Signature (Ramsey, N.J.)最新文献

In dentistry, the concept of realism can be applied to the creation of an artificial prosthesis that is not perfect, but real. If prosthesis are made to a flawless perfection, they will appear artificial. Ultimately, the clinician and ceramist should strive for realism. The IPS Empress System (Ivoclar Williams, Amherst, NY) is an all-ceramic restorative alternative utilizing a pressable leucite-reinforced glass ceramic for a variety of indications (e.g., crowns, inlays/onlays, veneers). The resulting tooth-colored and metal-free restorations combine strength and aesthetics approaching those of natural teeth. This article describes the technique and procedures required to achieve realistic anterior crowns with this all-ceramic system.

The utilization of synthetic resins and ceramics in combination with metal frameworks continues to be the mainstay of crown and bridge prosthetics. Although most of these systems have resulted in years of clinical success, each material when used in combination has inherent properties that induce stresses to the system. The combination of ceramic technology and polymer research, in addition to fiber integration, has resulted in the development and introduction of a new category of crown and bridge materials--a ceromer and fiber-reinforced restorative system. This article examines the history of polymer and ceramic technology, and reports the clinical and research data currently available on one indirect ceromer system (Targis System, Ivoclar Williams, Amherst, NY).

How a removable partial denture (RPD) attaches to its abutment teeth is the most important aspect of partial denture design. The reason is obvious: Many critical requirements for optimal design are dependent on the way the removable segment is related and secured to the abutment teeth. To appreciate the importance of the attachment design, it is necessary to understand several principles of overall RPD design. State-of-the-art RPD design is often the most effective means for achieving long-term maintainable health of the remaining teeth. Even weakened teeth with compromised bone support can, with good design, often be used effectively as abutments for RPDs while benefitting from the removable partial.

Proper cavity preparation and fabrication techniques for inlay and onlay restorations require particular scrutiny. Gold has been established as the most effective restorative material for this indication, demonstrating the maintenance of long-term function, marginal integrity, interproximal contacts, effective contouring, and soft tissue compatibility. This article examines the slot inlay restoration, the distal hollow-grind preparation--alone or with a pin, and the class III gold foil technique for the restoration of the distal of the cuspids, a procedure that remains technically demanding for the profession. The author outlines efficient methods by which these restorations can be accomplished for the repair of lesion that reside on the distal aspect of cuspid teeth.

Although porcelain-fused-to-metal (PFM) restorations are the most widely used full-coverage crown restoration systems, their inherent properties make the achievement of natural aesthetic restorations an elusive task. In contrast, the all-ceramic system (IPS Empress, Ivoclar North America, Amherst, NY) offers excellent translucency and vitality, without the opacity associated with PFM restorations. Its vitality is further enhanced by an adhesive resin cementation method that conducts the color of the underlying tooth structure. This article reports the status of a 5-year investigation, initiated in 1992, of the clinical performance of the IPS Empress all-ceramic system and the resin cementation system used with it.

No other restorative methodology has been as intensively and critically investigated as that of tooth-colored restorative options. As the biologic and physiochemical shortcomings of earlier adhesive and restorative resins systems have been identified and corrected, newer materials have been formulated, and new techniques utilized. The use of dental dam, attainment of proximal contacts, and the importance of the first layer of composite resin are often overlooked. This article presents various solutions in the quest for adhesive and aesthetic excellence in anterior and posterior applications using Tetric* (Ivoclar Vivadent, Amherst, NY), a microhybrid that meets the optimal criteria for direct composite resin restorations.