Journal of Esthetic and Restorative Dentistry最新文献

Objective: This case report offers information on accurate diagnostic and soft- and hard-tissue reconstruction periodontal surgery deal with "black triangles" in the aesthetic zone of anterior teeth caused by submucous alveolar cleft, which is rare and easily overlooked.

Clinical considerations: Vertical and horizontal bone augmentation was conducted via guided tissue regeneration and alveolar bone grafting (ABG) at the cleft site where favorable bone grafting conditions were absent. A customized, vascularized interpositional periosteal-connective tissue (VIP-CT) flap was applied as the barrier membrane to maintain the stability of bone replacement graft and provide soft-tissue foundation for gingival papilla growth. Adjustment on the contact point position of the anterior teeth and the shapes of crowns induced growth of the gingival papillae with resin restoration. The radiological and clinical parameters, and smiling photographs demonstrated a satisfactory treatment outcome.

Conclusions: When the inflammation and local alveolar bone destruction in the anterior area are disproportionate, submucous alveolar cleft should be considered a potential etiology. Surgical treatment combined with resin restoration substantially improved the affected area.

Clinical significance: The hard- and soft-tissue defects can be improved through ABG and VIP-CT flap in a single surgery.

Objective: Provisional removable partial denture (RPD) preserves esthetic and functional parameters until definitive treatment. This clinical report presents a 19-year-old victim of a road traffic accident who lost the maxillary right central and lateral incisors.

Clinical considerations: A 3D printed maxillary provisional RPD planned using a virtual patient was provided until the patient could undergo implant-supported rehabilitation. Intraoral and facial scans were conducted, and the images were integrated into a dental software program for digital prosthetic planning. The provisional RPD was designed considering the facial parameters, then 3D printed, characterized, and delivered to the patient.

Conclusions: The 3D printed provisional RPD demonstrated satisfactory esthetic and functional outcomes, offering a faster and more predictable alternative compared to the conventional method.

Clinical significance: Using virtual patients to design 3D printed provisional removable partial dentures can enhance the predictability of treatment, especially in the esthetic area.

Introduction: The objective of this bibliometric review is to address the main trends and development in dental whitening throughout the 21st century, as well as to identify knowledge gaps on the subject.

Method: A search was conducted in the Web of Science Core Collection database and information was extracted regarding the journal, authors, keywords, year of publication, number of citations, country, continent of the corresponding author. After reading the articles, data such as study design, type of bleaching technique, types of light sources used with the bleaching, occurrence of tooth sensitivity, and tooth color change analysis method were extracted.

Results: The journal with the largest number of publications was "Operative dentistry" (n = 61), and the authors with the most articles were Loguercio AD (n = 82) and Reis A (n = 76). The productions are concentrated in Brazil, with emphasis on the State University Ponta Grossa. Most of the articles are randomized clinical studies that used the in-office bleaching technique with 35% hydrogen peroxide.

Conclusion: Our results show that the most recent studies used light sources such as a violet LED during whitening; however, more studies are needed to prove the benefits in relation to color change and reduction of tooth sensitivity.

Objectives: The effect of pigmentation on color, aging behavior, and mechanical properties of zirconia is debated. The purpose of the paper is to conduct a systematic review and meta-analysis of the studies that evaluated the effect of coloring pigments on the properties of zirconia.

Data sources: A systematic electronic search was conducted using MEDLINE, Scopus, Cochrane Central, and EBSCO Host. A platform-specific search strategy was employed, using MeSH keywords and text words.

Study selection: The inclusion criteria were in vitro experimental studies that synthesized coloring pigments and evaluated their effect on zirconia. Case reports, narrative reviews, and systematic reviews were excluded. Commercially available pre-shaded zirconia, coloring liquids, and staining or glazing systems were not considered. Two investigators independently evaluated the risk of bias using modified CONSORT. Meta-analysis employed a random-effects model and assessed heterogeneity with the I-square test and continuous data with the inverse variance test.

Conclusions: Transitional metal oxides are used in pre-shaded blocks and rare earth metals in coloring liquids. These pigments can alter grain size and lattice parameters, increase porosity, reduce translucency, improve aging resistance, and affect zirconia's hardness, fracture toughness, and flexural strength. They demonstrated no effect on gingival fibroblast proliferation, indicating their cytocompatibility.

