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At least 253 records · Page 14Linked to original sources

Customized brackets and archwires for lingual orthodontic treatment.

After 20 months of clinical testing and more than 600 bonded arches, brief interim conclusions can be drawn on treatment with a new lingual bracket system, one that differs fundamentally from conventional appliances in both design and manufacture. The demand for maximum individuality is met by using state-of-the-art computer-aided design/computer-aided manufacturing technology to fuse the 2 normally separate processes of bracket fabrication and bracket positioning. Both the brackets and the pertinent archwires are customized. Additional advantages of the system include direct and thus simplified rebonding in the event of bracket loss, more precise finishing, and enhanced patient comfort.

Computer-Aided Design↗

Prevention of periodontal diseases.

The ultimate goal of periodontal disease prevention is to maintain the dentition over a lifetime in a state of health, comfort, and function in an aesthetically pleasing presentation. This article focuses on primary and secondary periodontal disease prevention as they relate to gingivitis and periodontitis. Risk assessment, mechanical plaque control, chemical plaque control, current clinical recommendations for optimal prevention, and future preventive strategies are discussed.

Dental Plaque↗

Comparative assessment of the roughness, hardness, and wear resistance of aesthetic bracket materials.

OBJECTIVE: The purpose of this study was to assess critical properties of orthodontic aesthetic bracket materials. METHOD: Samples of polycarbonate, poly(oxy)methylene, ultra high molecular weight polyethylene (UHMWPE), and polycrystalline alumina raw material used from bracket manufacturing were subjected to: (a) profilometry for the determination of Ra, Rq, Rmax and Rz roughness parameters; (b) Vickers hardness (HV50) testing; and (c) wear resistance determined by the scratch test. The results were analyzed with one-way ANOVA and Tukey multiple comparisons test at alpha=0.05 level of significance. RESULTS: The UHMWP and alumina specimens showed the highest roughness values for all parameters. The highest hardness, amongst the polymeric raw materials, was obtained from the poly(oxy)methylene appliances. Differences were also noted between the polycarbonate raw material of different manufacturers implying an effect from the manufacturing process. With the exception of alumina, the highest wear resistance was found for the poly(oxy)methylene specimens. SIGNIFICANCE: The results of this study reveal the variability among aesthetic plastic bracket raw materials, their reduced hardness and wear resistance relative to alumina as well as the inappropriateness of UHMWPE as alternative bracket material.

Aluminum Oxide↗

The further development and validation of the Liverpool Oral Rehabilitation Questionnaire: a cross-sectional survey of patients attending for oral rehabilitation and general dental practice.

BACKGROUND: Since the first version of the Liverpool Oral Rehabilitation Questionnaire (LORQ) was first published in 2004, the questionnaire has been modified to include more detail on chewing and appearance, and also details of denture, dental and implant status. AIM: The aim of this study is to report the ongoing development and validation of the LORQ version3. METHODS: A postal survey of the LORQv3 and OHIP-14 questionnaires was performed in April 2004 of 164 patients who had attended the oral rehabilitation clinic from February 2000. In addition The LORQv3 was administered to 349 patients attending six General Dental Practices, based in Liverpool, attending for routine care. RESULTS: Patients attending GDP scored appreciably better on most items in the LORQv3. The questionnaire discriminated between cancer and non-cancer oral rehabilitation patients in items such as swallowing, chewing, trismus, drooling and food clearance. There was no significant difference between rehabilitation groups for any of the seven OHIP-14 domains. The LORQv3 demonstrated good criterion validity when compared to the OHIP-14 with social items in the LORQv3 correlating well with items of the OHIP-14. Conversely various LORQv3 items did not have strong correlates within the OHIP-14 thus endorsing the additional items in the LORQv3.

Adolescent↗

Mandibular distraction osteogenesis in hemifacial microsomia: long-term follow-up.

AIM: Prospective, longitudinal, clinical long-term follow-up study of a homogeneous sample of children affected by hemifacial microsomia and treated by mandibular distraction osteogenesis. MATERIAL: Eight patients affected by types I and II hemifacial microsomia were operated on at an average age of 5.6 years with an average follow-up of 5.8 years. METHODS: Vertical changes were measured on postero-anterior cephalometric and panoramic radiographs taken sequentially. RESULTS: Angular changes of the infraorbital and nasal floor planes were not significant, showing that distraction osteogenesis starting after 5 years of age did not influence the maxillary skeletal base. Occlusal (plane) cant was reduced by 7 degrees on average following distraction osteogenesis, showing good dentoalveolar plasticity. Mandibular vertical changes showed a gradual return of the asymmetry, with growth in all patients (the ratio between affected and non-affected rami returned by 77% of the correction obtained by means of distraction 5 years postoperatively). CONCLUSION: Although aesthetic and psychological advantages of distraction osteogenesis are well accepted it should only be applied after careful patient selection and honest explanation of the long-term recurrence by genetically determined craniofacial growth patterns.

