Journal of Esthetic and Restorative Dentistry最新文献

The cover image is based on the article Three dimensionally printed template with an interproximal isolation design guide consecutive closure of multiple diastema with injectable resin composite by Yusen Shui et al., https://doi.org/10.1111/jerd.13268.

Objective: The present paper aims to demonstrate the incorporation of the double monolithic protocol (DMP) into a chairside digital workflow to reproduce the fluorescence properties of natural teeth with chairside monolithic restorations when exposed to different light sources.

Clinical considerations: A female patient reporting dissatisfaction with her upper anterior teeth was rehabilitated using seven veneers and a three-element bridge. The DMP was applied to the bridge, which consisted of a primary lithium disilicate framework to which leucite-reinforced glass ceramic veneers were cemented. The fluorescence of the different substrates and ceramic restorations was evaluated throughout the rehabilitation process, under 365 and 405 nm light.

Conclusions: The DMP allows chairside procedures to be optimized by achieving predictable, mechanically resistant, and esthetic restorations.

Clinical significance: The DMP is a new chairside solution for developing ceramic restorations with optimal esthetics and combined mechanical properties, eliminating the need for sintering or glazing procedures.

Objective: This systematic review and meta-analysis compared the accuracy of intraoral scanners and spectrophotometers in determining tooth shade.

Materials and methods: An electronic search of five databases (PubMed, Scopus, Embase, Web of Science, CENTRAL) was conducted on October 19, 2023. A total of 163 studies were identified from the databases, of which 23 articles were eligible for inclusion. In vivo and in vitro quasi-experimental studies were included. After data extraction, a quantitative analysis was performed to determine the accuracy of the intraoral scanner in subgroups using four outcomes: trueness and precision with different measurement locations. A random-effects model was used to pool effect sizes. The pooled proportion with a 95% confidence interval (CI) was used for the effect size measure.

Results: Eleven articles were included in the meta-analysis. Trueness with the intraoral scanner was between 0.28 (CI: 0.09-0.60) and 0.38 (CI: 0.24-0.53). Repeatability was between 0.81 (CI: 0.64-0.91) and 0.85 (CI: 0.74-0.92). Trueness showed low, and precision had moderate certainty of evidence.

Conclusion: The trueness of shade matching with intraoral scanners is low compared to spectrophotometers, although the precision is considered high and is similar to spectrophotometers.

Clinical significance: Shade determination with intraoral scanners is not recommended.

Objective: This in vitro study aimed to evaluate the effectiveness of a printed surgical guide for root sectioning in the socket-shield technique.

Materials and methods: A typodont model of the maxilla with augmented filler was used for the upper right central incisor, and CBCT images were obtained. Two types of vertical root sectioning guides were tested: one with a buccal sleeve (Group A, n = 10) and another with a buccal orientation slit (Group B, n = 10). Control group (n = 10) performed freehand cuts on printed models. After crown cutting with diamond burs, root sectioning was conducted using an ultrasonic tip with the guides. Mean and standard deviation were calculated for the remaining root length, width, and volume. Data were analyzed using the Kruskal-Wallis test and Dunn's post hoc test.

Results: Statistical analysis showed significant differences in root width between the control group (2.0 mm) and both Groups A (2.655 mm; p < 0.0001) and B (2.460 mm; p < 0.0001). Group B (5.585 mm) also showed a significant difference in root remnant compared with the control (13.880 mm; p < 0.0043). Groups A and B did not differ significantly from each other.

Conclusions: The socket shield technique is safe and effective, this study aimed to add improvements through the introduction of surgical guides, facilitating the root section, which is the critical phase so that the parameters that are requisite for success are achieved in terms of width, length, and volume of the root remnant. Both guided techniques effectively facilitated root sectioning, maintaining satisfactory root thickness and length.

Clinical significance: Sectioning the root is challenging for the correct angulation to remove the palatal portion in the socket shield technique. Therefore, modifying this technique with the use of the presented guides, it is possible to prevent damage to the soft tissues and to plan the surgery with the help of cone beam computed tomography (CBCT) scans to remove the root apex and maintain the root remnant with a thickness greater than 1.5 mm, making the socket-shield technique more predictable.

Objective: The purpose of this in vitro study was to evaluate the effect of staining, glazing, and polishing on the survival probability of monolithic crowns manufactured with preshaded stabilized zirconia with 5 mol% of yttrium oxide (5Y-TZP).

Materials and methods: Monolithic crowns in the shape of an upper canine (1.5 mm of thickness) were manufactured by CAD/CAM, adhesively cemented on metallic foundation, and divided into 6 groups (n = 21): C (control), S (staining), G (glazing), P (polishing), SG (staining and glazing), and SP (staining and polishing). The survival probability was determined by step-stress accelerated life testing with a load applied to the palatine concavity of the crown. First, the specimens were subjected to a single-load to fracture test (SLF) and next to the fatigue test (5 Hz, thermocycling immersed in water varying 5-55°C), including the light (n = 9), moderate (n = 6), and aggressive (n = 3) loading profiles (load ranged between 20% and 60% of SLF). The survival probability was calculated considering the cycles for failure (CFF) and fatigue failure load (FFL) and illustrated using a Kaplan-Meier graph. The comparison among groups was performed using a Log-Rank test (α = 0.05).

Results: The mean value of SLF was 586.7 N. There was no difference among groups in survival probability, considering CFF and FFL.

Conclusion: Staining, glazing, and polishing can be performed safely without damaging the mechanical behavior of 5Y-TZP monolithic crowns.

Clinical significance: Staining is used to characterize and improve the esthetic of zirconia monolithic crowns. It can be used to reproduce the color gradient in the cervical region of the crown and pigmented grooves. This study showed that staining, glazing, and polishing did not affect the survival probability and the use of finishing procedures (glazing or polishing) after staining did not improve the survival probability of zirconia monolithic crowns.