and widths of the gingival floor of the proximal box (1.5 mm and 2.5 mm). Artificial teeth were scanned 10 times each with Cerec Primescan AC, and another scan was performed subsequently with a laboratory scanner as a reference (n = 10). Standard tessellation language files were analyzed using a three-dimensional analysis software program. Experimental data were analyzed using two-way analysis of variance and the Bonferroni multiple comparison test.
RESULTS
The narrow shallow group had significantly higher deviation values for trueness than the wide deep group (p < 0.05). The wide deep group had the lowest average deviation value for trueness and there was no significant difference between the narrow deep and wide shallow groups (p > 0.05). For the mean maximum positive deviation, the wide groups had significantly lower values than the narrow groups (p < 0.05). Trueness was affected by both the width and depth(p < 0.05), whereas the mean maximum positive deviation was affected by the width (p < 0.05). The mean maximum negative deviation was affected by all three factors (p < 0.05). Precision was affected by the depth and the interaction between the depth of the occlusal cavity and width of the gingival floor (p < 0.05).
CONCLUSIONS
The design of different inlay cavity configurations affected the accuracy of the digital intraoral scanner. The highest average deviation for trueness was observed in the narrow shallow group and the lowest in the wide deep group. With regard to precision, the narrow shallow group showed the lowest average deviation, and the narrow deep group showed highest value.
Topics: Humans; Inlays; Computer-Aided Design; Dental Care; Dental Caries; Gingiva
PubMed: 37488581
DOI: 10.1186/s12903-023-03233-2 -
Journal of Cataract and Refractive... Oct 2023To demonstrate the safety and efficacy of allogenic corneal inlays designed to increase the depth of focus (DoF) in treated eyes.
PURPOSE
To demonstrate the safety and efficacy of allogenic corneal inlays designed to increase the depth of focus (DoF) in treated eyes.
SETTINGS
Medipol University Hospital, Istanbul, Turkey.
DESIGN
Prospective case series.
METHODS
This study includes 50 eyes of 25 patients with a follow-up of 3 years. Emmetropic patients with presbyopia had implantation of allogenic corneal inlays in the nondominant eye. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and uncorrected near visual acuity (UNVA) were evaluated in all eyes. A subjective visual acuity test system (Multifocal Lens Analyzer 3.0 application) was used to analyze the DoF by measuring the defocus curves.
RESULTS
No significant difference between the treated and fellow eyes in UDVA and CDVA was found, whereas UNVA was significantly better in the treated eyes ( P = .20, P = .07, P < .01, respectively). Comparing to the preoperative CDVA, there was a 1-line decrease in CDVA in 6 (%24) patients. The mean defocus curves reveal a DoF of 1.1 diopters (D) for the untreated eye at the logMAR = 0.2 threshold. By contrast, the mean DoF of the treated eye and binocularly was 2.8 D. The areas under the curve were significantly better in the near, intermediate, and total distances in the treated eyes, whereas it was better for the far distances in the untreated eyes. All values were significant ( P = .023 total, P < .01 others).
CONCLUSIONS
Allogenic presbyopic inlay implantation may be safe and provided a clinically and statistically significant increase in the DoF leading to good far, intermediate, and near-visual acuity in emmetropic presbyopic patients.
Topics: Humans; Refraction, Ocular; Prospective Studies; Visual Acuity; Emmetropia; Presbyopia; Hematopoietic Stem Cell Transplantation; Patient Satisfaction
PubMed: 37487178
DOI: 10.1097/j.jcrs.0000000000001270 -
The International Journal of Esthetic... Jul 2023Important changes have occurred over the last decades in the clinical application of the strategies for posterior restorations - from amalgam to composites in direct... (Review)
Review
Clinical guidelines for posterior restorations based on Coverage, Adhesion, Resistance, Esthetics, and Subgingival management. The CARES concept: Part I – partial adhesive restorations.
