PubMed · 15957637
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William P D Wynne, Karl Leinfelder. 2005. Material selection: a case report.. https://pubmed.ncbi.nlm.nih.gov/15957637/
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Margin cracks in loaded brittle dome structures are investigated. Dome structures consisting of glass shells filled with polymer resin, simulating the essential features of brittle crowns on tooth dentin, provide model test specimens. Disk indenters of diminishing elastic modulus are used to apply axisymmetric loading to the apex of the domes. Previous studies using hard indenters have focused on fractures initiating in the near-contact region of such specimens, including radial cracks at the glass undersurface directly below the contact axis. Here, we focus on fractures initiating at the remote support margins. Margin cracks can become dominant when loading forces are distributed over broad contact areas, as in biting on soft matter, here simulated by balsa wood disks. Cracks preinitiated at the dome edges during the specimen preparation propagate under load around the dome side into segmented, semilunar configurations reminiscent of some all-ceramic crown failures. Finite element analysis is used to determine the basic stress states within the dome structures, and to confirm a shift in maximum tensile stress from the near-contact area to the dome sides with more compliant indenters.
OBJECTIVES: There is currently no standardised technique to measure the amount of coronal dentine remaining in a root-treated tooth after crown preparation. The aim of this study was to develop a method of measuring remaining coronal dentine in root-treated teeth and to propose an index for grading tooth restorability. METHODS: The study recruited 20 patients who had completed molar endodontic treatment at the Eastman Dental Hospital and had been prescribed an amalgam coronal-radicular core with a full coverage cast restoration. Using a series of interlocking special trays and impressions, a method was devised to produce a cast of the amount of remaining dentine coronal to the finish line after crown preparation. This cast was scanned using a laser profilometer and the volume of remaining dentine was calculated. A tooth restorability index (TRI) was developed to assess the strategic value of the remaining dentine. The TRI allowed scores of 0-3 in each sextant with a maximum score of 18 per tooth. RESULTS: Twenty teeth were scored by three examiners and the TRI scores varied from 2 to 13. The volume of coronal dentine varied from 61.73 to 232.22 mm(3). CONCLUSIONS: A tooth restorability index has been devised to assess the strategic value of remaining dentine. A Kappa statistic was calculated to produce values of 0.584, 0.688 and 0.720, giving moderate-good agreement between the examiners.
Dental implants have become a widely accepted method for replacing missing teeth. While many oral surgeons and periodontists are actively involved in the surgical placement of dental implants, many general dentists do not perform such placements because they are intimidated by the seeming complexity of the procedures and hardware. In response to perceived complexity, dental implant manufacturers have developed implant systems that facilitate and simplify impression taking. As such simplified protocols become more common, implant-borne restorations will become more widely used by the profession as a routine treatment modality. This article describes a simple technique for restoring a single-tooth posterior Straumann implant.