Amalgam alternatives – micro‐leakage evaluation of clinical procedures. Part I: direct composite/composite inlay/ceramic inlay

The aesthetic composite inlay or ceramic ones are useful for restoring posterior teeth affected by decay processes. The choice of the inlay type can sometimes be a challenge for the dentist. The aim of this study is to identify the optimal type of an inlay used for second-class cavities that can assure a good long-term prognosis of dental restoration. In order to achieve this study, it was performed an 3D analysis of stresses recorded in a premolar restored with a composite inlay and a ceramic inlay, the simulation being done by finite elements method (FEM) using Ansys program. The study results showed that stresses registered in the tooth restored through ceramic inlay are more favorable than those recorded in the case of the tooth restored with composite inlay. The aesthetic composite inlays are preferred instead ceramic ones by many practitioners because of the advantages it presents: requires minimal preparations, technique is easier thanks to the easier handling of composite material, allow future adjustment of the occlusal surface, being easily adjusted and repaired, are radiopaque and, last but not least, have a lower cost. The question that arises frequently in medical practice is related to inlays behavior in case of functional requirements, depending on the material from which they are made. Configuration of preparation, the technique and the materials used for cementing, and restorative materials can influence the type of resistance to fracture of these restorations. The ability of restorative materials to support the masticatory forces and distribution of stresses in the vicinity of the adhesive interface constitutes a decisive factor in acquiring a restoration with a high degree of resistance to fracture.

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Amalgam alternatives – microleakage evaluation of clinical procedures. Part II: direct/indirect composite inlay systems

Journal of Oral Rehabilitation ◽

10.1046/j.1365-2842.1998.00272.x ◽

1998 ◽

Vol 25 (7) ◽

pp. 502-506 ◽

Cited By ~ 3

Author(s):

D. Ziskind ◽

B. Elbaz ◽

Z. Hirschfeld ◽

L. Rosen

Keyword(s):

Clinical Procedures ◽

Indirect Composite ◽

Composite Inlay

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Influence of Preparation Design and Restorative Material on Fatigue and Fracture Strength of Restored Maxillary Premolars

Operative Dentistry ◽

10.2341/20-032-l ◽

2021 ◽

Author(s):

JW Hofsteenge ◽

IA van den Heijkant ◽

MS Cune ◽

PK Bazos ◽

SAM van der Made ◽

...

Keyword(s):

Fracture Strength ◽

Restorative Material ◽

Load To Failure ◽

Maxillary Premolars ◽

Design Depth ◽

Composite Inlay ◽

Composite Inlays ◽

Preparation Design ◽

Ceramic Inlay ◽

Failure Types

SUMMARY Statement of Problem: Extensive carious lesions and/or large preexisting restorations possibly contribute to crack formation, ultimately resulting in a fracture that may lead to the loss of a tooth cusp. Hence, preparation design strategy in conjunction with the restorative material selected could be influential in the occurrence of a cuspal fracture. Purpose: The purpose of this in vitro study was to evaluate the fatigue behavior and fracture strength of maxillary premolars restored with direct composite and indirect ceramic inlays and overlays, with different preparation depths in the presence or absence of cuspal coverage, and analyze their failure types. Methods and Materials: Sound maxillary premolars (N=90; n=10) were divided into nine groups: group C: control; group DCI3: direct composite inlay 3 mm; group DCI5: direct composite inlay 5 mm; group ICI3: indirect ceramic inlay 3 mm; group ICI5: indirect ceramic inlay 5 mm; group DCO3: direct composite overlay 3 mm; group DCO5: direct composite overlay 5 mm; group ICO3: indirect ceramic overlay 3 mm; group ICO5: indirect ceramic overlay 5 mm. In indirect ceramic, lithium disilicate restoration groups, immediate dentin sealing was applied. After restoration, all specimens were tested in fatigue (1,200,000 cycles, 50 N, 1.7 Hz). Samples were critically appraised, and the specimens without failure were subjected to a load to failure test. Failure types were classified and the data analyzed. Results: Zero failures were observed in the fatigue testing. The following mean load to failure strengths (N) were recorded: group ICO5: 858 N; group DCI3: 829 N; group ICO3: 816 N; group C: 804 N; group ICI3: 681 N; group DCO5: 635 N; group DCI5: 528 N; group DCO3: 507 N; group ICI5: 482 N. Zero interaction was found between design-depth-material (p=0.468). However, significant interactions were found for the design-depth (p=0.012) and design-material (p=0.006). Within restorations at preparation depth of 3 mm, direct composite overlays obtained a significantly lower fracture strength in comparison to indirect ceramic onlays (p=0.013) and direct composite inlays (p=0.028). In restorations at depth 5 mm, significantly higher fracture load values were observed in indirect ceramic overlays compared with the inlays (p=0.018). Indirect ceramic overlays on 3 mm were significantly stronger than the deep inlays in ceramic (p=0.002) and tended to be stronger than the deep direct composite inlays. Severe, nonreparable fractures were observed with preparation depth of 5 mm within ceramic groups. Conclusions: The preparation depth significantly affected the fracture strength of tooth when restored with either composite or ceramic materials. Upon deep cavity preparations, cuspal coverage proved to be beneficial when a glass ceramic was used as the restorative material. Upon shallow cavity preparations, a minimally invasive approach regarding preparation design used in conjunction with a direct composite material was favorable.