Cephalometry↗

Maxillary lateral incisor implants: planning with the aid of orthodontics.

Implants are commonly used to replace congenitally missing lateral incisors in adolescent orthodontic patients. However, these restorations are often challenging for the orthodontist, surgeon, and restorative dentist. In some patients the space across the alveolar crest is too narrow to permit the surgeon to place the implant. Occasionally the root apices of the adjacent central incisor and canine are in close proximity. In other cases the ridge thickness could be inadequate and require augmentation. When the orthodontist opens the space, the papilla heights are adversely affected. Some adolescent patients have altered passive eruption after orthodontic treatment, which affects the level of the gingival margins. Finally, questions commonly arise regarding the appropriate age for implant placement in these young patients. If not addressed, these issues could compromise the aesthetics of the implant restoration. This article will use several clinical examples to discuss each of these 6 potential problems and provide guidelines for their solutions.

Adolescent↗

Gingival melanin pigmentation and its treatment with the CO2 laser.

OBJECTIVE: There are only a few reports in the literature evaluating the effects of the carbon dioxide (CO2) laser on gingival melanin pigmentation (GMP). This study was performed to evaluate the effects of the CO2 laser at superpulse mode, applied for gingival depigmentation. STUDY DESIGN: GMP at the anterior maxillary and mandibular gingiva of 10 patients was treated using the superpulsed CO2 laser (10 watts, 0.8 mm spot size, 20 Hz, 10 milliseconds). Pigmented areas were measured on pre- and postoperative standard digital images by the aid of an image- analyzing software. Statistical analysis of the data was performed by Mann Whitney U test. RESULTS: Ablation of the hyperpigmented gingiva was accomplished with minimal carbonization and almost no bleeding. Postoperative healing was uneventful with no significant postoperative pain. Two cases of partial repigmentation were observed during 24-month follow-up. Statistical analysis of the data revealed a significant difference between pre- and postoperative measurements of pigmented area. CONCLUSION: Application of the superpulse mode of CO2 laser appears to be an effective and safe method for the elimination of GMP.

Adult↗

The anatomy of a smile.

The anatomy of the smile is an integral part of dentistry. Its understanding involves close scrutiny of all elements of the oral region. It is not enough to establish the size of teeth based on the high and low lip lines, size of the mouth, and a shade to blend with the age and complexion. To create a harmonious smile the dentist must maintain or create the normal curvature of the lips, proper exposure of the red zone of the lips, an undistorted philtrum, and undisturbed nasolabial grooves. These entities, maintained in harmony with the exposed teeth, constitute the anatomy of a smile. In order that patients may be served properly, the smile must be understood, recorded, and analyzed so that desirable aspects may be preserved and graceless components returned to attractiveness.

Age Factors↗

Use of heat-pressed leucite reinforced porcelain in "difficult" veneer cases: a clinical report.

Two clinical situations are presented where a heat-pressed leucite reinforced ceramic veneer system was used. For these situations the system was advantageous when veneers (1) required bulk or variable thicknesses or (2) were under load from function and parafunctional activity. This porcelain veneer system addressed some of the concerns associated with standard feldspathic porcelain and castglass systems. Practitioners should consider its use for situations that require a stronger veneer material.

Adult↗

Establishing the gingival emergence profile of restorations by using a resilient gingival replica.

All references to gingival morphology are destroyed once the die is trimmed during construction of crowns, onlays, or veneers. The need for reconstruction of a gingival replica to assist in the reproduction of a restoration's gingival contour and emergence profile is discussed. A simple, practical approach to duplicate the natural sulcus and free gingival morphology with currently available materials is presented. The advantages and limitations of implementing this technique and its multiple uses in prosthodontic and implant reconstructions and implant cases are presented.

Crowns↗

[Patient perception of functional and cosmetic outcome of orthognathic surgery. Retrospective analysis of 45 patients].

INTRODUCTION: Orthognathic surgery is generally indicated for the treatment of maxillo-mandibular deformities. Surgery is performed to repair functional abnormalities, but also has a cosmetic impact. MATERIAL AND METHODS: We conducted a retrospective study of 60 patients who underwent orthognathic surgery in 1996 and 1997 in order to assess patient perception of functional and cosmetic outcome. A questionnaire was sent to all patients one year after their surgery; 45 responded. RESULTS: We noted cosmetic, functional, and psychological changes. Patients considered that the changes were for the better. For functional abnormalities, 88.9% considered their occlusion had improved and 80% their chewing; 73.4% reported psychological improvement stating they had more self-confidence; 97.8% considered their cosmetic aspect had improved. DISCUSSION: This study enabled us to assess patients' perception of surgical outcome. It must be recalled that the patient basically decides to undertake surgery for cosmetic reasons while the surgeon proposes surgery to improve function. The psychological consequences of orthognathic surgery must be taken into account because the impact is considerable.

