Survival of Prosthodontic Restorations Luted with Resin-Based versus Composite-Based Cements: Retrospective Cohort Study

The purpose of this study was to evaluate clinical performance, survival, and complications of indirect composite inlays, onlays, and overlays on posterior teeth. Digital records of 282 patients treated between 2014 and 2018 were accessed and analyzed retrospectively. The included patients received 469 composite restorations luted with seven different resin-based types of cement, i.e., Filtek Ultimate Flow, Enamel Plus, Relyx Ultimate, Harvard Premium Flow, Relyx Unicem, Filtek Bulk Fill Flowable, and Filtek Ultimate. The restorations had been clinically and radiographically evaluated annually. The mechanical and clinical complications, e.g., debonding, fracture, and secondary caries, were evaluated and recorded. The examined restorations exhibited a high survival rate (84.9%), and failure was found in only 71 cases. Fracture was the most common cause (n = 36), followed by prosthetic work release (n = 19) and secondary caries (n = 16). There was a statistically significant difference between failure and cement material (Sig. < 0.001); the composite-based cements (87.2%) had a high survival rate compared to the resin-based cement (72.7%). Similarly, the cements with high viscosity (90.2%) had significantly higher survival rates than the low-viscosity cements (78.9%). Moreover, onlays showed higher longevity compared to overlays (Sig. = 0.007), and patients aged under 55 years showed less complications (Sig. = 0.036). Indirect composite restoration was a successful solution to tooth structure loss. The material of the cementation is an important part of the success. Higher survival rate was found in our study when the fixation materials with high viscosity were used, thus suggesting using these materials with indirect restorations. Composite-based cements had significantly higher survival rate than resin-based cements.

Practical lessons from a general dentist of more than 50 years private practice plus 2 years of United States Air Force practice

Having practiced over 54 years the art and science of general dentistry, many changes in philosophy and performance have occurred. Some are minor while others very major. This series of observations will treat some in detail while others very briefly. The physical locations have been in the Dallas, Texas area of the USA. Definitions of terms set the stage for discussion of the basis of dentistry. Support for the scientific as well as evidence-based approaches is laid forth. Filling materials have transitioned from amalgam to composite being most prevalent. Fluoride added to local water supplies has decreased the number of decayed/sensitive teeth, the timing of initial decay, and the prognosis for remediation. pH is a major player in the deterioration of tooth structure. New understandings of tooth brushing and oral hygiene have significantly improved the future for continuing dental health. Absence of fluoride in bottled water has taken a front-center stage for helping/hurting chances of keeping teeth free of decay. Fluoride varnishes have widespread acceptance in America. Failure to seek routine dental care has influenced the outcomes for many younger patients, especially those who have graduated high school, gone off to college or into the workforce. Such lack of routine preventive influence raises the costs of care when it is received, often leading to complaints from patients about the high costs of repair. The alternative is prevention with ongoing consistent 6-month recalls/repairs when problems initiate, rather than allowing problems of long duration. The USA dental insurance industry adverse impact on practicing dentists is a vital monologue. Revealing the dental insurance industry as a number one concern of many surveys of practicing dentists is a way of preparing international countries for learning from the flawed USA models. Recent Congressional law, HR 1418, the Competitive Health Insurance Reform Act, will address some of the most critical wrongs by placing the dental insurance industry into antitrust restraints. Current concerns about digital X-ray’s diagnostic potential are revealed. Conservative dentistry is promoted. Results of conservative practice from nearly 50 years are documented with photos and X-rays. Bonded bridge technology is highlighted for its valued impact.

