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Case reports: evolution of prosthetic rehabilitation for a patient with severe loss of periodontal support.

This paper describes the development of a technique to make a fixed bridge for a patient with severe reduction of periodontal support. Initially, the bridge was temporarily cemented over copings. However, when the super-structure was periodically removed for inspection, the copings were easily dislodged, with a risk of fracture of the abutment teeth. Consequently, the technique was modified by using lateral screws to fix the bridge to the copings. This design allows easy periodical removal, cleaning, repair and inspection of the abutment teeth.

Cementation↗

The use of periodontal plastic surgery procedures in aiding esthetic restorative results.

The creation of an esthetic dental restoration with gingival harmony can provide a reconstructive challenge. The use of periodontal plastic surgical procedures can aid in evening-out the gingival margins and in creating ovate pontics that improve not only the overall esthetic result but also the phonetic result for the patients. Working closely with an esthetic-driven periodontal office using evidence-based procedures can set the stage for a truly esthetic restoration.

Adult↗

Assessment of dental treatment required and analysis of cost in the management of dental caries among semiurban primary school children of Kerala.

The study was carried out with the purpose of assessing the dental treatment requirement and analysis of cost in the management of dental caries among primary school children of Kerala. The sample consisted of 750 primary school children and their parents. 68.5% children were affected with dental caries. Decayed teeth accounted for the largest component. One surface restorations were the most frequent type of treatment required followed by extractions, pit and fissure sealants and pulp therapy. The treatment cost increased in direct proportion to the number of teeth involved. The average cost incurred for various dental treatment varied from Rs. 50 (consultation) to Rs. 300 (for filling and extraction) depending on the nature of treatment. Only 1/3rd of children requiring immediate dental treatment had approached for any form of dental consultation. The study also revealed that all the children who had approached the dentist for consultation and treatment had only done for temporary relief in relation to emergency management.

Child↗

[Negative carving: clinical applications].

The objective of the negative carving technique is to develop properly the occlusal principles during fabrication of occlusal surfaces of temporary crowns or metalhi restorations.

Crowns↗

Clinical performance and periodontal outcome of temporary crowns and fixed partial dentures: A randomized clinical trial.

STATEMENT OF PROBLEM: Different materials (autopolymerizing, dual curing, and light initiated) are used for fabricating provisional restorations during prosthetic treatment. Randomized clinical trials that have evaluated these provisional materials have not been published. PURPOSE: This clinical trial compared the handling, fitting, plaque adherence, gingivitis, color stability, and the subjective assessment of the provisional materials by the patient and the dentist for 2 autopolymerizing (Protemp, Luxatemp), 1 dual-curing (Provipont), and 1 light-initiated (Triad-VLC) material for the manufacturing of temporary crowns and fixed partial dentures. MATERIAL AND METHODS: Thirty subjects in need of 2 similar fixed prosthetic restorations (single crowns ¿20, three-quarter crowns ¿2, connected crowns ¿9, or fixed partial dentures ¿30) were treated with 1 temporary restoration of Protemp II (control) and one randomly selected from Luxatemp, Provipont, or Triad-VLC materials. The mean time of treatment was 37.5 days (minimum 2 days, maximum 156 days). All restorations were manufactured intraorally with a vacuum-formed template. RESULTS: Mechanical and retentive characteristics revealed a high level of clinical reliability. Plaque adherence of the teeth with temporary restorations was significantly increased (P =.0039) compared with the untreated mesial reference teeth. CONCLUSION: The advantageous mechanical properties of the light-curing and dual-curing materials reviewed in dental literature were clinically offset by disadvantages in handling.

Chi-Square Distribution↗

[Pre and postsurgical occlusal rehabilitation in Class III patients].

It shows how to plan pre and post surgical rehabilitation in a Angle Class III orthognathic surgery patient and the use of temporary pre-surgical restorations to establish and fix the mandible in its new position in habitual occlusion and vertical dimension from the same day of surgery.

Adult↗

The new removable denture patient: treatment procedures.

Dentists are beginning to see a new type of patient who requires removable prosthodontic rehabilitation. These patients are the result of both increases in longevity and dental treatment that has retained teeth, despite the onslaught of caries and periodontal disease. The current procedures for transitioning patients into removable prostheses can be modified for this new group of patients. This article presents a transition procedure for patients who are receiving removable prostheses, which dissociates the surgical phase of treatment from the prosthetic stage. The patient's existing teeth are incorporated into a removable prosthesis in a way that ensures the exact replication of the tooth position in the oral cavity. This method addresses many of the inadequacies of current procedures while at the same time requiring a minimum of chair time. Even with this procedure, this transition is still difficult for the patient.

Dental Abutments↗

In vitro resistance of reinforced interim fixed partial dentures.

