[The dental rake: a new type of anchorage for periodontally involved teeth].
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Six systems (one polycarboxylate, one polymethyl methacrylate, one unfilled BIS-GMA resin, two combinations of methyl cyanoacrylate and polymethyl methacrylate, and one combination of unfilled BIS-GMA and filled composite resin) were evaluated for in vitro retention to acid-etched human enamel. Also tested were one unfilled-filled resin combination backed by perforated orthodontic band metal and another unfilled resin backed by stainless steel wire mesh. Significant differences in retention were found. Results show that retention depends pril surface and to resist subsequent chemical degradation.
Periodontal disease may lead to tooth and tissue loss that can result in esthetic problems. Combined periodontal/prosthodontic treatment for patients with advanced periodontal disease is well documented. This clinical report illustrates a method of treatment for advanced tissue loss in an esthetic area using porcelain laminate veneers and a removable gingival prosthesis.
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A method is presented for the accurate application of the modified 3-3 retainer of multistrand wire described by Zachrisson . This lingual retainer or splint is noninvasive of dental tissue and is reversible. Wire breakage does not appear to occur, and the slightly elastic properties of the wire allow a physiologic mobility of the teeth, which is of advantage in the periodontal patient. The only breakage that may occur is of the composite bond, although this appears to be less than with bonded brackets, but repair is quick and simple. The present method is now offered to add simplicity, speed, and accuracy to the important advantages already enjoyed, widening the scope for employment of this type of retainer to as many as eight or ten teeth in a series and, perhaps more significantly, to the maxillary anterior teeth, even where a deep bite exists. The value of the method is also seen when an active orthodontic appliance is removed and retention or splinting is required within an hour or two, as for the patient who is concurrently undergoing periodontal treatment.
Healing of the periodontal ligament (PDL) after extrusive luxation of two upper central incisors was evaluated when one tooth was splinted and the other left untreated. One millimetre thick, transverse sections of tooth, PDL and alveolar bone were examined in a materials testing machine. Load deformation curves were recorded and a number of mechanical properties were assessed. To eliminate the influence of differences in sizes and fibre arrangements, load values were reduced by the area and deformation values by the width of the PDL, and comparisons between splinted and non-splinted teeth were made at identical root levels 2 weeks after injury. Healing was also evaluated histologically at 1, 2, 3, 4 and 8 weeks after injury. There were no significant differences in mechanical and histological properties between splinted and non-splinted teeth, which suggests that splinting is of doubtful value in treatment of extrusive luxated teeth. The values for the mechanical properties of injured PDL had returned to 50-60% of those of uninjured PDL by 2 weeks after injury, indicating a rapid healing rate.
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The procedure described can provide innovative cross-arch splinting for patients. The longevity of resin-bonded restorations has not been determined, but the procedure is promising, economical, and reversible. These facts should be made available to patients during presentation of the treatment plan.
A method of connecting "fixed partial denture" prostheses to osseointegrated implant fixtures has been described. The advantages of this system of restoration for partially and fully edentulous mouths are that it is more effective in addressing the problems of (1) stress-control on abutments, (2) a back-up system for abutment failures, (3) esthetics, and (4) control of bacterial plaques around abutments. To accomplish this procedure, the application of convertible periodontal prosthesis techniques with modifications to some existing implant systems is undertaken. The disadvantages of this method seem insignificant when one considers the complexities and risks involved with the present array of implant prosthesis alternatives. Some patients and dentists might consider the necessity of the prosthesis being detachable as one disadvantage. In reality, the prosthesis can be used as a fixed restoration until the patient has fully adapted to the new proprioception and appearance. A large percentage of patients feel uncomfortable with the word "removable" because it immediately creates a perception of unsightly metallic clasp display, palatal coverage, tongue interference, and negative body image. The use of the term "detachable" coupled with the doctor's offer to perform this task for the patient "whenever necessary" will usually relieve the patient's anxiety and allow the treatment to proceed. Once neuromuscular and esthetic adaptation have occurred and the patient has accepted the prosthesis, daily detaching and home-care hygiene by the patient will follow without incident. Esthetic improvement is obvious (Fig. 3).
A new technique for immobilization of teeth uses inexpensive, readily available, medically acceptable, and biocompatible nylon thread. Three monofilament nylon threads of sizes between Nos. 25 and 40 are interwoven to a braid to form, along with the threaded pins, the stabilization media. A channel along the stabilized teeth is prepared; the braid is placed in it and fastened onto the teeth with the help of pins, which are threaded on them through the braid. The advantages of this method are also presented and discussed.
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A modification of existing designs for resin-bonded retainers has been introduced. This new design is appropriate for the extracoronal splinting of anterior teeth with reduced periodontal support. The design of the splint will accommodate the increased risk of these teeth for endodontic failure. The versatility and advantages of this design have been presented and compared with other anterior splinting techniques. At present, there appears to be no clinically significant difference in the retentiveness of perforated and nonperforated etched metal retainers.