Natural and restorative oral esthetics. Part II: Esthetic treatment modalities.
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Dental Enamel↗
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Results for “DENTAL RESTORATION, PERMANENT”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Evolution of glass-ionomer cements: a personal view.
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Dental Restoration, Permanent↗
Protecting esthetic restorations with mouthguards and other appliances.
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Athletic Injuries↗
Luminescent veneers.
The ultimate esthetic dentistry takes into account the conservation of healthy tooth structure integrated with biologic and long-term functional requirements. Materials and techniques that address these inseparable issues are necessary for true excellence. One such material has been presented for the fabrication of porcelain veneers without the need for overt tooth destruction to create masking ability and without an unsightly opaque appearance.
Dental Porcelain↗
Esthetic restoration of endodontically treated teeth: factors that affect prognosis.
Restoration of endodontically treated teeth involves a complex system of components and component interfaces designed to resist force. Dental materials, forces on teeth, clinical circumstances, and restorative design determine restoration success. A new classification evaluates number of canals, amount of remaining tooth surface, chamber space, canal quality, and canal orientation.
Adult↗
Rationalization of esthetic restorative dentistry based on biomimetics.
UNLABELLED: The exponential progressivism that characterizes the current decade often comes with substantial financial implications. Dental care is not spared by this phenomenon. However, new generations of concepts emerging from biomimetics provide the operator with the ability to restore the biomechanical, structural, and esthetic integrity of teeth. The development of adhesion and the evolution of porcelain veneers constitute striking examples of this nascent process. Indications for bonding porcelain are extending to more perilous situations (crown-fractured incisors, nonvital teeth), resulting in considerable improvements, comprising both the medical-biologic aspect (economy of sound tissues and maintenance of tooth vitality) and the socioeconomical context (decrease of costs compared to traditional and more invasive prosthetic treatments). CLINICAL SIGNIFICANCE: In the bonded porcelain veneer and its extensions, restorative dentistry has found new solutions for the anterior segment that balance the need for functional and esthetic reconstruction. The optimal stiffness of porcelain in thin section, the ideal surface characteristics, and the biomechanical continuum achieved through high performance bonding mean the crown of the tooth as a whole can support incisal or masticatory function. By the same token, the conduction of optical effects from within the tooth combined with the ideal surface features of the porcelain veneer make this restorative approach the ultimate in esthetic satisfaction, for both the practitioner and the patient.
Cuspid↗
Packable composites: overview and technical considerations.
OBJECTIVE: New composites, called packable or condensable composites, are being promoted as amalgam alternatives. The purposes of this review article are to identify these products, define new terminology associated with them, summarize the advertised properties for the materials, discuss the ideal properties for packable composites, review the properties of the major products, and critically evaluate the proposed handling procedures for these materials. REVIEW: The term packable is preferable to condensable for describing this new class of materials. All materials should be considered amalgam alternatives, not amalgam substitutes. The compositions and physical properties reported by manufacturers reveal that none of the materials represents a remarkable improvement over the properties of more traditional universal composites. The designs of Solitaire (Heraeus Kulzer), ALERT (Jeneric-Pentron), and SureFil (Dentsply/Caulk) are discussed in detail. The distinguishing characteristics of all packable compositions are less stickiness or stiffer viscosity than conventional composites, which allow them to be placed in a manner that somewhat resembles amalgam placement. CONCLUSIONS: Packable composites may allow more convenient placement in posterior sites and may offer some technique advantages over conventional composites. However, there is no evidence that their clinical properties are consistently better than those of conventional universal composites. CLINICAL SIGNIFICANCE: Packable composites may be selected as alternatives to amalgam or conventional universal composites, but they are not equal to or better than dental amalgam in all respects. Also, in most cases, mechanical properties of packable composites are not substantially better than those of most conventional universal composites.
Composite Resins↗
Amalgam substitutes: a critical analysis.
