The European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry最新文献

Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the classical crown supported by radicular metal posts remains widely spread in dentistry, its invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are nowadays available. They allow performing a more conservative, faster and less expensive dental treatment. All clinical cases presented in this paper are solved by using these modern techniques, from direct composite restorations to indirect endocrowns.

This study aimed to evaluate whether preheated resin-based flowable restoratives would show increased hardness and softening susceptibility after an early cariogenic challenge. Fluroshield- Yellowed, Bioseal, Wave, Master Flow, Fluroshield-White, Conseal F, Filtek Z350 Flow, and Opallis Flow were tested. Preheating was performed using a microwave device. Five specimens of each preheated or room temperature material (n = 5) were fabricated. Hardness was assessed before and after a cariogenic challenge. The analysis was done by two-way analysis of variance (ANOVA) with repeated measures (cariogenic challenge) and Tukey's test for multiple comparisons (

Purpose: To evaluate translucency, fluorescence and opalescence stabilities of direct and indirect composite resins after aging.

Materials and methods: One direct (16 shades) and two indirect composite resins (16 and 26 shades) were investigated. Resins were filled in a mold (1 mm thick) and light cured; post-curings were performed for indirect resins. Color was measured before and after 5,000 cycles of thermocycling on a reflection spectrophotometer in reflectance and transmittance modes to calculate parameters for translucency (TP), fluorescence (FL) and opalescence (OP). Differences in the changes of TP, FL and OP after aging by the type of resin were determined by t test, and those were also determined by one-way ANOVA with the factor of the brand or the shade group (P < 0.05).

Results: Changes in TP, FL and OP were -1.2 to 0.7, -0.2 to 0.4 and -0.6 to 1.3, respectively, for direct resins; and were -2.0 to 1.8, -0.9 to 0.4 and -2.9 to 3.7, respectively, for indirect resins. Changes in TP were not significantly different by the type of resin, but those in FL and OP were different (P = 0.05). Changes in optical parameters were influenced by the brand or the shade group of the resins (P < 0.05).

Conclusion: Stabilities in optical properties of resins varied depending on type, brand or shade group. Aging significantly affected fluorescence and opalescence, but not translucency, of indirect resins compared to those of direct resins.

Composite resins are the most commonly used materials in restorative dentistry. When first introduced in dental practice, they began to change the esthetic approach to anterior teeth treatments. At first they simply represented a 'white' alternative to unesthetic materials. Today, the clinician can select different materials depending on the characteristics required, such as opalescence, fluorescence, translucency, transparency, viscosity, elasticity, and, obviously, shade. It is no longer a mere matter of selecting the right single syringe. The thicknesses of one or several materials may drastically change the final outcome. A three-dimensional way of planning restorations has overcome the old monochromatic bi-dimensional one. Sound tooth preservation, affordable treatments, and reparability are only a few of the advantages of using composite resins. Clinicians generally consider non-vital anterior teeth a big challenge from an esthetic point of view and they very often prefer to treat them with full or partial indirect ceramic restorations. In the present article, through the analysis of several step-by-step clinical cases, the authors point out that direct restorations could lead to successful esthetic outcomes if correct techniques are applied in order to make up for the differences between vital and non-vital teeth.

Enamel white spot lesions are frequent and can impact patients' quality of life. The most conservative treatment in such cases is microabrasion, a technique that presents some drawbacks. The proposed strategy is not based on the elimination of dysplastic enamel, but on masking the lesion by infiltrating the porous subsurface enamel with a hydrophobic resin that has a refraction index closer to that of sound enamel, after permeating the non-porous surface enamel through hydrochloric acid erosion. Erosion-infiltration approaches have been proposed to treat initial caries, but this report suggests extending it to two novel indications: fluorosis and traumatic hypo-mineralization lesions. Four cases were treated by erosion infiltration following the original protocol. They were followed up clinically at several intervals during a period of 19 months of clinical service. The clinical results, although not perfect, satisfied the patients entirely. Erosion infiltration could be a promising alternative for minimally invasive treatment in similar situations.

Purpose: To measure the influence of light activation, color pigments and extended application time on the in vitro bleaching efficacy of a hydrogen peroxide bleaching agent.

Methods: Ninety-six 2.5 mm thick bovine enamel and dentin samples were selected for the study. Samples were stained in a tea solution for three days and then randomly divided into three groups. Bleaching was performed with a 35% hydrogen peroxide gel containing different color pigments. Red pigments were used in group one, black pigments were used in group two, and no pigments (transparent gel) in group three. In these three groups the bleaching agent was applied once every 15 min (4 x 15 min). Then each group was divided into subgroups: with or without light activation. In addition, a fourth group with red pigment was used to test the efficacy of an extended application time (2 x 30 min). All samples were measured with a spectrophotometer to determine the L*a* b* values before and after bleaching. The ΔE value was then calculated. Analysis of variance and Duncan post-hoc test were used to identify differences between groups at a preset a of 0.05.

Results: When black and red pigments were used on enamel, light activation of the bleaching gel had a significant effect on the ΔE values. On dentin without light activation, transparent gel was significantly different from the red and black colored gel. There was no significant difference in the ΔE values between 4 applications of 15 min each and 2 applications of 30 min each.

Conclusions: Within the limitations of this in vitro study, no difference in the bleaching effect could be observed between applying the product 2 times of 30 min each and applying the product 4 times of 15 min each. The effect of light activation on colored gel was limited to enamel surface.

A full-mouth adhesive rehabilitation in case of severe dental erosion may present a challenge for both the clinician and the laboratory technician, not only for the multiple teeth to be restored, but also for their time schedule, difficult to be included in a busy agenda of a private practice. Thanks to the simplicity of the 3-step technique, full-mouth rehabilitations become easier to handle. In this article the treatment of a very compromised case of dental erosion (ACE class V) is illustrated, implementing only adhesive techniques. The very pleasing clinical outcome was the result of the esthetic, mechanic and most of all biological success achieved, confirming that minimally invasive dentistry should always be the driving motor of any rehabilitation, especially in patients who have already suffered from conspicuous tooth destruction.

In a historical pendulum of porcelain veneer preparation concepts, an oversimplified version of the so-called "no prep" approaches has resurfaced. A case from the USC student clinics is presented, which could be easily considered by many as a "no prep" veneer case. Moderate tooth preparations guided by natural morphology were used instead with a great benefit on the final outcome. While it is widely accepted that minimally invasive restorative approaches should be favored, a certain controversy exists regarding strictly noninvasive approaches. The purpose of this article is to re-emphasize the concept of guided tooth preparations, based of natural tooth morphology (given by a wax-up and a mock-up), a customized and sensible approach to indirect ceramic veneer tooth preparations.

Background: The treatment of gingival recessions is one of the important branches of periodontics related to esthetics. However, no surgical technique has been reported for the treatment of a particular type of gingival recession called Stillman's cleft.

Methods: The technique proposed is a laterally moved, coronally advanced flap. After local anesthesia, two parallel incisions, one along the cleft and the second parallel to the first one, have been placed beyond the mucogingival junction, allowing a rotating partial-thickness flap to cover the recession.

Results: The procedure, in this case presentation, resulted in successfully covering the previously exposed root surface.

Conclusion: Root coverage of a Stillman's cleft can be obtained and maintained for 5 years follow-up with a laterally moved, coronally advanced flap.