Journal of Esthetic and Restorative Dentistry最新文献

Objectives: To evaluate the color-match with extracted natural teeth of three single-shade universal composites, a group-shade universal composite, and a highly translucent-shade conventional composite.

Methods: Twenty extracted human teeth were divided into light- and dark-shade groups (n = 10, LSG and DSG). A preparation was restored with the 3 single-shade universal composites, OMNICHROMA (OMC), Admira Fusion x-tra U (AFU), and Essentia U (ESU); a highly translucent-shade conventional composite, Tetric EvoCeram T (TEC-T); and two shades of a group-shade universal composite-Filtek Universal Restorative (FUR A1 and A4). Composites were photopolymerized, polished, and stored in water for 24 h. The ΔE₀₀ value between the unprepared and restored surfaces was obtained using a spectrophotometer. Composite placement and measurements were repeated three times per tooth. Color differences were statistically analyzed with the within-between-subjects t-test and repeated-measures analysis of variance (ANOVA), followed by post hoc pairwise comparisons with a Bonferroni adjustment (α = 0.05).

Results: There were no statistically significant differences between OMC and FUR (A1 and A4). AFU and ESU showed significantly higher ΔE₀₀ values than OMC and TEC-T (p < 0.05). Single-shade composites exhibited significantly higher ΔE₀₀ values in the DSG than in the LSG except ESU (p < 0.05). None of the composites satisfied the criteria for an acceptable match (ΔE₀₀ >1.8).

Conclusion: OMC showed the same color matching ability as a group-shade universal composite. A highly translucent-shade conventional composite and OMC exhibited better color matching ability than other single-shade composites. Overall, single-shade universal composites performed better in lighter-shaded teeth.

Clinical significance: Single-shade universal composites have the potential to reduce chair time by eliminating shade selection in cavities with lighter-shade teeth. Highly translucent incisal conventional composites also may be used if the appropriate shade of composite is not available.

Objective: To evaluate the effect of polishing and bleaching on the recovery of lightness, color, whiteness, and relative translucency parameter (RTP) in CAD/CAM materials and changes in these properties when another staining in coffee was conducted after the treatments.

Materials and methods: Disks of Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), IPS e.max CAD (EMAX), and Vita Suprinity (VS) were (1) not treated (control), (2) polished with Proxyt or (3) Ceramisté, (4) bleached with Opalescence PF or (5) Whiteness HP Blue, and (6) air polished with Clinpro Prophy Powder. CIE L*a*b* color coordinates were registered at baseline (R₀), after staining with coffee for 30 min daily for 36.5 days and treatment (R₁), and after another staining (R₂). Differences (R₁-R₀ and R₂-R₀) in lightness (ΔL₀₀), color (ΔE₀₀), RTP (ΔRTP₀₀), and whiteness (ΔWI_D) were evaluated by mixed repeated measures ANOVA and 95% confidence intervals (α = 0.05) and interpreted in function of their respective 50:50% PT and AT thresholds. Topography was evaluated by scanning electron microscopy (SEM).

Results: In LU, Opalescence PF and Proxyt decreased ${\Delta L}_{00\left(R_1-R_0\right)}$ , ${\Delta E}_{00\left(R_1-R_0\right)}$ , and ${\mathrm{\Delta WI}}_{D\left(R_1-R_0\right)}$ and showed lower ${\Delta L}_{00\left(R_2-R_0\right)}$ , ${\Delta E}_{00\left(R_2-R_0\right)}$ , and

Objective: To describe an esthetic flap design for surgical endodontics in the anterior zone and to discuss the treatment outcome.

Clinical significance: Traditional flaps used in apical surgery in the anterior region are created with horizontal and vertical incisions. These incisions do not completely avoid scarring, and may sometimes cause esthetic defects. We describe an envelope flap with no vertical incision for apical surgery in anterior that mainly consists of oblique incision in interproximal papilla. The approach achieve rapid would healing while avoiding scar formation.

Conclusions: The present report describes successfully treated cases of surgical endodontics in the esthetic zone using an envelope flap that the author recommend in order to achieve better esthetic results.

Case report: This case report describes the multidisciplinary approach performed in a 9-year-old male patient with dental agenesia affecting teeth 21 and 22. Autotransplantation of the right upper second premolar with incomplete rhizogenesis to the missing area was combined with coronary reshaping with resin composite and orthodontic therapy. The treatment began with the extraction of the deciduous upper left central incisor, bone preparation for the recipient site of the donor tooth, atraumatic extraction of the right upper second premolar and immediate autotransplantation in the surgically prepared recipient site. Subsequently, sutures to reposition the flap and a rigid splint were performed. After 12 months, coronary reshaping of the autotransplanted tooth with resin composite was carried out. Orthodontic treatment involving the use of a fixed appliance was used to correct the interdental spaces and achieve adequate occlusion. Clinical and radiographic follow-up 10 years after tooth autotransplantation and 9 years after reshaping revealed partial obliteration of the pulp chamber, root resorption, ankylosis and the presence of endodontic treatment.

Conclusions: The long-term outcomes highlighted that tooth autotransplantation represents a biologically and cost-effective procedure for replacing missing teeth in young patients, particularly in cases of incomplete rhizogenesis of the autotransplanted tooth.

Clinical significance: This case report discusses tooth autotransplantation and resin composite reshaping as viable and long-term clinical options for treating young patients with dental agenesis.