Objectives: This systematic review aimed to assess the influence of printing orientations alone and with other parameters, such as applied material and postprocessing, on the physical-mechanical properties and mechanical behavior of provisional fixed dental prostheses (FDPs).

Materials and methods: A comprehensive search of websites such as PubMed, Scopus, Web of Science, and Cochrane was conducted in July 2024. Adhering to PRISMA 2020 guidelines, the studies that investigated the impact of printing orientations on the physical and mechanical properties were included in this review. The modified CONSORT statement was utilized for the risk of bias assessment. A total of 24 records were included; the main build-up angles were horizontal, oblique, and vertical (0°, 45°, and 90°), and other angles such as 30° and 150° were also reported. The data focused on the impact of orientation on 3D-printed products from different materials, applying various postcuring times and artificial aging. Horizontally printed specimens exhibited significantly superior mechanical properties and behavior compared with other angles, while vertically printed specimens displayed the lowest results. Additionally, the material type, amount, and type of fillers and postcuring had the most substantial impacts; zirconia fillers showed more enhanced strength compared to silica fillers, and the mechanical behavior was enhanced with postcuring time of up to 120 min. Optical properties were more related to the materials and technology applied than to printing directions. Polishing of the products enhances surface quality and removes differences from various orientations. Resin specimens exhibited a high susceptibility to staining, irrespective of printing orientation. Furthermore, aging significantly influenced the mechanical properties, gloss, and surface quality of the specimens.

Conclusions: To achieve high-quality provisional FDPs, it is essential to select a horizontal orientation. Careful selection of materials is necessary, as well as adherence to optimal printing parameters. 3D-printed resin may not yet be suitable for permanent rehabilitation; however, it is appropriate for short- and long-term temporization.

Clinical significance: The production of dental parts is shifting to additive manufacturing; it is crucial to understand the impact of various parameters on the physical and mechanical behavior of dental parts, particularly provisional restorations, to ensure their durable clinical service.

Objective: This case report examines the combination of orthodontic treatment and bone augmentation using an interdisciplinary approach to simultaneously improve a gummy smile and Class III facial profile. The subject is a 26-year-old female presenting with a gummy smile, congenitally missing teeth, an open bite tendency, and a Class III profile with a left-deviated mandible.

Clinical considerations: The interdisciplinary treatment included lingual inclination of the maxillary and mandibular anterior teeth to improve the gummy smile, facial esthetic bone augmentation (FABA) to enhance facial esthetics, and implant therapy for the missing teeth. Additionally, interdisciplinary treatment objectives and postoperative facial profile predictions were planned using the Dual Incisal Positioning (DIP) method.

Conclusion: The desired facial profile was achieved, with esthetic improvements in both the gummy smile and Class III profile. This case demonstrates the effectiveness of a comprehensive interdisciplinary approach that combines the DIP and FABA methods to address multifaceted dental and facial esthetic challenges.

Objective: Although interdental papilla augmentation has been thought to be impossible or at best unpredictable, microsurgical, connective tissue grafting to achieve papilla augmentation is the focus of this paper.

Overview: Two cases of severely traumatized interdental papillae are reconstructed through microsurgical connective tissue grafting. Because the surgical site is so small, access to this area can be very challenging necessitating microscopic magnification. Soft tissue augmentation was accomplished using microscalpels expressly designed to allow customization and bendability with a blade width of less than a millimeter. Magnification of the surgical site also permits visibility and accessibility. A special form of suspensory suturing safeguards tissue positioning during the healing process.

Conclusion: This paper demonstrates that correction of iatrogenic defects traumatizing the interdental papillae can be accomplished.

Objective: This study evaluated the impact of dentifrices containing amine fluoride (AmF) and/or tin on tooth discoloration and surface roughness under cycles of staining and abrasion.

Materials and methods: Specimens of enamel (n = 10) and dentin (n = 19) were allocated into six groups: (1) Negative control (Distilled water), (2) NaF (regular fluoridated dentifrice without amine and tin), (3) AmF, (4) AmF/NaF/SnCl₂, (5) SnF₂/SnCl₂, and (6) SnF₂. Daily staining-toothbrushing cycling was performed: staining solution (30 min), toothbrushing (45 strokes), and human saliva (1 h), 2×/day, for 21 days. Tooth color change (ΔE, ΔL, Δa, and Δb) was determined using a spectrophotometer (CIEDE2000), while surface roughness (ΔRa) was measured with an optical profilometer, and the data were statistically analyzed (α = 0.05).

