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

Background: The need for proper framework support for the veneer porcelain in fixed partial dentures (FPDs) has been well documented. The aim of this study was to compare the variations of the support provided by frameworks designed directly on the computer, or indirectly through scanning a wax pattern.

Materials and methods: For each of the six upper anterior FPDs that were involved in the study, prior to milling one framework was designed conventionally in wax and scanned and another one was directly digitally designed. The restorations consisted of full coverage retainers and pontics on natural abutment teeth and implant abutments at random. The produced frameworks were evaluated regarding the incisal support they would provide to the veneer material, as this was revealed by a silicon key representing the outer labial contour of the provisional restoration. The distances between the distal and mesial incisaledges and the corresponding negative incisal contour of the key were measured with a digital caliper. Statistical analysis was performed by linear regression with the design method, abutment type and pontic type as independent parameters (a = 0.05).

Results: The values recorded were: means ± SD: 3.3 ± (direct CAD), 2.6 ± mm (indirect CAD) 2.7 ± mm (for retainers on natural teeth) 2.7 (on implant abutments), and 3.3 mm (for pontics). Linear regression analysis showed that the indirect technique provided more intimate incisal support for the ceramic veneer on a statistically significant level and even more so in the pontic areas.

As the demand for an esthetically satisfactory smile has increased, interest in less invasive procedures, such as composite restoration and tooth bleaching, has also increased. Composite resins exhibit several optical properties, including fluorescence, which are intended to mimic the natural dentition. The aim of this study was to evaluate the effect of hydrogen peroxide (HP) bleaching protocols for home and in-office applications on the fluorescence of composite resins. Sixty composite resin specimens (shade A2) were divided into 2 groups of 30 each according to the material type (groups R1 and R2 were made up of 4 Seasons and Opallis specimens, respectively). Each group was subdivided into 3 subgroups (n = 10) according to the bleaching protocol administered: home application (HP 7.5%); in-office application (HP 35%); and control (Co), immersion in deionised water. The fluorescence intensities were measured before and after the bleaching treatments using a Cary Eclipse fluorescence spectrophotometer and statistically analysed by paired t test, Student's t test, analysis of variance (ANOVA), and Tukey's multiple comparison test (P < 0.05). Significant differences between groups R1 and R2 after the different treatments were noted. The fluorescence intensities differed across the subgroups after 30 days of treatment. The HP 7.5% protocol induced the greatest change in the fluorescence intensities among the specimens in the R1 group.

Purpose: The aim of this paper is to describe a protocol for a one-stage technique called Immediate Dentoalveolar Restoration (IDR), which uses autogenous bone grafts to restore peri-implant bone defects, presenting the results of mid-term follow-up.

Summary: The patient presented a left central incisor that was compromised and with a total loss of buccal bone wall. The proposed treatment followed a protocol of immediate implantation, with a flapless surgery, using corticocancellous bone graft harvested from the maxillary tuberosity to restore the bone defect in question. The graft was shaped to the defect size and inserted between the implant and the remaining buccal soft tissue. The provisional restoration was made at the same time. The patient was followed for 36 months. The results were analyzed by means of clinical assessment, photography, periapical radiography and cone beam computed tomography.

Conclusion: The treatment described appears to afford satisfactory esthetic results, with lower overall costs and treatment time.

This study aimed to evaluate the perception of lip position preferences in a Saudi population and compare it to the perception of other populations. Master pictures of a male and female Saudi model were prepared with the upper lip 3 mm from Ricketts' E-line and the lower lip 1 mm behind. The lip position was then altered using computer imaging to create a range of pictures from the upper lip 15 mm behind the E-line to the upper lip 6 mm beyond the E-line. One hundred and fifty-six individuals (60 male, 96 female) were asked to rate the pictures in terms of acceptability and also which picture they liked best. The preferences were compared based on gender, perception of their own lateral profile and history of previous orthodontic treatment. The study found that regardless of gender, the Saudi population has a distinct preference for lip positions that are further away from the E-line than the current Western standard. The population studied also showed a greater tolerance for deviation in the lip position away from the E-line than deviations towards the E-line.