PURPOSE: Quality standards for restorations recently have been defined in Switzerland. Amalgam substitutes must meet restoration Grade 2 requirements (i.e., pulp and dental hard substance must be preserved, and both form and function of the tooth have to be reconstituted). The pertinent operative technique has to be simple and amalgam-like. A minimum service life of 8 years is required. This in vitro study investigated the clinical potential of several amalgam substitutes, taking into account the operative requirements, the defined restorative guidelines, and the required service life. MATERIALS AND METHODS: Potential amalgam substitutes evaluated in this study included compomers (Compoglass, Dyract, Dyract AP, Elan, F 2000) and resin-based composites (Alert, Ariston, Definite, Nulite, Solitaire, Surefil). The composites Adaptic and Tetric Cream, using a simplified placement technique, were tested as negative and positive controls, respectively. Marginal adaptation and wear properties were measured in vitro in mixed Class II cavities. Relative radiopacity was measured in terms of millimeters of equivalent aluminum. RESULTS: All compomers showed a radiopacity of 2.5 mm or more aluminum. Only Dyract AP and Elan were more wear resistant than amalgam. After stressing, the percentage of continuous margin was at best 31% overall and 17% in dentin only. Among resin-based composites, the minimum requirements of radiopacity were fulfilled only by Alert, Surefil, and Tetric. Only Definite, Surefil, Solitaire, and Tetric exhibited wear resistance greater than amalgam. After stressing, the best marginal qualities were 41% continuous margin overall, and 8% in dentin only.
Compomers↗
The clinical microscope in an aesthetic restorative practice.
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Dental Impression Technique↗
Instant orthodontics: viable treatment option or "quick fix" cop-out?
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Crowns↗
Effects of bleaching with carbamide peroxide gels on microhardness of restoration materials.
The objective of this in vitro study was to quantitatively assess the effects of bleaching with 10 and 15% carbamide peroxide (CP) on restoration materials by performing superficial microhardness analysis. Acrylic cylindrical containers (4 x 2 mm) were filled with the following restoration products: Charisma (Heraues Kulzer, Vila Santa Catarina, São Paulo, Brazil), Durafill VS (Heraeus Kulzer), Vitremer (3M, Sumaré, São Paulo, Brazil), Dyract (Dentsply, Petrópolis, Rio de Janeiro, Brazil), and Permite C (SDI, São Paulo, São Paulo, Brazil). Sixty samples were prepared of each restoration material. Twenty samples received bleaching treatment with 10% CP, 20 samples received bleaching treatment with 15% CP, and 20 samples were kept submerged in artificial saliva, which was replaced daily. The treatment consisted of immersion of the specimens in 1 cm3 of CP at 10 and 15% for 6 hours per day during 3 weeks, whereupon the test specimens were washed, dried, and kept immersed in artificial saliva for 18 hours. Then the test and control specimens were analyzed using a microhardness gauge. The Knoop Hardness Number (KHN) was taken for each test and control specimen at five different locations by applying a 25 g force for 20 seconds. The values obtained were transformed into KHNs and the mean was calculated. The data were submitted to statistical analysis by analysis of variance and Tukey test, p < .05. The means/standard deviations were as follows: Charisma: CP 10% 38.52/4.08, CP 15% 34.31/6.13, saliva 37.36/4.48; Durafill VS: CP 10% 18.65/1.65, CP 15% 19.38/2.23, saliva 18.27/1.43; Dyract AP: CP 10% 30.26/2.81, CP 15% 28.64/5.44, saliva 33.88/3.46; Vitremer: CP 10% 28.15/3.04, CP 15% 17.40/3.11, saliva 40.93/4.18; and Permite C: CP 10% 183.50/27.09, CP 15% 159.45/5.78, saliva 215.80/26.15. A decrease in microhardness was observed for the materials Dyract AP, Vitremer, and Permite C after treatment with CP at 10 and 15%, whereas no effect on either of the two composites (Charisma and Durafill) was verified. CLINICAL SIGNIFICANCE The application of the carbamide peroxide gels at 10 and 15% did not alter the microhardness of the composite resins Charisma and Durafill. In situ and clinical studies are necessary to enable one to conclude that the reduction in microhardness of the materials effectively results in clinical harm to the restorations.
Analysis of Variance↗
Esthetic techniques and restorative systems used in the second-year undergraduate dental curriculum.
