Oral health最新文献

The composite resins have reached a high degree of excellence and are now used with predictable results in restoring the anterior dentition. This article discusses the development of these resins and the histologic and optical considerations (polychromatic characteristics, hue translucency and opacity, chroma, value, strength and polishability). In restorative materials, the use of universal or all-purpose restorative resins is considered: i.e. materials that combine the junctional strength necessary for the posterior regions and the high gloss polishability necessary to emulate enamel in the anterior. The restorative sequence of cervical, middle, and incisal thirds describes the materials best suited for each third, along with aids to create the intricate refinement of hue, chroma, and value. The learning objective of this article is to review the principles involved in these restorations and to provide a protocol for their clinical implementation.

Implant success is as difficult to describe as the success criteria required for a tooth. A range from health to disease exists in both conditions. The primary criteria for assessing implant quality are pain and mobility. The presence of either one greatly compromises the implant, and removal is usually indicated. Probing depths may be related to the presence of local disease or pre-existing tissue thickness before the implant was inserted. An increasing probing depth is more diagnostic and signifies bone loss, gingival hyperplasia or hypertrophy. Bone loss is usually evaluated best with probing rather than with radiographs. The most common cause of bone loss during the first few years of function are exaggerated factors of stress. The bleeding index is easily observed and indicates inflammation of the gingiva. However, implant health status is not as related to sulcular inflammation as would be the case for a natural tooth. Implant failure is easier to describe and may consist of a variety of factors. Any pain, vertical mobility, uncontrolled progressive bone loss, and/or generalized periradiolucency warrant implant removal. Implant quality factors were established by James and modified by Misch into an implant quality scale which not only assesses the implant health-disease continuum, but relates treatment and prognosis to the existing conditions.

The Endopore implant provides a novel method for reliable fixation of endosseous dental implants within the bone. Through the use of a porous-surfaced zone formed by sintering Ti alloy particles of the appropriate size and under appropriate processing conditions to a sold Ti alloy core of desired shape (tapered truncated cone), an implant is now available that can be placed using a relatively simple surgical procedure using either surgical burs or hand osteotomes. Of even greater value is the suitability of this implant design for treatment of cases that because of minimal bone height cannot be treated routinely using other currently-available implants. The high success rates experienced with significantly shorter implant lengths compared with other designs indicate the appropriateness of this system for difficult-to-treat cases. The Endopore system represents the next generation of endosseous dental implants characterized by uncomplicated and reliable treatment for a wider range of dentally-compromised patients. Its history is founded on extensive and fully-documented research at the human preclinical stage as well as human use experiences. The results during the past nine years have confirmed the high expectations that those early studies suggested.

The anticipated prosthesis now dictates the placement and angulation of the implant, thereby improving the function and the aesthetics of the final result. To establish a logical continuity between the surgical phases and the planned prosthesis, it is essential to use a transfer device. The restorative clinician can request a precise position and orientation of each implant with this communication tool. However, it is difficult to use a conventional surgical template following the soft tissue reflection and during preparation of implant osteotomy. The proper positioning of each implant is difficult to achieve, especially on a completely edentulous maxilla where restorations require even more ideal implant placement.