STATEMENT OF PROBLEM: Comprehensive restorative dental treatment often necessitates the use of interim fixed partial dentures (FPDs) with high stiffness, especially in long-span restorations or areas of heavy occlusal stress. PURPOSE: This in vitro study evaluated the fracture load of interim FPDs made with various materials and span lengths. MATERIAL AND METHODS: Groups (n = 3) of interim FPDs were fabricated with prosthodontic resin materials on 2 abutments with 3 different pontic widths of 3 units (12 mm), 4 units (19 mm), and 5 units (30 mm). The following materials were tested: (1) a thermoplastic polymer (Promysan Star), (2) Promysan Star with a veneering composite (Vita Zeta), (3) a nonimpregnated polyethylene fiber reinforced resin (Ribbond) with a veneering composite (Sinfony), (4) an impregnated fiber reinforced composite system (Targis/Vectris), and (5) a conventional polymethyl methacrylate, Biodent K+B, (control group). After 5000 thermocycles in 2 water baths at 5 degrees and 55 degrees C, the FPDs were temporarily fixed with a provisional cement on the corresponding abutments and subjected to 3-point bending until fracture by a universal testing machine. Statistical analysis consisted of an analysis of variance (ANOVA, 1-way, 2-way) and Bonferroni-Dunn's multiple comparisons post hoc analysis for test groups (alpha = .05). RESULTS: Fracture resistance (N) differed significantly for 3 (mean: 640 +/- 146 N), 4 (626 +/- 229 N), and 5 unit (658 +/- 98 N) Targis/Vectris FPDs compared with the corresponding Promysan (284 +/- 21 N to 125 +/- 73 N), Biodent K+B (247 +/- 91 N to 218 +/- 85 N), and Promysan/Vita Zeta (95 +/- 15 N to 82 +/- 6 N) groups (P < .05). Significant differences were obtained for the 4 and 5 unit Targis/Vectris FPDs compared with the Sinfony/Ribbond FPDs (281 +/- 25 N - 252 +/- 74 N) for the corresponding pontic spans. CONCLUSION: Within the limitations of this in vitro study the impregnated fiber reinforcement may considerably enhanced the fracture resistance of interim FPDs of different span lengths.

Analysis of Variance↗

Dental erosion: part 2. The management of dental erosion.

Dental erosion is an important cause of tooth tissue loss in both children and adults. An earlier article (Mahoney and Kilpatrick, 2003) discussed the prevalence and causes of dental erosion. This second article will discuss the management of this condition which is often complicated by the multifactorial nature of tooth wear. Management of dental erosion can be considered in three phases: immediate, interim and long-term. Immediate management includes the early diagnosis of dental erosion, recording the status of the disorder at baseline and implementing appropriate preventive strategies including those aimed at reducing the acidic exposure as well as those that attempt to increase an individual's resistance to erosive tooth tissue loss. Interim and long-term treatment includes the provision of temporary diagnostic restorations, ongoing monitoring of disease progression, definitive restorative work where appropriate, and modification and reinforcement of preventive advice. Each phase will be discussed in light of current evidence.

Beverages↗

Surgical template impression during stage I surgery for fabrication of a provisional restoration to be placed at stage II surgery.

The fixture impression method presented permits the construction of a master cast after stage I surgery, enabling the dentist and dental technician to make a provisional crown before stage II surgery. At stage II surgery the surgeon can place the provisional crown instead of a classic abutment or healing cylinder. This eliminates the need for the patient to visit the restorative dentist immediately after stage II surgery for the making of a provisional crown, which can be a scheduling and logistic problem. In addition, better soft tissue contour is possible at stage II surgery, as the premade provisional crown can be shaped to the desired dimensions in the laboratory for ideal esthetics. The soft tissue will adapt to the predetermined surface dimensions during initial healing. Ideal soft tissue contours are present and stable when the final impression is made, which enables better esthetics to be developed for the permanent fixture-retained single-tooth restoration.

Acrylic Resins↗

Alternative procedure for reconstructing anterior guidance using an autopolymerizing resin pattern.

For restoring anterior teeth, treatment planning often includes a compromise between esthetic and functional requirements. A well-developed provisional restoration helps to achieve this aim. The next step is to duplicate provisional restoration contours in the final prosthesis. This article describes an alternative method for transferring the anterior guidance established in a provisional restoration to a casting pattern for the final restoration.

Acrylic Resins↗

Using irreversible hydrocolloid to evaluate preparations and fabricate temporary immediate provisional restorations.

Two unique techniques that use irreversible hydrocolloid and an Omnivac matrix have been presented. The first technique is used to evaluate the adequacy and uniformity of the tooth preparation. The second technique is used to create a TIPR for the patient while the PIPR is being fabricated. The TIPR-PIPR system can be used to facilitate proper diagnosis, planning, and treatment; and it results in improved patient comfort, dentist efficiency, and increased control over the final restoration.

Colloids↗