Metal-free tooth-colored restorative systems for fabricating indirect intracoronal and extracoronal restorations have been developed because of patients' demand for superior esthetics. During the past decade, long-term clinical studies have demonstrated the success of many of these types of restorations in terms of function and esthetics. Ceramic veneers, all-ceramic crowns, ceramic onlays, and composite-resin inlays are becoming an integral part of contemporary clinical practice. The constant evolution in bonding techniques, adhesive systems, and cements plays a major role in the success of these metal-free restorations. In addition, home-bleaching procedures have become an integral part of the esthetically oriented dental practice. This article discusses the rationale, scientific basis, and implementation of a new undergraduate preclinical esthetics course for second-year dental students at the Louisiana State University Health Sciences Center School of Dentistry.
Crowns↗
Selecting nanotechnology-based composites using colorimetric and visual analysis for the restoration of anterior dentition: a case report.
Currently it is possible to use direct composites and layering techniques to replicate the complex internal structures, visible shape, color, and surface anatomy of natural teeth. To do so, however, requires dentists to understand the principles of nature and the science of dental materials to determine the most suitable restorative material for a specific indication. By incorporating relatively new technologies--colorimetric analysis, which provides computerized shade guide definitions of a tooth and essential information to verify shade mapping, and a new nanotechnology-based direct composite--into composite layering techniques, dentists can more predictably replicate the esthetics of natural teeth. This article presents a case in which both technologies, used in combination with a composite layering technique, contributed to the esthetic and functional restoration of the maxillary central incisors.
Adult↗
Selection defines design.
The era of "extension for prevention" used restorative materials and cavity preparation designs in an attempt to arrest the caries process. In the new era of "prevention to eliminate extension," many of the old limitations are no longer applicable because of advances in research and technology. The advances in restorative materials and adhesive technology require the use of an adhesive design concept when considering restorative material selection, preparation designs, and adhesive protocol and placement procedures and techniques. This adhesive design concept has been instrumental in the paradigm shift from the principles of extension for prevention to an ultraconservative principle of prevention to eliminate extension. From the early onset of the disease to initial placement of the restoration, this modern philosophy has three clinical objectives: prevention, preservation, and conservation. The clinician should strive to preserve the maximum integrity of the natural dentition by preventing the placement of the initial restoration, preserving and conserving tooth structure during the preparation of restoration, and conserving the tooth and restoration by increasing the longevity of the restoration between replacements. This article describes an incremental layering technique that uses a conservative restorative adhesive design concept (adhesive preparation design and protocol) for preparing, restoring, and finishing a Class IV restoration, and it demonstrates how the selection of a small-particle hybrid composite influences the preparation design. CLINICAL SIGNIFICANCE Selection of improved restorative materials that simulate the physical properties and other characteristics of natural teeth in combination with an adhesive design concept and preoperative considerations during the diagnostic and treatment planning phases of the restorative procedures provide the framework that ensures the optimal development of an esthetic restoration while preserving, conserving, and reinforcing the tooth-restoration complex.
Color↗
Influence of phosphoric acid pretreatment on self-etching bond strengths.