Attitude to Health↗

patients' satisfaction with different types of veneer restorations.

OBJECTIVES: The aim of this study was to measure the satisfaction of patients with respect to the aesthetics of veneer restorations (VRs) and to identify potential factors influencing their satisfaction. MATERIALS AND METHODS: One hundred and eighty VRs of three different types (direct composite, indirect composite and porcelain) were placed on anterior teeth. Patients were asked to fill in questionnaires at baseline and at one- and two-year recalls. RESULTS: At baseline the overall satisfaction was 76%, after two years this was 78%. The variable 'type of VR' was the only factor measured that had a significant influence on the satisfaction of the patient. At the two-year evaluation patients with porcelain VRs were more satisfied than those with direct composite VRs (P < 0.05). CONCLUSIONS: From the results of this study it is concluded that differences in clinical procedures had no effect on satisfaction. Also the number of VRs had not influenced the level of satisfaction. After two years a significant difference was observed for the variable 'type of VR', with the best results for porcelain.

Composite Resins↗

Psychological effects of aesthetic dental treatment.

OBJECTIVE: To demonstrate that aesthetic restorative dental treatment, using the porcelain laminate veneer, has a positive effect on the self-esteem of a patient. METHODS: A study group of 17 patients, unhappy with their dental appearance, were assessed psychologically at the pre-operative, immediate post operative and 6 month review stages. Porcelain laminate veneer restorations were used to improve the dental aesthetics for the patients in the study group. A comparison group of 27 subjects, without a dental appearance problem, were also psychologically assessed at comparable intervals. The assessments included Cattell's 16PF Personality Inventory, a Body-Esteem index, a computer administered version of the Repertory Grid technique and semi-structured interviews. RESULTS: The results showed that there were no significant differences between the study and comparison groups on any first or second-order factor of the 16PF. However, highly significant changes in a positive direction (p < 0.005) were observed in the study group in responses to a Body-Esteem questionnaire at each stage in the procedure. Comparison group changes were not significant. Repertory Grid analyses showed a significant overall convergence in the study group compared with the comparison group. There were also significant positive shifts amongst the study group in the normalised ratings of "self' on several of the constructs. Interviews confirmed the Repertory Grid findings. CONCLUSIONS: The study shows that aesthetic restorative treatment has a positive effect on patients' self-esteem.

Adult↗

Dimensional changes during veneering procedures on discoloured teeth.

OBJECTIVES: The aim of the study was to determine the dimensional changes of teeth when veneering procedures are involved. METHODS: Fifteen discoloured central incisors were selected from a group of 180 veneer restorations (VRs) composed of three different types of materials (direct resin composite, indirect resin composite and porcelain). Impressions and dies were made before treatment, after preparation and after placement and finishing the restoration. Contact stylus profilometry and subsequent analysis of the 3-D surface images provided quantitative data of the differences between the various treatment phases. RESULTS: The preparation reduction was the most for indirect resin composite VRs and the least for direct resin composite VRs. All veneer restorations showed nearly the same thickness and dimensional change after treatment, except one, which resulted in an additional increase of volume of the tooth. CONCLUSION: From the results of this study it is concluded that the dimensions of a discoloured tooth treated with a veneer restoration unintentionally increased, resulting in overcontour.

Analysis of Variance↗

Porcelain veneers: a review of the literature.

OBJECTIVES: Porcelain veneers are steadily increasing in popularity among today's dental practitioners for conservative restoration of unaesthetic anterior teeth. As with any new procedure, in vitro and in vivo investigations are required to assess the ultimate clinical efficacy of these restorations. The current literature was therefore reviewed in search for the most important parameters determining the long-term success of porcelain veneers. DATA SOURCES: Laboratory studies focusing on parameters in prediction of the clinical efficacy of porcelain veneers such as the tooth preparation for porcelain veneers, the selection and type of the adhesive system, the quality of marginal adaptation, the resistance against microleakage, the periodontal response, and the aesthetic characteristics of the restorations have been reviewed. The clinical relevance of these parameters was then determined by reviewing the results of short and medium to long-term in vivo studies involving porcelain veneers performed during the last 10 years. CONCLUSIONS: The adhesive porcelain veneer complex has been proven to be a very strong complex in vitro and in vivo. An optimal bonded restoration was achieved especially if the preparation was located completely in enamel, if correct adhesive treatment procedures were carried out and if a suitable luting composite was selected. The maintenance of aesthetics of porcelain veneers in the medium to long term was excellent, patient satisfaction was high and porcelain veneers had no adverse effects on gingival health inpatients with an optimal oral hygiene. Major shortcomings of the porcelain veneer system were described as a relatively large marginal discrepancy, and an insufficient wear resistance of the luting composite. Although these shortcomings had no direct impact on the clinical success of porcelain veneers in the medium term, their influence on the overall clinical performance in the long term is still unknown and therefore needs further study.

Cementation↗