Hemisection- A Saviour for Periodontally & Cariously Involved Permanent Mandibular Molar

Progressive carious and inflammatory involvement of teeth if left untreated will ultimately lead the loss of tooth structure in the oral cavity. Earlier clinician was left with no option but extraction of such hopeless teeth followed by replacement with fixed partial denture, removable partial denture or implants. Hemisection is a removal of compromised root and the associated crown portion. It is one of the treatment options for preserving remaining part of molar having sound periodontium. This case report presents a patient in which distal half of the teeth was carious but with sound periodontium and the periodontally compromised mesial root was resected, and after healing, fixed dental prosthesis was delivered to restore proper form and function

Zirconia Inlay on Vital Teeth with Profunda Caries

Background: Dental caries has historically been considered the most critical component of the global burden of oral disease. Health facilities and dental health education counselling have been conducted, but public knowledge about dental caries is still low. The increasing number of dental caries is currently influenced by one of the factors of community behaviour. Most people do not realize the importance of taking care of oral and dental health. The ignorance of the community results in a decrease in productivity due to the influence of the perceived illness. Advances in dentistry since the last decade has allowed the use of conservative dental care. Modern restorative dentistry offers many methods for restoring teeth, both direct and indirect. The need for restoration of posterior teeth is related to aesthetic purposes and functional, biocompatibility and biomechanical aspects of the remaining tooth structure. Some materials that are widely used as tooth-coloured indirect restorations in posterior teeth are zirconia. Zirconia has its characteristics, especially in terms of functionality, such as mechanical strength, physical strength and aesthetics. Purpose: This study aims to determine the management of indirect restoration treatment using zirconia inlay on upper premolar. Case(s): A 46-yearold male patient complained that the filling of his upper left tooth was often loose and uncomfortable when used for eating because the food was stuck in it. The patient wants his teeth treated. The history of treatment on the tooth in question has been patched two times, but it often comes off partially. Case Management: From the examination that has been carried out, a clinical diagnosis of reversible pulpitis was established. The treatment plan that will be carried out is indirect pulpcapping using MTA and resin-modified glass ionomer cement as the base material. The planned restoration treatment is a fixed inlay restoration made of monolithic zirconia. Conclusion: Recently, zirconia has also been developed staining with improved translucency so that it becomes more aesthetic. Zirconia has a higher level of material resistance than otherrestorative materials such as composites. This is what makes zirconia the choice, especially for use as a framework for all-ceramic and partially-fixed crowns dental prosthesis.

Effect of CAD/CAM Ceramic Thickness on Shade Masking Ability of Discolored Teeth: In Vitro Study

Shade matching is a common challenge that dentists face during fabrication of esthetic dental restoration. Thus, the aim of the current study was to assess the masking ability of two types of CAD/CAM ceramics for gaining high esthetic prosthesis. This in vitro study used a total sample size of 66 lithium disilicate (LD) and leucite reinforced (LR) CAD/CAM ceramics sub-grouped into three thicknesses: 0.5, 1, and 1.5 mm. Nine shades of natural dentin die materials were prepared as a replica of the underlying tooth structure. The difference in color (ΔE) and translucency parameter (TP) were assessed for both tested ceramics at the three thicknesses. One-way ANOVA was performed to compare the three thicknesses of each ceramic, followed by multiple pairwise comparisons between both ceramics. LR had significantly higher ΔE than LD at all thicknesses used unlike the case in TP. Thickness of 0.5 mm exhibited the highest ΔE and TP, while 1.5 mm thickness showed the lowest ΔE and TP in both ceramics. Increase in ceramic thickness had a great impact on both color masking ability of the underlying tooth structure and its translucency. The higher the ceramic thickness, the better the masking ability and the lower the translucency was reported.