Objective: To assess the clinical performance of two composite materials with two universal adhesives and a two-step self-etch adhesive on class II restorations for 18 months.

Materials and methods: Two hundred and fifty-two class II cavities were bonded with G-Premio Bond, Single Bond Universal, and Clearfil SE Bond 2. A nanohybrid composite (Filtek Z550 Universal) or a microhybrid composite (G-aenial Posterior) was used to fill the bonded cavities. World Dental Federation criteria were used to evaluate the restorations at 1 week, 6, and 18 months. Statistical analysis was performed using Friedman and Fisher's exact tests (α = 0.05).

Results: Retention loss and fracture were not observed in any restorations during the 18 months. The adhesives used showed no significant differences for all criteria examined (p > 0.05) regardless of composite material. After an 18-month follow-up, seven G-aenial Posterior and three Filtek Z550 Universal restorations presented slight marginal discrepancies, with no significant differences (p = 0.246). At 1 week, Filtek Z550 Universal (9.5%) led to significantly higher postoperative sensitivity compared with G-aenial Posterior (0.8%) (p = 0.001).

Conclusions: Universal adhesives showed similar clinical performance to Clearfil SE Bond 2. The restorations with Filtek Z550 Universal had a relatively higher risk of postoperative sensitivity.

Clinical significance: Universal adhesives were clinically successful for 18 months. At 1 week, the type of composite material used significantly affected the occurrence of postoperative sensitivity.

Objective: This article describes an interdisciplinary treatment that helped a patient with displaced upper anterior teeth. A gingivectomy, root canal therapies, digital smile design, digital wax-up, and guided tooth preparations were applied.

Clinical considerations: A patient with pathologically migrated teeth asked for treatment without orthodontic involvement due to a primary failed orthodontic treatment history. A smile photo was taken and superimposed with the dentition in a CAD software to accomplish a digital smile design. The jaw movements were recorded with two different methods, a mechanical articulator and an intraoral scanner with Patient-Specific-Motion function. The occlusal contacts during protrusive and lateral movements were compared and the digital wax-up was designed according to the later occlusal data. An aesthetic crown lengthening and pre-op root canal treatment were carried out in advance accordingly. After guided tooth preparation with a silicone index, the final fixed restorations were manufactured and cemented. A 2-year follow-up showed that our prosthesis functions well.

Conclusions: This clinical report revealed that an intraoral scanner with Patient-Specific-Motion function can effectively record individual dynamic occlusal patterns and these data can be integrated into the CAD/CAM process to enhance the fulfillment of clinical requirements.

Clinical significance: This clinical procedure with a 2-year follow-up demonstrated that a prosthodontic-based interdisciplinary treatment of pathologically migrated teeth using dynamic occlusal recording with an intraoral scanner could achieve satisfactory esthetics in a relatively short treatment period. The Patient Specific Motion module may be used to record a personalized functional movement and the data can be integrated into the design process of the final restorations.

Objective: This case report presents a female adult patient who exhibits poor oral hygiene, a mutilated dentition with multiple missing teeth, and skeletal asymmetry.

Clinical considerations: Interdisciplinary treatment was necessary to maintain oral hygiene, treat caries, extract residual roots, and upright a horizontally impacted third molar using a miniplate. Additionally, orthodontic mini-implants were utilized as anchorage to improve sagittal relationship and space closing. Space management was completed with orthodontic treatment, followed by restoration of the multiple missing teeth with dental implants.

Conclusion: Consequently, an esthetic smile and functional occlusion were achieved by interdisciplinary treatment using orthodontic skeletal anchorage devices and dental implants.

Clinical significance: Missing mandibular first molar spaces were closed with retraction of the anterior teeth and protraction of the mandibular second molars using orthodontic mini-implants. The mandibular right third molar, which should have erupted, was protracted with the second molar, while the horizontally impacted mandibular left third molar was uprighted using a miniplate and was protracted with an orthodontic mini-implant. The missing maxillary lateral incisors were replaced with the maxillary canines, and the maxillary canines were replaced with the maxillary first premolars. The missing maxillary right second premolar and first molar and left first and second molars were successfully restored with dental implants.

Objective: The color matching of single-shade resin composites after in-office whitening was investigated.

Materials and methods: Four single-shade resin composites were used. A total of 35% hydrogen peroxide was used as the whitening agent. The resin composite was placed in a cavity of an artificially discolored bovine tooth. The color differences between the restoration and surrounding enamel before and after whitening were determined based on ΔE*_ab, ΔE₀₀, and ΔWI_D. The color stability, surface roughness (Sa), and surface gloss (GU) of the resin composite alone were also evaluated. Statistical analyses were performed using repeated-measures analysis of variance with the Tukey-Kramer test.

Results: Based on the 50:50% of perceptibility and acceptability thresholds of ΔE*_ab and ΔE₀₀, none of the resin composite restorations were clinically acceptable before or after whitening. Regarding ΔWI_D, although all resin composites showed "acceptable match" in the baseline, they showed "mismatch" after the third session of whitening. Most of the resin composites alone were stable in color against whitening.

Conclusions: Although the single-shade resin composites failed to achieve the expected color matching on discolored teeth either before or after the whitening, the impact of the whitening on the color of the resin composite alone may be negligible.