In this two-part case presentation, the benchmarks of our treatment planning principles are briefly exposed and their application is discussed with regards to a 35-year-old female patient with multiple failing restorations and an esthetic complaint regarding the maxillary anterior teeth. In the first part, our four treatment principles were proposed, the patient's main problems were presented and three treatment options were discussed. In the second part, the treatment choice is disclosed along with the decision making process, the respective diagnostic procedures involved, and finally the sequential treatment. The aim of these articles is to stimulate a debate and to promote therapeutic choices that take into account the evolution of contemporary dental medicine.

The aim of this in vitro study was to evaluate the sorption (Sp) and solubility (Sl) of a nanofilled composite (Filtek™ Z350) light-activated from the top in three curing light distances (0 mm, 3 mm and 6 mm) and immersed in three different mouthwashes (Plax Fresh Mint, Plax Alcohol Free, and Plax Whitening). Specimens (6 mm Ø and 1 mm height) were prepared (n = 5) and initially the degree of conversion (DC%) of discs was obtained by using a fourier transform infrared spectrometer. Then, the specimens were placed in a desiccator at 37°C and were weighed until a constant mass (m1) was obtained. The discs were immersed in the mouthwashes for 30 days. Twice a day, the samples were immersed in 2 ml of the mouthwashes (12 hr intervals). After the 30-day period, the discs were reweighed (m2). The reconditioning in the desiccator was done until a constant mass (m3) was obtained. The data of DC% were analyzed by analysis of variance (ANOVA) in split plots and the results showed statistical difference when photoactivated to 6 mm from the tip of the curing unit. The sorption data were submitted to two-way ANOVA and Tukey's Test at a 5% level of significance and it was observed that a statistical difference (P < 0.05) was only cured when the distance was 6 mm, but there was no difference in sorption between mouthwashes. The solubility data were analyzed by Kruskal-Wallis's Test (P = 0.05) and Dunn's Test, since a non-normal data distribution was observed. The values were negative, which means that there was a mass gain, masking the real solubility.

Minimally invasive treatment modalities allow for the preservation of sound tooth substance. However, by limiting the preparation to the extent of a defect, the transition between restoration and natural tooth may be moved to more visible areas. The materials available for the restoration of a limited defect in the anterior area are either resin composite materials or porcelain. A patient was presented who asked for the replacement of a discolored filling on the maxillary right central incisor. Tooth preparation was limited to the extent of the old filling, and a porcelain partial veneer restoration was fabricated. Despite the horizontal finish line in the middle of the clinical crown, a result could be achieved that was regarded as a success by the patient. This type of restoration proves to be a suitable alternative to direct composite restorations in the anterior area for the reconstruction of a limited defect, eg, due to a dental trauma.

Interdisciplinary, multidisciplinary and comprehensive treatment plans are now part of everyday practice. The interaction between different specialists can provide patients with better, more conservative and more pleasing results. This case report shows the step by step of a multidisciplinary treatment plan and the rationale for each part of a process where conservative dentistry, periodontics, orthodontics, implant dentistry and prosthetics are involved.

It is currently accepted that success in implant-supported restorations is based not only on osseointegration, but also on achieving the esthetic outcome of natural teeth and healthy soft tissues. The socalled "pink esthetic" has become the main challenge with implant-supported rehabilitations in the anterior area. This is especially difficult in the cases with two adjacent implants. Two components affect the final periimplant gingiva: a correct bone support, and a sufficient quantity and quality of soft tissues. Several papers have emphasized the need to regenerate and preserve the bone after extractions, or after the exposure of the implants to the oral environment. The classical implantation protocol entails entering the working area several times and always involves the surgical manipulation of peri-implant tissues. Careful surgical handling of the soft tissues when exposing the implants and placing the healing abutments (second surgery) helps the clinician to obtain the best possible results, but even so there is a loss of volume of the tissues as they become weaker and more rigid after each procedure. The present study proposes a new protocol that includes the connective tissue graft placement and the soft tissues remodeling technique, which is based on the use of the ovoid pontics. This technique may help to minimize the logical scar reaction after the second surgery and to improve the final emergence profile.