Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995)最新文献

Digital technology that utilizes 3D printing has become a viable alternative to the traditional fabrication of wax patterns and definitive restorations for pressable ceramics. Digital workflows afford clinicians fewer variables, improved repeatability, and faster design and fabrication times. The print/press technique for producing zirconia-reinforced lithium-disilicate restorations offers benefits in terms of convenience, precision, and improved mechanical properties. This article describes an efficient workflow for monolithic ceramic restorations using the print/press technique and a novel zirconia-reinforced silicate ceramic.

Background: Dentin hypersensitivity is a global oral health concern. This in vitro study and clinical evaluation tested the efficacy of 0.454% stannous fluoride toothpaste stabilized with nitrate and phosphates (SNaP) to occlude dentin and reduce dentin hypersensitivity.

Methods: Human dentin specimens were treated with test and control toothpaste slurries and evaluated for dentin occlusion. In a phase III randomized controlled trial, eligible participants were randomized to SNaP toothpaste (test group), a potassium nitrate desensitizing dentifrice (positive control), or a non-desensitizing sodium monofluorophosphate dentifrice (negative control). Baseline, day 1, day 3, and day 7 dentin hypersensitivity was assessed using tactile and air blast stimuli. Mean tactile and air blast hypersensitivity scores were calculated for each treatment group. For statistical analysis, significance was set to P ≤ .05.

Results: In vitro mean percent tubule occlusion for test and control samples were 86% and 35%, respectively (P less than .05). One-hundred-twenty participants completed the clinical trial. After 7 days of product use, relative to the positive control and negative control groups, the test group exhibited significant reduction in tactile hypersensitivity (79.8% and 90.2%, respectively; P less than .001) and reduction in air blast hypersensitivity (47.1% and 47.9%, respectively; P less than .001). SNaP significantly reduced hypersensitivity pain after 1, 3, and 7 days.

Conclusions: In vitro and clinical evaluation results indicate that SNaP is highly effective in coating the dentin surface, occluding exposed dentin tubules, and offering sensitivity relief from the first day of use, a benefit that continues to improve with use.

Practical implications: This multi-benefit formula reduces dentin hypersensitivity, thereby improving the daily lives of patients, promoting better oral health, and potentially helping patients avoid more serious dental problems in the future.

Designing and fabricating dental restorations via the indirect method emerged as a strategic response to the loss of tooth coronal structure that prompted the need for different treatment options depending on the extent of the damage (eg, partial-coverage restorations such as inlays/onlays and laminate veneers, or full-coverage restorations such as crowns). The complexities of the oral environment and patient management in the dental chair also factored into the development of indirect restorations. Indirect restorations involve manufacturing them away from the oral cavity, avoiding some of the difficulties of direct techniques, such as polymerization contraction and marginal adaptation, as polymerization shrinkage stresses only affect the cement layer, reducing the impact on the cavity walls.

Effective and accessible oral care strategies, like the use of a multi-benefit, antimicrobial toothpaste, are a key tool in preventive public health. For over 30 years, Colgate Total toothpastes have represented a gold standard in multi-benefit toothpastes to help fight bacteria and provide whole-mouth care. This review introduces the next generation of Colgate's research and development featuring stannous fluoride (SnF2) stabilized by nitrate and phosphates. The uniqueness of this engine is detailed through a review of SnF2 oral benefits, the historic challenges associated with SnF2 toothpastes, and the advantages that this chemistry can bring to patients seeking multi-benefit oral care. With this novel technology, a new balance in efficacy, stability, and streamlined design enables flexible formulation and customized user experiences inspired by key therapeutic areas.

Background: This study compared the extrinsic tooth stain removal efficacy of a 0.454% stannous fluoride dentifrice stabilized with nitrate and phosphates (SNaP) versus a non-whitening regular fluoride dentifrice (negative control) after 3 and 6 weeks of product use.

Methods: This phase III, double-blind, randomized, two-cell, parallel-group study was conducted on 80 healthy adults in Puerto Rico. After a baseline tooth stain assessment and oral examinations, study participants were randomly assigned to either the SNaP (test) group or a negative control group. Participants brushed their teeth twice daily for 2 minutes for the 6-week duration. The efficacy for extrinsic tooth stain removal was assessed via Lobene composite stain index, stain area index, and stain intensity index scores for each treatment group at baseline, 3 weeks, and 6 weeks.