Results: For enamel, no significant differences in ΔE were observed among groups; however, for dentin, AmF exhibited the highest ΔE value, differing from all groups except Negative control (p > 0.05). Both substrates showed a decrease in luminosity (-ΔL), with significant differences in dentin for the AmF group (p < 0.05). For dentin, all groups showed an increase in tooth yellowness (+Δb); while for enamel, only the tin-containing groups showed this effect. All groups showed an increase in surface roughness after cycling. Enamel Ra showed significant differences post-treatment, with AmF differing from NaF/AmF/SnCl₂ (p = 0.012) and control (p = 0.042). Correlations between ΔRa and ΔE were weak in both substrates (ρ = 0.12 for enamel; ρ = 0.22 for dentin).

Conclusions: Brushing with AmF/NaF/SnCl₂, SnF₂/SnCl₂, and SnF₂-containing toothpastes promoted a yellowing of enamel. Brushing with AmF resulted in the greatest darkening of dentin compared with other fluoride salts.

Clinical significance: Some components in dentifrices can induce tooth discoloration, which seems to impact dental aesthetics; therefore, clinicians should advise patients on potential color alterations when choosing specific dentifrice products.

Objective: This study aims to compare the accuracy of various intraoral scanners and traditional analog impressions in scanning root canals for CAD/CAM post-fabrication.

Methods: A dental mannequin with a factory-made #21 tooth root canal was used to simulate clinical settings. Three intraoral scanners were tested: CEREC Primescan, TRIOS 3, and CEREC Omnicam. The inEos X5 desktop scanner provided high-resolution control images. The analog impression polyvinyl siloxane (PVS) material was used with custom trays, following standard protocols. The surface areas were measured with CAD software and compared with the desktop scanner's reference.

Results: Primescan demonstrated the highest accuracy among the intraoral scanners, followed by Trios 3 and Omnicam. Significant differences were found between each scanner and the true surface area. The analog impression method demonstrated superior accuracy compared with intraoral scanners; however, this high precision is attributed to irregularities in the silicone material.

Conclusions: The analog impression method was more accurate in capturing the details of complex root canal anatomy; however, material irregularities can affect its clinical efficacy. Intraoral scanners showed high accuracy but had some limitations in capturing complex geometries. Further development of scanner technology will increase precision and, therefore, the clinical outcome.

Clinical significance: The use of CAD/CAM technology and intraoral scanners offers potential for precise, custom-fit post-and-core restorations.

Objectives: To introduce no-prep zirconia cantilever resin-bonded fixed dental prostheses (Z-RBFDPs) as a noninvasive and simple approach to replacing individual anterior and posterior teeth.

Clinical considerations: Sixteen no-prep Z-RBFDPs were placed in 11 patients with a single missing tooth (15 lateral incisors, 1 canine, and 1 premolar); nine exhibited bruxism, and four used a nightguard. Bridges were bonded using a rubber dam and Panavia V5 resin cement after grit-blasting zirconia, etching the enamel (n = 13) or Vita Enamic palatal veneer (n = 3), and applying an MDP-based primer. The survival rate was 100% after a mean follow-up of 3.0 ± 2.6 years (range: 1 month-9.5 years). An Z-RBFDP on an upper canine showed debonding after 2 years, and the bonding procedure was successfully repeated. Patient-reported outcomes were positive. Key considerations included restoration design, material selection, bonding procedures, and multidisciplinary soft tissue management. An innovative 3D-printed resin guide was introduced to ensure accurate bridge positioning during the bonding procedure, and the simple orthodontic extrusion technique was used to manage the limited occlusal space.

Conclusion: This case series provides proof of principle for no-prep Z-RBFDPs, demonstrating high survival and success rates, even in the presence of known risk factors such as bruxism and unfavorable occlusal relationships.

Clinical significance: No-prep Z-RBFDPs offer a promising, noninvasive, cost-effective, and straightforward alternative to dental implants for single-tooth replacement. They effectively avoid related complications such as infraposition and peri-implantitis. Further research is required to validate these preliminary findings, particularly for posterior applications. Treatment choices should increasingly align with the patient's preference for noninvasive procedures that prioritize tooth tissue preservation and avoid surgical interventions, as demonstrated in this case series.