Resin-Based Cement Applied to Enamel and Dentin Pre-Treated with Phytic Acid: An In Vitro Study

Phytic acid (IP6) has the ability to etch tooth structure due to its acidity and chelating properties. This study aimed to evaluate the micro-tensile bond strength (μTBS) of resin-based cement to enamel and dentin using manufacturer-provided etchants, phosphoric acid (PA) for enamel and a mixture of 10% citric acid and 3% ferric chloride (CAF) for dentin and compare them to IP6. Enamel surfaces were etched for 30 s with either PA or IP6 (1%, 5% or 10%). Dentin surfaces were etched for 15 s with either CAF or 1% IP6. Pre-polymerized composite blocks were bonded to enamel and dentin surfaces. After 24 h, the specimens were sectioned into beams and subjected to μTBS testing. De-bonded specimens and smear layer removal were analyzed with a scanning electron microscope. Etching enamel with 1% and 5% IP6 resulted in μTBS values that are comparable to the control (PA) (p > 0.05), while 10% IP6 negatively affected the μTBS (p < 0.05). The μTBS to dentin etched with 1% IP6 was higher compared to the control (CAF) (p = 0.001). IP6 effectively removed enamel and dentin smear layer, and at specific concentrations, it may be a suitable alternative conditioner agent for bonding resin-based cement to enamel and dentin.

Complexities in endodontics: A case series

There are cases in the endodontic treatment which are a real challenge. There are teeth with different anatomies of the root canals of different teeth and their treatment. There are most of the cases which are sevely carious and has lost more than 50% of the tooth structure. Patients usually lose their teeth because these problems. The aim of this study is to investigate several cases with different root canal anatomies like in open apex with blunderbuss canals in maxillary central incisors or mandibular premolar and molars with severly decayed crown tooth structures and their management. one case with severly decayed lower mandibular premolar i.e 45, one case of maxillary first molar with severly decayed crown structure i.e 16, a case of severly decayed mandibular first molar i.e 36, Three Cases of maxillary central incisors with immature open apex and blunderbuss canals w.r.t 21. Results are observed after several years. In performing a root canal treatment on such teeth, one should appreciate the complexity of the root canal system, canal obliteration and configuration, and the potential for regenerating the original anatomy of the tooth either Endodontic or Post Endodontic. Knowledge of the phenomenon of the complexity of the root canal system, canal obliteration and configuration, and the potential for regenerating tooth anatomies with the help of rebond fibres, MTA and Composite restorations, this will improve the medical practice of the general dental practitioner.

Endodontically Treated Maxillary Premolars Restored with Glass Fiber Post under All Ceramic Crown

Glass fiber posts and core are increasingly used in order to restore severely damaged endodontically treated teeth and particularly maxillary premolars that are prone to fracture. Their low modulus of elasticity which is similar to that of dentin allows the post to absorb stress and prevent root fracture. In addition, the glass fiber posts provide a natural hue by integrally bonding to the composite, thereby improving the aesthetics without compromising much on the strength. Various factors are involved in the longevity of such treatment option, remaining tooth structure seems to be the most important. Key words: glass fiber posts, premolars, endodontically treated teeth, composite resin, fracture resistance, crown, ferrule, failure .

Tooth Structure and Replacement of the Triassic Keichousaurus (Sauropterygia, Reptilia) From South China

The small-sized sauropterygian Keichousaurus hui was one of the most abundant marine reptiles from the Triassic Yangtze Sea in South China. Although Keichousaurus has been studied in many aspects, including the osteology, ontogeny, sexual dimorphism, and reproduction, the dentition of this marine reptile was only briefly described in external morphology. In this study, we provide new information on Keichousaurus tooth implantation, histology, and replacement based on a detailed examination of well-preserved specimens collected in the past decades. The tooth histology has been investigated for the first time by analyzing cross-sections of premaxillary teeth and the tooth attachment and implantation have been further revealed by X-ray computed microtomography. We refer the tooth replacement of Keichousaurus to the iguanid replacement type on the basis of the observed invasion of small replacement tooth into the pulp cavity of the functional tooth. Given the resemblance to other extinct and modern piscivorous predators in the morphology and structure of teeth, Keichousaurus might mainly feed on small or juvenile fishes and some relatively soft-bodied invertebrates (e.g., mysidacean shrimps) from the same ecosystem.