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PubMed2004

[Economic evaluation in oral care. Methods and examples in restorative dentistry].

This article briefly outlines the principles of economic evaluation in dentistry. It discusses the different types of analyses, such as cost-effectiveness analysis, cost-benefit analysis and cost-utility analysis. Furthermore, it makes clear when these analyses are most appropriate for use. Having a basic understanding of the most common analyses can be helpful to make choices between different interventions. Increasing demand for dental interventions and limited budgets necessitate the allocation of scarce resources efficiently. By identifying, measuring, valuing and comparing costs and outcome of interventions, economic evaluation can also help patients and carers in choosing between interventions. The article gives some examples in restorative dentistry to explain the relevance of economic evaluation.

Cost-Benefit Analysis↗
PubMed2004

In vivo study of the marginal integrity of composite resin buildups after full crown preparation.

PURPOSE: The purpose of this in vivo study was to evaluate the marginal integrity of composite resin buildups after full crown preparation, and to identify possible changes during the provisional phase of the manufacturing process of the final restorations. MATERIALS AND METHODS: Two test groups were determined for the use of an autocuring (Clearfil New Bond, Kuraray) and a light-curing (Optibond FL, Kerr) dentin adhesive. After rubber-dam application, both dentin adhesives were used with the total-etch technique. Then, an autocuring composite resin was applied for the core buildup. Impressions of the built-up teeth were taken directly after preparation and before cementation of the final restorations. During the provisional phase, which lasted from 7 to 28 days, the prepared teeth were restored with cemented provisional crowns. Replicas of the built-up teeth were manufactured and examined with a scanning electron microscope. RESULTS: For the autocuring dentin adhesive, only one buildup showed a gap 10 microm wide and 100 microm long. For the light-curing dentin adhesive, two samples revealed gaps that were 10 microm wide and had lengths of 100 microm and 75 microm, respectively. No change could be perceived when comparing the state of the composite/tooth interface after preparation and before final cementation. CONCLUSION: The results show that when using an autocuring composite resin in combination with dentin adhesives, nearly gap-free margins of composite buildups can be achieved and therefore might serve as a sound basis for the final restoration.

Acid Etching, Dental↗
PubMed2004

[Calcium hydroxide and treatment of inflammatory inter-radicular bone resorption of non-vital deciduous molars].

On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.

Alveolar Bone Loss↗
PubMedDate not supplied

[Composite materials in pedodontics].

A brief account is given of the features of 1st and 2nd generation compounds and their clinical applications. Reference is made to many years of personal experience in an assessment of their long-term results.

Child↗
PubMed2004

Influence of air abrasion preparation on microleakage in glass ionomer cement restorations.

The aim of this study was to assess microleakage in class V cavities prepared by air abrasion or high-speed dental bur and restored with different glass ionomer cements. Sixty bovine incisors were equally divided into 6 groups: I, II and III (preparation by high-speed) and IV, V and VI (preparation by air abrasion). Groups I and IV were restored with Fuji IX; groups II and V with Ketac Molar; and groups III and VI with Vitremer. After 24 h (37 degrees C), specimens were thermocycled, isolated with nail varnish, immersed in a 0.2% Rhodamine B solution for 24 hours, sectioned longitudinally and analyzed for microleakage using an optical microscope connected to a digital camera and a computer. The images were digitized and a software allowed the quantitative evaluation of microleakage in millimeters. Data were analyzed by Wilcoxon and Kruskal-Wallis tests. It was observed that there were significant differences (p < 0.05) between incisal (enamel) and cervical (dentine/cementum) margins, mainly for Ketac Molar; there was no difference (p > 0.05) between preparation methods, except for group II (high-speed/Ketac Molar) that showed higher infiltration; regarding the materials, Ketac Molar demonstrated the highest microleakage values (p < 0.05), and only Vitremer sealed completely both margins of restorations. It was concluded that air abrasion preparation did not influence microleakage in class V restorations with the employed glass ionomer cements.

Air Abrasion, Dental↗
PubMed2005

Immediate restoration of implants utilizing a flapless approach to preserve interdental tissue contours.

Dental implants have become widely accepted for the replacement of missing teeth due to their high success rates. Conventional multistage approaches to implant reconstruction have contributed to professionals' acceptance of implant dentistry as a treatment option, yet innovative implant procedures often enable clinicians to achieve function and aesthetics in shorter treatment periods. This presentation describes recent advances in surgical procedures and provisionalization techniques that, when applied properly, provide soft tissue integration and long-term implant success.

Dental Abutments↗
PubMedDate not supplied

Immediate esthetic management of a catastrophically fractured anterior.

A quick, failsafe method for the esthetic replacement of a catastrophically fractured anterior tooth was presented. This method required minimal armamentarium and no anesthesia. In addition, it employed a technique that is not technique sensitive. The patient and the dental team both benefit by resolving the esthetic crisis using simple methods and excellent time resource management.

Crowns↗
PubMed2005

Sequencing patients to implant-supported, full-mouth reconstructions: a case report.

UNLABELLED: Patients presenting with debilitated dentitions are often excellent candidates for implant-supported reconstructions. Their existing teeth, even if compromised structurally, help preserve the ridge anatomy and can be used to support fixed, interim prostheses. While the result is often a straightforward, treatment-planning decision, the diagnosis and interim stages of sequential extraction cases leave numerous decisions to be made. The authors' goal is to highlight some of the major treatment planning decisions that need to be made for the interim portion of sequential extraction treatment. LEARNING OBJECTIVES: This article describes several of the treatment-planning decisions that clinicians must consider when preparing to treat the partially edentulous patient with implant therapy. Upon reading this article, the reader should be able to: Understand the various transitional approaches used to convert a patient from a tooth- to an implant-supported restoration. Identify the steps involved in the sequential extraction of failing teeth.

Dental Abutments↗