Journal of Esthetic and Restorative Dentistry最新文献

Objective

This article describes a novel 3D-printed template armed with interproximal matrices to isolate interproximal contact areas and guide injectable resin composite for consecutive closure of multiple diastema.

Clinical Considerations

Among several treatment options proposed for diastema closure, direct resin composite is noninvasive and easy to repair. The “composite injection technique” has been introduced to improve time efficiency and reduce technique sensitivity for clinicians. However, in the case of multiple diastema, the overflow of excess resin materials onto the adjacent teeth during injection poses challenges for recontouring the interproximal anatomy. A 3D-printed template with special-designed gaps at interproximal areas was designed and fabricated based on a virtual diagnostic wax-up. Flowable resin composite was then consecutively injected through the template to close diastemata at multiple adjacent teeth.

Conclusion

This technique using a 3D-printed template with interproximal isolation design contributed to an efficient and accurate operation for multiple anterior diastema closure.

Clinical Significance

Efficient and accurate freehand buildups of composite restoration for multiple diastema are challenging in operative dentistry. The described noninvasive full digital workflow provides a predictable method to accurately recontour the multiple target restorations and reduce the chair-side time and technical sensitivity.

Objective

This case report aims to present how digital technology can be employed to plan the orthodontic movement of teeth into their final positions for prosthodontic rehabilitation. An interdisciplinary approach to treatment planning and the result of prosthodontic treatment involves the cooperation of an orthodontist and a prosthodontist. When planned to achieve optimal results for a minimally invasive and functional prosthodontic treatment, orthodontic pretreatment provides superior esthetic results and favorable long-term success.

Clinical Considerations

The orthodontic movements of the teeth were planned so that the prosthodontist could reconstruct an optimally functional and esthetic occlusion while preserving the hard dental tissues. The orthodontic pretreatment minimized the need to prepare the teeth, avoiding any mucogingival surgery to improve the gingival architecture.

Conclusions

In complex clinical cases, it is essential to evaluate the advantages of an orthodontic pretreatment before starting a prosthodontic treatment. This pretreatment can help preserve dental tissues, reduce or eliminate the need for surgical intervention, and achieve long-term stability and esthetic results.

Clinical Significance

This case clearly shows the benefits of orthodontic pretreatment for prosthodontic outcomes. With modern digital tools, such an orthodontic pretreatment should become standard clinical practice when planning a complex clinical case.

Objective

Dental implants placed in adolescent patients pose a challenge to restore and maintain an esthetic outcome over longer period of follow-up. Maxillomandibular changes throughout adulthood may lead to complications such as implant infraocclusion and interproximal contact loss. This case report describes an alternate prosthetic treatment strategy for maxillary single implant placed in an adolescent patient in the esthetic zone with inappropriate implant axis and screw hole placement.

Clinical considerations

With temporary restorations, the gingiva and soft tissues were shaped to imitate the emerging profile of the contralateral side. A zirconia screw-retained abutment was customized as a copy-mirror from the contralateral prepared tooth to mimic the exact shape and to avoid labiolingual over contour by computer-aided design/computer-assisted manufacture (CAD/CAM). The porcelain laminate veneer was bonded to the zirconia abutment. Porcelain adhesive approach was used instead of traditional principles of retention and resistance form of the abutment.

Conclusions

A functional and esthetic outcome was achieved and maintained, while a minimally invasive procedure was implemented to use the malplaced implant instead of explanting it.

Clinical significance

The present report illustrates the prosthetic management of a malpositioned dental implant placed 20 years ago, utilizing a minimally invasive digital protocol.

Objective

This study aimed to develop the Turkish version of the Orofacial Esthetic Scale (OES-Tr) and to evaluate its psychometric properties.

Materials and Methods

The OES-Tr questionnaire was obtained from the English version of OES by translation and back-translation. The current version's psychometric properties were evaluated in a cohort of 221 participants (81 dental students, 70 dentists with 1–10 years of clinical experience, and 70 dentists with 11–20 years of clinical experience). To assess the test–retest reliability, the OES was administered twice to all participants, with a time interval of 2–4 weeks. The reliability and validity of the questionnaire were assessed. Also, in validity studies, OES total scores were correlated with Oral Health Impact Profile-Turkish Version (OHIP-Tr) total scores.