Results: Seventy-eight participants completed the 6-week study. The SNaP dentifrice provided more stain removal relative to baseline tooth stain scores (3-week: 24.4%; 6-week: 35.6%; P less than .001) and more stain removal relative to the regular fluoride dentifrice (3-week: 24.3%; 6-week: 39.1%; P less than .001).

Conclusion: The results indicate that the SNaP toothpaste provides a greater level of efficacy in the removal of extrinsic tooth stain as compared to a regular fluoride toothpaste when used twice a day, as measured with Lobene stain index at 3 weeks and 6 weeks.

Practical implications: A new stannous fluoride dentifrice stabilized with nitrate and phosphates offers greater efficacy in removing extrinsic tooth stain as compared to regular fluoride toothpaste.

The advancement of digital technologies, including 3-dimensional (3D) imaging and computer-aided design/computer-aided manufacturing (CAD/CAM), and material science has significantly transformed dentistry. Current CAD/CAM techniques incorporate both subtractive and additive (eg, 3D printing) manufacturing methods, with 3D printing offering such benefits as reduced material waste and the ability to produce complex geometries. Much research has focused on the development of hybrid materials that merge the esthetics and durability of ceramics with the high flexural strength, low abrasiveness, and intraoral repairability characteristics of resin composites. Most hybrid ceramics, however, have been optimized for subtractive manufacturing methods, and only a few 3D-printed hybrid materials are available for permanent dental restorations. This case report documents the clinical application of digital technologies in the full-arch rehabilitation of a patient with terminal dentition, highlighting the use of 3D-printed nanoceramic hybrid materials for long-term provisionalization and as a potential permanent solution in the subsequent transition to definitive restorations. The article describes the clinical steps used in the fabrication of the 3D-printed implant-supported restoration, which was clinically tested over 1 year.

Young patients often times are poor candidates for implant-supported restorations due to ongoing jawbone development. This case report describes a viable restorative option for a 16-year-old patient who had a large cleft defect and a hopeless prognosis for the right lateral incisor. The clinician utilized a combination of a fixed bonded ceramic restoration to replace tooth No. 7 and direct composite resin, including pink composite resin, to restore the symmetry and gingival level of tooth No. 8. This conservative approach allowed for an esthetic outcome while providing the patient a stable and functional restoration.

Intraoral scanners (IOSs) have transformed digital dentistry by enabling the capture of detailed intraoral optical impressions, resulting in high-precision virtual models. This article provides an overview of the technological advancements and emerging applications of IOSs in various dental specialties. Recent innovations have improved IOS speed, resolution, and functionality, eliminating the need for scanning powder and allowing for seamless integration with other digital tools. IOSs are widely used in restorative dentistry for computer-aided design/computer-aided manufacturing of dental restorations, offering accuracy comparable to traditional methods. Additionally, IOSs play critical roles in prosthodontics, orthodontics, and oral and maxillofacial surgery. Automated tooth segmentation and orthodontic landmarking have become more efficient due to advancements in machine learning. However, although IOSs are highly accurate for most dental procedures, they face limitations in edentulous areas and full-arch implant impressions. Efforts to expand their diagnostic capabilities-such as caries detection and the monitoring of soft-tissue levels and tooth wear-are underway, aided by advancements in imaging technologies. As research continues, future developments in IOS technology, including better integration with other digital tools and teledentistry applications, should further enhance its utility in dental care. This article highlights the pivotal role IOSs play in modern dentistry while acknowledging ongoing challenges.

Careful treatment planning, both clinically and radiographically, and when needed, utilization of a surgical guide, are prerequisites for proper implant placement. Accurate implant insertions with respect to position, angulation, and sink depth facilitate successful fabrication of prosthetic constructs. However, non-optimally located fixtures concerning these three facets of therapy can create biologic and prosthetic complications. This article discusses guidelines for correct implant insertions and for adjustments to surgical and prosthetic protocols to diminish problems associated with suboptimal implant placements.