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

When replacing a missing tooth in the esthetic zone, the implant supported single tooth restoration can result in a very natural and pleasing solution for the patient, being also a conservative procedure that preserves the adjacent remaining dentition. Immediate implant placement with an immediate provisional crown can avoid stressful and uncomfortable healing time for the patient who no longer has to wear an interim removable appliance. In selected clinical situations, excellent tooth esthetics for implant supported single tooth restorations can be achieved by using the natural extracted tooth as both provisional and final restoration. No longterm data is available today as far as the survival rate of such restorations and the predictability of such a treatment modality. This case report describes a technique for utilizing the patient's extracted tooth for the fabrication of an inconspicuous final anterior restoration, reporting a 5-year follow-up.

Objective: The aim of this study was to identify the presence of monoclinic zirconia phase (m-ZrO2) in 5 computeraided design/computer-assisted manufacture zirconia systems composed of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP).

Materials and methods: Three-unit fixedpartial dentures were prepared from Cercon (CR); Lava (LW); Zenotec Zr Bridge (WD); In-Ceram YZ (YZ); and IPS e-max ZirCAD (ZC), all milled in a pre-sintered stage and then fully sintered according to the manufacturers' instructions. Raman spectroscopy was used to identify and map the distribution of the m-ZrO2 phase at cervical crown margins, pontic and connector regions. Three sets of data were obtained from each material (n = 2) and the percentage volume (%Vm) of the m-ZrO2 phase was calculated per region. Statistical analysis was performed by two-way analysis of variance and Tukey test (a = 0.05).

Results: The m-ZrO2 phase was detected in all the specimens, with the highest intensity located at the crown margins. WD showed the lowest %Vm content (0- 3.14%), followed by LW (10.26-12.39%), CR (11.72-13.19%), ZC (11.13-14.10%) and YZ (12.15-14.99%). No statistically significant difference was found among LW, CR, ZC, YZ per region. Within each material group, significant differences were found between margin-pontic/connector (WD, YZ), margin-connector (CR, ZC) and margin-pontic (LW).

Significance: The Y-TZP destabilizing m-ZrO2 phase was identified in all the fully sintered frameworks tested, with the highest %Vm located at the margins. The extent to which the presence of this phase may be implicated with zirconia low temperature degradation or porcelain to zirconia bonding is unknown.

Introduction: The development of countless types and trends of high viscosite and flowable composite resins, with different physical and chemical properties applicable to their broad use in dental clinics calls for further studies regarding their radiopacity level.

Purpose of the study: The aim of this study was to evaluate the radiopacity levels of high viscosity and the flowable composite resins, using digital imaging.

Materials and methods: 96 composite resin discs 5 mm in diameter and 3 mm thick were radiographed and analyzed. The image acquisition system used was the Digora® Phosphor Storage System and the images were analyzed with the Digora software for Windows. The exposure conditions were: 70 kVp, 8 mA, and 0.2 s. The focal distance was 40 cm. The image densities were obtained with the pixel values of the materials in the digital image.

Results: Most of the high viscosity composite resins presented higher radiopacity levels than the flowable composite resins, with statistically significant differences between the trends and groups analyzed (P < 0.05).

Conclusions: Among the high viscosity composite resins, Tetric®Ceram presented the highest radiopacity levels and Glacier® presented the lowest. Among the flowable composite resins, Tetric®Flow presented the highest radiopacity levels and Wave® presented the lowest.

In this article, the interdisciplinary management of an isolated-type recession defect in a severely compromised mandibular incisor of a young post-orthodontic patient is described. The prognosis of root coverage surgery was very questionable and unpredictable due to the severe root malposition (III Miller class gingival recession). The treatment plan consisted of: (1) interproximal enamel reduction to gain space within the dental arch, (2) orthodontic repositioning of the root of the affected tooth within the alveolar bone and (3) root coverage mucogingival surgery. Clinical re-evaluation 7 months after fixed orthodontic treatment revealed major improvements in the root coverage prognosis due to the resolution of root malposition and de novo formation of keratinized tissue apical to the root exposure (I Miller class gingival recession). A subepithelial connective tissue graft was performed as a root coverage surgical procedure. Clinical examination 1 year after surgery revealed complete root coverage, good color blending with adjacent soft tissue and an increase in facial gingival thickness. Successful periodontal and esthetic outcomes can be accomplished after the combined orthodontic-periodontal treatment of a severely mucogingivally compromised tooth.

This study examined the correlation between maxillary anterior tooth form and gender with three-dimensional data. Three-dimensional digital models of the area between the maxillary right central incisor and the maxillary right canine were obtained from 120 Caucasian subjects (60 males and 60 females) with healthy dentitions. Correlation between gender and tooth form was assessed applying logistic regression, with and without size standardization. Success rates were estimated using 10-fold cross-validation. Principal components that correlated with gender were evaluated with a Wald test. Values for the significance of the predictors were provided with a likelihood ratio test (P < 0.05). Significant correlation between gender and tooth shape was found for the maxillary central incisor (P = 0.003), lateral incisor (P ≤ 0.001), and canine individually (P ≤ 0.001), and for the three teeth combined (P ≤ 0.001) without size standardization. For the maximillary right lateral incisor (P=0.004), canine (P ≤ 0.001), and a correlation of the teeth (P ≤ 0.001), a correlation was also established after size standardization. Prediction of gender was not possible without information on tooth size for the maxillary right central incisor (P =0.15). maxillary anterior teeth have gender-specific differences. Differences in tooth size account for part of the correlation. However, tooth shapes are also gender specific.