Important changes have occurred over the last decades in the clinical application of the strategies for posterior restorations - from amalgam to composites in direct restorations and from traditional resistance form crowns to adhesive partial restorations such as onlays. Despite much evidence available for these advances, there are still very few established guidelines for common clinical questions: When does an indirect restoration present a clinical advantage over a direct one? When should one perform adhesive cusp coverage such as an onlay? When to implement resistance form designs in adhesive restorations? Which conditions create limitations for adhesion so that a resistance form preparation with a stiffer material such as a traditional crown might be more appropriate? In order to provide clinical guidelines, the present authors consider five parameters to support and clarify decisions - Coverage of cusps, Adhesion advantages and limitations, Resistance forms to be implemented, Esthetic concerns, and Subgingival management - the CARES concept. In Part I of this three-part review article, the focus is on clinical decisions for partial adhesive restorations regarding indications for direct versus indirect materials as well as the need for cusp coverage and/or resistance form preparations based on remaining tooth structure and esthetics.
Topics: Humans; Dental Restoration, Permanent; Esthetics, Dental; Tooth; Crowns; Inlays; Composite Resins
PubMed: 37462378
DOI: No ID Found -
Healthcare (Basel, Switzerland) May 2023Since Japan has implemented Universal Health Coverage (UHC), most dental treatments are covered by public health insurance. Therefore, when receiving fixed dental...
Since Japan has implemented Universal Health Coverage (UHC), most dental treatments are covered by public health insurance. Therefore, when receiving fixed dental restoration/prosthesis (FDRP) treatment, such as inlays, crowns, and bridges, the patient can choose whether or not it is covered by insurance. This study aimed to evaluate whether those who receive dental check-ups regularly chose uninsured FDRP treatment. Data were collected from 2088 participants, who had undergone FDRP treatment, via a web-based survey and analyzed. Among them, 1233 (59.1%) had received regular dental check-ups (RDC group) and 855 (40.9%) had not (non-RDC group). The multivariate logistic regression model showed that compared to the non-RDC group, those in the RDC group were statistically significantly associated with higher rates of good oral health behaviors (brushing teeth ≥ 3 times daily, odds ratios (OR):1.46; practiced interdental cleaning habitually, OR: 2.22) and received uninsured FDRP treatment more often (OR: 1.59), adjusted for socioeconomic factors. These results suggest that health policy interventions to promote access to RDC among individuals may improve the oral health of people and reduce the financial burden on the public health insurance system.
PubMed: 37297722
DOI: 10.3390/healthcare11111582 -
Dental Materials Journal Aug 2023The purpose of the present study is to evaluate the fracture resistance and the fit of CAD-CAM produced inlay-retained fixed partial dentures. Eighteen experimental...
The purpose of the present study is to evaluate the fracture resistance and the fit of CAD-CAM produced inlay-retained fixed partial dentures. Eighteen experimental groups were generated according to different CAD-CAM ceramic materials (zirconia, lithium disilicate, and zirconia-reinforced lithium silicate), different connector dimensions (12, 14, and 16 mm), and application of thermomechanical-aging (1,200,000 cycles of cyclic loading with simultaneous thermal cycling). Gap values of thermomechanically-aged groups were measured by using periapical radiographs. Then, the specimens were tested for fracture resistance and failure types were examined. The results were statistically analyzed (α=0.05). Higher gap values were observed after aging. Zirconia showed the highest fracture resistance values among the most of the experimental groups. In non-aged groups, the most frequent failure type was decementation in zirconia group. In the aged groups, the most frequent failure type was molar connector fracture. Thermomechanical-aging increased the gap values and decreased the fracture resistance values.
Topics: Inlays; Materials Testing; Dental Restoration Failure; Dental Stress Analysis; Dental Porcelain; Ceramics; Zirconium; Denture, Partial, Fixed; Computer-Aided Design
PubMed: 37271542
DOI: 10.4012/dmj.2022-230