Results

The Cronbach's alpha value obtained from seven items was 0.866 in the examination performed on all individuals. Reliability results show that all questionnaire items are consistent within the test. Bartlett's test of sphericity was statistically significant (p < 0.05) and Kaiser–Meyer–Olkin test was 0.794. The results of the exploratory factor analysis indicated the creation of a single-factor structure. The examinations conducted on all participants revealed a statistically significant weak negative correlation between OES and OHIP scores (r = −0.144).

Conclusions

OES-Tr can be utilized as a reliable tool to evaluate an individual's perception of their orofacial appearance. With its excellent psychometric properties, it serves as a valuable instrument for assessing self-perceived orofacial esthetics.

Clinical Significance

OES-Tr is a valuable instrument for assessing the appearance of the orofacial region, with good psychometric properties.

Objective

This study aimed to examine the shear bond strength (SBS) of repair material to conventionally, subtractive-, and additive-manufactured denture bases after different surface treatments.

Materials and Methods

Disk-shaped test specimens (N = 300) were prepared from denture base materials produced by one conventional (Procryla), one subtractive (Yamahachi), and one additive (Curo Denture) method. The test specimens were randomly divided into five groups (n = 10) and exposed to a variety of surface treatments—Group A: no surface treatment; Group B: grinding with silicon carbide paper; Group C: sandblasting; Group D: erbium: yttrium-aluminum-garnet laser; and Group E: plasma. Repair was performed with autopolymerizing acrylic resin (Meliodent). Surface roughness analyses were performed with a profilometer. Scanning electron microscopy was used to examine one specimen from each subgroup. SBS was evaluated on a universal testing machine. Failure types were observed under a stereomicroscope.

Results

Surface roughness values were significantly higher in all test materials in Group D than in the other groups (p < 0.001). For conventional resin, the SBS values were higher in Group C than in Groups A, D, and E (p < 0.001). For CAD/CAM material, Groups B and C had significantly greater SBS increases compared with Group E (p < 0.001). For 3D material, Group D showed higher SBS than all groups except Group C (p < 0.001).

Conclusions

For SBS, sandblasting was most effective in the conventional group, whereas laser treatment was the most effective in the additive-manufactured group. For the subtractive group, surface treatments other than plasma exhibited similar SBS.

Clinical Significance

In repairing fractured prostheses, any degree of roughening suitable for the material content may provide an SBS benefit.

Statement of Problem

Limited evidence is available for the effect of chairside adjustment using rotary cutting instruments on the surface roughness and optical properties of different zirconia types.

Purpose

To evaluate the effect of simulated adjustments on surface roughness and optical properties of different zirconia types.

Materials and Methods

Three Partially Stabilized Zirconia (PSZ) types based on mole percent yttria (Y) concentration from the same manufacturer (Katana; Kuraray) were used: 3Y-PSZ, 4Y-PSZ, and 5Y-PSZ. Thirty disk-shaped specimens (Ø14 × 1.2 mm) from different zirconia types (N = 90) were prepared. Specimens were either left without adjustment (NA), adjusted with Dialite ZR finishing and polishing system (Brasseler) (APol), or adjusted with course diamond instruments only (ADia). The specimens were distributed into 9 groups (n = 10): Group 3Y-PSZ/NA, Group 3Y-PSZ/APol, Group 3Y-PSZ/ADia, Group 4Y-PSZ/NA, Group 4Y-PSZ/APol, Group 4Y-PSZ/ADia, Group 5Y-PSZ/NA, Group 5Y-PSZ/APol, and Group 5Y-PSZ/ADia. The surface roughness of specimen was analyzed using an Atomic Force Microscope (AFM) (Bruker's Dimension Icon, Bruker) and Root Means Square (RMS) were recorded (nm). Surface Gloss (SG), Translucency Parameter (TP), and Contrast Ratio (CR) values of all groups were recorded using an integrating sphere spectrophotometer. Statistical analysis was performed using analysis of variance (ANOVA) and Tukey's multiple comparison tests for pairwise comparisons at p < 0.05 and 95% confidence interval.

Results

APol had no effect on the surface roughness (p = 0.88) while ADia had a significant negative effect (p < 0.05) despite the type of zirconia. Out of the three testes optical properties, only SG was negatively affected by ADia for all types of zirconia (p < 0.05). The two adjustment types did not affect the TP of all the tested zirconia (p = 0.91). The CR was not affected by the tested adjustments for all zirconia types (p = 0.726).

Conclusion

Proper zirconia adjustment following a sequence of burs and polishers can maintain acceptable roughness and optical properties. Adjustment of zirconia with rough diamond can lead to deleterious effects and should be avoided.

Clinical Significance