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Techniques used by a group of United Kingdom-based dental practitioners during the provision of indirect tooth-coloured restorations.

A number of techniques involving the use of various instruments, brushes and devices have been described for the removal of excess luting material and subsequent finishing around the margins of indirect tooth-coloured restorations. There is little information available on the clinical techniques employed by UK dental practitioners in the placement of these restorations, or on the effectiveness of these techniques. A questionnaire was designed to elicit such information. This was distributed to 500 UK-based dental practitioners. A total of 301 practitioners returned completed questionnaires, giving a response rate of 60%. The results indicated that 88% of the respondents routinely provided porcelain veneers for their patients, with 94% of these respondents indicating that they routinely prepared teeth during the provision of such restorations. A light-cured resin composite luting material was used by 29% of the respondents in placement of veneers, while 69% used a dual cured composite. Excess uncured luting material was removed by a number of methods and a variety of methods were used by respondents to finish the margins of the veneers after placement. Of the respondents 68% indicated that they routinely provided tooth-coloured inlays and onlays, with 89% indicating that they routinely used a dentine bonding system when luting their indirect tooth-coloured restorations. It is concluded that a high proportion of the practitioners surveyed were providing porcelain veneers and tooth-coloured inlays and that a wide variety of materials and finishing techniques were being used.

Composite Resins↗

Further studies on gold alloys used in fabrication of porcelain-fused-to-metal restorations.

Composition, microstructure, castability, mechanical properties, and heat treatment characteristics of two gold-palladium-silver-based alloys were studied. The materials exhibited compositional as well as microstructural differences. Clinically acceptable castings could not be obtained when manufacturers' recommended casting temperatures were used. Ultimate tensile strength, yield strength, modulus of elasticity, and Brinell hardness values for the alloys were comparable. The elastic limit of Cameo, however, was significantly higher than that of vivo-star. Maximum rehardening of annealed castings occurred on reheat treatment at temperatures between 1,200 and 1,300 F. As-cast specimens, however, were not heat hardenable. The sequence of heat treatments used in the application of porcelain reduced slightly the hardness of both alloys. Hardness of the metal substructures was not increased by return of porcelain-coated specimens to a 1,250 F oven for final heat treatment.

Dental Casting Investment↗

Fracture resistance of mandibular molars with occlusal class I amalgam preparations.

The finding that large occlusal Class I restorations weaken premolars is not confirmed for natural mandibular molars because no statistically significant difference was found in the mean loads needed to fracture mandibular molars that were unprepared, minimally prepared, or prepared with a large occlusal amalgam restorations. Similarly, there was no statistically significant change in the amount of force necessary to fracture natural mandibular molars prepared with sharp vs round internal line angles (a no. 56 vs a no. 330 bur). Duplication of the experiment in acrylic resin mandibular molars confirmed the results of a previous experiment by Re and Norling as well as the results relating to sharp vs round internal line angles found in this experiment on natural mandibular molars. Acrylic resin teeth of homogeneous shape and substance overcome some of the sampling problems inherent in obtaining suitable human teeth for testing purposes; however, further testing of this material is indicated.

Dental Amalgam↗

Dental management of the chronic vomiting patient.

A review of dental erosion secondary to medical or psychologic causes (or both) has been presented. Clinical signs and symptoms and appropriate restorative therapy have been discussed. Diagnosis and stabilization of the chronic vomiting patient must precede definitive restorative procedures.

Chronic Disease↗

Hemisection and root amputation.

The disciplines of endodontics and periodontics fuse when molars that have bifurcation or trifurcation involvements are treated with hemisection and root amputation. Attempts to save parts of teeth go back 100 years or more, but it is the increased predictability of success of endodontic therapy and the increased sophistication of periodontal treatment that have given us the means to save molars with furcation problems that, otherwise, would be lost. Even when less invasive modes of therapy have failed (scaling, root planing, occlusal adjustment, and flap surgery perhaps with osseous recontouring and synthetic or natural bone grafting material where indicated), it is no longer necessary to lose a molar with complete furcation problems. When restorative dentistry has already been finished, and the retention of part of the tooth will extend the life of a crown or fixed partial denture, the patient certainly deserves the option of hemisection or root amputation rather than extraction.

Dental Plaque↗

Dentist and laboratory: communication for success.

Currently used shade guides have obvious inadequacies. For example, many porcelain materials do not match their shade guide. But communication between dental practitioner and laboratory technician need not suffer because of these defects. Straightforward and specific written instructions, shade diagrams, casts, and clinical photographs can communicate and produce consistently acceptable esthetic results.

Audiovisual Aids↗

Composite resin restoration in esthetic dentistry.

The revolution in esthetic dentistry is attributable to improvement in materials, such as composite resins. The varied types of resins can be used in many restorative situations, using an acid-etch technique for these restorations, whether Class V, labial veneer, or posterior composite restoration. Dentists who take advantage of continuing education (especially hands-on courses), learn from experience, stay informed about current materials, and exercise imagination and commitment will meet the needs of the 20th century.

Acid Etching, Dental↗

Anterior composite resins and veneers: treatment planning, preparation, and finishing.

Today's esthetic dental restorations are limited only by the practitioner's artistic ability and imagination. Less invasive procedures such as bleaching, bonding, and veneer placement are useful adjuncts and economic alternatives to more extensive procedures such as crown placement, orthodontic treatment, and orthognathic surgery. In addition to a discussion of the considerations when planning esthetic restorative treatment, technique and material selection, tooth preparation, material placement, and finishing are presented.

Composite Resins↗

Marginal ridge strength of restored teeth with modified Class II cavity preparations.

This study compared marginal ridge fracture resistance in two groups of teeth restored with modified Class II cavity preparations, with control groups. The results indicated that the composite resin and dental amalgam restored teeth fractured at compressive loads that were not statistically different from those of the control (unprepared, intact) teeth. The marginal ridges of the unrestored, prepared teeth were significantly weaker.

Composite Resins↗