PURPOSE: The purpose of this investigation was to evaluate the influence of phosphoric acid pretreatment on shear bond strength of two self-etching bonding systems to enamel and dentin. MATERIALS AND METHODS: Forty-eight extracted third human molar teeth were mounted, embedded into polystyrene resin, polished with 600-grit aluminum oxide papers, and randomly divided into four groups (n = 12): group 1-Clearfil Liner Bond 2V (Kuraray Co. Ltd., Osaka, Japan); group 2-One Up Bond F (Tokuyama Corp., Tokyo, Japan); group 3-phosphoric acid (Condicionador Dental Gel, Dentsply Ind. Com. LTDA, Rio de Janeiro, Brazil) and Clearfil Liner Bond 2V; group 4-phosphoric acid and One Up Bond F. In groups 3 and 4 the substrate was pre-etched for 15 seconds with 37% phosphoric acid, rinsed, and dried with an air stream. In all groups adhesive systems were applied according to manufacturers' instructions and light cured; then a restorative composite resin (TPH Spectrum, Dentsply Ind. Com. LTDA) was placed in a polytef matrix and cured. The specimens were stored in humidity for 7 days at 37 degrees C. The shear bond strength test was performed in a universal test machine with a crosshead speed of 0.5 mm/min. All procedures were repeated for the dentin evaluation. Mean values were analyzed with two-way analysis of variance and Duncan tests (p < .05). RESULTS: The values obtained are listed in decreasing order: enamel-group 3 = 24.6 MPa, group 4 = 23.6 MPa, group 1 = 19.2 MPa, group 2 = 8.5 MPa; dentin-group 1 = 17.2 MPa, group 2 = 16.1 MPa, group 4 = 13.1 MPa, group 3 = 11.3 MPa. CONCLUSIONS: Under the conditions of this study, enamel etching with 37% phosphoric acid provided statistically significant higher shear bond strength values, regardless of the adhesive system. However, in dentin, for Clearfil Liner Bond 2V, phosphoric acid pretreatment negatively affected bond strength values. CLINICAL SIGNIFICANCE: The use of self-etching systems in composite-to-enamel bonding restorative techniques still needs improvement when compared with the high bond strengths obtained with phosphoric acid treatment. However, lower shear bond strengths were observed in dentin when phosphoric acid was used in association with either adhesive system.
Acid Etching, Dental↗
Effect of stepped exposure on quantitative in vitro marginal microleakage.
PURPOSE: The aim of this in vitro study was to evaluate the effect of a soft-start curing mode on microleakage MATERIALS AND METHODS: Standardized Class V cavities were prepared within all the margins in the buccal enamel or dentin surface of sound, freshly extracted inferior bovine incisors. Forty preparations were filled with a restorative system (Single Bond and Filtek Z250, 3M ESPE, St. Paul, MN, USA). Ten restorations of each group were made on both types of substrates and polymerized with a conventional curing technique (600 mW/cm2/40 s) or with a soft-start technique (150 mW/cm2/10 s + 600 mW/cm2/30 s). All specimens were thermocycled 3000 times and then immersed in methylene blue 2% for 12 hours. The specimen microleakage was quantitatively determined in a spectrophotometer. RESULTS: The soft-start technique resulted in statistically significant less microleakage for each substrate (p < .05). The conventional groups exhibited 6.1 (dentin) to 15.4% (enamel) more leakage compared with the soft-start groups. When compared with the enamel margins, the dentin margins demonstrated greater microleakage: from 15.5% greater with the conventional light-curing mode to 25.6% greater with the soft-start light-curing mode. CONCLUSIONS: The polymerization technique using a very low initial intensity (150 mW/cm2/10 s) decreased the microleakage of composite resin restorations. CLINICAL SIGNIFICANCE: A soft-start light-curing approach to resin composite polymerization resulted in less microleakage at enamel and dentin margins in Class V cavities compared with resin composite restorations polymerized using a conventional light-curing approach.
Analysis of Variance↗
Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97.
OBJECTIVE: This study compared types and costs of dental services rendered to children who had received care in a hospital operating room (H) with children who had not (NH). METHODS: The study population consisted of all children aged 1-5 years who received a dental service reimbursed by the Louisiana Medicaid EPSDT program from October 1996 through September 1997. Claim files were provided by the Louisiana Bureau of Health Services Financing. A treatment intensity index [TII = 3 x (# extractions) + 2 x (# pulpotomies + # crowns) + # simple restorations] was calculated for H children (n = 2, 142) and NH children (n = 38,423). Using logistic regression, a dichotomous hospitalization variable (H vs NH) was regressed against treatment intensity and selected personal and parish (county) characteristics for each of the five age groups. Total and average reimbursement per child were calculated for both groups of children, by age. RESULTS: The mean treatment intensity scores for H and NH children were 24.02 (SD = 11.82) and 2.16 (SD = 4.78), respectively. For all age groups, children with treatment intensity scores greater than 8 were at least 132 times more likely to be hospitalized than were children with scores less than or equal to 8. The mean cost for care provided to H children was $1,508 compared with $104 for NH. Total costs for dental care rendered to H children (5% of the study population) were $3,229,851 (45% of total dental costs for the study population). CONCLUSION: Reducing severe caries through early interventions could provide substantial cost savings.
Age Factors↗