[Parapulpal anchored Class IV restorations (2)].
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Biomedical subjects
Publications and source records attributed to W Gernet.
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A total of 107 bonded bridges could be re-evaluated after a mean period of 2.3 years and a maximum of 5 years. The preparation of mechanical retentive aids, such as grooves and bores resulted in a significant reduction of failure rates after one year. Electrolytical etching or silicoating of the CoCr restorations failed to have any effect on the failure rates of those bridges that were provided with adequate mechanical retention.
53 patients with 120 endosseous implants could be re-evaluated after a mean period of 2.7 years (maximum 5 years). Using casts from the upper with transfer posts and lower jaw, we measured the deviation of the implant axes from their ideal direction and localisation. Furthermore, we tried to find out, whether an unfavourable localisation compromised the prognosis of osseointegrated implants. Ideal, axial load by the prosthetic construction was often impossible because of unfavourable localisation of the implants. In a rank correlation analysis we found a significant influence of unfavourable localisation on prognosis in the group of hinge bars. Further weak correlations were revealed between loss of attachment and gingiva index which in turn was correlated with the plaque index.
The retentive part of parapulpal pins is often very bulky, and this may compromise the strength of the amalgam restoration. This in turn may considerably limit the range of applications of parapulpal pins. For this reason the geometry of the retentive pin portion was optimized with the aid of a finite element analysis. This manoeuvre resulted in a better stress distribution and improved retention, although the pin size was reduced. In clinical terms this implies a wider range of possible applications, because these pins allow safe anchorage of extensive amalgam restorations and do not affect the strength of the restoration.
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25 patients with reciprocal clicking in one or both temporomandibular joints were examined clinically and with an electronic axiographic system (SAS-System). Studying the direction of the sudden change of the condylar path during clicking, we established a tentative differential diagnosis of "centric anterior dislocations" of the disc and "eccentric posterior dislocations". Interpreting the axiographic pathways we found an eccentric posterior dislocation of the disc in 20 TMJs. But in at least 11 cases, which could be re-evaluated by magnetic resonance tomography (CMR), the diagnosis "eccentric posterior dislocation" was false. As we found several variations of anterior dislocations with a cranial and lateral deviation of the condylar path during opening clicking, the diagnosis of "eccentric disc dislocations" established by axiography was not reliable.
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It's be reported on the clinical behaviour of 37 for the first time used adhesive bridges and of 11 new installations integrated since 1985. The comparatively high failure rate is explained by an insufficient standardization and above all by preparation defects.
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The relationship between periodontal disease and dysfunction of the stomatognathic system was examined with the usual analysis of function in the context of a clinical study. In addition to neuromuscular incoordination, premature centric contacts deflect the mandible from a muscularly stable contact position and traumatize the periodontium mechanically. After suitable treatment, the causes of functional damage to the tooth attachment apparatus may be demonstrated in connection with an exact clinical registration of the findings by a simple instrumental analysis of function. This analysis may be adequately carried out with a semiadjustable articulator together with a rapidly transmitted curve.
Operative planning for progenia is carried out using prosthetic principles. Correction of a malpositioned mandible, modelling of incongruent dental arches, functional distribution of piers, and a favorable interalveolar connecting line form the basis for stable occlusion and articulation. The fitting of a prosthesis later is simplified by such intensive interdisciplinary cooperation.
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The exactitude of transferring castings was tested in two currently used methods of casting. Results showed that alginate casting from a remontage matrix and simple casting with IMPREGUM are sufficiently exact for clinical purposes. When the mixing relations between the casting substances is exactly maintained a transfer exactitude of +/- 0.11 is achieved by the methods tested. When there is a change in the relationship of the mixtures deviations of up to 0.20 mm occur.