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Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations ◽

10.1044/cds15.3.66 ◽

2008 ◽

Vol 15 (3) ◽

pp. 66-72 ◽

Cited By ~ 1

Author(s):

José G. Centeno

Keyword(s):

Stroke Rehabilitation ◽

Culturally Diverse ◽

Treatment Strategies ◽

The United States ◽

Intervention Strategies ◽

Steady Increase ◽

Clinical Procedures ◽

Bilingual Speakers ◽

Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

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Augmented Reality in Orthopedic Surgery Is Emerging from Proof of Concept Towards Clinical Studies: a Literature Review Explaining the Technology and Current State of the Art

Current Reviews in Musculoskeletal Medicine ◽

10.1007/s12178-021-09699-3 ◽

2021 ◽

Author(s):

Fabio A. Casari ◽

Nassir Navab ◽

Laura A. Hruby ◽

Philipp Kriechling ◽

Ricardo Nakamura ◽

...

Keyword(s):

Augmented Reality ◽

Orthopedic Surgery ◽

Relevant Literature ◽

Comprehensive Overview ◽

Basic Principles ◽

Clinical Procedures ◽

Current State ◽

Tremendous Progress ◽

Orthopedic Oncology ◽

Technological Developments

Abstract Purpose of Review Augmented reality (AR) is becoming increasingly popular in modern-day medicine. Computer-driven tools are progressively integrated into clinical and surgical procedures. The purpose of this review was to provide a comprehensive overview of the current technology and its challenges based on recent literature mainly focusing on clinical, cadaver, and innovative sawbone studies in the field of orthopedic surgery. The most relevant literature was selected according to clinical and innovational relevance and is summarized. Recent Findings Augmented reality applications in orthopedic surgery are increasingly reported. In this review, we summarize basic principles of AR including data preparation, visualization, and registration/tracking and present recently published clinical applications in the area of spine, osteotomies, arthroplasty, trauma, and orthopedic oncology. Higher accuracy in surgical execution, reduction of radiation exposure, and decreased surgery time are major findings presented in the literature. Summary In light of the tremendous progress of technological developments in modern-day medicine and emerging numbers of research groups working on the implementation of AR in routine clinical procedures, we expect the AR technology soon to be implemented as standard devices in orthopedic surgery.

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Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

BMC Medical Education ◽

10.1186/s12909-021-02649-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuji Nishizaki ◽

Keigo Nozawa ◽

Tomohiro Shinozaki ◽

Taro Shimizu ◽

Tomoya Okubo ◽

...

Keyword(s):

Physical Examination ◽

General Medicine ◽

Cross Sectional Study ◽

Medical Interview ◽

Sectional Study ◽

University Hospitals ◽

Community Based ◽

Cross Sectional ◽

Clinical Competencies ◽

Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

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