Introduction: Each facial feature might affect the perception of the balance of the other features so the whole of the face must be considered in facial evaluation. There are no studies that have examined the effect of forehead and neck position on profile esthetics. The objective of this study was to evaluate the effects of forehead and neck positions on profile esthetics judged by lay people, dental students and art students.

Materials and methods: A straight silhouette (black right-facing profile in white background) was digitally manipulated to make variations of profiles. The positions of all compartments of face were similar except for anteroposterior position of forehead and neck. The 310 raters (100 dental students, 100 art students and 110 lay people) were asked to rate profiles with a Likert scale. The nonparametric Mann-Whitney test, chisquare tests, Spearman rank correlation coefficients, one-way analysis of variance (ANOVA) and Kruskal-Wallis analyses were used in data analysis.

Results: The scores given to profiles with straight, retruded and protruded necks and foreheads were significantly different. (P < 0.05). In three groups, the most and least attractive profiles judged by raters were comparable (P > 0.05).

Conclusion: This study showed that the position of the forehead and the neck has an effect on the beauty of profile silhouettes and this effect is so noticeable that all of the raters could perceive the differences. It is necessary to evaluate the whole of the face, including the forehead and neck, in a facial evaluation.

Purpose: Pyogenic granuloma is a relatively rare hyperplastic lesion of the oral tissues. Clinically it is heterogeneous and can be similar to malignant epithelial and mesenchymal neoplasms. The treatment of choice is the surgical excision of the lesion. This approach often results in unpleasant gingival defects, especially when the pyogenic granuloma is located in the esthetic zone.

Materials and methods: This report describes the clinical and histological findings of pyogenic granuloma diagnosed in the maxilla of a 24-year-old female, as well as the successful treatment of the mucogingival defect that occurred following excision of the lesion, by placement of a subepithelial free connective tissue graft with the envelope-technique concurrently with the biopsy procedure.

Results: One-year postoperative complete root coverage of tooth 11 was achieved with a harmonious gingival contour, and no further recurrence was noted.

Conclusion: Early diagnosis of pyogenic granuloma, and consequent therapy with adequate excision in a safe distance of at least 1 mm, is essential for prevention of neighboring structures and minimizing the risk of a relapse. Histopathological evaluation is obligatory to confirm the tentative clinical diagnosis and to exclude malignant neoplasms. The immediate esthetic rehabilitation with free connective tissue grafts presents a complementary procedure in the treatment of mucogingival defects after total excision of oralmucosal diseases.

Purpose: To evaluate the efficacy of tooth bleaching with high concentration agents, varying the catalyst sources and exposure times.

Materials and methods: Stained human third molar fragments were randomized and placed into 8 groups (n = 5). G1: Whiteness HP Maxx (FGM, Joinville, SC, Brazil) 35% (HP)/5 min on enamel surface without external catalyst source; G2: HP/15 min without external catalyst association; G3: HP/5 min with Quartz Tungstein Halogen (QTH: Optilux 501C, Demetron/Kerr, Danbury, CT, USA) as a catalyst; G4: HP/15 min with QTH as a catalyst; G5: HP/5 min with LED/laser as a catalyst; G6: HP/15 min with LED/ laser as a catalyst; G7: HP/5 min with ultrasound as a catalyst; G8: HP/15 min with ultrasound as a catalyst. The efficacy of bleaching was measured using a spectrophotometer (initial fotoreflectance analysis, after artificial staining with black tea, and after each of the bleaching sessions). Three bleaching sessions were performed. Data were submitted to Analysis of Variance and Tukey-Kramer tests (P < 0.05).

Results: No significant differences were found between the catalyst sources as related to the factor of exposure time and within each evaluation time. For the 15 min exposure, the best result was achieved in the second bleaching session, except for the LED/laser group. For the 5 min exposure, the best result was achieved in the third session, except for ultrasound. The 15 min of exposure time showed higher reflectance than 5 min for LED/laser and ultrasound in all bleaching sessions and for halogen in the second bleaching session.

Conclusion: Light sources did not increase the catalytic efficiency of bleaching, and allowing a longer time for gel exposure on the enamel achieves faster results.

Objectives: This in vitro study evaluated the accordance of dental color measurement devices with a Commission Internationale de l'Eclairage (CIE)-compliant reference system, by comparing the CIE lightness, chroma, and hue (L*C*h°) color coordinates of ceramic samples.

Methods: Four color measurement devices: Vita Easyshade® Advance (A); DeguDent Shadepilot™ (B); X-Rite® Shadevision (C); and Crystaleye Olympus (D), were compared with a CIE-compliant reference system by recording the L*C*h° color coordinates of ceramic samples matching the tooth colors of the Vita Linearguide 3D-Master®, under standardized test conditions. Differences between regression lines for the dental color measurement device data and regression lines for the CIE-compliant reference system data were evaluated.

Results: All devices offered high intraclass correlation coefficients (0.9771- 0.9999) for the L*C*h° color coordinates. The regression lines of the L* and C* coordinates for device A were steeper than those of the CIE-compliant reference system; the regression lines for devices B, C, and D were nearly parallel to those of the reference system, but with an offset. The regression lines of the h° coordinates for all devices were almost parallel to those of the reference system, with slopes near 1. Excluding the L* and h° coordinate measurements of device A, the measurements with the devices exhibited deviations from the reference system that were greater than those expected by chance (P < 0.0002).

Conclusions: The dental color measurement devices assessed here offered excellent reproducibility, but showed significant deviations from the CIE-compliant reference system regarding the L*C*h° color coordinates.